LPN LPN
ATI Maternal Newborn
1. A client who is at 42 weeks gestation and in labor asks the nurse what to expect because the baby is postmature. Which of the following statements should the nurse make?
- A. Your baby will have excess baby fat.
- B. Your baby will have flat areola without breast buds.
- C. Your baby's heels will easily move to his ears.
- D. Your baby's skin will have a leathery appearance.
Correct answer: D
Rationale: The correct answer is D: 'Your baby's skin will have a leathery appearance.' Postmature infants, born after 42 weeks of gestation, may have a leathery appearance of the skin due to prolonged exposure to amniotic fluid. This occurs as the protective vernix caseosa is shed, and the skin loses its protective covering, leading to a wrinkled and dry appearance. Choices A, B, and C are incorrect. Excess baby fat is not a typical characteristic of postmature infants. Flat areola without breast buds and the ability of the baby's heels to easily move to his ears are not associated with postmaturity.
2. 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.
3. When reinforcing discharge teaching to the parents of a newborn regarding circumcision care, which statement made by a parent indicates an understanding of the teaching?
- A. The circumcision will heal within a couple of days.
- B. I should not remove the yellow mucus that will form.
- C. I will clean the penis with each diaper change.
- D. I will give him a tub bath within a couple of days.
Correct answer: C
Rationale: The correct answer is C because cleaning the penis with each diaper change is essential for preventing infection and promoting healing after circumcision. This practice helps maintain good hygiene and reduces the risk of complications. Removing the yellow mucus or giving a tub bath too soon can interfere with the healing process and increase the likelihood of infection. Choice A is incorrect because circumcision healing usually takes about a week or more, not just a couple of days. Choice B is incorrect because parents should gently clean the area, including removing any discharge or debris as part of proper care. Choice D is incorrect because tub baths should be avoided until the circumcision is fully healed to prevent infection.
4. 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.
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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