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ATI Pediatrics Proctored Exam 2023 with NGN
1. The healthcare provider is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?
- A. (+) Moro reflex
- B. Heart rate is 80 bpm
- C. Respirations are irregular
- D. Uneven head shape
Correct answer: B
Rationale: A heart rate of 80 bpm is least likely to be observed in a normal newborn. The normal heart rate range for a newborn is usually higher than 80 bpm, typically ranging from 120-160 bpm. The Moro reflex (choice A) is a normal newborn reflex, respirations being irregular (choice C) are expected due to the immature respiratory control center, and an uneven head shape (choice D) is common due to molding during vaginal delivery.
2. A breastfeeding mother reports breast engorgement. The nurse advises her to:
- A. Increase the frequency of feedings
- B. Apply ice packs to the breasts
- C. Avoid breastfeeding until the pain subsides
- D. Use a breast pump to empty the breasts completely
Correct answer: A
Rationale: Breast engorgement occurs when the breasts become overfilled with milk. By increasing the frequency of feedings, the mother can ensure that her breasts are emptied regularly, helping to relieve the discomfort associated with engorgement. This advice promotes effective milk removal and prevents further accumulation, which can worsen the condition. Applying ice packs may provide temporary relief, but it does not address the underlying issue of milk accumulation. Avoiding breastfeeding can lead to further engorgement and potential complications. Using a breast pump to empty the breasts completely may be necessary in some cases, but increasing the frequency of feedings is the initial and most appropriate intervention to manage breast engorgement.
3. The client is being taught about perineal care postpartum. Which instruction should the client receive?
- A. Use ice packs to reduce swelling for the first 24 hours.
- B. Apply heat packs immediately after birth to reduce pain.
- C. Avoid using a peri-bottle to cleanse the perineum.
- D. Use tampons to absorb lochia discharge.
Correct answer: A
Rationale: The correct instruction for the client postpartum is to use ice packs to reduce swelling for the first 24 hours. This helps alleviate discomfort and promote healing. Applying heat packs immediately after birth is not recommended as they can increase swelling. A peri-bottle is advised for cleansing the perineum, not to be avoided. Tampons should not be used to absorb lochia discharge as they can increase the risk of infection. Therefore, the use of ice packs is the most appropriate and beneficial instruction for perineal care postpartum.
4. One of the signs of CHF is shortness of breath. What is the term for shortness of breath when lying down?
- A. Platypnea
- B. Orthopnea
- C. Apnea
- D. Epistaxis
Correct answer: B
Rationale: Orthopnea is the specific term used to describe shortness of breath when lying down. This condition is commonly seen in patients with congestive heart failure (CHF) due to the redistribution of fluid in the body when changing positions. Platypnea refers to shortness of breath that worsens when sitting or standing, apnea is the cessation of breathing, and epistaxis is the medical term for a nosebleed. Therefore, the correct answer is B (Orthopnea).
5. Before drying off the newborn after birth, which assessment finding should the healthcare professional document to ensure an accurate gestational rating on the Ballard gestational assessment tool?
- A. Amount and area of vernix coverage
- B. Creases on the sole
- C. Size of the areola
- D. Body surface temperature
Correct answer: A
Rationale: To ensure an accurate gestational rating on the Ballard gestational assessment tool, healthcare professionals should document the amount and area of vernix coverage before drying the newborn. Drying the baby after birth could disturb the vernix, potentially affecting the gestational age assessment. Assessing and documenting the vernix coverage beforehand enables a more precise evaluation using the Ballard gestational assessment tool. Choices B, C, and D are incorrect as they are not directly related to gestational rating on the Ballard assessment tool.
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