ATI LPN
ATI LPN Maternal Newborn 2023 IV Questions
Extract:
A charge nurse is discussing risk factors for postpartum hemorrhage with a newly licensed nurse.
Question 1 of 5
Which of the following conditions should the nurse include as a risk factor?
Correct Answer: C
Rationale: Retained placental fragments prevent uterine contraction, a significant risk factor for postpartum hemorrhage.
Extract:
Nurses' Notes (Postpartum Assessment) 1200: The client successfully delivered a viable newborn via vaginal delivery. 1300: The client reports feeling tired and anxious. Assessment reveals the fundus is deviated to the left, boggy, and located 1 cm above the umbilicus. The perineal pad is saturated with lochia rubra, indicating excessive bleeding. The client reports an inability to ambulate to the bathroom due to residual numbness from the labor epidural. Pain is reported as 0 on a scale of 0 to 10. Fundal massage performed during assessment has yielded no improvement in uterine tone. A nurse is caring for a 36-year-old female client in the labor and delivery unit at 39 weeks of gestation admitted for evaluation of postpartum bleeding following a vaginal delivery.
Question 2 of 5
Select the 2 interventions the nurse should perform immediately.
Correct Answer: B,C
Rationale: Inserting a catheter empties the bladder, aiding uterine contraction; methylergonovine stimulates contractions to reduce bleeding from a boggy uterus.
Extract:
Vital Signs 0830: Temperature: 36.9°C (98.4°F), Heart rate: 89/min, Respiratory rate: 16/min, Blood pressure: 110/60 mm Hg, Oxygen saturation: 97% on room air. 0930: Temperature: 38.2°C (100.8°F), Heart rate: 90/min, Respiratory rate: 20/min, Blood pressure: 120/68 mm Hg, Oxygen saturation: 98% on room air. A nurse is caring for a 27-year-old female client at 32 weeks gestation in the labor and delivery unit admitted for evaluation of a suspected infection during labor.
Question 3 of 5
For each potential provider prescription, click to specify whether the prescription is anticipated or contraindicated for the client: A. Betamethasone 12 mg IM now and repeat in 24 hr, B. Position the client supine, C. Terbutaline 0.25 mg Subcutaneous now, D. Collect a urine sample.
| Prescription | Anticipated | Contraindicated |
|---|---|---|
| Betamethasone 12 mg IM now and repeat in 24 hr (Anticipated) | ||
| Position the client supine (Contraindicated) | ||
| Terbutaline 0.25 mg Subcutaneous now (Anticipated) | ||
| Collect a urine sample (Anticipated) |
Correct Answer: A,C,D
Rationale: Betamethasone aids fetal lung maturity, terbutaline delays preterm labor, and urine sample assesses infection; supine position risks uterine perfusion.
Extract:
A nurse is caring for a 37-year-old female client in the labor and delivery unit in early labor with contractions and reports feeling fetal movement.
Question 4 of 5
The nurse should anticipate a provider's prescription for ___ due to the client’s ___.
Correct Answer: A
Rationale: Continuous fetal monitoring ensures observation of fetal heart rate and labor progress in a term client with regular contractions.
Extract:
Nurses' Notes 0830: The client is a gravida 2 para 1 at 30 weeks of gestation. Reports low back pain and abdominal cramping for the past two days. History includes cesarean birth for breech presentation. Reports smoking half a pack of cigarettes per day. BMI is greater than 30. The client is grimacing and has a positive report of fetal movement. External electronic fetal monitoring applied, showing fetal heart rate of 148/min. The abdomen is soft and nontender to palpation. 0845: Uterine contractions every 2–3 minutes, moderate in strength. Sterile vaginal examination reveals cervix dilated to 2 cm, 80% effaced, and -1 station. Mucous vaginal discharge and a small amount of bright red bleeding noted on the perineal pad. Vital Signs: Temperature: 36.8°C (98.2°F), Heart rate: 98/min, Respiratory rate: 18/min, Blood pressure: 112/68 mm Hg, Oxygen saturation: 98% on room air.
Question 5 of 5
For each finding, click to specify if the client finding is consistent with placenta previa, preterm labor, or abruptio placentae: A. Pain report, B. Uterine contractions, C. Perineal pad findings, D. Cervical dilation.
| Findings | Placenta Previa | Preterm Labour | Abruptio Placentae |
|---|---|---|---|
| Pain report | |||
| Uterine contractions | |||
| Perineal pad findings | |||
| Cervical dilation |
Correct Answer: A,B,C,D
Rationale: Pain and contractions suggest preterm labor/abruptio placentae; bleeding fits all three; dilation aligns with preterm labor/placenta previa.