ATI Maternal Newborn Proctored Exam

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A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, PaCO2 68 mm Hg, Base excess -2, PaO2 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L

  • A. Respiratory acidosis
  • B. Metabolic acidosis
  • C. Metabolic alkalosis
  • D. Respiratory alkalosis
Correct Answer: A

Rationale: The ABG values provided indicate respiratory acidosis. In respiratory acidosis, there is an increase in PaCO2 above the normal range (35-45 mm Hg) leading to a decrease in pH (<7.35). In this case, the pH is 7.22 (below normal) with an elevated PaCO2 of 68 mm Hg. The other values do not suggest metabolic acidosis (which would typically show low bicarbonate levels) or metabolic alkalosis. Therefore, the correct interpretation of the ABGs is respiratory acidosis.

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The nurse is teaching a client about signs of postpartum hemorrhage. What statement indicates understanding?

  • A. Passing a few clots is normal.
  • B. Soaking one pad in an hour is concerning.
  • C. Heavy bleeding stops within 48 hours.
  • D. I should ignore mild cramping.
Correct Answer: B

Rationale: Soaking a pad in an hour may indicate postpartum hemorrhage and should be reported immediately.

The nurse is monitoring a client with severe preeclampsia. What assessment finding indicates worsening condition?

  • A. Proteinuria of +1.
  • B. Respiratory rate of 16 breaths per minute.
  • C. New-onset confusion and restlessness.
  • D. Urine output of 40 mL/hr.
Correct Answer: C

Rationale: New-onset confusion and restlessness may indicate cerebral edema or impending eclampsia.

The nurse is attempting to explain physiologic birth. What do they say?

  • A. Physiologic birth involves interventions that do not harm the baby.”
  • B. Physiologic birth occurs only in birth centers.”
  • C. If your partner and I give you support, you can have a birth without medical intervention.”
  • D. If you want to have a cesarean birth, we can ask your health-care provider to schedule it.”
Correct Answer: C

Rationale: Physiologic birth focuses on minimal intervention, supported by a calm environment and supportive care.

A client with acute respiratory failure (ARF) may present with which of the following manifestations? (Select one that doesn't apply.)

  • A. Severe dyspnea
  • B. Decreased level of consciousness
  • C. Headache
  • D. Nausea
Correct Answer: D

Rationale: In acute respiratory failure (ARF), the body is not getting enough oxygen, leading to respiratory distress. Symptoms of ARF typically include severe dyspnea (difficulty breathing), decreased level of consciousness due to hypoxia, and headache from inadequate oxygenation to the brain. Nausea is not a typical manifestation of ARF and would not be expected in this condition.

The APGAR is performed at what minutes?

  • A. 1 and 5
  • B. 2 and 4
  • C. 5 and 10
  • D. At birth and 5 minutes
Correct Answer: A

Rationale: The APGAR score is a quick assessment tool used to evaluate a newborn's health and overall condition immediately after birth and again at 5 minutes after birth. The five categories evaluated in the APGAR score are Appearance, Pulse, Grimace, Activity, and Respiration. The assessment is typically done at 1 minute and 5 minutes after birth to quickly determine if the baby needs any immediate medical attention or interventions. The scores at both time points provide valuable information about the baby's well-being and can guide healthcare providers in deciding on appropriate next steps for care.

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