ATI PN COMPREHENSIVE EXIT EXAM 180 NGN QUESTIONS AND VERIFIED ANSWERS & RATIONALES WELL GRADED, BEST ATI COMPREHENSIVE 1. A nurse is collecting data on a newborn who is 3 days old. Exhibit 1 History and Physical Newborn was delivered at 37 weeks gestation via cesarean section for fetal distress.Apgar scores 8 at 1 min and 9 at 5 min.Birthweight 2,892 g (6 lb 6 oz)The cli ent who gave birth plans to breastfeed. Exhibit 2 Flow Sheet Day 2 of Life 0900: Temperature 36.7° C (98° F)Heart rate 140/minRespiratory rate 48/minWeight 2,718 g (6 lb), 6% weight lossDay 3 of Life 0800: Temperature 36.4° C (97.5° F)Heart rate 140/minRespiratory rate 48/minWeight 2,545 g (5 lb 9 oz), 12% weight loss Exhibit 3 Nurses' Notes Day 3 of Life 0800: Skin color consistent with newborn's genetic background. Respirations easy and unlabored. Abdomen soft with active bowel sounds. Mild tremors noted when awake. Anterior fontanel level and soft. Large ecchymotic caput suc- cedaneum noted on posterior scalp. Small amount of bloody mucus discharge noted from vag: Click to highlight the findings that require follow-up. To deselect a finding, cli ck on the finding again. Temperature 36.4° C (97.5° F) Weight 2,545 g (5 lb 9 oz) 12% weight loss Mild tremors noted when awake. Breastfeeding every 3 to 5 hr for 5 to 10 min. Birth parent reports nipple discomfort throughout the feeding. When recognizing cues, the nurse should identify that a temperature of 36.4° C (97.5° F) is below the expected reference range. Hypothermia can lead to the occur- rence of hypoglycemia and respiratory distress. The newborn breastfeeding for short intervals, nipple discomfort, and a weight loss of greater than 10% of birth weight can indicate inadequate transfer of breastmilk, which can result in hypoglycemia. The presence of mild tremors can be a manifestation of hypoglycemia. 2. A nurse is assisting with the care of a client who was admitted to the emergency department (ED). Exhibit 1 Admission Assessment Day 1 1930: Client admitted to the ED by police after report of violent behavior in public. Client smashed a glass window with their hands. Client is stating, "I am Je- sus." Client is attempting to hit staff. Client placed in restraints. Neuro: Client is alert and oriented x 0. Client is swinging their arms and shouting. Client is unable to answer questions and their speech is rapid and unorganized. Heart rate is 108/min, regularIntegumentary: Laceration noted to the client's left hand (2 cm x 2.5 cm). Laceration noted to the left forearm (4 cm x 6 cm). Profuse bleeding noted. Multiple small lacerations noted to face, left arm, and right arm. Allergies: Unable to assess Exhibit 2
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