ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. When admitting a client at 33 weeks of gestation with a diagnosis of placenta previa, which action should the nurse prioritize?
- A. Monitor vaginal bleeding
- B. Administer glucocorticoids
- C. Insert an IV catheter
- D. Apply an external fetal monitor
Correct answer: D: Apply an external fetal monitor
Rationale: Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to potential bleeding. When admitting a client with placenta previa, the priority is to assess the fetal well-being. Applying an external fetal monitor helps in continuous monitoring of the fetal heart rate and ensures timely detection of any distress or changes in the fetal status, which is crucial in managing this condition. While monitoring vaginal bleeding is important, identifying fetal well-being takes precedence in this situation.
2. A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?
- A. Blood glucose of 110 mg/dL.
- B. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
- C. WBC count of 6,500/mm3.
- D. Temperature of 37.3°C (99.1°F).
Correct answer: B
Rationale: A weight loss of 0.5 kg (1.1 lb) in 24 hours may indicate dehydration or malnutrition, which are critical concerns for a client receiving total parenteral nutrition (TPN). Therefore, the nurse should report this finding to the provider. Elevated blood glucose levels (Choice A) can be managed by adjusting TPN components, WBC count (Choice C) and a slightly elevated temperature (Choice D) are not directly related to TPN administration and may not require immediate intervention.
3. What is a likely effect on a patient whose lab results reveal hypoalbuminemia?
- A. Infection
- B. Rickets
- C. Hypertension
- D. Edema
Correct answer: D
Rationale: Hypoalbuminemia, which refers to low albumin levels in the blood, is often associated with edema. Albumin helps maintain oncotic pressure, which keeps fluid within blood vessels. When albumin levels are low, this pressure decreases, leading to fluid leakage from the blood vessels into the surrounding tissues, resulting in edema. The other choices are less likely effects of hypoalbuminemia. Hypoalbuminemia doesn't directly cause infections (Choice A), rickets (Choice B) caused by vitamin D deficiency, or hypertension (Choice C) associated with factors like high sodium intake, obesity, and genetic predisposition.
4. A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?
- A. WBC
- B. Serum potassium
- C. Platelet count
- D. Liver function test
Correct answer: D
Rationale: The correct answer is D, Liver function test. Acarbose can cause liver toxicity when taken long-term. Monitoring liver function tests periodically is essential to assess for any potential liver damage. Choices A, B, and C are incorrect because Acarbose does not directly impact white blood cell count, serum potassium levels, or platelet count.
5. A nurse is caring for a client who is 2 hours postoperative following a thoracotomy. Which of the following findings should the nurse report to the provider?
- A. Chest tube drainage of 60 mL/hr
- B. Oxygen saturation of 95%
- C. Chest tube drainage of 120 mL/hr
- D. Heart rate of 88/min
Correct answer: C
Rationale: The correct answer is C. Chest tube drainage of more than 100 mL/hr may indicate active bleeding, which is a serious complication post-thoracotomy surgery. This finding should be reported to the healthcare provider immediately for further evaluation and intervention. Choices A, B, and D are within normal limits for a client 2 hours post-thoracotomy and do not require immediate reporting. Oxygen saturation of 95% is acceptable, and a heart rate of 88/min is within the normal range for an adult.
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