ATI LPN Maternal Newborn 2023

Extract:

A nurse is contributing to the plan of care for a newborn who requires phototherapy for hyperbilirubinemia.

Question 1 of 5

Which of the following interventions should the nurse recommend including in the plan?

A. Reposition the newborn every 2 to 3 hr. B. Monitor the newborn's blood glucose level every 2 hr. C. Give the newborn 30 ml of distilled water after each feeding. D. Apply a water-based ointment to the newborn's skin every 4 to 6 hr.

Correct Answer: A

Rationale: Repositioning the newborn every 2 to 3 hours helps ensure uniform exposure to the phototherapy lights, maximizing the effectiveness of the treatment. This prevents uneven distribution of light and reduces the risk of pressure ulcers or skin breakdown from prolonged immobility.

Extract:

A nurse in a provider's office is collecting data from a client who is at 34 weeks of gestation and reports having a sudden gush of vaginal fluid.

Question 2 of 5

Which of the following manifestations is the priority?

A. Maternal temperature 36.3Â°C (101) B. Amniotic fluid with meconium noted C. Fetal heart tones 98/min D. Foul smelling vaginal discharge

Correct Answer: C

Rationale: In this scenario, the priority is to assess the well-being of the fetus. Fetal heart tones provide critical information about fetal status, indicating whether the baby is experiencing any distress or compromise. A fetal heart rate of 98 beats per minute (bpm) is below the normal range (110-160 bpm), suggesting potential fetal distress that requires immediate attention.

Extract:

A nurse is assisting with the care of a client who is in labor and has an epidural infusion for pain management. The client's blood pressure is 80/40 mm Hg.

Question 3 of 5

Which of the following actions should the nurse take?

A. Assist the client to empty her bladder. B. Place the client in knee chest position C. Administer methylergonovine IM D. Give a bolus of lactated Ringer's

Correct Answer: D

Rationale: The client's blood pressure is low (80/40 mm Hg), indicating hypotension, a common side effect of epidural anesthesia during labor. Administering a bolus of intravenous fluids, such as lactated Ringer's solution, is the initial intervention to increase intravascular volume, improving blood pressure and perfusion to vital organs.

Extract:

Question 4 of 5

A nurse is reinforcing teaching with a client about laboratory testing during pregnancy. Which of the following statements should the nurse include in the teaching?

A. A Papanicolaou test will be performed to detect the presence of herpes simplex type 1. B. A group B streptococcus screening will be performed to determine the presence of STs. C. A multiple marker screening will be performed to identify neural tube defects. D. A glucose tolerance test will be performed to predict hyperglycemia in your baby

Correct Answer: C

Rationale: Multiple marker screening, also known as maternal serum screening or quad screen, is a routine prenatal test performed between 15 and 20 weeks of gestation. It helps identify the risk of certain chromosomal abnormalities, including neural tube defects like spina bifida and anencephaly.

Extract:

A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth.

Question 5 of 5

Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?

A. Apply elastic stockings before the client gets out of bed B. Have the client ambulate as often as possible. C. Apply warm, moist packs to the client's lower legs D. Administer NSAIDs every 4 to 6 hr.

Correct Answer: B

Rationale: Ambulation helps prevent thrombophlebitis by promoting blood circulation in the lower extremities. Moving the legs and walking encourage the calf muscles to contract, which aids in pushing blood back towards the heart, reducing the risk of blood stasis and clot formation.

ATI LPN Maternal Newborn 2023 | Nurselytic

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