ATI RN
ATI RN Maternal Newborn Updated 2023 Questions
Extract:
A client who is postpartum and has a perineal laceration.
Question 1 of 5
Which of the following findings places the client at risk for delayed wound healing?
Correct Answer: A
Rationale: The correct answer is A because changing the perineal pad only once daily can lead to increased moisture and potential for infection, thus delaying wound healing.
Choice B, using witch hazel pads, can actually promote wound healing due to its anti-inflammatory properties.
Choice C, cleaning the perineum with a squeeze bottle, promotes hygiene and wound healing.
Choice D, a well-approximated suture line, indicates good wound closure and does not place the client at risk for delayed healing.
Extract:
A postpartum client who has a prescription for a rubella immunization.
Question 2 of 5
Which of the following client statements indicates understanding of the teaching?
Correct Answer: D
Rationale: The correct answer is D because it demonstrates understanding of the teaching regarding the need to avoid pregnancy for at least 1 month following the immunization to prevent any potential harm to the fetus.
Choice A is incorrect because breastfeeding is not contraindicated after immunization.
Choice B is incorrect because it provides incorrect information about the immunization schedule.
Choice C is incorrect because joint pain is a common side effect of some vaccines and does not necessarily require immediate reporting.
Extract:
A newborn who has a prescription for a total serum bilirubin.
Question 3 of 5
Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct action is to puncture the lateral side of the heel for the procedure. This is because the lateral side of the heel is the recommended site for a heel stick, as it has fewer nerve endings and blood vessels, reducing the risk of injury and pain. Selecting a 21-gauge needle (option
A) is not specific to the procedure and may not be appropriate. Applying an alcohol pad after the procedure (option
B) is not recommended as it can cause unnecessary pain and irritation. Placing a cool cloth at the site before the procedure (option
C) is not necessary and may not be effective for pain relief. Puncturing the lateral side of the heel is the correct and most appropriate action for this procedure.
Extract:
A client who has a placenta previa.
Question 4 of 5
Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: The correct answer is D: Painless, vaginal bleeding. This finding is indicative of placenta previa, a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. Uterine hypertonicity (
A) suggests uterine hyperstimulation, not typically associated with placenta previa. Persistent headache (
B) is more commonly seen in conditions like preeclampsia. A firm, rigid abdomen (
C) is characteristic of uterine rupture, not placenta previa. In summary, painless vaginal bleeding is a key sign of placenta previa, distinguishing it from the other options.
Extract:
A client who is in the second stage of labor and is experiencing a shoulder dystocia.
Question 5 of 5
Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Assist the client in pulling their knees toward their abdomen. This position helps facilitate the delivery of the baby by widening the pelvic outlet, reducing pressure on the perineum, and promoting descent of the fetus. This action also eases the process of childbirth and minimizes the risk of perineal tears.
Choice B is incorrect as pressing firmly on the client's suprapubic area can increase discomfort and is not a recommended practice during labor.
Choice C, moving the client onto their hands and knees, may not be suitable for all women and does not provide the same benefits as pulling knees toward the abdomen.
Choice D, applying pressure to the client's fundus, is not recommended during labor as it can cause complications.