ATI LPN
Maternal Newborn ATI Proctored Exam
1. A healthcare provider is assisting with the care for a client who has a prescription for magnesium sulfate. The provider should recognize that which of the following are contraindications for the use of this medication? (Select all that apply)
- A. Fetal distress
- B. Cervical dilation greater than 6 cm
- C. Vaginal bleeding
- D. All of the Above
Correct answer: D
Rationale: The correct answer is D, 'All of the Above.' Magnesium sulfate should not be used in cases of fetal distress, vaginal bleeding, or cervical dilation greater than 6 cm. These conditions can be exacerbated by the administration of magnesium sulfate, leading to further complications for the client. Choice A, fetal distress, is a contraindication because magnesium sulfate can further affect the fetal heart rate. Choice B, cervical dilation greater than 6 cm, is a contraindication as magnesium sulfate can potentially suppress uterine contractions, prolonging labor. Choice C, vaginal bleeding, is a contraindication as magnesium sulfate can further increase bleeding tendencies.
2. A client has a new prescription for chlamydia. Which of the following statements should the nurse provide?
- A. This infection is treated with one dose of azithromycin.
- B. If your sexual partner has no symptoms, no medication is needed.
- C. You should avoid sexual relations for 3 days.
- D. You need to return in 6 months for retesting.
Correct answer: A
Rationale: The correct treatment for chlamydia is a one-time dose of azithromycin. It is crucial for the client to understand the correct medication regimen for effective treatment. Choice B is incorrect because treatment is necessary for the partner even if asymptomatic. Choice C is incorrect because sexual relations should be avoided until treatment is completed. Choice D is incorrect as retesting should generally occur 3 months after treatment.
3. 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.
4. A healthcare provider is preparing to administer vitamin K by IM injection to a newborn. The medication should be administered into which of the following muscles?
- A. Vastus lateralis
- B. Ventrogluteal
- C. Dorsogluteal
- D. Deltoid
Correct answer: A
Rationale: Vitamin K is typically administered in the vastus lateralis muscle of a newborn to prevent bleeding disorders. The vastus lateralis muscle is the preferred site for IM injections in infants due to its size and accessibility, allowing for easy and safe administration. The ventrogluteal and dorsogluteal sites are more commonly used in adults due to better muscle mass and less risk of injury to nearby structures. The deltoid muscle is typically used for older children and adults for IM injections, as it is a well-developed muscle suitable for injections in these populations.
5. A parent of a newborn is being taught about crib safety. Which statement by the client indicates understanding of the teaching?
- A. I will place my baby on his stomach when he is sleeping.
- B. I should remove extra blankets from my baby's crib.
- C. I should pad the mattress in my baby's crib so that he will be more comfortable when he sleeps.
- D. I should place my baby's crib next to the heater to keep him warm during the winter.
Correct answer: B
Rationale: The correct answer is B. Removing extra blankets from the crib is essential to prevent suffocation and reduce the risk of sudden infant death syndrome (SIDS). Extra blankets can pose a suffocation hazard to the baby during sleep. It is recommended to keep the crib free from loose bedding, pillows, and other soft items to provide a safe sleep environment for the newborn. Choices A, C, and D are incorrect. Placing the baby on his stomach (Choice A) increases the risk of SIDS. Padding the mattress (Choice C) can also pose a suffocation risk, and placing the crib next to a heater (Choice D) can lead to overheating, which is associated with an increased risk of SIDS.
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