LPN LPN
ATI Maternal Newborn Proctored
1. A client who underwent an amniotomy is now in the active phase of the first stage of labor. Which of the following actions should the nurse implement with this client?
- A. Maintain the client in the lithotomy position.
- B. Perform vaginal examinations frequently.
- C. Remind the client to bear down with each contraction.
- D. Encourage the client to empty her bladder every 2 hours.
Correct answer: D
Rationale: Encouraging the client to empty her bladder every 2 hours is essential during labor to prevent bladder distention, which can hinder labor progress and cause discomfort. A distended bladder can also lead to potential complications such as uterine atony or increased risk of infection. Choice A is incorrect as maintaining the client in the lithotomy position is not necessary during the active phase of the first stage of labor and may not be comfortable for the client. Choice B is incorrect because performing vaginal examinations frequently can increase the risk of introducing infection and disrupt the natural progress of labor. Choice C is incorrect as bearing down with each contraction is typically reserved for the second stage of labor when the cervix is fully dilated, not during the active phase of the first stage.
2. A healthcare professional is assessing a newborn immediately following a scheduled cesarean delivery. Which of the following assessments is the healthcare professional's priority?
- A. Respiratory distress
- B. Hypothermia
- C. Accidental lacerations
- D. Acrocyanosis
Correct answer: A
Rationale: The correct answer is A: Respiratory distress. Assessing for respiratory distress is the priority when evaluating a newborn after a cesarean delivery. Newborns born via cesarean section are at higher risk for respiratory complications, making it crucial to monitor their breathing and ensure proper oxygenation immediately after birth. Choice B, hypothermia, is important too but assessing breathing takes precedence to ensure adequate oxygen supply. Choices C and D, accidental lacerations and acrocyanosis, are not the immediate priorities following a cesarean delivery.
3. When advising a woman considering pregnancy on nutritional needs to reduce the risk of giving birth to a newborn with a neural tube defect, what information should the nurse include?
- A. Limit alcohol consumption.
- B. Increase intake of iron-rich foods.
- C. Consume foods fortified with folic acid.
- D. Avoid foods containing aspartame.
Correct answer: C
Rationale: The correct answer is C: Consume foods fortified with folic acid. Folic acid plays a crucial role in preventing neural tube defects. It is advised to consume foods fortified with folic acid or take a supplement containing at least 400 micrograms of folic acid daily. This nutrient is essential for the developing fetus and can significantly reduce the risk of neural tube defects when taken before and during early pregnancy. Choices A, B, and D are incorrect. While limiting alcohol consumption is important during pregnancy, it is not directly related to reducing the risk of neural tube defects. Increasing intake of iron-rich foods is essential for preventing anemia but is not specifically linked to neural tube defects. Avoiding foods containing aspartame is generally recommended, but it is not directly related to reducing the risk of neural tube defects.
4. A client who is postpartum received methylergonovine. Which of the following findings indicates that the medication was effective?
- A. Increase in blood pressure
- B. Fundus firm to palpation
- C. Increase in lochia
- D. Report of absent breast pain
Correct answer: B
Rationale: Methylergonovine is used to prevent or treat postpartum hemorrhage by contracting the uterus. A firm fundus indicates effective uterine contraction and less bleeding. Therefore, the correct answer is a firm fundus to palpation. The increase in blood pressure (Choice A) is not a typical finding associated with the effectiveness of methylergonovine. Increase in lochia (Choice C) may indicate excessive bleeding rather than the medication's effectiveness. Absence of breast pain (Choice D) is not directly related to the medication's effectiveness in treating postpartum hemorrhage.
5. A client who is at 6 weeks of gestation with her first pregnancy asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make?
- A. This will occur during the last trimester of pregnancy.
- B. This will happen by the end of the first trimester of pregnancy.
- C. This will occur between the fourth and fifth months of pregnancy.
- D. This will happen once the uterus begins to rise out of the pelvis.
Correct answer: C
Rationale: Quickening, which is the first perception of fetal movements by the mother, typically occurs between the fourth and fifth months of pregnancy, around 18-20 weeks of gestation. Choice C is correct as it provides the client with accurate information about the expected timing of this significant milestone in her pregnancy. Choices A, B, and D are incorrect because quickening does not happen during the last trimester, by the end of the first trimester, or once the uterus begins to rise out of the pelvis. The correct timeframe for quickening is during the second trimester, specifically between the fourth and fifth months.
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