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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Document preview page 1

ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 1

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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions)

ATI RN Maternal Newborn NGN Proctored Exam with Answers simplifies your exam prep with solved past exams that mirror the actual test questions.

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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 1 preview image(NGN)ATIRNMATERNALNEWBORNPROCTOREDEXAMTESTBANKACTUALQUESTIONSWITHVERIFIED DETAILEDSOLUTIONS/A+GRADEASSURED1.A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa.Which ofthe followingfindingssupportthisdiagnosis?A.PainlessredvaginalbleedingRationale:Placentapreviaisaconditionofpregnancywhentheplacentaimplantsinthelowerpartoftheuterus, partly or completely obstructing the cervical os (outlet to the vagina). Bright red, painlessvaginal bleedingoccursinthesecondandthirdtrimester.B.Increasingabdominalpainwith anonrelaxed uterusRationale:Abruptioplacentaisseparationoftheplacentafromthesiteofuterineimplantationbeforedelivery of the fetus. When the placenta separates prematurely, there is internal bleeding, whichispainful,and the uterusisnonrelaxedorbecomes rigidastheseparation advances.C.Abdominalpain with scantred vaginalbleedingRationale:Placentapreviainvolvesminimaltoseverebrightredvaginalbleedingintheabsenceofabdominal pain.D.Intermittentabdominal painfollowing passageofbloodymucusRationale:Intermittentabdominalpainfollowingpassageofbloodymucusisadescriptionofnormallabor.Thepassageofbloodymucusrepresentsthelossofthecervicalmucousplug,alsoreferredto
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 2 preview image
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 3 preview imageas the"bloodyshow."2.A nurse is caring for a client who is 1 hr postpartumand observes a large amount of lochia rubra and several smallclotson theclient'sperinealpad.Thefundusismidlineand firmatthe umbilicus.Which ofthe following actionsshouldthenursetake?A.Documentthefindingsand continueto monitorthe client.Rationale:Theseareexpectedfindings.At1hr postpartum,lochiarubrashouldbeintermittentandassociated with uterine contractions. The volume of lochia resembles that of a heavy menstrualperiod.Small clotsarecommon.Thenurseshoulddocumentthefindingsandcontinue tomonitortheclient.B.Notifytheclient‟sprovider.Rationale:Theseareexpectedfindings,sothereisnoneedtonotifytheprovider.C.Increase thefrequencyoffundal massage.Rationale:Theseareexpectedfindingsandthefundusisalreadyfirm.Increasingthefrequency offundalmassageisnotindicatedatthistime.D.Encouragethe clienttoemptyher bladder.Rationale:Theseare expectedfindings,and the fundus isfirmat the midline.If the funduswasdeviated,this would be an indication of a distended bladder and the client should be encouraged to void toprevent uterineatony.A+TestBankPage
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 4 preview image3.A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what isthe prioritynursingaction?A.AdministervitaminK.Rationale:AdministrationofvitaminKisimportant,butitcanbedelayeduntilthenewbornisheldbythemotherandisbreastfed.Thereisanother,moreimportantnursingaction.B.Drytheskin.Rationale:Thenewbornshouldbethoroughlydried,coveredwithawarm blanket,placedonthemother‟sabdomen, and a cap applied to the newborn‟s head to prevent cold stress. The newbornrespondstothecoolerenvironmentbyincreasinghisrespiratoryrate,whichcanleadtorespiratorydistress.BasedonMaslow‟shierarchyofneeds,thisisthemostimportantnursingactionaftersecuringtheairway.C.Administereyeprophylaxis.Rationale:Administrationofeyeprophylaxisshouldoccurwithinthefirsthourafterbirth.Thereisanother,moreimportantnursingaction.D.Placeanidentificationbracelet.Rationale:Correctidentificationof the newbornisimportant,but itcanbe delayed,aslongasitiscompleted prior to the mother and newborn leaving the delivery room. There is another, moreimportantnursingaction.A+TestBankPage 3
