Questions 74

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ATI Maternal Newborn Exam Final Questions

Extract:

A client who is 2 hr postpartum following a vaginal birth


Question 1 of 5

Which of the following findings indicates the client's bladder is distended?

Correct Answer: A

Rationale: A distended bladder displaces the fundus to the right due to pressure on the uterus. Contractions, thirst, and minimal lochia are not related to bladder distension.

Extract:

A client who is 2 days postpartum, is breastfeeding, and reports nipple soreness


Question 2 of 5

Which of the following measures should the nurse suggest to reduce discomfort during breastfeeding?

Correct Answer: A,B,C

Rationale: A: Starting with the less sore nipple reduces pain as the infant sucks more vigorously initially. B: Changing positions distributes pressure, preventing further irritation. C: Breast milk has antibacterial properties that soothe and heal sore nipples. D: Massaging may increase irritation. E: Breast pads manage leakage but do not directly reduce soreness.

Extract:

A client who is in the first stage of labor, umbilical cord protruding from the vagina


Question 3 of 5

Which of the following actions should the nurse perform first?

Correct Answer: A

Rationale: Inserting a gloved hand to relieve cord pressure prevents fetal hypoxia in cord prolapse, an emergency. Other actions follow to maintain cord viability and prepare for delivery.

Extract:

A client who is in her first trimester of pregnancy, upset because she and her husband planned this pregnancy but she is having doubts and second thoughts


Question 4 of 5

What is an appropriate response by the nurse?

Correct Answer: D

Rationale: Validating ambivalent feelings normalizes the client's experience, reducing anxiety. Counseling, family discussions, or dismissive reassurance are less supportive initially.

Extract:

A newborn who is small for gestational age (SGA)


Question 5 of 5

Which of the following is the priority intervention the nurse should include in the newborn's plan of care?

Correct Answer: C

Rationale: SGA newborns are at high risk for hypoglycemia due to limited glycogen stores, making blood glucose monitoring the priority. Temperature, weight, and stimulation are important but secondary.

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