ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A client at 22 weeks of gestation with uncontrolled gestational diabetes mellitus may require medication. Which of the following medications would the provider likely prescribe?
- A. Acarbose
- B. Repaglinide
- C. Glyburide
- D. Glipizide
Correct answer: C
Rationale: Glyburide is commonly prescribed for gestational diabetes mellitus when diet and exercise are insufficient to control blood sugar levels. It is considered safe and effective during pregnancy, making it a suitable choice for managing diabetes in pregnant individuals. Acarbose, Repaglinide, and Glipizide are not typically recommended for use in pregnancy due to potential risks to the fetus.
2. A client who experienced a cesarean birth due to dysfunctional labor expresses disappointment for not having a natural childbirth. Which response should the nurse make?
- A. Validate the client's feelings by saying, 'It sounds like you are feeling sad that things didn't go as planned.'
- B. Assure the client by stating, 'At least you know you have a healthy baby.'
- C. Encourage the client by suggesting, 'Maybe next time you can have a vaginal delivery.'
- D. Provide information by saying, 'You can resume sexual relations sooner than if you had delivered vaginally.'
Correct answer: A
Rationale: The correct response is to acknowledge and validate the client's feelings of disappointment. This empathetic approach demonstrates understanding and support for the client's emotional state, fostering a therapeutic nurse-client relationship. Options B, C, and D do not address the client's emotional needs or provide appropriate support in this situation.
3. A client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios is found to have which of the following?
- A. The client is carrying more than one fetus
- B. There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid
- C. An excessive amount of amniotic fluid is present
- D. The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor
Correct answer: C
Rationale: Polyhydramnios refers to the presence of an excessive amount of amniotic fluid around the fetus. This condition can result from various causes, such as maternal diabetes, fetal anomalies, or genetic disorders. It can lead to complications during pregnancy and delivery, such as preterm labor, placental abruption, or fetal malpresentation. Understanding this diagnosis is crucial for providing appropriate care and monitoring to ensure the best outcomes for both the mother and the fetus.
4. 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.
5. 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:
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