ATI RN
ATI RN Maternal Newborn level 3 Final Exam 2023 (All Correct Answers). Maternal-Child Nursing Questions
Extract:
Question 1 of 5
A nurse is planning care for a client who is pregnant and has HIV.
Correct Answer: B
Rationale: The correct answer is B: Bathe the newborn before initiating skin-to-skin contact. This is important to reduce the risk of HIV transmission from the mother to the newborn. Bathing the newborn before skin-to-skin contact helps remove any potential infectious material present on the baby's skin. This practice is recommended by the CDC to reduce the risk of transmission of HIV from the mother to the baby. It is crucial to prevent direct contact with any bodily fluids that may contain the virus. In contrast, choices A, C, and D are incorrect:
A) Using a fetal scalp electrode can increase the risk of exposure to maternal blood during labor.
C) Stopping antiretroviral medication can lead to increased viral load and transmission risk.
D) Administering pneumococcal immunization is not directly related to preventing HIV transmission.
Question 2 of 5
A nurse on a labor and delivery unit is receiving infection control standards with a newly licensed nurse. The nurse should instruct the newly licensed nurse to don gloves for which of the following procedures?
Correct Answer: D
Rationale: The correct answer is D: Performing umbilical cord care. Gloves should be worn during this procedure to prevent the spread of infection. The umbilical cord stump is a potential entry point for bacteria. Assisting a mother with breastfeeding (
A) does not require gloves unless there are open wounds on the breast. Performing a newborn’s initial bath (
B) does not typically require gloves unless there is a specific reason such as the presence of infections. Administering the measles, mumps, rubella vaccine (
C) requires proper aseptic technique but not necessarily gloves unless there is a chance of exposure to blood or body fluids.
Question 3 of 5
A nurse is caring for a client who is experiencing sore nipples from breastfeeding. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Ensure the newborn’s mouth is wide open before latching to the breast. This is important because a proper latch is crucial in preventing sore nipples during breastfeeding. When the newborn's mouth is wide open, it ensures that the nipple is deeply in the baby's mouth, allowing for a more effective and comfortable feeding. This helps prevent nipple trauma and decreases the likelihood of soreness.
Choice A is incorrect because placing a snug dressing on the nipple can further irritate the area and hinder proper healing.
Choice C is incorrect as limiting the feeding time can lead to inadequate milk intake for the baby.
Choice D is incorrect as starting with the most tender nipple can worsen the soreness.
Question 4 of 5
A nurse is caring for a client who is 36 weeks gestation and has MRSA. Which of the following isolation precautions should the nurse initiate?
Correct Answer: B
Rationale: The correct answer is B: Contact precautions. MRSA is typically spread through direct contact with an infected person or contaminated surfaces. By implementing contact precautions, the nurse can prevent the transmission of MRSA to other patients or healthcare workers. Droplet precautions are used for infections spread through respiratory droplets, such as influenza. Airborne precautions are used for diseases like tuberculosis that are transmitted through small droplets that remain in the air. Protective environment is used for immunocompromised patients to protect them from outside infections.
Therefore, in this case, contact precautions are the most appropriate choice to prevent the spread of MRSA.
Question 5 of 5
A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors paces the client at risk for infection.
Correct Answer: C
Rationale: The correct answer is C: Midline episiotomy. A midline episiotomy is a surgical incision made during childbirth that increases the risk of infection due to the proximity to the anus and rectum. The incision site is more prone to contamination from fecal matter, leading to a higher risk of infection. Placenta previa (
B) is a condition where the placenta partially or fully covers the cervix, which can lead to bleeding but not necessarily infection. Meconium-stained amniotic fluid (
A) can indicate fetal distress but does not directly increase the risk of infection. Prolonged labor (
D) can increase the risk of infection due to prolonged exposure to bacteria, but it is not as direct a risk factor as a midline episiotomy.