2024 NGN ATI RN Maternal Newborn 2019 Exam with
NGN Updated 2024 with All Questions, Answers and
Rationale
Question 1:
A nurse is assisting the
... [Show More] provider to administer a dinoprostone insert to induce
labor for a client. Which of the following actions should the nurse take?
A. Place the client in a semi-Fowler's position for 1 hr after administration.
B. Instruct the client to avoid urinary elimination until after administration.
C. Verify that informed consent is obtained prior to administration.
D. Allow the medication to reach room temperature prior to administration.
Show correct answer and explanation
Explanation
Choice A rationale:
Placing the client in a semi-Fowler's position for 1 hour after administering the
dinoprostone insert is not necessary. There is no evidence or indication that this
position enhances the medication's effectiveness or safety.
Choice B rationale:
Instructing the client to avoid urinary elimination until after administration is not
appropriate and can lead to discomfort and potential complications. There is no
connection between urinary elimination and the administration of dinoprostone.
Choice C rationale:
Verifying that informed consent is obtained before administering any medication
or procedure is a crucial nursing responsibility. Informed consent ensures that
the client is fully aware of the risks, benefits, and alternatives, and gives
permission for the procedure to take place.
Choice D rationale:
Allowing the medication to reach room temperature prior to administration is not
necessary for a dinoprostone insert. Medications that require temperature
adjustment are specified in the manufacturer's instructions or facility protocols,
and this is not one of them.
Dinoprostone is a medication that is used to soften and dilate the cervix in
pregnant women who need to have labor induced. It is inserted into the vagina
as a gel, jelly, or a small tampon-like device.
According to the guidelines from the American College of Obstetricians and
Gynecologists (ACOG), the correct answer is c. Verify that informed consent is
obtained prior to administration4. This is because dinoprostone is associated
with some risks and side effects, such as excessive bleeding, infection, uterine
rupture, and fetal distress. Therefore, the provider should explain the benefits and
risks of the medication to the client and obtain their written consent before
proceeding with the induction.
The other options are incorrect for the following reasons:
a. Place the client in a semi-Fowler’s position for 1 hr after administration. This is
not necessary, as the client can change positions as desired after the insertion of
dinoprostone, unless there are other medical reasons to restrict their mobility.
b. Instruct the client to avoid urinary elimination until after administration. This is
not advisable, as the client should be encouraged to empty their bladder before
and after the insertion of dinoprostone, to reduce the risk of urinary tract infection
and discomfort.
d. Allow the medication to reach room temperature prior to administration. This is
not required, as dinoprostone can be administered at refrigerated or room
temperature, depending on the product used
Question 2:
A nurse is assessing a full-term newborn. Which of the following findings
should the nurse report to the provider?
A. Blood pressure 80/50 mm Hg.
B. Respiratory rate 55/min.
C. Heart rate 72/min.
D. Temperature 36.5°C (97.7°F).
Show correct answer and explanation
Explanation
Choice A rationale:
A blood pressure reading of 80/50 mm Hg in a full-term newborn is considered
low and should be reported to the provider. Normal blood pressure for a newborn
is typically around 60-90 mm Hg systolic and 30-60 mm Hg diastolic.
Choice B rationale:
A respiratory rate of 55/min in a full-term newborn is within the normal range.
The normal respiratory rate for newborns is typically 30-60 breaths per minute.
Choice C rationale:
A heart rate of 72/min in a full-term newborn is within the normal range. The
normal heart rate for newborns is typically 70-190 beats per minute.
Choice D rationale:
A temperature of 36.5°C (97.7°F) in a full-term newborn is within the normal
range. Normal axillary temperature for a newborn is generally considered to be
between 36.5°C to 37.5°C (97.7°F to 99.5°F). [Show Less]