ATI MATERNAL NEWBORN EXAM 2 LATEST 2023 REAL
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES|AGRADE (NEWEST VERSION(!!)
01. A nurse is demonstrating to a client how to bathe her newborn. In which order
should the nurse perform the following actions? (Move the steps into the box on the
right, placing them in the selected order of performance. Use all the steps.)
Wipe the newborn’s eyes from the inner canthus outward.
Wash the newborn’s neck by lifting the newborn’s chin.
Cleanse the skin around the newborn’s umbilical cord stump.
Wash the newborn’s legs and feet.
Clean the newborn’s diaper area.
RATIONALE: The nurse should demonstrate how to bathe a newborn by using a head to
toe, clean to dirty, approach. Therefore, the nurse should first wipe the newborn's eyes
from the innercanthus outward using plain water. The nurse should then wash the
newborn's neck by lifting the newborn's chin. Next, the nurse should cleanse the skin
around the umbilical cord stump followed by washing the newborn's legs and feet. The last
step of the bath should be to clean the newborn's diaper area.
02. A nurse is caring for a client and her partner who have experienced a fetal death.
Which of the following actions should the nurse take?
Take photos of the newborn to give to the parents.
RATIONALE: The nurse should create a memory box that includes mementos of the
newborn (for example, photos, the newborn's ID bands, the newborn's hat, and the
newborn's blanket).
03. A nurse is caring for a client who is at 36 weeks of gestation and has a positive
contraction stress test. The nurse should plan to prepare the client for which of the
following diagnostic tests?
, Biophysical profile
RATIONALE: A positive contraction stress test indicates that further evaluation of the fetus
is necessary.A biophysical profile will provide further evaluation with real-time
ultrasound.
04. A nurse is reviewing the medical record of a client who is postpartum and has
preeclampsia. Which of the following laboratory results should the nurse report to
the provider?
Platelets 50,000/mm3
RATIONALE: A platelet count of 50,000/mm3 is below the expected reference range, which
can indicate disseminated intravascular coagulation. The nurse should report this result to
the provider.
05. A nurse is assessing a newborn who was born at 26 weeks of gestation using the
New Ballard Score. Which of the following findings should the nurse expect?
Minimal arm recoil
RATIONALE: The nurse should expect a newborn who was born at 26 weeks of gestation
to havedecreased muscular tone, or minimal arm recoil.
06. A nurse is assessing a newborn following a circumcision. Which of the following
findings should the nurse identify as an indication that the newborn is experiencing
pain?
Chin quivering
RATIONALE: Behavioral responses to a newborn's pain include facial expressions (for
example, chinquivering, grimacing, and furrowing of the brow).
07. A nurse is assessing the newborn of a client who took a selective serotonin
reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations
should the nurse identify as an indication of withdrawal from an SSRI?
Vomiting
RATIONALE: Expected clinical manifestation associated with fetal exposure to SSRIs include
irritability,agitation, tremors, diarrhea, and vomiting. These manifestations typically last 2
days.
Tachypnea – Hypoglycemia -- Low birth weight
10. A nurse is developing a plan of care for a newborn who is to undergo
phototherapy for hyperbilirubinemia. Which of the following actions should the
nurse include in the plan?
Remove all clothing from the newborn except the diaper.
RATIONALE: The nurse should remove all the newborn's clothing except the diaper while
under phototherapy. Maximum skin exposure to the ultraviolet light is needed to break down
theexcess bilirubin.
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES|AGRADE (NEWEST VERSION(!!)
01. A nurse is demonstrating to a client how to bathe her newborn. In which order
should the nurse perform the following actions? (Move the steps into the box on the
right, placing them in the selected order of performance. Use all the steps.)
Wipe the newborn’s eyes from the inner canthus outward.
Wash the newborn’s neck by lifting the newborn’s chin.
Cleanse the skin around the newborn’s umbilical cord stump.
Wash the newborn’s legs and feet.
Clean the newborn’s diaper area.
RATIONALE: The nurse should demonstrate how to bathe a newborn by using a head to
toe, clean to dirty, approach. Therefore, the nurse should first wipe the newborn's eyes
from the innercanthus outward using plain water. The nurse should then wash the
newborn's neck by lifting the newborn's chin. Next, the nurse should cleanse the skin
around the umbilical cord stump followed by washing the newborn's legs and feet. The last
step of the bath should be to clean the newborn's diaper area.
02. A nurse is caring for a client and her partner who have experienced a fetal death.
Which of the following actions should the nurse take?
Take photos of the newborn to give to the parents.
RATIONALE: The nurse should create a memory box that includes mementos of the
newborn (for example, photos, the newborn's ID bands, the newborn's hat, and the
newborn's blanket).
03. A nurse is caring for a client who is at 36 weeks of gestation and has a positive
contraction stress test. The nurse should plan to prepare the client for which of the
following diagnostic tests?
, Biophysical profile
RATIONALE: A positive contraction stress test indicates that further evaluation of the fetus
is necessary.A biophysical profile will provide further evaluation with real-time
ultrasound.
04. A nurse is reviewing the medical record of a client who is postpartum and has
preeclampsia. Which of the following laboratory results should the nurse report to
the provider?
Platelets 50,000/mm3
RATIONALE: A platelet count of 50,000/mm3 is below the expected reference range, which
can indicate disseminated intravascular coagulation. The nurse should report this result to
the provider.
05. A nurse is assessing a newborn who was born at 26 weeks of gestation using the
New Ballard Score. Which of the following findings should the nurse expect?
Minimal arm recoil
RATIONALE: The nurse should expect a newborn who was born at 26 weeks of gestation
to havedecreased muscular tone, or minimal arm recoil.
06. A nurse is assessing a newborn following a circumcision. Which of the following
findings should the nurse identify as an indication that the newborn is experiencing
pain?
Chin quivering
RATIONALE: Behavioral responses to a newborn's pain include facial expressions (for
example, chinquivering, grimacing, and furrowing of the brow).
07. A nurse is assessing the newborn of a client who took a selective serotonin
reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations
should the nurse identify as an indication of withdrawal from an SSRI?
Vomiting
RATIONALE: Expected clinical manifestation associated with fetal exposure to SSRIs include
irritability,agitation, tremors, diarrhea, and vomiting. These manifestations typically last 2
days.
Tachypnea – Hypoglycemia -- Low birth weight
10. A nurse is developing a plan of care for a newborn who is to undergo
phototherapy for hyperbilirubinemia. Which of the following actions should the
nurse include in the plan?
Remove all clothing from the newborn except the diaper.
RATIONALE: The nurse should remove all the newborn's clothing except the diaper while
under phototherapy. Maximum skin exposure to the ultraviolet light is needed to break down
theexcess bilirubin.
