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 tor a newborn.
Exhibit1:
Medical History. Apgar score 9 at 1 min and 9 at 5 min Birth weight 4,706 g (10 lb 6 oz)| Gestational age
40 weeks Difficult vaginal birth with shoulder dystocia.
EXHIBIT2:
Nurses: Notes 1700: Newborn is active and moves all extremities except for right arm. No spontaneous
movement of the right arm noted, Right arm remains at side during Moro reflex.
Exhibit3:
Physical examination 1830: Absent Moro reflex noted in right arm. Right shoulder and arm are internally
rotated and adducted. Elbow extended. Forearm pronated with wrist and fingers flexed. Diagnosis.
brachial prexus injury resulting in trot Duchenne (Erb's palsy) paralysis

Which of the following actions should the nurse plan to implement? For each potential nursing action, click to specify if the intervention is Indicated or contraindicated for the newborn

  • A. Educate the parents to begin range of motion exercises on the affected arm after 1 week.
  • B. Assess for grasp reflex in the affected extremity.
  • C. Immobilize the arm across the abdomen by pinning the newborn's sleeve to their shirt.
  • D. Instruct parents to limit physical handling for 2 weeks.
Correct Answer: B

Rationale: [0, 1, 0, 0]
Assess for grasp reflex in the affected extremity is the correct answer. This action is indicated as it allows the nurse to evaluate neurological function and muscle strength in the affected arm without causing harm. Educating parents to begin range of motion exercises after 1 week (A) is contraindicated as it may exacerbate injury or delay healing. Immobilizing the arm across the abdomen (C) is also contraindicated as it can restrict movement and hinder recovery. Instructing parents to limit physical handling for 2 weeks (D) is not the best option as it may not provide the necessary assessment and treatment for the newborn's condition.

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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.

A nurse is caring for a client who is to receive oxytocin to augment their labor. Which of the following findings contraindicates the initiation of the oxytocin infusion and should be reported to the provider?

  • A. Late decelerations.
  • B. Moderate variability of the FHR.
  • C. Cessation of uterine dilation.
  • D. Prolonged active phase of labor.
Correct Answer: A

Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, meaning the baby is not getting enough oxygen during contractions. Administering oxytocin, which can further stress the baby by increasing contractions, can worsen the situation. Late decelerations are a sign of fetal distress and require immediate intervention.

B: Moderate variability of the FHR is a normal finding and does not contraindicate the initiation of oxytocin.
C: Cessation of uterine dilation would suggest a potential issue with labor progress but does not directly contraindicate oxytocin.
D: Prolonged active phase of labor may warrant oxytocin to augment contractions but is not a contraindication itself.

A nurse is reviewing the provider's prescription in the adolescent's medical chart
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 should first implement --- and ---

  • A. Providing education on medications.
  • B. Administering doxycycline.
  • C. Administering ceftriaxone.
  • D. Administering metronidazole and educating on condom.
  • E. Administering metronidazole.
Correct Answer: B, C

Rationale: The correct answer is B, C. The nurse should first implement administering doxycycline and ceftriaxone in the treatment of certain infections like gonorrhea and chlamydia. Administering these antibiotics promptly is crucial to start the treatment process effectively. Providing education on medications (choice A) can follow once the initial treatment is administered. Administering metronidazole alone (choice E) or with educating on condoms (choice D) is not appropriate for the initial treatment of gonorrhea or chlamydia. Administering metronidazole alone would not effectively address these infections.

A nurse is assessing a newborn who was born at 26 weeks of gestation using the New Ballard Score. Which of the following findings should the nurse expect?

  • A. Minimal arm recoil.
  • B. Popliteal angle of 90°.
  • C. Creases over the entire foot sole.
  • D. Raised areolas with 3 to 4 mm buds.
Correct Answer: A

Rationale: The correct answer is A: Minimal arm recoil. In preterm infants, particularly those born at 26 weeks of gestation, minimal arm recoil is expected due to underdeveloped muscle tone. This is a characteristic finding in the New Ballard Score assessment for preterm newborns. Option B, popliteal angle of 90°, is incorrect as preterm infants typically have a popliteal angle greater than 90°. Option C, creases over the entire foot sole, is also incorrect as preterm infants usually have a smooth foot sole without creases. Option D, raised areolas with 3 to 4 mm buds, is not relevant to the assessment of gestational age in preterm newborns.

A nurse is planning care for a client who is to undergo a nonstress test. Which of the following actions should the nurse include in the plan of care?

  • A. Maintain the client NPO throughout the procedure.
  • B. Place the client in a supine position.
  • C. Instruct the client to massage the abdomen to stimulate fetal movement.
  • D. Instruct the client to press the provided button each time fetal movement is detected.
Correct Answer: D

Rationale: The correct answer is D: Instruct the client to press the provided button each time fetal movement is detected. This action is essential during a nonstress test to track fetal movement and heart rate patterns. By pressing the button each time fetal movement is felt, the nurse can correlate these movements with any changes in the fetal heart rate, providing valuable information about fetal well-being. Maintaining the client NPO (A) is not necessary for a nonstress test. Placing the client in a supine position (B) can reduce blood flow to the fetus and is not recommended. Instructing the client to massage the abdomen (C) may lead to inaccurate test results by artificially stimulating fetal movements.