ATI LPN
ATI PN Maternal Newborn 2023 II Questions
Extract:
A nurse is caring for a client who is postpartum and has inverted nipples.
Question 1 of 5
Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Placing breast shells in the client's bra helps to draw out inverted nipples by applying gentle pressure, making breastfeeding easier. They also protect the nipples from friction and irritation.
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 2 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.
Extract:
A nurse is assisting with the care of a client who is in active labor. The fetal monitor tracing shows late decelerations.
Question 3 of 5
Which of the following actions should the nurse take first?
Correct Answer: B
Rationale: Turning the client onto their side is correct. This intervention can improve blood flow to the fetus and reduce the pressure on the vena cava, potentially alleviating late decelerations.
Extract:
A nurse is reinforcing teaching about breastfeeding with the mother of a newborn.
Question 4 of 5
Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: Ensuring the newborn empties the first breast allows them to receive the nutrient-rich hindmilk, which is crucial for growth.
Extract:
A nurse is caring for a client who is postpartum and has an episiotomy.
Question 5 of 5
Which of the following actions should the nurse take?
Correct Answer: D
Rationale: Alternating warm and ice packs to the site every 2 hours for the first 24 hours postpartum is correct. This method helps manage pain and swelling effectively, promoting healing and comfort for the client.