ATI LPN
PN ATI Capstone Maternal Newborn
1. A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?
- A. Retract the foreskin gently without force.
- B. Use a cotton swab to clean under the foreskin.
- C. Apply petroleum jelly to the foreskin.
- D. Wash the penis once a day with soap and water.
Correct answer: D
Rationale: The correct answer is to wash the penis once a day with soap and water. It is important to advise against forcefully retracting the foreskin as it can cause pain and injury. Using a cotton swab is not recommended as it can introduce foreign particles, and applying petroleum jelly is unnecessary and may lead to issues. Washing with soap and water is sufficient for hygiene without the need for additional products or manipulation of the foreskin.
2. A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?
- A. Abruptio placentae
- B. Hydatidiform mole
- C. Preterm labor
- D. Placenta previa
Correct answer: A
Rationale: Continuous abdominal pain and vaginal bleeding in a client with a history of cocaine use suggest abruptio placentae, where the placenta detaches from the uterus prematurely, posing serious risks to both mother and fetus. Hydatidiform mole is characterized by abnormal trophoblastic tissue growth, not continuous pain and bleeding. Preterm labor is premature contractions leading to birth before 37 weeks gestation. Placenta previa involves the placenta partially or completely covering the cervix, presenting with painless vaginal bleeding.
3. A community health nurse is reviewing primary prevention for West Nile virus with a group of patients in a rural health clinic. What instructions should the nurse include?
- A. Eliminate areas of standing water.
- B. Wear a mask when outdoors.
- C. Ensure food is cooked thoroughly.
- D. Avoid contact with sick individuals.
Correct answer: A
Rationale: The correct answer is A: 'Eliminate areas of standing water.' Standing water provides breeding grounds for mosquitoes, which spread West Nile virus. By eliminating standing water, individuals can reduce the risk of mosquito breeding and the transmission of the virus. Choices B, C, and D are incorrect. Wearing a mask when outdoors, ensuring food is cooked thoroughly, and avoiding contact with sick individuals are not directly related to primary prevention strategies for West Nile virus.
4. A healthcare provider is teaching a client about the use of sertraline. Which of the following should be included?
- A. It can cause weight gain
- B. It is an antipsychotic
- C. Monitor for suicidal thoughts
- D. It has no side effects
Correct answer: C
Rationale: Correct answer: Monitoring for suicidal thoughts is essential when a client is prescribed sertraline, an antidepressant. Choice A is incorrect because weight gain is not typically associated with sertraline. Choice B is incorrect as sertraline is not an antipsychotic medication. Choice D is incorrect because all medications, including sertraline, have potential side effects.
5. A nurse is preparing to teach a client about the management of hypoglycemia. Which sign should the nurse instruct the client to monitor for?
- A. Diaphoresis
- B. Polyuria
- C. Abdominal pain
- D. Thirst
Correct answer: A
Rationale: The correct answer is A: Diaphoresis. Diaphoresis, which refers to excessive sweating, is a classic symptom of hypoglycemia. Instructing the client to monitor for diaphoresis is crucial as it can help them recognize and address hypoglycemic events promptly. Polyuria (excessive urination), abdominal pain, and thirst are not typical signs of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes mellitus, while abdominal pain and thirst are not specific indicators of low blood sugar levels.
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