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 5 preview image4.Anurseinaprenatalcliniciscaringfor a clientwhoisat7weeksofgestation.Theclient reports urinaryfrequencyandasksifthiswill continueuntildelivery.Whichofthefollowingresponsesshouldthe nursemake?A."It'saminorinconvenience,whichyoushould ignore."Rationale:Thisisanontherapeuticresponsethatdisregardstheclient‟sconcernandoffersunwarrantedreassurance.B."Inmost casesit onlylastsuntilthe12thweek,butitwillcontinueifyou havepoorbladder tone."Rationale:Thepresence orabsenceof bladder tonehas nobearing onurinaryfrequencyduringpregnancy.C."Thereis nowayto predicthowlongitwill lastin each individual client."Rationale:Thisisanontherapeuticresponsethatdoesnotprovideappropriateinformationtotheclient.D."It occursduring thefirst trimesterandneartheendofthepregnancy."Rationale:Urinaryfrequencyisduetoincreasedbladdersensitivityduringthefirsttrimesterandrecursnear theendofthepregnancyasthe enlarginguterusplacespressureonthebladder.A+TestBankPage 4
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 6 preview imageAnurseis caring fora clientduringthefirst trimester ofpregnancy.Afterreviewingtheclient'sbloodwork,thenursenotices shedoesnothaveimmunitytorubella.Whichofthefollowing timesshouldthenurseunderstandisrecommendedforrubellaimmunization?E.Shortlyaftergiving birthRationale:Therubellaimmunizationshouldbeofferedtotheclientfollowingbirth, preferablypriortodischarge from the hospital. This prevents the client from contracting rubella during the currentor subsequent pregnancies,whichwouldputherfetusat riskforrubellasyndrome.F.In thethirdtrimesterRationale:Becausetherubellavaccinecontainsalivevirus,immunizingtheclientatthispointinpregnancy wouldputherfetusatriskfordevelopingrubellasyndrome.G.ImmediatelyRationale:Becausetherubellavaccinecontainsalivevirus, immunizingtheclient duringthefirsttrimesterwouldputthefetusatriskfordevelopingaseveremanifestationsofrubella syndrome.H.During her next attempt toget pregnantRationale:Rubellaimmunizationmustbegivenatleast28 days priortopregnancytoassurethat thedeveloping fetusisnot exposed tothevirusandput atriskforrubellasyndrome.5.A nurse is caring for a client who just delivereda newborn. Following the delivery, which nursing action should bedonefirsttocareforthenewborn?A+TestBankPage 5
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 7 preview imageA.Cleartherespiratorytract.Rationale:Clearingtheairwayoftheinfantisthefirstactionthenurseshouldtakeimmediatelyfollowingdelivery.B.Drytheinfantoffandcoverthe head.Rationale:Dryingtheinfantandcoveringtheheadshouldbedoneshortlyafterthedelivery,butitisnotthefirstactionthenurseshouldtake.C.Stimulatethe infantto cry.Rationale:Stimulatingtheinfanttocryshouldbedoneshortlyafterthedelivery,butitisnotthefirstactionthe nurseshouldtake.D.Cutthe umbilicalcord.Rationale:Cuttingtheumbilicalcordshouldbedoneshortlyafterthedelivery,butitisnotthefirstactionthe nurseshouldtake.6.Anurseinafamilyplanning clinic is caringfora17-year-oldfemaleclient whois requestingoralcontraceptives.Theclient statesthatshe isnervousbecause shehasnever had apelvic examination.Which ofthe followingresponsesshouldthenursemake?A+TestBankPage 6
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 8 preview imageA."What partoftheexammakesyoumostnervous?"Rationale:Thistherapeuticresponserecognizestheclient'sfeelings.Italsousesthetherapeutictechniqueofclarificationtoencouragetheclient totell thenursemoreaboutherconcerns.B."Don'tworry, Iwillbe withyouduring the exam."Rationale:Thisclosed-endednontherapeuticresponsediscountstheclient'sfeelingsanddoesnotencourage furtherdiscussion.C."Allyou needto dois relax."Rationale:Thisclosed-endednontherapeuticresponsedoesnotaddresstheclient'sconcernsanddoesnot encourage furtherdiscussion.Itblockscommunicationbyusingaclichéandfalsereassurance.D."Apelvicexamisrequired ifyouwantbirthcontrol pills."Rationale:Thisstatementfailstoaddresstheclient‟sfeelingsthatshesharedwiththenurse.Itblockscommunicationanddoesnotencouragefurtherdiscussion.7.A nurse in labor and delivery is caring for a client. Following delivery of the placenta, the nurse examines theumbilicalcord.Which ofthefollowingvesselsshouldthe nurseexpect toobservein theumbilicalcord?A.Two veinsandonearteryRationale:Thisisnotthecorrectcombinationofvessels.A+TestBankPage 7
