LPN LPN
ATI Maternal Newborn
1. A client has postpartum psychosis. Which of the following actions is the nurse's priority?
- A. Reinforce the importance of taking antipsychotics as prescribed
- B. Ask the client if they have thoughts of harming themselves or their infant
- C. Monitor the infant for signs of failure to thrive
- D. Check the client's medical record for a history of bipolar disorder
Correct answer: B
Rationale: In a situation where a client has postpartum psychosis, the priority action for the nurse is to ask the client if they have thoughts of harming themselves or their infant. This is crucial to assess the risk of harm and ensure the safety of the client and the infant. While reinforcing the importance of taking antipsychotics as prescribed is essential for treatment, safety concerns take precedence. Monitoring the infant for signs of failure to thrive is important for the infant's well-being but is not the priority when the immediate safety of the client and infant is at risk. Checking the client's medical record for a history of bipolar disorder is relevant for understanding the client's medical history but is not the priority when addressing current safety concerns.
2. A newborn is small for gestational age (SGA). Which of the following findings is associated with this condition?
- A. Moist skin
- B. Protruding abdomen
- C. Gray umbilical cord
- D. Wide skull sutures
Correct answer: D
Rationale: Wide skull sutures are a common finding in newborns who are small for gestational age (SGA) due to reduced intrauterine growth. This occurs because the skull bones do not grow at the same rate as the brain, leading to wider sutures. Moist skin, a protruding abdomen, and a gray umbilical cord are not typically associated with being small for gestational age.
3. When checking for the Moro reflex in a newborn, what action should the nurse take?
- A. Hold the newborn vertically under arms and allow one foot to touch the table.
- B. Stimulate the pads of the newborn's hands with stroking or massage.
- C. Stimulate the soles of the newborn's feet on the outer lateral surface of each foot.
- D. Hold the newborn in a semi-sitting position, then allow the newborn's head and trunk to fall backward.
Correct answer: D
Rationale: The correct action to check for the Moro reflex in a newborn is to hold the newborn in a semi-sitting position and then allow the newborn's head and trunk to fall backward. The Moro reflex is elicited by a sudden loss of support or a loud noise. The normal response involves symmetrical abduction and extension of the arms, followed by their return to the midline in an embracing motion. Choices A, B, and C do not describe the correct method for assessing the Moro reflex and are therefore incorrect.
4. When assessing a newborn with respiratory distress syndrome who received synthetic surfactant, which parameter should the nurse monitor to evaluate the newborn's condition?
- A. Oxygen saturation
- B. Body temperature
- C. Serum bilirubin
- D. Heart rate
Correct answer: A
Rationale: In a newborn with respiratory distress syndrome who has received synthetic surfactant, monitoring oxygen saturation is crucial to evaluate the effectiveness of the treatment. Oxygen saturation levels provide valuable information about the newborn's respiratory status and the adequacy of gas exchange. Changes in oxygen saturation can indicate improvements or deterioration in the newborn's condition following the administration of synthetic surfactant. Monitoring oxygen saturation helps the nurse assess the newborn's response to treatment and make timely interventions if needed. Body temperature, serum bilirubin, and heart rate are important parameters to monitor in newborns for other conditions but are not specific indicators of the effectiveness of synthetic surfactant in treating respiratory distress syndrome.
5. When assisting a client with breastfeeding, which of the following reflexes will promote the newborn to latch?
- A. Babinski
- B. Rooting
- C. Moro
- D. Stepping
Correct answer: B
Rationale: The correct answer is B: Rooting. The rooting reflex is crucial in newborns as it helps them locate the nipple for feeding. This reflex involves turning the head towards a stimulus that touches the cheek or mouth, aiding in the process of latching onto the breast for breastfeeding. The Babinski reflex is the fanning out and curling of the toes when the sole of the foot is stroked, the Moro reflex is the startle reflex in response to a sudden noise or movement, and the stepping reflex is the appearance of taking steps when an infant is held upright with feet touching a solid surface. Therefore, choices A, C, and D are incorrect as they do not play a direct role in promoting a newborn to latch during breastfeeding.
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