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ATI RN Capstone Exam (I)

RN - Nursing Exam(s) 44 Questions ✓ Free Access

RN Capstone

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Q1: A nurse is assisting with the care of a newborn immediately following birth. Which of the following medications should the nurse anticipate administering? Select all that apply.

Answer Choices:

A. Antibiotic ointment to both eyes
B. Hepatitis B immunization
C. Lidocaine gel to the umbilical stump
D. Haemophilus influenzae type b immunization
E. Vitamin K injection
Correct Answer: Antibiotic ointment to both eyes
Rationale:

Antibiotic ointment to both eyes

⩥ This is routinely administered to prevent ophthalmia neonatorum, a severe eye infection caused by Neisseria gonorrhoeae or Chlamydia trachomatis.

⩥ The ointment, usually erythromycin, is applied within 1–2 hours of birth as a prophylactic measure.

⩥ This intervention is mandated in many regions and is critical for preserving visual health in the newborn.

⩥ Delaying or omitting this medication could result in corneal ulceration and blindness.

Hepatitis B immunization

⩥ The hepatitis B vaccine is recommended for all newborns within 12 hours of birth, especially if the mother's HBsAg status is positive or unknown.

⩥ Early administration helps initiate the development of active immunity against the hepatitis B virus.

⩥ This vaccine is part of the routine immunization schedule and reduces the risk of chronic liver disease later in life.

⩥ If maternal status is positive, the vaccine is given alongside hepatitis B immune globulin (HBIG).

Vitamin K injection

⩥ Newborns are born with low stores of vitamin K, putting them at risk for vitamin K deficiency bleeding (VKDB).

⩥ A single intramuscular dose of vitamin K is administered shortly after birth to promote normal blood clotting.

⩥ This preventive measure is essential to avoid intracranial hemorrhage and other potentially fatal bleeding disorders.

⩥ Oral administration is less effective and not typically recommended in the immediate newborn period.

Q2: A nurse is preparing to assess a newborn who is post-term. Which of the following findings should the nurse expect? (Select all that apply)

Answer Choices:

A. Vernix in the folds and creases
B. Abundant lanugo
C. Positive Moro reflex
D. Cracked peeling skin
E. Short soft fingernails
Correct Answer: Positive Moro reflex
Rationale:

Positive Moro reflex

⇨ The Moro reflex, also called the startle reflex, is a normal primitive reflex present at birth in both term and post-term infants.

⇨ Its presence indicates neurologic integrity, and it typically persists until around 4 months of age.

⇨ Absence of this reflex would be abnormal and concerning, not expected.

⇨ Therefore, its presence is a reassuring and expected finding in a post-term newborn.

Cracked peeling skin

Cracked, dry, or peeling skin is a classic feature of post-term infants, often due to reduced vernix caseosa and prolonged exposure to amniotic fluid.

⇨ These newborns may appear to have desquamation, especially on the hands and feet.

⇨ The loss of protective vernix results in a weathered, over-mature appearance.

⇨ This skin change helps differentiate post-term from term or preterm neonates.

Q3: A nurse is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the nurse’s priority?

Answer Choices:

A. Accidental lacerations
B. Respiratory distress
C. Hypothermia
D. Acrocyanosis
Correct Answer: Respiratory distress
Rationale:

✍️ Respiratory distress is the priority assessment immediately after birth, particularly after a cesarean delivery, where retained lung fluid is more common.

✍️ Newborns require a patent airway and effective breathing for oxygenation.

✍️ While hypothermia, acrocyanosis, and lacerations may be present, airway and breathing come first per the ABCs of neonatal care.

✍️ Immediate action may include suctioning or oxygen support.

Q4: A nurse in a provider’s office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?

Answer Choices:

A. Cocaine use
B. Blunt force trauma
C. Hypertension
D. Cigarette smoking
Correct Answer: Hypertension
Rationale:

🖊️ Hypertension is the most common risk factor for placental abruption, due to the pressure exerted on the placental vasculature.

🖊️ This causes premature separation of the placenta and can lead to fetal and maternal distress.

🖊️ Cocaine use and trauma are significant risks but are less common.

🖊️ Smoking is a contributing factor but not the primary cause.

Q5: A nurse is assessing a newborn who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?

Answer Choices:

A. Inwardly turned foot on the affected side
B. Absent plantar reflexes
C. Lengthened thigh on the affected side
D. Asymmetric thigh folds
Correct Answer: Asymmetric thigh folds
Rationale:

🔶 Asymmetrical thigh or gluteal folds may indicate developmental dysplasia of the hip (DDH), especially in infants.

🔶 Other signs include limited abduction, a shortened femur, and a positive Ortolani or Barlow maneuver.

🔶 An inwardly turned foot suggests clubfoot, not DDH.

🔶 Reflexes are typically intact in this condition.

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Exam Details
Total Questions: 44 practice questions
Category: RN - Nursing Exam(s)
Subcategory: ATI Exams
Domain: ATI CAPSTONE
Last Updated: Nov 29, 2025
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