LPN LPN
ATI Maternal Newborn
1. A client who is breastfeeding and has mastitis is receiving teaching from the nurse. Which of the following responses should the nurse make?
- A. Limit the amount of time the infant nurses on each breast.
- B. Nurse the infant only on the unaffected breast until resolved.
- C. Completely empty each breast at each feeding or use a pump.
- D. Wear a tight-fitting bra until lactation has ceased.
Correct answer: C
Rationale: The correct response is to completely empty each breast at each feeding or use a pump to prevent milk stasis, which can exacerbate mastitis. By ensuring proper drainage of the affected breast, the client can help alleviate symptoms and promote healing. Choice A is incorrect because limiting feeding time can lead to inadequate drainage, potentially worsening the condition. Choice B is incorrect as it can cause engorgement in the unaffected breast, leading to further complications. Choice D is incorrect as wearing a tight-fitting bra can worsen symptoms by putting pressure on the affected breast, hindering proper drainage and exacerbating mastitis.
2. A client who is postpartum and has thrombophlebitis requires nursing interventions. Which of the following nursing interventions should the nurse recommend?
- A. Apply cold compresses to the affected extremity
- B. Massage the affected extremity
- C. Allow the client to ambulate
- D. Measure leg circumferences
Correct answer: D
Rationale: Measuring leg circumferences is crucial in monitoring for changes that may indicate worsening of thrombophlebitis, such as increased swelling or redness. This assessment helps in early detection of complications and timely intervention, reducing the risk of further health problems for the client. Applying cold compresses may worsen the condition by causing vasoconstriction. Massaging the affected extremity can dislodge a clot and lead to embolism. Allowing the client to ambulate may increase the risk of clot migration.
3. During Leopold maneuvers on a client in labor, which technique should be used by the nurse to identify the fetal lie?
- A. Apply palms of both hands to sides of the uterus
- B. Palpate the fundus of the uterus
- C. Grasp the lower uterine segment between thumb and fingers
- D. Stand facing the client's feet with fingertips outlining cephalic prominence
Correct answer: B
Rationale: Palpating the fundus of the uterus during Leopold maneuvers is crucial to identify the fetal lie. This technique allows the nurse to determine the position of the baby's back and locate the fetal heart sounds, aiding in assessing the fetal lie. Choices A, C, and D are incorrect as they do not directly relate to identifying the fetal lie during Leopold maneuvers. Applying palms to the sides of the uterus or grasping the lower uterine segment do not provide the necessary information about the fetal lie. Standing facing the client's feet and outlining cephalic prominence is more related to assessing the fetal presentation, not the fetal lie.
4. A client in the delivery room just delivered a newborn, and the nurse is planning to promote parent-infant bonding. What should the nurse prioritize?
- A. Encourage the parents to touch and explore the newborn's features
- B. Limit noise and interruptions in the delivery room
- C. Place the newborn at the client's breast
- D. Position the newborn skin-to-skin on the client's chest
Correct answer: D
Rationale: Positioning the newborn skin-to-skin on the client's chest is the priority action to promote warmth, regulate the newborn's heart rate and breathing, and enhance parent-infant bonding. This method facilitates early bonding, stabilizes the baby's temperature, and encourages breastfeeding initiation. Encouraging parents to touch and explore the newborn's features is important but not the priority at this moment. Limiting noise and interruptions can be beneficial but not as crucial as skin-to-skin contact for bonding. Placing the newborn at the client's breast is essential for breastfeeding but should come after the initial skin-to-skin contact for bonding and temperature regulation.
5. A client is receiving postpartum discharge teaching after being vaccinated for varicella due to lack of immunity. Which statement by the client indicates understanding?
- A. I will need a second vaccination at my postpartum visit.
- B. I need a second vaccination at my postpartum visit.
- C. I was given the vaccine to protect myself from varicella.
- D. I will be tested in 3 months to confirm my immunity status.
Correct answer: B
Rationale: The correct answer is B because the client needs a second varicella vaccination at the postpartum visit to ensure immunity. Option A is incorrect as it implies a future need for a second vaccination without a clear action plan. Option C is incorrect as the varicella vaccine is primarily for the client's protection, not others. Option D is not the appropriate action as waiting to be tested for immunity delays the necessary second vaccination.
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