ATI RN Maternal Newborn
1. Exhibit 1: Medical hx Respiratory findings is incor-
Newborn delivered by repeat cesarean rect. The newborn's respiratory
birth at 40 weeks of gestation. Birth weight rate is within the expected ref-
3,515 g (7 lb 12 oz) Apgar scores 8 at 1 erence range of 30 to 60/min.
min and 9 at 5 min. Maternal history of There is no indication the new-
methadone use during pregnancy. born has an alteration in res-
Exhibit 2: VS piratory status; therefore, this
@0700: Heart rate 156/min. Respiratory finding does not need to be re-
rate 58/min. Temperature 37.2° C (98.9° F) ported to the provider.
Oxygen saturation 98% on room air Temperature is incorrect. The
@1100: Heart rate 160/min. Respiratory newborn's temperature is with-
rate 60/min. Temperature 37.3° C (99.2° F) in the expected reference
Oxygen saturation 96% on room air range of 36.5° to 37.5° C (97.7°
Exhibit 3: Phys Exam to 99.5° F). Therefore, this find-
Newborn is inconsolable with a ing does not need to be report-
high-pitched cry. Newborn sucks vigor- ed to the provider.
ously on pacifier but breastfeeds poor- Oxygen saturation is incorrect.
ly. Respirations unlabored. Lungs sound The newborn's oxygen satu-
clear on auscultation. Increased muscle ration is within the expect-
tone with moderate to severe tremors ed reference range of greater
when disturbed. Hyperactive Moro reflex than 94%; therefore, this find-
noted. Several loose stools today. ing does not need to be report-
Exhibit 4: Diagnostic Results ed to the provider.
Maternal urine toxicology screen positive Central nervous system find-
for opiates (-). Newborn urine toxicology ings is correct. The new-
screen positive for opiates (- born is displaying inconsolabil-
ity, high-pitched cry, increased
muscle tone, tremors, hyper-
active Moro reflex, and ex-
cessive sucking. These find-
ings are manifestations of NAS
and should be reported to the
provider.
Gastrointestinal findings is cor-
rect. The newborn is displaying
poor feeding and loose stools.
These findings are manifesta-
tions of NAS and should be re-
ported to the provider.
, ATI RN Maternal Newborn
2. Exhibit 1: RN note When generating solutions, in-
@ 0900: Client reports a small amount of serting a large bore intra-
bright red blood in their underwear upon venous catheter is indicated.
awakening. Client denies contractions or Clients who have third trimester
abdominal pain. External fetal monitor ap- vaginal bleeding may experi-
plied. ence a sudden hemorrhage
@0930: Client passed large amount of and require fluid resuscitation
bright red blood from vagina. Denies pain. or the administration of blood
Uterine tone soft and nontender to palpa- products. The nurse should
tion. Contraction pattern: no contractions weigh perineal pads. Weighing
noted. Fetal heart rate pattern: Fetal heart perineal pads after use will pro-
rate baseline 135/min. Moderate variabili- vide a more accurate assess-
ty. No decelerations noted. ment of the volume of blood
Exhibit 2: VS loss that the client is experienc-
@0900: Temperature 36.2°C (97.2° F)Pulse ing.
rate 78/min. Respiratory rate 20/min.
Blood pressure 112/64 mmHg. Fetal heart When generating solutions, the
rate 132/min nurse should not administer
@0930: Pulse rate 82/min. Blood pressure methotrexate or assess for cer-
116/60 mmHg. Fetal heart rate 160/min vical dilation because it is
Exhibit 3: Medical hx contraindicated for this client.
G4P3. 30 weeks gestation. Previous preg- Methotrexate is an antimetabo-
nancies delivered via cesarean section lite and folic acid antagonist
which destroys 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 for any pregnant
client who is experiencing vagi-
nal bleeding. Manipulation of
the cervix during the examina-
tion may result in further dam-
age to the placenta and com-
promise the well-being of the
client and fetus.
, ATI RN Maternal Newborn
3. A nurse is assessing the newborn of a d. Vomiting
client who took selective serotonin re-
uptake inhibitor (SSRI) during pregnan- Expected manifestations asso-
cy. Which of the following manifestations ciated with fetal exposure to
should the nurse identify as an indication SSRIs include irritability, agi-
of withdrawal from an SSRI? tation, tremors, diarrhea, and
a. Large for gestational age vomiting. These manifestations
b. Hyperglycemia typically last 2 days.
c. Bradypnea
d. Vomiting
4. A nurse in a family planning clinic is car- Cholecystitis, hypertension,
ing for a client who requests an oral con- and migraine headaches is cor-
traceptive. Which of the following findings rect. A history of gallbladder
in the client's history should the nurse rec- disease is a contraindication for
ognize as a contraindication to oral con- the use of oral contraceptives.
traceptives? (Select all that apply) Hypertension is a contraindica-
a. Cholecystitis tion for the use of oral contra-
b. Hypertension ceptives. A history of migraine
c. Human papillomavirus headaches is a contraindica-
d. Migraine headaches tion for the use of oral contra-
e. Anxiety disorder ceptives.
HPV and anxiety disorder is
incorrect. The presence of hu-
man papillomavirus is not a
contraindication for the use of
oral contraceptives. The pres-
ence of an anxiety disorder is
not a contraindication for the
use of oral contraceptives.
