ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A client at 37 weeks of gestation with placenta previa asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?
- A. There is an increased risk of introducing infection.
- B. This could initiate preterm labor.
- C. This could result in profound bleeding.
- D. There is an increased risk of rupture of the membranes.
Correct answer: C
Rationale: Performing an internal examination in a client with placenta previa can lead to significant bleeding due to the proximity of the placenta to the cervical os. This bleeding can be severe and potentially life-threatening. Therefore, it is crucial to avoid any unnecessary manipulation that could disrupt the delicate balance and lead to hemorrhage.
2. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?
- A. A client who is at 38 weeks of gestation and reports a cough and fever
- B. A client who has missed a period and reports vaginal spotting
- C. A client who is at 14 weeks of gestation and reports nausea and vomiting
- D. A client who is at 28 weeks of gestation and reports of painless vaginal bleeding
Correct answer: D
Rationale:
3. A client who is 2 hours postpartum following a cesarean birth has a history of thromboembolic disease. Which of the following nursing interventions should be included in the plan of care?
- A. Apply warm, moist heat to the client's lower extremities.
- B. Massage the client's posterior lower legs.
- C. Place pillows under the client's knees when resting in bed.
- D. Have the client ambulate.
Correct answer: D
Rationale: The correct intervention for a client who is 2 hours postpartum following a cesarean birth with a history of thromboembolic disease is to have the client ambulate. Early ambulation is crucial in preventing complications such as deep vein thrombosis in postpartum clients. Applying warm, moist heat, massaging the legs, or placing pillows under the knees do not directly address the risk of thromboembolic disease in this scenario.
4. A client is being assessed for postpartum infection. Which of the following findings should indicate to the healthcare provider that the client requires further evaluation for endometritis?
- A. Localized area of breast tenderness
- B. Pelvic pain
- C. Vaginal discharge with foul odor
- D. Hematuria
Correct answer: B
Rationale: Pelvic pain is a common symptom of endometritis, which is an infection of the uterine lining. It is an important finding that warrants further evaluation. Localized area of breast tenderness may indicate mastitis, vaginal discharge with a foul odor could suggest a vaginal infection, and hematuria points towards a urinary tract issue, but they are not specific to endometritis.
5. A client at 37 weeks of gestation with severe gestational hypertension is being admitted by a nurse. Which of the following actions should the nurse NOT expect to implement?
- A. Administer magnesium sulfate IV.
- B. Provide a dark, quiet environment.
- C. Assess respiratory status every 4 hours.
- D. Ensure that calcium gluconate is readily available.
Correct answer: C
Rationale: Assessing respiratory status every 4 hours is not a priority for a client with severe gestational hypertension. In this scenario, the focus should be on monitoring blood pressure, assessing for signs of preeclampsia, administering medications like magnesium sulfate for seizure prophylaxis, and ensuring that calcium gluconate is readily available in case of magnesium toxicity. Respiratory status assessment is important in other conditions but is not directly related to managing severe gestational hypertension.
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