ATI RN
Palliative Care Perinatal Loss Case Questions
Question 1 of 5
The nurse has made it a goal to increase the rate at which women begin prenatal care in the first trimester. The nurse relates this decision to national goals for better maternal and infant outcomes. What guidelines will the nurse use to guide her maternal health goals?
Correct Answer: D
Rationale: The correct answer is D) Healthy People 2020. The nurse will use Healthy People 2020 guidelines to guide her maternal health goals because Healthy People 2020 is a comprehensive set of national health objectives aimed at improving the health and well-being of all Americans. It provides science-based, 10-year national objectives for promoting health and preventing disease. The goals and objectives related to maternal and child health focus on improving prenatal care utilization, reducing infant mortality rates, and promoting maternal health throughout pregnancy. Option A) WHO Maternal care guidelines may provide valuable information, but for national goals and initiatives specific to the United States, Healthy People 2020 would be more relevant. Option B) State Practice Acts pertain to the legal scope of nursing practice within a specific state and do not provide comprehensive national health goals like Healthy People 2020. Option C) AWHONN white papers may offer evidence-based recommendations for perinatal care, but they do not encompass the broad range of maternal health goals and objectives outlined in Healthy People 2020. For the nurse, understanding and aligning with national initiatives like Healthy People 2020 not only ensures evidence-based practice but also contributes to improving overall maternal and infant outcomes on a larger scale. This knowledge helps nurses advocate for policy changes, implement best practices, and ultimately enhance the quality of care provided to pregnant women and their babies.
Question 2 of 5
A bottle-feeding woman, 11â„2 weeks postpartum from a vaginal delivery, calls the obstetric office to state that she has saturated 2 pads in the past 1 hour. Which of the following responses by the nurse is appropriate?
Correct Answer: D
Rationale: The correct response, option D, is appropriate because it prioritizes the woman's health and safety by advising her to be examined by a doctor promptly. This is crucial as saturating 2 pads in 1 hour postpartum could indicate excessive bleeding, which may be a sign of a serious complication like postpartum hemorrhage or retained placental tissue. Option A is incorrect as it dismisses the woman's concern and does not address the potential seriousness of the situation. Option B is also incorrect as it wrongly attributes the bleeding to the return of menstruation, which is not typical so soon after delivery. Option C is incorrect as it normalizes heavy bleeding without considering the need for medical evaluation. Educationally, it is important for healthcare providers to be able to recognize and respond to postpartum complications promptly to ensure the well-being of mothers. Understanding the potential risks and knowing when to seek medical help are vital aspects of providing comprehensive perinatal care. This case highlights the importance of appropriate triage and communication skills in managing postpartum issues effectively.
Question 3 of 5
On admission to the labor and delivery unit, a client's hemoglobin (Hgb) was assessed at 11.0 gm/dL, and her hematocrit (Hct) at 33%. Which of the following values would the nurse expect to see 2 days after a normal spontaneous vaginal delivery?
Correct Answer: C
Rationale: In this scenario, option C (Hgb 10.5 gm/dL; Hct 31%) is the correct answer. After a normal spontaneous vaginal delivery, it is expected that the client's hemoglobin and hematocrit levels will decrease slightly due to physiological changes postpartum. This decrease is a normal response to the blood loss that occurs during delivery. Option A (Hgb 12.5 gm/dL; Hct 37%) is incorrect because it shows an increase in the values, which is not expected after delivery. Options B (Hgb 11.0 gm/dL; Hct 33%) and D (Hgb 9.0 gm/dL; Hct 27%) are also incorrect as they do not reflect the expected slight decrease in hemoglobin and hematocrit levels postpartum. From an educational standpoint, understanding the normal physiological changes that occur in the postpartum period is crucial for providing quality care to women during this vulnerable time. Nurses need to be able to recognize and interpret lab values accurately to assess the postpartum client's health status effectively. This knowledge helps in identifying deviations from normal and providing appropriate interventions promptly.
Question 4 of 5
The nurse asks a woman about how the woman's husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which of the following statements?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) "My husband is ready for the pregnancy to end so that we can have sex again." This statement raises concerns as it indicates a lack of emotional connection to the pregnancy and focuses solely on the physical aspect of the relationship. It suggests potential unresolved issues or emotional distress that may require counseling or support. Option B) "My husband is excited about becoming a father" is incorrect as it shows a positive and appropriate response to the pregnancy. Option C) "My husband has been very supportive throughout my pregnancy" indicates a supportive partner, which is a positive sign. Option D) "My husband is helping me prepare for the baby's arrival" also displays engagement and readiness for the baby. Educationally, this question highlights the importance of assessing emotional well-being and support systems during perinatal care. It emphasizes the need for nurses to recognize signs of distress or disconnect in partners experiencing perinatal loss and the significance of offering appropriate support and counseling services in such situations.
Question 5 of 5
After instructing participants in a childbirth education class about methods for coping with discomforts in the first stage of labor, the nurse determines that one of the pregnant clients needs further instruction when she says that she has been practicing which of the following?
Correct Answer: D
Rationale: In this scenario, option D, pelvic tilt exercises, is the correct method for coping with discomforts in the first stage of labor. Pelvic tilt exercises help to relieve back pain and discomfort during labor by strengthening the muscles in the lower back and abdomen. These exercises also help to improve the position of the baby in the pelvis, which can facilitate a smoother labor process. Option A, biofeedback, is not typically used for coping with discomforts in labor but rather for stress management and relaxation in other contexts. Option B, effleurage, involves light circular stroking movements on the abdomen and is more commonly used for pain relief during labor rather than discomfort in the first stage. Option C, guided imagery, can be a helpful relaxation technique during labor, but it is not specifically targeted at coping with discomforts in the first stage. Providing this educational context can help pregnant clients understand the rationale behind using pelvic tilt exercises as a coping mechanism during labor.