LPN LPN
ATI Maternal Newborn
1. A client at 28 weeks of gestation received terbutaline. Which of the following findings should the nurse expect?
- A. Fetal heart rate 100/min
- B. Weakened uterine contractions
- C. Enhanced production of fetal lung surfactant
- D. Maternal blood glucose 63 mg/dL
Correct answer: B
Rationale: Terbutaline is a tocolytic medication that works by relaxing the uterine muscles, leading to weakened uterine contractions. This effect helps to prevent preterm labor. Therefore, the nurse should expect weakened uterine contractions in a client who has received terbutaline at 28 weeks of gestation. Choices A, C, and D are incorrect. Terbutaline administration would not directly affect the fetal heart rate, enhance fetal lung surfactant production, or cause maternal hypoglycemia.
2. A nurse concludes that the parent of a newborn is not showing positive indications of parent-infant bonding. The parent appears very anxious and nervous when asked to bring the newborn to the other parent. Which of the following actions should the nurse use to promote parent-infant bonding?
- A. Hand the parent the newborn and suggest that they change the diaper.
- B. Ask the parent why they are so anxious and nervous.
- C. Tell the parent that they will grow accustomed to the newborn.
- D. Provide reinforcement about infant care when the parent is present.
Correct answer: D
Rationale: Providing reinforcement about infant care when the parent is present can help alleviate anxiety and promote positive parent-infant bonding. By offering guidance and support while the parent is interacting with the newborn, the nurse can help build the parent's confidence and strengthen the bond between the parent and the infant. Choice A is not ideal as it does not address the parent's anxiety and may increase stress levels. Choice B focuses on the parent's emotions without providing direct support for bonding. Choice C is dismissive and does not offer practical assistance in fostering bonding between the parent and the infant.
3. A client is being discharged after childbirth. At 4 weeks postpartum, the client should contact the provider for which of the following client findings?
- A. Scant, non-odorous white vaginal discharge
- B. Uterine cramping during breastfeeding
- C. Sore nipple with cracks and fissures
- D. Decreased response with sexual activity
Correct answer: C
Rationale: Sore nipples with cracks and fissures should be reported to the provider as this can indicate improper breastfeeding techniques or infection, which requires medical evaluation and intervention to prevent further complications such as mastitis or decreased milk supply. Scant, non-odorous white vaginal discharge is a normal finding postpartum. Uterine cramping during breastfeeding is also common due to oxytocin release. Decreased response with sexual activity may be expected at 4 weeks postpartum due to hormonal changes and fatigue, but it is not typically a concern that needs immediate medical attention.
4. A client who is 2 days postpartum has a saturated perineal pad with bright red lochia containing small clots. What should the nurse document in the client's medical record?
- A. Moderate lochia rubra
- B. Excessive lochia serosa
- C. Light lochia rubra
- D. Scant lochia serosa
Correct answer: A
Rationale: The correct answer is 'Moderate lochia rubra.' On the second day postpartum, it is normal for lochia to be bright red and contain small clots, indicating moderate lochia rubra. This amount of bleeding is expected as the uterus continues to shed its lining after childbirth. Excessive lochia serosa, light lochia rubra, and scant lochia serosa do not accurately reflect the described scenario. Excessive lochia serosa is more characteristic of a later postpartum period, while light and scant lochia serosa are not consistent with the bright red color and small clots observed in this case.
5. When reinforcing teaching with new parents on bathing a newborn, a nurse observes a bluish-brown marking across the newborn's lower back. Which of the following statements should the nurse make concerning the variation?
- A. This is more commonly seen in newborns who have dark skin.
- B. This is a finding indicating hyperbilirubinemia.
- C. This is a forceps mark from an operative delivery.
- D. This is related to prolonged birth or trauma during delivery.
Correct answer: A
Rationale: A bluish-brown marking across the lower back is more commonly seen in newborns with dark skin. These markings are known as Mongolian spots and are benign. They are not related to hyperbilirubinemia, forceps marks, or trauma during delivery. Choice B is incorrect because hyperbilirubinemia presents as jaundice, not as a bluish-brown marking. Choice C is incorrect because forceps marks would have a different appearance and location. Choice D is incorrect as Mongolian spots are not related to prolonged birth or trauma during delivery.
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