LPN LPN
ATI Maternal Newborn Proctored
1. 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.
2. A client is 1 hour postpartum and the nurse observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?
- A. Notify the healthcare provider.
- B. Increase the frequency of fundal massage.
- C. Encourage the client to empty their bladder.
- D. Document the findings and continue to monitor the client.
Correct answer: D
Rationale: In the postpartum period, the presence of lochia rubra and small clots along with a firm, midline fundus at the umbilicus is considered normal. In this situation, the appropriate action is to document the findings and continue to monitor the client. Changes in the amount and character of lochia, deviation of the fundus from the midline, or fundal height above or below the expected level may indicate a need for further intervention. Encouraging bladder emptying is important but not the priority in this scenario. Notify the healthcare provider if there are signs of abnormal postpartum bleeding or fundal abnormalities. Therefore, choice D is the correct answer. Choices A, B, and C are incorrect because at this stage, there are no signs of abnormality that require immediate notification of the healthcare provider, increased frequency of fundal massage, or immediate bladder emptying.
3. A client at 36 weeks of gestation is suspected of having placenta previa. Which of the following findings support this diagnosis?
- A. Painless red vaginal bleeding
- B. Increasing abdominal pain with a non-relaxed uterus
- C. Abdominal pain with scant red vaginal bleeding
- D. Intermittent abdominal pain following the passage of bloody mucus
Correct answer: A
Rationale: Painless red vaginal bleeding is a hallmark sign of placenta previa. In this condition, the placenta partially or completely covers the cervical opening, leading to painless, bright red bleeding due to the separation of the placenta from the uterine wall. Other types of bleeding, such as those associated with abdominal pain or mucus passage, are more indicative of conditions like placental abruption rather than placenta previa. Therefore, choices B, C, and D are incorrect as they describe findings more consistent with placental abruption rather than placenta previa.
4. While caring for a newborn, a nurse auscultates an apical heart rate of 130/min. Which of the following actions should the nurse take?
- A. Ask another nurse to verify the heart rate.
- B. Document this as an expected finding.
- C. Call the provider to further assess the newborn.
- D. Prepare the newborn for transport to the NICU.
Correct answer: B
Rationale: An apical heart rate of 130/min is within the expected range for a newborn. It is not necessary to seek verification from another nurse, call the provider for further assessment, or prepare for NICU transport based on this heart rate. Documenting the heart rate as an expected finding is the appropriate action in this situation as it falls within the normal range for a newborn's heart rate.
5. A client is being educated by a healthcare provider about the changes she should expect when planning to become pregnant. Identify the correct sequence of maternal changes. A. Amenorrhea B.Lightening C. Goodell's sign D. Quickening
- A. A,B,C,D
- B. D,B,A,C
- C. A,D,B,C
- D. A,C,D,B
Correct answer: D
Rationale: The correct sequence of maternal changes during pregnancy is as follows: Amenorrhea (absence of menstrual periods), Goodell's sign (softening of the cervix), Quickening (first fetal movements felt by the mother), and Lightening (baby descending into the pelvis). These changes occur at different stages of pregnancy and are important indicators of fetal development and maternal adaptation. Choice A is correct as it is the initial change indicating possible pregnancy. Choices B, C, and D follow in the correct order of occurrence during pregnancy. Choices B, C, and D are incorrect as they do not follow the correct sequence of maternal changes.
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