LPN LPN
ATI Maternal Newborn
1. 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.
2. 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.
3. When reinforcing teaching with a group of new parents about proper techniques for bottle feeding, which of the following instructions should be provided?
- A. Burp the newborn at the end of the feeding
- B. Hold the newborn close in a supine position
- C. Keep the nipple full of formula throughout the feeding
- D. Refrigerate any unused formula
Correct answer: C
Rationale: The correct technique for bottle feeding includes keeping the nipple full of formula throughout the feeding to prevent air from entering the baby's stomach. This helps reduce the risk of the baby swallowing air, which can lead to discomfort and colic. Therefore, maintaining a full nipple during feeding is essential for the baby's comfort and digestion. Option A is incorrect as burping should be done during the feeding to prevent excessive air intake. Option B is incorrect as the baby should be held semi-upright, not in a supine position, to reduce the risk of choking and ear infections. Option D is irrelevant to the feeding process and does not contribute to the baby's well-being.
4. 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.
5. A nurse on a labor unit is admitting a client who reports painful contractions. The nurse determines that the contractions have a duration of 1 minute and a frequency of 3 minutes. The nurse obtains the following vital signs: fetal heart rate 130/min, maternal heart rate 128/min, and maternal blood pressure 92/54 mm Hg. Which of the following is the priority action for the nurse to take?
- A. Notify the provider of the findings.
- B. Position the client with one hip elevated.
- C. Ask the client if she needs pain medication.
- D. Have the client void.
Correct answer: B
Rationale: The priority action for the nurse in this situation is to position the client with one hip elevated. This position can help improve blood flow to the placenta and stabilize blood pressure, which is crucial for both the client and the fetus during labor. It can also help optimize fetal oxygenation by improving circulation. Notifying the provider of the findings may be necessary, but ensuring proper positioning of the client takes precedence to address the immediate physiological needs. Asking the client about pain medication or having the client void are important interventions but are not the priority in this scenario where the client is experiencing painful contractions and has low blood pressure.
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