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 9 preview imageB.One arteryandoneveinRationale:Thisisnotthecorrectcombinationofvessels.C.Twoarteriesand oneveinRationale:Theveincarriedtheoxygenated,nutrient-richbloodfromtheplacentatothefetus,andthetwoarteriesreturnedthebloodtotheplacenta.D.Twoarteries and twoveinsRationale:Thisisnotthecorrectcombinationofvessels.8.A nurse is caring for a client who is considering several methods of contraception. Which of the following methodsofcontraceptionshouldthenurseidentifyasbeingmostreliable?A.AmalecondomRationale:Thismethodofcontraceptionhas11to16failuresforevery100users.B.An intrauterine device (IUD)Rationale:AnIUDisfoundtohaveafailurerateoflessthan1in100users,whichmakesitoneofthemostA+TestBankPage 8
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 10 preview imagereliablemethodsofcontraception.C.AnoralcontraceptiveRationale:This method of contraception has about 8 failures for every 100 users, due to failure to take pillconsistently anddecreasedefficacywhen takenwithcertainmedications.D.Adiaphragmwithspermicide.Rationale:This method of contraception has about 16 failures for every 100 users during the first year ofuse.9.A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of thefollowingisthecorrectinterpretationofthisdata?A.Theclientis notexperiencingarubellainfectionatthistime.Rationale:Anegativerubellatiterindicatestheclientissusceptibletotherubellavirus.Itdoesnotindicate thepresenceorabsenceofa rubellainfection.B.Theclientis immunetotherubella virus.Rationale:Anegativerubellatiterindicatestheclientissusceptibletotherubellavirus.C.Theclientrequiresarubella vaccination atthistime.Rationale:Rubellavaccinationduringpregnancyiscontraindicatedbecauseofpossibleinjurytothedevelopingfetus.A+TestBankPage 9
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 11 preview imageD.Theclient requiresarubellaimmunizationfollowingdelivery.Rationale:Anegativerubellatiterindicatesthattheclientissusceptibletotherubellavirusandneedsvaccinationfollowingdelivery.Immunizationduringpregnancyiscontraindicatedbecauseofpossible injury to the developing fetus. Following rubella immunization, the client should becautionednottoconceivefor1month.10.Anurseina hospital iscaring for a clientwhoisat38weeksofgestationandhasalarge amountofpainless,bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of 138/minandno uterine contractions. The client'svitalsignsare:bloodpressure 98/52 mmHg, heartrate118/min,respiratoryrate24/min,andtemperature 36.4°C (97.6°F).Which ofthe following istheprioritynursingaction?A.Insertan indwelling urinarycatheter.Rationale:Anindwellingurinarycathetercanbeinsertedinthedeliveryroomjustpriorto delivery.This isnotthepriority nursingaction.B.Initiate IVaccess.Rationale:Insertionofalarge-boreIVcatheteristheprioritynursingaction.Theclientislosingbloodrapidly, has hypotension, and tachycardia. IV access will allow IV fluids and blood to beadministeredquicklyifhypovolemiadevelops.A+TestBankPage 10
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 12 preview imageD.Excessive uterineenlargementC.Witnessthesignaturefor informed consentforsurgery.Rationale:RationaleC.Thisisnotthenurse'spriorityactionatthistime.Afamilymembercansigntheconsentformifneeded.D.Prepare theabdominalandperinealareas.Rationale:Skinpreparationcanbedelayeduntiljustpriorto acesareandelivery. Thisisnotheprioritynursingaction.12.AA nurseinaprenatal cliniciscaringforaclientwhoissuspectedofhavingahydatidiformmole.Whichofthe followingfindingsshouldthe nurseexpectto observeinthisclient?A.Rapiddeclineinhumanchorionic gonadotropin(hCG)levelsRationale:AclientwhohasahydatidiformmoleusuallyhasanelevatedserumhCGlevel.B.Profuse,clearvaginaldischargeRationale:A client who has a hydatidiform mole often has vaginal bleeding later in the pregnancy. Thisdischargecanbedarkbrown,brightred,scant,orprofuse.C.Irregular fetalheartrateRationale:When a client has a hydatidiform mole, fetal heart tones arenot heard since there is nodeveloping fetus.A+TestBankPage 11
