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RN ATI CAPSTONE MATERNAL NEWBORN, PRACTICE QUESTIONS AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 100 QUESTIONS AND CORRECT DETAILED ANSWERS$14.99
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ATI RN Maternal Ne wborn
1.Exhibit 1: Medical hx
Newborn delivered b y repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (7 lb 12 oz) Apgar scores 8 at 1 min and 9 at 5 min. Maternal histor y of methadone use during pregnanc y.
Exhibit 2: VS
@0700: Heart rate 156/min. Respirator y rate 58/min. Temperature 37.2° C (98.9° F) Oxygen saturation 98% on r oom air
@1100: Heart rate 160/min. Respirator y rate 60/min. Temperature 37.3° C (99.2° F) Oxygen saturation 96% on r oom air
Exhibit 3: Phys Exam
Newborn is inconsolab le with a high-pitc hed cry. Newborn suc ks vigor-
ously on pacifier b ut breastf eeds poor-
ly. Respirations unlabored. Lungs sound clear on auscultation. Increased m uscle tone with moderate to se vere tremor s when disturbed. Hyperactive Mor o reflex noted. Several loose stools toda y.
Exhibit 4: Diagnostic Results
Maternal urine to xicology screen positive for opiates (-). Newborn urine to xicology screen positive f or opiates (-Respiratory findings is incor-
rect. The newborn's respiratory rate is within the e xpected ref -
erence range of 30 to 60/min. There is no indication the new-
born has an alter ation in res-
piratory status; therefore, this finding does not need to be re-
ported to the pro vider.
Temperature is incorrect. The newborn's temperature is with-
in the expected ref erence range of 36.5° to 37.5° C (97.7° to 99.5° F). Therefore, this find-
ing does not need to be report-
ed to the pro vider.
Oxygen satur ation is incorrect. The newborn's oxygen satu-
ration is within the e xpect-
ed reference range of greater than 94%; therefore, this find-
ing does not need to be report-
ed to the pro vider.
Central nervous system find-
ings is correct. The new-
born is displa ying inconsolabil-
ity, high-pitched cr y, increased muscle tone , tremors, hyper-
active Moro refle x, and ex-
cessive sucking. These find-
ings are manifestations of NAS and should be repor ted to the provider.
Gastrointestinal findings is cor-
rect. The newborn is displaying poor feeding and loose stools . These findings are manif esta-
tions of NAS and should be re-
ported to the pro vider. ATI RN Maternal Ne wborn
2.Exhibit 1: RN note
@ 0900: Client repor ts a small amount of bright red b lood in their underwear upon awakening. Client denies contractions or abdominal pain. External fetal monitor ap-
plied.
@0930: Client passed lar ge amount of bright red blood from vagina. Denies pain. Uterine tone soft and nontender to palpa-
tion. Contraction pattern: no contractions noted. Fetal hear t rate pattern: Fetal hear t rate baseline 135/min. Moderate v ariabili-
ty. No decelerations noted.
Exhibit 2: VS
@0900: Temperature 36.2°C (97.2° F)Pulse rate 78/min. Respirator y rate 20/min. Blood pressure 112/64 mmHg. Fetal hear t rate 132/min
@0930: Pulse rate 82/min. Blood pressure 116/60 mmHg. Fetal hear t rate 160/min
Exhibit 3: Medical hx
G4P3. 30 weeks gestation. Previous preg-
nancies delivered via cesarean sectionWhen gener ating solutions , in-
serting a large bore intr a-
venous catheter is indicated. Clients who have third trimester vaginal bleeding ma y experi-
ence a sudden hemorrhage and require fluid resuscitation or the administr ation of blood products. The nurse should weigh perineal pads . Weighing perineal pads after use will pro-
vide a more accur ate assess-
ment of the v olume of b lood loss that the client is experienc-
ing.
When generating solutions, the nurse should not administer methotrexate or assess for cer-
vical dilation because it is contraindicated f or this client. Methotrexate is an antimetabo-
lite and folic acid antagonist which destro ys rapidly dividing cells. It can be administered during pregnancy to medical-
ly resolve an ectopic pregnan-
cy during the first trimester. As-
sessing cervical dilation is con-
traindicated f or any pregnant client who is experiencing vagi-
nal bleeding. Manipulation of the cervix during the examina-
tion may result in fur ther dam-
age to the placenta and com-
promise the w ell-being of the client and f etus. ATI RN Maternal Ne wborn
3.A nurse is assessing the ne wborn of a client who took selective ser otonin re-
uptake inhibitor (SSRI) during pregnan-
cy. Which of the f ollowing manif estations should the n urse identify as an indication of withdra wal from an SSRI?
a. Large for gestational a ge
b. Hyperglycemia
c. Bradypnea
d. Vomitingd. Vomiting
Expected manifestations asso-
ciated with f etal exposure to SSRIs include irr itability, agi-
tation, tremors , diarrhea, and vomiting. These manif estations typically last 2 da ys.
4.A nurse in a famil y planning c linic is car-
ing for a client who requests an oral con-
traceptive . Which of the following findings in the client's history should the nurse rec-
ognize as a contraindication to oral con-
traceptives? (Select all that appl y)
a. Cholecystitis
b. Hypertension
c. Human papilloma virus
d. Migraine headac hes
e. Anxiety disor derCholecystitis , hypertension, and migraine headaches is cor-
rect. A history of gallbladder disease is a contraindication for the use of or al contraceptives. Hypertension is a contraindica-
tion for the use of or al contra-
ceptives. A history of migraine headaches is a contr aindica-
tion for the use of or al contra-
ceptives.
HPV and anxiety disorder is incorrect. The presence of hu-
man papilloma virus is not a contraindication f or the use of oral contraceptives. The pres-
ence of an anxiety disorder is not a contr aindication f or the use of oral contraceptives.
5.A nurse is caring f or a newborn.
Exhibit 1: Medical hx
@1600: Apgar score 9 at 1 min and 9 at 5 min. Birth weight 4,706g (10lb 6oz). Gesta-
tional age 40 weeks. Difficult vaginal birth with shoulder d ystocia.Educate the parents to begin range of motion e xercises on the affected arm after 1 w eek is indicated. Passive ROM ex-
ercises of the arm are indicated to restore function of the e x-
tremity. The initiation of these
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