ATI LPN
PN ATI Capstone Maternal Newborn
1. A nurse is caring for a client who is receiving oxytocin to augment labor. The client has an intrauterine pressure catheter and an internal fetal scalp electrode for monitoring. Which of the following is an indication that the nurse should discontinue the infusion?
- A. Contraction frequency every 3 minutes
- B. Contraction duration of 100 seconds
- C. Fetal heart rate with moderate variability
- D. Fetal heart rate of 118/min
Correct answer: B
Rationale: A contraction duration of 100 seconds indicates potential uterine hyperstimulation, which can lead to fetal distress and decreased uterine perfusion. Prolonged contractions may reduce oxygen supply to the fetus, putting it at risk. Discontinuing the oxytocin infusion is crucial to prevent adverse effects on both the mother and the fetus. The other options do not raise immediate concerns that would necessitate discontinuing the oxytocin infusion. Contraction frequency every 3 minutes is within a normal range. Fetal heart rate with moderate variability and a rate of 118/min are both reassuring signs of fetal well-being.
2. A nurse is caring for a client in a mental health facility. The client’s daughter is crying and tells the nurse that she feels guilty for leaving her father in the hospital. Which of the following is an appropriate response?
- A. I’d like to know more about what’s bothering you.
- B. Why are you feeling this way?
- C. You did the right thing by bringing him here.
- D. I’m sure your father doesn’t blame you.
Correct answer: A
Rationale: The correct response is A: 'I’d like to know more about what’s bothering you.' Encouraging the daughter to express her feelings allows her to explore her emotions, which can be helpful in addressing her guilt and providing emotional support. Choice B is not as open-ended and may come across as confrontational. Choice C may invalidate the daughter's feelings of guilt by implying she shouldn't feel that way. Choice D assumes the father's emotions and may not address the daughter's feelings of guilt effectively.
3. A client has been prescribed metformin. What should be included in the teaching?
- A. It can cause weight gain
- B. Take it with food
- C. It is an insulin
- D. Monitor for hyperglycemia
Correct answer: B
Rationale: The correct answer is to take metformin with food. This is important to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect as metformin is not typically associated with weight gain. Choice C is wrong as metformin is not an insulin but a medication that helps control blood sugar levels. Choice D is also incorrect as metformin is not known to cause hyperglycemia.
4. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
- A. Advise the client to take the medication once daily at bedtime.
- B. This medication is for acute management of asthma.
- C. Avoid dairy products while taking this medication.
- D. If the client forgets to take the medication for a few days, he can double up on doses to catch up.
Correct answer: A
Rationale: The correct answer is to advise the client to take the medication once daily at bedtime. Montelukast, a leukotriene modifier, is used for long-term therapy of asthma in adults and children, as well as to prevent exercise-induced bronchospasm. It should be taken once daily in the evening for optimal effectiveness. Choice B is incorrect because montelukast is not for acute management but for long-term therapy. Choice C is incorrect as there is no need to avoid dairy products while taking montelukast. Choice D is incorrect and potentially harmful advice; clients should never double up on doses if they forget to take a medication.
5. When designing a program for young adults regarding safe sexual practices, which strategy might reach the greatest number in the target group?
- A. Web-based applications
- B. Print-based media such as newspapers
- C. Television advertisements
- D. Brochures in kiosks in malls
Correct answer: A
Rationale: Web-based applications are the most effective strategy for reaching young adults in the target group regarding safe sexual practices. Young adults today are highly engaged with mobile technology and the internet, making web-based applications the most accessible and convenient method to disseminate information. Print-based media like newspapers may not have the same reach and engagement among young adults. Television advertisements might reach a broader audience, but they may not be as targeted to the specific demographic of young adults. Brochures in kiosks in malls are less likely to reach a large number of young adults compared to web-based applications, which can be accessed anytime and anywhere through mobile devices.
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