ATI Custom PNU Maternity Fall 2023 | Nurselytic

Questions 48

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ATI Custom PNU Maternity Fall 2023 Questions

Extract:

A nurse is assisting a client with breastfeeding her newborn.


Question 1 of 5

The nurse should explain that which of the following reflexes will initiate sucking?

Correct Answer: A

Rationale: The correct answer is A: Rooting. When the cheek or lip is touched, the infant turns the head toward the stimulus and opens the mouth to suck. This reflex helps initiate sucking during breastfeeding. Moro reflex (
B) is a startle reflex, stepping reflex (
C) is for walking, and Babinski reflex (
D) is for assessing neurological function.

Choices E, F, G are not applicable.

Extract:

A nurse is caring for a client who is postpartum.


Question 2 of 5

Which of the following findings is an indication for the nurse to administer Rho(D) immune globulin?

Correct Answer: A

Rationale: The correct answer is A. Rho(
D) immune globulin is administered to Rh-negative mothers who give birth to Rh-positive babies to prevent sensitization of the mother's immune system. If the mother's blood is exposed to Rh-positive blood during birth, she may develop antibodies that can harm future Rh-positive pregnancies.

Choices B, C, and D do not involve the Rh incompatibility issue, so Rho(
D) immune globulin is not indicated.

Extract:

A nurse is reinforcing teaching about quickening with a client who is at 6 weeks of gestation.


Question 3 of 5

Which of the following information should the nurse include?

Correct Answer: B

Rationale: The correct answer is B: Quickening occurs between the fourth and fifth months of pregnancy. Quickening refers to the first fetal movements felt by the mother, typically occurring around 18-22 weeks of pregnancy. This is due to the development of the fetal nervous system and muscle coordination.

Choices A, C, and D are incorrect because quickening does not occur as early as the first or second months of pregnancy, immediately after implantation, or during the last weeks of pregnancy. It is important for the nurse to provide accurate information to ensure proper understanding and expectations during pregnancy.

Extract:

A nurse is caring for a client who is 2 weeks postpartum. The client tells the nurse, 'I feel really down and sad lately. I have no energy and I feel like I'm going to cry.'


Question 4 of 5

Which of the following actions should the nurse take first?

Correct Answer: D

Rationale: The correct action for the nurse to take first is using a postpartum depression-screening tool with the client (
Choice
D). This is the priority because postpartum depression can have serious consequences for both the mother and the baby. Screening for postpartum depression allows for early identification and intervention, which is crucial for the well-being of the mother and infant. Counseling (
Choice
A) may be needed, but addressing the possibility of postpartum depression should come first. Requesting antidepressant medication (
Choice
B) should only be considered after a proper assessment and diagnosis. Reinforcing teaching about rest and sleep (
Choice
C) is important but addressing mental health concerns takes precedence.

Extract:


Question 5 of 5

Which of the following reflects the normal sequence of postpartum vaginal discharge?

Correct Answer: D

Rationale: The correct sequence is Lochia rubra, lochia serosa, lochia alba. Lochia rubra consists of blood and tissue debris, lasting for the first 3-4 days postpartum. Lochia serosa is pinkish or brownish and persists from days 4-10. Lochia alba is the final stage, yellowish-white discharge lasting up to 6 weeks. This sequence reflects the normal progression of postpartum vaginal discharge, starting with the presence of blood and ending with a lighter-colored discharge as the healing process progresses.
Choice D is correct.

Choices A, B, and C have the sequence of colors in the incorrect order, not following the typical progression of postpartum discharge.

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