ATI LPN
ATI PN Maternal Newborn 2023 II Questions
Extract:
A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse notes maternal exposure to rubella during pregnancy.
Question 1 of 5
After delivery, the nurse should monitor the newborn for which of the following conditions?
Correct Answer: D
Rationale: Deafness is a significant risk associated with congenital rubella syndrome. Rubella can damage the developing auditory system in utero, leading to permanent hearing loss in the newborn.
Extract:
A nurse is contributing to the plan of care for a client who is in early labor and reports low-back pain during contractions.
Question 2 of 5
Which of the following interventions should the nurse include in the plan?
Correct Answer: A
Rationale: Assisting the client's partner to apply counterpressure to the sacrum can help alleviate the low-back pain associated with early labor by providing direct pressure to the area experiencing discomfort.
Extract:
A nurse is caring for a newborn who had a circumcision 4 hr ago. During a diaper change, the nurse notes bright red blood oozing from the incision.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Applying gentle pressure using a sterile dry gauze pad is the appropriate action to control bleeding. Applying direct pressure helps to stop the bleeding and allows for proper assessment of the wound.
Extract:
Vital Signs: Heart rate: 80/min, Temperature: 37.2°C (99°F), Blood pressure: 120/80 mm Hg, Respiratory rate: 18/min. Diagnostic Results: January 8 / 0900: Oral Glucose Tolerance Test with 75-g glucose load - 190 mg/dL (Normal: less than 180 mg/dL). February 8 / 0900: Fasting: 110 mg/dL (Normal: less than 110 mg/dL), 1000: 220 mg/dL (Normal: less than 180 mg/dL), 1100: 165 mg/dL (Normal: less than 140 mg/dL), 1200: 142 mg/dL (Normal: 70 to 115 mg/dL). Nurses' Notes: On January 8 at 0900, the fundal height was measured at 22 cm and fetal heart tones were 150/min. On February 8 at 0900, the fundal height was measured at 27 cm and fetal heart tones were 145/min. The client reports positive fetal movement, denies abdominal cramping, vaginal bleeding, and leaking of fluids. The client also denies headaches, visual disturbances, and epigastric pain. History and Physical: The client is a 32-year-old female, gravida 2 para 1, with a history of gestational diabetes mellitus (GDM) during her previous pregnancy. She is currently at 28 weeks of gestation. The client reports no other significant medical history. She is adhering to a diabetic diet and taking insulin as prescribed.
Question 4 of 5
Complete the following sentence by using the lists of options. The nurse should prepare to reinforce teaching with the client about a ___ with a prescription of ___
Correct Answer: A
Rationale: The nurse should prepare to reinforce teaching with the client about a diabetic diet with a prescription of insulin therapy. Elevated glucose levels indicate the need for continued dietary and insulin management.
Extract:
Vital Signs: Heart rate: 132/min, Axillary temperature: 36° C (96.8° F), Respiratory rate: 72/min, Weight: 4,366 g (9 lb 10 oz). History and Physical: The newborn was delivered via spontaneous vaginal birth at 41 weeks of gestation. The mother is gravida 2 para 2 with a history of syphilis in the first trimester, treated with penicillin, and no reoccurrence during the pregnancy. The mother also reports intermittent cannabis use during pregnancy. Diagnostic Results: Blood type: A+, Venereal Disease Research Laboratory (VDRL): negative, Rapid Plasma Reagin (RPR): negative, Urine drug screen: Positive for marijuana, negative for opiates, cocaine, amphetamines, or barbiturates. Nurses' Notes: The newborn is lying in a bassinet, lightly swaddled. The newborn is noted to be jittery with a weak cry when disturbed. Extremities are mottled with acrocyanosis. Respirations are rapid and unlabored.
Question 5 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Correct Answer:
Rationale: Hypoglycemia is most likely given the newborn's jitteriness, weak cry, and mottled extremities. Actions: Feed the newborn to increase blood sugar; monitor phototherapy for jaundice. Parameters: Assess skin integrity; monitor bilirubin levels.