a nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy which of the following statements by th
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ATI LPN

Maternal Newborn ATI Proctored Exam 2023

1. A client with pregestational type 1 diabetes mellitus is being taught by a nurse about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Correct answer: C

Rationale: The correct answer is C. It is essential for a client with pregestational type 1 diabetes mellitus to continue taking insulin as prescribed even if they experience nausea and vomiting. This is crucial to prevent fluctuations in blood glucose levels that could lead to serious complications. Choice A is incorrect because the fasting blood glucose target for pregnant women with diabetes is usually lower. Choice B is incorrect as engaging in exercise when blood glucose is high is not recommended. Choice D is incorrect as avoiding exercise is not the appropriate approach when blood glucose levels are elevated.

2. During the third trimester of pregnancy, which of the following findings should a nurse recognize as an expected physiologic change?

Correct answer: A

Rationale: During pregnancy, gradual lordosis is a common adaptation to the growing fetus. Lordosis refers to an increased lumbar curve in the spine, which helps to shift the center of gravity forward, supporting the enlarging uterus. This change is necessary to maintain balance and reduce strain on the back muscles as the pregnancy progresses. Increased abdominal muscle tone, posterior neck flexion, and decreased mobility of pelvic joints are not typical physiological changes during pregnancy. Increased abdominal muscle tone is not expected as the abdominal muscles tend to stretch and separate to accommodate the growing fetus. Posterior neck flexion is not a common finding and decreased mobility of pelvic joints is not an expected change and can cause discomfort.

3. During a nonstress test for a pregnant client, a nurse uses an acoustic vibration device. The client inquires about its purpose. Which response should the nurse provide?

Correct answer: D

Rationale: The acoustic vibration device is utilized during a nonstress test to awaken a sleeping fetus. This action helps ensure more accurate test results by eliciting fetal movements and heart rate accelerations, which are indicators of fetal well-being. Choices A, B, and C are incorrect because the primary purpose of the acoustic vibration device during a nonstress test is not to stimulate uterine contractions, decrease uterine contractions, or lull the fetus to sleep. Instead, it is specifically used to awaken a sleeping fetus to assess fetal well-being.

4. A client is being discharged after childbirth. At 4 weeks postpartum, the client should contact the provider for which of the following client findings?

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.

5. A parent of a newborn is being taught about crib safety. Which statement by the client indicates understanding of the teaching?

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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