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 13 preview imageRationale:A hydatidiform mole is a rare tumor that forms inside the uterus at the beginning of a pregnancyand results in the over-production of tissue that would normally develop into the placenta. Thistissueconsistsof fluid-filledvesicles.Arapidlyenlarginguterusisaclassicfinding in clientswho have a molar pregnancy. It is often accompanied by severe nausea and vomiting, elevatedhumanchorionicgonadotropinlevels,signsofhyperthyroidism,and earlyonsetofpreeclampsia.13.AAnurseiscaringforanewmotherwhoisconcernedthathernewborn'seyescross.Whichofthefollowingstatementsisatherapeuticresponsebythenurse?A."I willcallyourprimarycareprovidertoreportyour concerns."Rationale:Thisisaninappropriateresponsebythe nursebecauseitdoesnotaddresstheclient'sfeelingsofconcern.B."Iwilltakeyourbabyto thenurseryfor further examination."Rationale:Itisnotnecessaryforthenurse tocompleteadditionalexaminationof thenewborn.Thisalsodoesnotaddresstheclient‟sconcerns.C."This occurs because newborns lack musclecontroltoregulate eyemovement."Rationale:A+TestBankPage 12
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 14 preview imageThis addresses the client‟s concerns because it provides information that addresses herconcerns. The eyes of newborns are structurally incomplete and muscle control is not fullydevelopedfor3months.D."This isaconcern,but strabismus is easilytreatedwithpatching."Rationale:Thisisaninappropriatestatementbythenursebecauseitoffersunwarrantedreassurance.Thenurseismaking anassumption thatthat shouldbeaddressedbytheprovider.14.AAnurseiscaringforaclientwhoishavinganonstresstestperformed.Thefetalheartrate(FHR)is130to 150/min, but there has been no fetal movement for 15 min. Which of the following actions should thenurseperform?A.Immediatelyreportthesituation totheclient's providerandpreparetheclient forinductionof labor.Rationale:Thefetusmightnotbemovingbecauseitisasleep,ortheremightbeanotherbenignreason.B.Encouragethe clienttowalkaround without the monitoringunit for 10 min,thenresumemonitoring.Rationale:Havingtheclientwalkisnotlikelytopromotefetalmovement.C.Offer the clientasnackoforange juice and crackers.Rationale:Anonstresstestdependsuponfetalmovement,andthisfetusismostlikelyasleep.Mostfetusesare moreactiveafter meals due totheincrease inthemother's blood sugar. Givingthemotherasnackwillpromotefetalmovement.D.Turn the clientontoher leftside.A+TestBankPage 13
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 15 preview imageRationale:Turningtheclientontoherleftside increasestheplacentalperfusionofoxygentothefetus,butthe FHRof130to150/minisnotindicativeoffetaldistress.15.AAnurseonalaborunit isadmitting aclientwhoreportspainfulcontractions. Thenursedeterminesthatthecontractions haveaduration of1 min anda frequencyof3min. Thenurse obtainsthe followingvital signs: fetalheart rate 130/min, maternal heart rate 128/min and maternal blood pressure 92/54 mm Hg. Which of the followingisthepriority actionforthenursetotake?A.Notifytheprovider ofthe findings.Rationale:Callingtheprovidermaybeappropriate;however,thisisnotthepriorityintervention.B.Positiontheclientwithone hip elevated.Rationale:BasedonMaslow‟shierarchyof needs,the client'sneedforan adequatebloodpressuretoperfuseherselfandher fetusisaphysiologicalneedthatrequires immediateintervention.Supinehypotensionisafrequent causeoflowblood pressure in clientswho arepregnant. Byturningthe client onher sideand retakingher bloodpressure, the nurseisattemptingtocorrectthelowbloodpressureandreassess.C.Askthe clientifsheneeds pain medication.Rationale:A+TestBankPage 14
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ATI RN Maternal Newborn NGN Proctored Exam with Answers (250 Solved Questions) - Page 16 preview imageTheclient's comfortshould beaddressed;however,this is notthepriorityintervention.D.Have the clientvoid.Rationale:Theclientshouldbeencouragedtoemptyherbladderevery2hrduringlabor;however,thisisnotthepriority intervention.16.AAnurseiscaringforaclientwhoisaprimigravida,atterm,andhavingcontractionsbutisstatingthatsheis"notreallysureifsheisinlaborornot." Whichofthe following shouldthenurserecognize asasignoftruelabor?A.Rupture ofthe membranesRationale:Themembranescanrupturespontaneouslylongbeforetheonsetoflabor.B.Changesin the cervixRationale:Assessmentofprogressivechangesintheeffacementanddilationofthecervixisthemostaccurateindicationoftruelabor.C.Stationofthepresenting partRationale:Aclientwhoisaprimigravidawilltypicallyengagebeforelaborandcanenterlaborat-1,0,oreven+1station.D.Patternof contractionsRationale:Aclientcanhaveregularcontractionsforasignificantperiod of timepriortotheonsetof truelabor.A+TestBankPage 15
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