ATI RN Maternal Newborn Proctored

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Sample questions from ATI RN Maternal Newborn Proctored

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 28-year-old client at 30 weeks of gestation is seen in the prenatal clinic. She reports a severe headache and seeing spots; blood pressure is 168/112 mm Hg on repeat measurement, and urine protein is 3+. Which action should the nurse take first?

   • A.Place the client in a quiet, dimly lit room and notify the health care provider
   • B.Encourage oral fluids and recheck the blood pressure in 1 hour
   • C.Ask the client to walk for 10 minutes to reduce anxiety
   • D.Teach the client to restrict sodium and return for the next appointment

   Rationale: Severe-range blood pressure with headache and visual changes indicates preeclampsia with severe features and requires immediate evaluation and stabilization. Oral fluids and delayed reassessment could postpone treatment, while walking is unsafe with these symptoms. Sodium restriction does not treat the acute condition, and routine follow-up is inappropriate.

2. 2.A 32-year-old client at 34 weeks of gestation is receiving magnesium sulfate for preeclampsia. The nurse notes respirations of 10/min, absent patellar reflexes, and urine output of 20 mL/hr. What is the nurse's priority action?

   • A.Stop the magnesium sulfate infusion
   • B.Increase the infusion rate to prevent seizures
   • C.Place the client supine and reassess in 30 minutes
   • D.Administer the prescribed antihypertensive medication

   Rationale: Respiratory depression, absent reflexes, and oliguria are signs of magnesium toxicity, so the infusion must be stopped immediately. Increasing magnesium worsens toxicity, and waiting to reassess is unsafe. An antihypertensive does not reverse magnesium toxicity; the nurse should also notify the provider and prepare to administer calcium gluconate as prescribed.

3. 3.A 25-year-old client at 31 weeks of gestation arrives at the emergency department with painless, bright-red vaginal bleeding. Vital signs are stable, and the fetal heart rate is 145/min. Which action should the nurse take?

   • A.Perform a sterile vaginal examination to assess cervical dilation
   • B.Apply an external fetal monitor and avoid vaginal examination
   • C.Encourage the client to ambulate to determine whether bleeding increases
   • D.Begin fundal massage to promote uterine contraction

   Rationale: Painless bright-red bleeding suggests placenta previa, and external fetal monitoring is appropriate while the source is evaluated. Vaginal examination can disrupt a placenta overlying the cervix and cause catastrophic hemorrhage. Ambulation is unnecessary, and fundal massage is not indicated before birth.

4. 4.A 30-year-old client at 35 weeks of gestation reports sudden abdominal pain and dark vaginal bleeding. The uterus is firm and tender, and the fetal heart rate is 100/min. Which action is the priority?

   • A.Prepare for immediate evaluation and stabilization for possible placental abruption
   • B.Perform a vaginal examination to determine the stage of labor
   • C.Reassure the client that dark bleeding is expected near term
   • D.Encourage oral fluids and obtain a urine specimen

   Answer and rationale are in the full material.

5. 5.A 27-year-old client at 29 weeks of gestation reports a sudden gush of clear fluid 1 hour ago. Temperature is 37.0 C (98.6 F), and the fetal heart rate is 140/min. Which nursing action is appropriate?

   • A.Perform a digital vaginal examination to assess cervical dilation
   • B.Apply a clean pad and assess the fluid and fetal status
   • C.Encourage the client to take a warm tub bath
   • D.Administer oxytocin to begin labor

   Answer and rationale are in the full material.