RN ATI Maternal Newborn 2023 with NGN

RN ATI Maternal Newborn 2023 with NGN Related

Review RN ATI Maternal Newborn 2023 with NGN related questions and content

A nurse is caring for a newborn who is 48 hr old.
Exhibit 1
Vital Signs
Day 2, 0900:
Heart rate 174/min
Respiratory rate 88/min
Temperature 36.1° C (97.0° F)
Oxygen saturation 97% on room air

Exhibit 2
Diagnostic Results
Day 1, 0800: Newborn results
Blood type: A+
Urine toxicology screen: positive marijuana
Day 2, 0800: Newborn results
Total bilirubin 10 mg/dL (1.0 to 12.0 mg/dL)
Day 2, 0915:
Blood glucose: 38 mg/dL (expected value greater than 40 to 45
gm/dL

Exhibit 3
Nurses Notes
Day 2, 0900:
Newborn awake, alert, and crying. Loosely wrapped in one
blanket. Mild tremors noted. Yellow discoloration of mucus
membranes and sclera noted. Respirations 88/min, no
retractions, grunting, or nasal flaring noted. Diaper changed for
small amount of urine and transitional stool. Exhibit 4
Medical History
Apgars: 7 at 1 min and 8 at 5 min of age
Birth weight: 3,515 g (7 lb 12 oz)
Maternal blood type: O+
Uncomplicated pregnancy. Maternal use of marijuana during
pregnancy
Client who gave birth plans to breastfeed.

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing. 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

  • A. Place newborn skin to skin on birthing parents chest, Encourage birthing parents to breastfeed, Obtain prescription for arterial blood gases, Plan to initiate phototherapy, Perform neonatal abstinence system scoring
  • B. Cold stress, Acute bilirubin encephalopathy, Respiratory distress syndrome, Neonatal abstinence syndrome (NAS)
  • C. Stool output, Temperature, Lung sounds, Blood glucose level, Bilirubin level
Correct Answer:

Rationale: Action to Take: A, B; Potential Condition: B; Parameter to Monitor: C, E.
Rationale:
The correct answer is to place the newborn skin to skin on the birthing parent's chest and encourage breastfeeding to address Cold stress, a potential condition the client is most likely experiencing. These actions help regulate the newborn's temperature and provide essential warmth and nutrition. Parameters to monitor would include temperature (to assess for hypothermia) and bilirubin level (to monitor for jaundice, a common issue in newborns). Monitoring these parameters will help the nurse assess the client's progress and ensure appropriate interventions are implemented.

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A nurse on an antepartum unit is caring for four clients. Which of the following clients should the nurse identify as the priority?

  • A. A client who has gestational diabetes and a fasting blood glucose level of 120 mg/dL (less than 95 mg/dL).
  • B. A client who is at 34 weeks of gestation and reports epigastric pain.
  • C. A client who is at 28 weeks of gestation and has an Hgb of 10.4 g/dL (11 to 16 g/dL).
  • D. A client who is at 39 weeks of gestation and reports urinary frequency and dysuria.
Correct Answer: B

Rationale: The correct answer is B. The client at 34 weeks with epigastric pain is the priority as it could indicate preeclampsia, a serious condition requiring immediate attention to prevent harm to both the mother and the baby. Epigastric pain can be a sign of liver involvement in preeclampsia. Gestational diabetes (choice A) with slightly elevated blood glucose levels can be managed and monitored. Low hemoglobin levels at 28 weeks (choice C) may require treatment but are not as urgent as potential preeclampsia. Urinary symptoms at 39 weeks (choice D) could be indicative of a urinary tract infection, which is important but not as urgent as suspected preeclampsia.

A nurse is teaching a client who is at 10 weeks of gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

  • A. I should increase my protein intake to 60 grams each day.
  • B. I should drink 2 liters of water each day.
  • C. I should increase my overall daily caloric intake by 300 calories.
  • D. I should take 600 micrograms of folic acid each day.
Correct Answer: D

Rationale: The correct answer is D because folic acid is crucial during pregnancy to prevent birth defects like spina bifida. It is recommended to take 600 micrograms daily. Choice A is incorrect as the recommended protein intake is 71 grams/day. Choice B is important but doesn't address nutrition specifically. Choice C is unnecessary and could lead to excessive weight gain.

A nurse is caring for a newborn.
Exhibit1
Vital Signs
8 hr of age:
Temperature: 37.1° C (98.8° F) Axillary
Pulse rate: 132/min
Respiratory rate: 52/min
36 hr of age:
Temperature: 36.1° C (97" F) Axillary
Pulse rate: 160/min
Respiratory rate: 78/min”

For each assessment finding, click to specify if the finding is consistent with hypoglycemia, hyperbilirubinemia, or sepsis.

  • A. Ecchymotic caput Succedaneum.
  • B. Decreased temperature.
  • C. Lethargy.
  • D. Poor feeding.
  • E. Respiratory distress.
  • F. Yellow sclera and oral mucosa.
Correct Answer: B, C, D, E, F

Rationale: The correct answer is because decreased temperature (B), lethargy (C), poor feeding (D), respiratory distress (E), and yellow sclera and oral mucosa (F) are consistent with hypoglycemia, hyperbilirubinemia, and sepsis. Decreased temperature can indicate hypoglycemia, lethargy and poor feeding can be seen in hypoglycemia and sepsis, respiratory distress can be a sign of sepsis, and yellow sclera and oral mucosa can be indicative of hyperbilirubinemia. Ecchymotic caput succedaneum is more related to birth trauma and is not specific to these conditions.

A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication?

  • A. Depression.
  • B. Polyuria.
  • C. Hypotension.
  • D. Urticaria.
Correct Answer: A

Rationale: The correct answer is A: Depression. Combined oral contraceptives can lead to mood changes, including depression, as a potential adverse effect due to hormonal fluctuations. This is important for the nurse to include in teaching to monitor and address any mental health concerns. Polyuria (increased urination) is not a common adverse effect of combined oral contraceptives. Hypotension (low blood pressure) is not typically associated with this medication. Urticaria (hives) is more commonly seen with allergic reactions rather than as a side effect of oral contraceptives.

A nurse is reviewing the provider's prescription in the adolescent's medical record
Exhibit 1
History and Physical, Adolescent is sexually active with two current partners.
IUD in place, Reports not using condoms during sexual activity.
History of type 1 diabetes mellitus

The nurse suspects the adolescent is experiencing pelvic inflammatory disease and is planning care. Which of the following prescriptions should the nurse expect the provider to prescribe? Drag words from the choices below to fill in each blank in the following sentence. The nurse should anticipate a provider's prescription for---------------------- and ------------------

  • A. doxycydline
  • B. acyclovir
  • C. imiquimod
  • D. fluconazole
  • E. ceftriaxone
  • F. Providing education on medications
Correct Answer: A,E,F

Rationale: The correct answer is A, E, and F. Pelvic inflammatory disease is commonly caused by sexually transmitted infections, such as Chlamydia and Gonorrhea. The recommended treatment involves antibiotics like doxycycline (A) and ceftriaxone (E) to target these infections. Providing education on medications (F) is essential to ensure compliance and understanding of the treatment regimen. Acyclovir (B) is used to treat herpes infections, not PID. Imiquimod (C) is used for certain skin conditions, not PID. Fluconazole (D) is an antifungal medication, not typically used for PID treatment.