ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A healthcare provider is preparing to administer an injection of Rho (D) immunoglobulin. The provider should understand that the purpose of this injection is to prevent which of the following newborn complications?
- A. Hydrops fetalis
- B. Hypobilirubinemia
- C. Biliary atresia
- D. Transient clotting difficulties
Correct answer: B
Rationale: Rho (D) immunoglobulin is given to Rh-negative individuals to prevent hemolytic disease of the newborn (HDN) caused by Rh incompatibility between the mother and the fetus. If an Rh-negative mother carries an Rh-positive fetus, there is a risk of sensitization during pregnancy or childbirth. Sensitization can lead to the production of antibodies that may attack Rh-positive red blood cells in future pregnancies, potentially causing severe hemolytic disease in the newborn, including complications like hydrops fetalis. Hydrops fetalis is a condition characterized by severe edema and fetal organ enlargement due to severe anemia and heart failure in the fetus.
2. A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?
- A. A client who experienced a cesarean birth 4 hours ago and reports pain
- B. A client who has preeclampsia with a BP of 138/90 mm Hg
- C. A client who experienced a vaginal birth 24 hours ago and reports no bleeding
- D. A client who is scheduled for discharge following a laparoscopic tubal ligation
Correct answer: A
Rationale: The nurse should prioritize seeing the client who experienced a cesarean birth 4 hours ago and reports pain first. Pain assessment and management are crucial post-cesarean birth to ensure the client's comfort and well-being. Immediate attention is needed to address the client's pain and provide appropriate interventions. The other clients may require attention but do not have an immediate postoperative concern like pain following a cesarean birth.
3. A healthcare provider in the emergency department is caring for a client who comes to the emergency department reporting severe abdominal pain in the left lower quadrant. The provider suspects a ruptured ectopic pregnancy. Which of the following signs indicates to the provider the presence of intra-abdominal bleeding?
- A. Chvostek's sign
- B. Cullen's sign
- C. Chadwick's sign
- D. Goodell's sign
Correct answer: B
Rationale: Cullen's sign is the presence of periumbilical ecchymosis indicating intra-abdominal bleeding, which can be associated with a ruptured ectopic pregnancy. Chvostek's sign is a facial spasm related to hypocalcemia. Chadwick's sign is a bluish discoloration of the cervix, vagina, and labia during early pregnancy. Goodell's sign is a softening of the cervix in early pregnancy.
4. A client with preterm labor is being admitted. The nurse anticipates a prescription by the provider for which of the following medications?
- A. Prostaglandin E2
- B. Indomethacin
- C. Methylergonovine
- D. Oxytocin
Correct answer: B
Rationale: Indomethacin is used to delay premature labor by inhibiting uterine contractions. Prostaglandin E2, Methylergonovine, and Oxytocin are not typically used to manage preterm labor. Prostaglandin E2 can be used for cervical ripening and labor induction. Methylergonovine is used to prevent or control postpartum hemorrhage. Oxytocin is used for labor induction and augmentation of labor in term pregnancies.
5. A client with severe preeclampsia is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe to continue the infusion?
- A. Diminished deep-tendon reflexes
- B. Respiratory rate of 16/min
- C. Urine output of 50 mL in 4 hours
- D. Heart rate of 56/min
Correct answer: B
Rationale: A respiratory rate of 16/min within the normal range is an essential parameter to monitor when administering magnesium sulfate, as respiratory depression is a potential adverse effect. Diminished deep-tendon reflexes may indicate magnesium toxicity, warranting immediate intervention. A urine output of 50 mL in 4 hours is below the expected amount, suggesting decreased kidney perfusion, which can be exacerbated by magnesium sulfate. A heart rate of 56/min is bradycardic and may indicate magnesium toxicity, requiring assessment and possible discontinuation of the infusion.
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