ATI RN Maternal Newborn 2023 IV

Extract:

A nurse is providing teaching to a postpartum client who has a prescription for a rubella immunization.

Question 1 of 5

Which of the following client statements Indicates understanding of the teaching?

A. I should avoid breastfeeding for 2 weeks following the immunization.' B. I should avoid becoming pregnant for at least 1 month following the immunization.' C. I will report joint pain that develops after the immunization to my provider immediately.' D. I will receive a series of three immunizations and each one will be a month apart.'

Correct Answer: B

Rationale: Avoiding pregnancy for 1 month post-rubella vaccination prevents potential fetal risk from the live vaccine. Breastfeeding is safe, joint pain is mild and expected, and itâ€™s a single dose.

Extract:

A nurse is caring for a client who is postpartum and has a perineal laceration.

Question 2 of 5

Which of the following findings places the client at risk for delayed wound healing?

A. The client cleans the perineum with a squeeze bottle after urinating. B. The client's perineal suture line is well-approximated. C. The client is changing the perineal pad once daily. D. The client is using witch hazel pads on the perineum.

Correct Answer: C

Rationale: Changing the perineal pad only once daily increases infection risk due to moisture buildup, delaying healing. Cleaning, approximation, and witch hazel support healing.

Extract:

A nurse is assessing a newborn who was born via a forceps-assisted birth.

Question 3 of 5

Which of the following findings should the nurse identify as an injury caused by the forceps?

A. Depressed anterior fontanel B. Epicanthal folds C. Facial asymmetry D. Uneven gluteal skinfolds E. Jitteriness

Correct Answer: C

Rationale: Facial asymmetry can result from forceps pressure causing bruising or nerve injury. Other findings are unrelated to forceps use.

Extract:

A nurse is planning care for a client in the postpartum unit.

Question 4 of 5

Which of the following goals should the nurse identify for the client to accomplish during the taking-in phase of postpartum adjustment?

A. The client will verbalize appropriate car seat safety. B. The client will demonstrate proper bathing of the infant. C. The client will identify individual family member roles. D. The client will have adequate nutritional intake.

Correct Answer: D

Rationale: During the taking-in phase, the focus is on maternal recovery, making adequate nutritional intake a key goal for healing and breastfeeding support.

Extract:

A nurse is caring for a client who is postpartum and just delivered a newborn who weighs 4.5 kg (10 lb).

Question 5 of 5

Which of the following manifestations should the nurse recognize as a potential sign of hemorrhage?

A. Heart rate 90/min B. Blood pressure 88/40 mm Hg C. Urinary output 40 mL/hr D. Moderate rubra lochia

Correct Answer: B

Rationale: Hypotension (88/40 mm Hg) indicates significant blood loss, a key sign of postpartum hemorrhage, especially after a large newborn delivery increasing uterine stretch risk.

ATI RN Maternal Newborn 2023 IV | Nurselytic

Nurselytic

ATI RN

ATI RN