ATI RN Custom 2023 Fall Exam 3 | Nurselytic

Correct Answer: D

Rationale: The correct answer is D because the third stage of labor begins with the time of delivery of the fetus and ends with the time of the delivery of the placenta. This stage typically lasts around 5-30 minutes. It is important to document the timings accurately as it is crucial for monitoring the progression of labor and ensuring the safe delivery of the placenta.


Choice A is incorrect as it refers to the second stage of labor which involves full cervical dilation and delivery of the fetus.


Choice B is incorrect as it refers to the postpartum period, not the third stage of labor.


Choice C is incorrect as it does not accurately describe the end point of the third stage of labor.

Overall, the correct answer D provides the most accurate and specific documentation for the third stage of labor.

Correct Answer: C

Rationale: The correct answer is C: Dry the newborn and place it skin-to-skin on the mother. This is the priority action as it helps regulate the newborn's temperature, promotes bonding, and initiates breastfeeding. Assessing the newborn's glucose level (
A) can be done after ensuring the baby's immediate needs are met. Swaddling and placing the infant in the bassinet (
B) can wait until after skin-to-skin contact. Completing a full head-to-toe assessment (
D) is important but not immediately necessary as the newborn's basic needs should be addressed first.

Correct Answer: D

Rationale: The correct answer is D because postpartum depression is more likely to occur in women with a history of depression due to predisposing factors.
Choice A is incorrect as harming the infant is not the most common manifestation.
Choice B is incorrect as postpartum depression can occur anytime within the first year.
Choice C is incorrect as psychotic behavior is not common in postpartum depression.

Correct Answer: D

Rationale: The correct answer is D because the Apgar score is based on evaluating the newborn's heart rate, respiratory effort, muscle tone, reflex irritability, and color. Heart rate and respiratory effort assess the baby's cardiovascular and respiratory functions. Muscle tone and reflex irritability indicate the baby's neurological status. Skin color reflects the baby's overall oxygenation level. Other choices are incorrect because they do not encompass all 5 essential parameters assessed in the Apgar score.

Correct Answer: C

Rationale: The correct action for the nurse to take is to choose C: Document the findings and continue to monitor the client. This is the correct answer because it is important for the nurse to document the client's condition accurately and continue to monitor for any changes. By documenting the findings, the nurse ensures that there is a clear record of the client's status for future reference and communication with other healthcare providers. Increasing the frequency of fundal massage (choice
B) may not be necessary or appropriate based on the client's current condition. Notifying the client's provider (choice
A) may be necessary at a later stage depending on the client's progress. Encouraging the client to empty her bladder (choice
D) is important but may not be the immediate priority in this situation.