ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A newborn is born to a mother with poorly controlled type 2 diabetes. The newborn is macrosomic and presents with respiratory distress syndrome. The most likely cause of the respiratory distress is which of the following?
- A. Hyperinsulinemia
- B. Increased deposits of fat in the chest and shoulder area
- C. Brachial plexus injury
- D. Increased blood viscosity
Correct answer: A: Hyperinsulinemia
Rationale: The correct answer is hyperinsulinemia. In infants born to mothers with poorly controlled diabetes, the excess glucose crosses the placenta, leading to fetal hyperglycemia. This results in fetal hyperinsulinemia, which in turn can cause macrosomia (large birth weight), increasing the risk of respiratory distress syndrome due to the immature lungs' inability to handle the increased workload. Hyperinsulinemia, not increased deposits of fat, brachial plexus injury, or increased blood viscosity, is the most likely cause of respiratory distress in this scenario.
2. The healthcare provider is assessing a client before surgery. Which assessments contraindicate the client from having surgery as scheduled? (Select one that does not apply.)
- A. Potassium level of 2.8 mEq/L
- B. International normalized ratio (INR) of 4
- C. Prothrombin time (PT) of 30 seconds
- D. Positive pregnancy test
Correct answer: Prothrombin time (PT) of 30 seconds
Rationale: The correct answer is C: Prothrombin time (PT) of 30 seconds. A low potassium level (choice A) and an elevated INR (choice B) indicate potential bleeding risks during surgery. A positive pregnancy test (choice D) in a female client can lead to complications during surgery. However, a Prothrombin time of 30 seconds is within the normal range and does not contraindicate the client from having surgery as scheduled.
3. What potential risk should the nurse identify as being associated with infliximab (Remicade) in the treatment of rheumatoid arthritis?
- A. Risk for infection
- B. Risk for decreased level of consciousness
- C. Risk for nephrotoxicity
- D. Risk for hepatotoxicity
Correct answer: A
Rationale: The correct answer is A: Risk for infection. Infliximab (Remicade) is a medication used to treat autoimmune conditions like rheumatoid arthritis. One of the main risks associated with infliximab is an increased susceptibility to infections due to its immunosuppressive effects. This drug works by targeting specific proteins in the body's immune system, which can weaken the body's ability to fight off infections. Choices B, C, and D are incorrect because infliximab is not typically associated with decreased level of consciousness, nephrotoxicity, or hepatotoxicity. It is important for healthcare providers to monitor patients on infliximab for signs of infection and educate them on the importance of infection prevention strategies.
4. A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse’s priority action?
- A. Hold the beta blocker and notify the healthcare provider.
- B. Administer the beta blocker as ordered.
- C. Administer a diuretic to reduce blood pressure.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct answer: A
Rationale: The correct answer is to hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is already low, and beta blockers can further decrease blood pressure. Administering the beta blocker can potentially worsen the situation, leading to complications. Administering a diuretic or continuing to monitor the client without taking immediate action could delay necessary intervention. Therefore, holding the beta blocker and involving the healthcare provider promptly is crucial in this scenario.
5. What play activities should the nurse implement to encourage fluid intake for a child? (Select all that apply.)
- A. Have a tea party.
- B. Use a crazy straw.
- C. Cut gelatin into fun shapes.
- D. All of the above
Correct answer: D
Rationale: Encouraging fluid intake can be fun and engaging through activities like having a tea party, using a crazy
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