ATI RN
ATI Maternal Newborn Proctored Exam 2023
1. A client at 37 weeks of gestation with severe gestational hypertension is being admitted by a nurse. Which of the following actions should the nurse NOT expect to implement?
- A. Administer magnesium sulfate IV.
- B. Provide a dark, quiet environment.
- C. Assess respiratory status every 4 hours.
- D. Ensure that calcium gluconate is readily available.
Correct answer: C
Rationale: Assessing respiratory status every 4 hours is not a priority for a client with severe gestational hypertension. In this scenario, the focus should be on monitoring blood pressure, assessing for signs of preeclampsia, administering medications like magnesium sulfate for seizure prophylaxis, and ensuring that calcium gluconate is readily available in case of magnesium toxicity. Respiratory status assessment is important in other conditions but is not directly related to managing severe gestational hypertension.
2. A healthcare provider is caring for a group of clients on an intrapartum unit. Which of the following findings should be reported to the provider immediately?
- A. A tearful client who is at 32 weeks of gestation and is experiencing irregular, frequent contractions
- B. A client who is at 28 weeks of gestation and receiving terbutaline reports fine tremors
- C. A client who has a diagnosis of preeclampsia has 2+ proteinuria and 2+ patellar reflexes
- D. A client who has a diagnosis of preeclampsia reports epigastric pain and an unresolved headache
Correct answer: D
Rationale: The correct answer is a client who has a diagnosis of preeclampsia reporting epigastric pain and an unresolved headache. These symptoms indicate severe preeclampsia, which requires immediate medical attention due to the potential risks of complications such as HELLP syndrome or eclampsia. The other options describe concerning situations but do not represent immediate life-threatening conditions like those seen in severe preeclampsia.
3. When admitting a client at 33 weeks of gestation with a diagnosis of placenta previa, which action should the nurse prioritize?
- A. Monitor vaginal bleeding
- B. Administer glucocorticoids
- C. Insert an IV catheter
- D. Apply an external fetal monitor
Correct answer: D
Rationale: Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to potential bleeding. When admitting a client with placenta previa, the priority is to assess the fetal well-being. Applying an external fetal monitor helps in continuous monitoring of the fetal heart rate and ensures timely detection of any distress or changes in the fetal status, which is crucial in managing this condition. While monitoring vaginal bleeding is important, identifying fetal well-being takes precedence in this situation.
4. A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following comp
- A. Placenta previa
- B. Prolapsed cord
- C. Incompetent cervix
- D. Abruptio placentae
Correct answer: D
Rationale:
5. During an assessment, a nurse is evaluating a pregnant client for preeclampsia. Which of the following findings should indicate to the nurse that the client requires further evaluation for this disorder?
- A. Increased urine output
- B. Vaginal discharge
- C. Elevated blood pressure
- D. Joint pain
Correct answer: C
Rationale: Preeclampsia is characterized by elevated blood pressure, proteinuria, and sometimes edema. Hypertension is a key sign of preeclampsia, and if present, further evaluation and monitoring are necessary to prevent complications for both the mother and the fetus.
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