5. A nurse is caring for a newborn. Educate the parents to begin
range of motion exercises on
Exhibit 1: Medical hx the affected arm after 1 week
@1600: Apgar score 9 at 1 min and 9 at 5 is indicated. Passive ROM ex-
min. Birth weight 4,706g (10lb 6oz). Gesta- ercises of the arm are indicated
tional age 40 weeks. Difficult vaginal birth to restore function of the ex-
with shoulder dystocia. tremity. The initiation of these
1. Exhibit 1: Medical hx Respiratory findings is incor-
Newborn delivered by repeat cesarean rect. The newborn's respiratory
birth at 40 weeks of gestation. Birth weight rate is within the expected ref-
3,515 g (7 lb 12 oz) Apgar scores 8 at 1 erence range of 30 to 60/min.
min and 9 at 5 min. Maternal history of There is no indication the new-
methadone use during pregnancy. born has an alteration in res-
Exhibit 2: VS piratory status; therefore, this
@0700: Heart rate 156/min. Respiratory finding does not need to be re-
rate 58/min. Temperature 37.2° C (98.9° F) ported to the provider.
Oxygen saturation 98% on room air Temperature is incorrect. The
@1100: Heart rate 160/min. Respiratory newborn's temperature is with-
rate 60/min. Temperature 37.3° C (99.2° F) in the expected reference
Oxygen saturation 96% on room air range of 36.5° to 37.5° C (97.7°
Exhibit 3: Phys Exam to 99.5° F). Therefore, this find-
Newborn is inconsolable with a ing does not need to be report-
high-pitched cry. Newborn sucks vigor- ed to the provider.
ously on pacifier but breastfeeds poor- Oxygen saturation is incorrect.
ly. Respirations unlabored. Lungs sound The newborn's oxygen satu-
clear on auscultation. Increased muscle ration is within the expect-
tone with moderate to severe tremors ed reference range of greater
when disturbed. Hyperactive Moro reflex than 94%; therefore, this find-
noted. Several loose stools today. ing does not need to be report-
Exhibit 4: Diagnostic Results ed to the provider.
Maternal urine toxicology screen positive Central nervous system find-
for opiates (-). Newborn urine toxicology ings is correct. The new-
screen positive for opiates (- born is displaying inconsolabil-
ity, high-pitched cry, increased
muscle tone, tremors, hyper-
active Moro reflex, and ex-
cessive sucking. These find-
ings are manifestations of NAS
and should be reported to the
provider.
Gastrointestinal findings is cor-
rect. The newborn is displaying
poor feeding and loose stools.
These findings are manifesta-
tions of NAS and should be re-
ported to the provider.
, ATI RN Maternal Newborn
2. Exhibit 1: RN note When generating solutions, in-
@ 0900: Client reports a small amount of serting a large bore intra-
bright red blood in their underwear upon venous catheter is indicated.
awakening. Client denies contractions or Clients who have third trimester
abdominal pain. External fetal monitor ap- vaginal bleeding may experi-
plied. ence a sudden hemorrhage
@0930: Client passed large amount of and require fluid resuscitation
bright red blood from vagina. Denies pain. or the administration of blood
Uterine tone soft and nontender to palpa- products. The nurse should
tion. Contraction pattern: no contractions weigh perineal pads. Weighing
noted. Fetal heart rate pattern: Fetal heart perineal pads after use will pro-
rate baseline 135/min. Moderate variabili- vide a more accurate assess-
ty. No decelerations noted. ment of the volume of blood
Exhibit 2: VS loss that the client is experienc-
@0900: Temperature 36.2°C (97.2° F)Pulse ing.
rate 78/min. Respiratory rate 20/min.
Blood pressure 112/64 mmHg. Fetal heart When generating solutions, the
rate 132/min nurse should not administer
@0930: Pulse rate 82/min. Blood pressure methotrexate or assess for cer-
116/60 mmHg. Fetal heart rate 160/min vical dilation because it is
Exhibit 3: Medical hx contraindicated for this client.
G4P3. 30 weeks gestation. Previous preg- Methotrexate is an antimetabo-
nancies delivered via cesarean section lite and folic acid antagonist
which destroys 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 for any pregnant
client who is experiencing vagi-
nal bleeding. Manipulation of
the cervix during the examina-
tion may result in further dam-
age to the placenta and com-
promise the well-being of the
client and fetus.
, ATI RN Maternal Newborn
3. A nurse is assessing the newborn of a d. Vomiting
client who took selective serotonin re-
uptake inhibitor (SSRI) during pregnan- Expected manifestations asso-
cy. Which of the following manifestations ciated with fetal exposure to
should the nurse identify as an indication SSRIs include irritability, agi-
of withdrawal from an SSRI? tation, tremors, diarrhea, and
a. Large for gestational age vomiting. These manifestations
b. Hyperglycemia typically last 2 days.
c. Bradypnea
d. Vomiting
4. A nurse in a family planning clinic is car- Cholecystitis, hypertension,
ing for a client who requests an oral con- and migraine headaches is cor-
traceptive. Which of the following findings rect. A history of gallbladder
in the client's history should the nurse rec- disease is a contraindication for
ognize as a contraindication to oral con- the use of oral contraceptives.
traceptives? (Select all that apply) Hypertension is a contraindica-
a. Cholecystitis tion for the use of oral contra-
b. Hypertension ceptives. A history of migraine
c. Human papillomavirus headaches is a contraindica-
d. Migraine headaches tion for the use of oral contra-
e. Anxiety disorder ceptives.
HPV and anxiety disorder is
incorrect. The presence of hu-
man papillomavirus is not a
contraindication for the use of
oral contraceptives. The pres-
ence of an anxiety disorder is
not a contraindication for the
use of oral contraceptives.
5. A nurse is caring for a newborn. Educate the parents to begin
range of motion exercises on
Exhibit 1: Medical hx the affected arm after 1 week
@1600: Apgar score 9 at 1 min and 9 at 5 is indicated. Passive ROM ex-
min. Birth weight 4,706g (10lb 6oz). Gesta- ercises of the arm are indicated
tional age 40 weeks. Difficult vaginal birth to restore function of the ex-
with shoulder dystocia. tremity. The initiation of these
