Questions 55

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ATI Maternity Nur230 Questions

Extract:

Client who gave birth 2 hr ago with blood pressure 60/50 mm Hg


Question 1 of 5

A nurse is caring for a client who gave birth 2 hr ago. The nurse notes that the client's blood pressure is 60/50 mm Hg. What is the first action the nurse should take?

Correct Answer: A

Rationale: A boggy uterus may indicate uterine atony, a common cause of postpartum hemorrhage and hypotension, requiring immediate assessment.

Extract:

Child with suspected acute rheumatic fever


Question 2 of 5

A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

Correct Answer: A

Rationale: A recent sore throat may indicate a streptococcal infection, a common precursor to acute rheumatic fever.

Extract:

6-month-old infant who underwent a cardiac catheterization for pulmonary stenosis


Question 3 of 5

A nurse is providing care for a 6-month-old infant who underwent a cardiac catheterization. The child was diagnosed with pulmonary stenosis early in infancy and was admitted today for a balloon angioplasty procedure. Which of the following should the nurse plan to include in the discharge teaching?

Correct Answer: C

Rationale: Administering acetaminophen or ibuprofen for pain management is appropriate post-catheterization to alleviate discomfort from the procedure site.

Extract:

Child who has Kawasaki disease


Question 4 of 5

A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?

Correct Answer: D

Rationale: Kawasaki disease primarily affects the cardiovascular system, causing vasculitis and potential heart complications, requiring close monitoring.

Extract:

Adolescent client at 38 weeks with preeclampsia


Question 5 of 5

A nurse is caring for an adolescent client who is gravida 1 and para 0. The client was admitted to the hospital at 38 weeks of gestation with a diagnosis of preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia?

Correct Answer: A

Rationale: Deep tendon reflexes of +1 (hyporeflexia) are inconsistent with preeclampsia, which typically involves hyperreflexia.

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