Questions 74

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ATI Nur 232 Maternity Final Exam SP24 Questions

Extract:

A nurse is assessing a client who is 4 hours postpartum following a vaginal delivery.


Question 1 of 5

Which of the following findings should the nurse identify as the priority?

Correct Answer: C

Rationale: A saturated perineal pad in 30 minutes indicates potential postpartum hemorrhage, a life-threatening condition requiring immediate attention.

Extract:

The nurse is conducting a newborn assessment and identifies a collection of blood beneath the newborn's scalp that does not cross the suture lines.


Question 2 of 5

How should the nurse document this finding?

Correct Answer: C

Rationale: Cephalohematoma is a collection of blood under the scalp that does not cross suture lines, caused by trauma during delivery.

Extract:

A nurse in a clinic is caring for a client who is 3 weeks postpartum following the birth of a healthy newborn. The client reports feeling 'down', sad, having no energy, and wanting to cry.


Question 3 of 5

Which of the following is a priority action by the nurse?

Correct Answer: C

Rationale: Asking if the client has considered harming her newborn is the priority to assess for postpartum depression and ensure the safety of the newborn and mother.

Extract:

A nurse is caring for a client who experienced a vaginal delivery 12 hr ago.


Question 4 of 5

When palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?

Correct Answer: A

Rationale: The uterine fundus is expected to be at the level of the umbilicus 12 hours post-delivery, indicating normal uterine involution.

Extract:

A newborn tests positive for the hepatitis B surface antigen.


Question 5 of 5

Which of the following should the nurse administer?

Correct Answer: B

Rationale: Administering hepatitis B immune globulin and vaccine within 12 hours of birth provides immediate and long-term protection for a newborn testing positive for hepatitis B surface antigen.

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