ATI RN
Current Issues in Maternal Newborn Nursing Questions
Question 1 of 5
A nurse is assessing a newborn who was born vaginally with vacuum extractor assistance. The nurse notes swelling over the newborn's head that crosses the suture line. The nurse should identify the swelling as which of the following findings?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Caput succedaneum. Caput succedaneum is a diffuse swelling of the newborn's scalp that crosses suture lines and is commonly seen in infants born vaginally with vacuum extractor assistance. It is caused by pressure on the baby's head during delivery and usually resolves within a few days. Option A) Nevus ammeus is a birthmark that appears as a bluish discoloration of the skin and is unrelated to the swelling seen in this case. Option C) Cephalohematoma is a collection of blood between a baby's skull and the periosteum and does not cross suture lines. It is typically caused by trauma during delivery. Option D) Erythema toxicum is a common rash seen in newborns that presents as blotchy red spots with a central white or yellow papule. It is unrelated to the swelling observed in this scenario. Educationally, understanding the different types of newborn swellings and skin conditions is crucial for nurses working in maternal newborn care. Recognizing and correctly differentiating these conditions can help in providing appropriate care and interventions for newborns. This knowledge is essential for effective assessment, early detection of complications, and ensuring optimal outcomes for newborns and their families.
Question 2 of 5
A nurse is caring for a client who is pregnant for the fourth time. The client delivered two full-term newborns and had one spontaneous abortion at 10 weeks of gestation. The nurse should document the client's obstetrical history as which of the following?
Correct Answer: C
Rationale: In maternal newborn nursing, understanding obstetrical history is crucial for providing individualized care. In this scenario, the correct answer is C) Gravida 4, Para 2. Gravida refers to the total number of pregnancies, including current, while Para denotes the outcomes of those pregnancies. Since the client is currently pregnant for the fourth time, she is Gravida 4. However, she has only delivered two full-term newborns, making her Para 2. Option A (Gravida 3, Para 2) is incorrect because it does not account for the current pregnancy, resulting in an inaccurate representation of the client's obstetrical history. Option B (Gravida 3, Para 3) is incorrect as it inaccurately states that the client has delivered three babies, which is not the case. Option D (Gravida 4, Para 3) is incorrect as it overestimates the number of pregnancies the client has carried to term. Understanding correct documentation is essential for effective communication among healthcare providers and accurate assessment of the client's pregnancy-related risks and needs. By selecting the correct option, the nurse ensures clarity and precision in documenting the client's obstetrical history, contributing to safe and individualized care provision.
Question 3 of 5
A nurse is caring for a client who is at 14 weeks of gestation and has hyperemesis gravidarum. Which of the following medications should the nurse plan to administer?
Correct Answer: C
Rationale: In the context of caring for a pregnant client with hyperemesis gravidarum at 14 weeks of gestation, the correct medication choice is Vitamin B6 (option C). Hyperemesis gravidarum is characterized by severe nausea and vomiting in pregnancy, and Vitamin B6 (pyridoxine) is a common and safe treatment recommended to alleviate these symptoms. Vitamin B6 has been shown to be effective in reducing nausea and vomiting in pregnant women without posing harm to the fetus. It is a well-established and evidence-based therapy for managing hyperemesis gravidarum. Option A, Digoxin, is a cardiac medication used to treat heart conditions and would not be appropriate for treating hyperemesis gravidarum during pregnancy. Option B, Calcium gluconate, is a mineral supplement used to treat calcium deficiencies and would not address the symptoms of hyperemesis gravidarum. Option D, Propranolol, is a beta-blocker used for various conditions like high blood pressure and anxiety, but it is contraindicated in pregnancy due to potential adverse effects on fetal development. In an educational context, understanding the appropriate management of hyperemesis gravidarum in pregnancy is crucial for maternal newborn nurses. Knowing the safe and effective medications to use, such as Vitamin B6, helps nurses provide optimal care for pregnant clients experiencing severe nausea and vomiting. It also highlights the importance of considering the unique needs and safety of both the mother and the developing fetus when selecting medications during pregnancy.
Question 4 of 5
A nurse is teaching a client who is to start using a diaphragm for contraception. Which of the following client statements indicates an understanding of the teaching?
Correct Answer: D
Rationale: The correct answer is D) "I will place 2 teaspoons of spermicide on the inside of the diaphragm before inserting it." This statement indicates an understanding of the correct usage of a diaphragm for contraception. Spermicide is necessary to immobilize sperm and increase the effectiveness of the diaphragm. Option A is incorrect because the diaphragm should be left in place for at least 6 hours after intercourse, not 4 hours. Option B is incorrect because the diaphragm should be removed by hooking the rim with the index finger and thumb, not by catching the rim below the dome with the forefinger. Option C is incorrect because mineral oil can degrade latex diaphragms, so it should not be used. In an educational context, it is crucial for nurses to provide accurate information on contraceptive methods to ensure their clients use them correctly and effectively. Understanding the proper use of a diaphragm is essential to prevent unintended pregnancies and promote reproductive health. Nurses play a key role in educating clients on contraceptive options and empowering them to make informed decisions about their sexual health.
Question 5 of 5
A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?
Correct Answer: D
Rationale: In this scenario, the correct intervention is to reposition the newborn every 2 to 3 hours (Option D). Repositioning the newborn helps to ensure optimal exposure to the phototherapy lights, which is crucial for the treatment of hyperbilirubinemia. Option A, checking the newborn's temperature every 8 hours, is not the priority intervention in this case. While monitoring temperature is important, it is secondary to ensuring effective phototherapy. Option B, applying moisturizing lotion to the newborn's skin every 4 hours, is not indicated for the treatment of hyperbilirubinemia. This intervention does not address the underlying cause or contribute to the effectiveness of phototherapy. Option C, giving the newborn glucose water every 4 hours, is not an appropriate intervention for hyperbilirubinemia. Providing glucose water is unrelated to the treatment of this condition and does not address the need for phototherapy. In an educational context, it is important for nurses to understand the rationale behind interventions for newborns with hyperbilirubinemia. By repositioning the newborn regularly, nurses can optimize the effectiveness of phototherapy and ensure the best possible outcome for the newborn. This knowledge is essential for providing safe and effective care to neonates with this condition.