LPN 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?
- A. I should aim to maintain my fasting blood glucose between 100 and 120.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or higher.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will avoid exercise if my blood glucose exceeds 250.
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. A client who is 3 days postpartum is receiving education on effective breastfeeding. Which of the following information should the nurse include?
- A. Your milk will replace colostrum in about 10 days.
- B. Your breasts should feel firm after breastfeeding.
- C. Your newborn should urinate at least 10 times per day.
- D. Your newborn should appear content after each feeding.
Correct answer: D
Rationale: The correct answer is D. The nurse should inform the client that a baby who is sated will appear content after feedings. This indicates that the baby is effectively emptying the breasts during feedings. Choices A, B, and C are incorrect because: A) Breast milk replaces colostrum within a few days, not 10 days. B) Breasts feeling firm after breastfeeding may indicate engorgement or plugged ducts, not necessarily effective breastfeeding. C) While the frequency of urination is important, it is not directly related to effective breastfeeding.
3. A client who is 2 hours postpartum is in the taking-hold phase. Which intervention should the nurse plan to implement during this phase of postpartum behavioral adjustment?
- A. Discuss contraceptive options with the client and her partner.
- B. Repeat information to ensure client understanding.
- C. Listen to the client and her partner as they reflect upon the birth experience.
- D. Demonstrate to the client how to perform a newborn bath.
Correct answer: D
Rationale: During the taking-hold phase of postpartum behavioral adjustment, the new mother starts taking a stronger interest in her new role as a mother. This phase involves the mother focusing on the care of her newborn and acquiring parenting skills. Demonstrating how to perform a newborn bath is an appropriate intervention during this phase as it helps the mother actively engage in caring for her baby, which aligns with the developmental tasks of this phase. Choices A, B, and C are incorrect as they do not specifically address the mother's need to actively engage in caring for her newborn during the taking-hold phase. Discussing contraceptive options, repeating information, and listening to reflections on the birth experience are more relevant to other phases of postpartum adjustment.
4. A client in labor requests epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care?
- A. Position the client supine for 30 minutes after the first dose of anesthetic solution.
- B. Administer 1,000 mL of dextrose 5% in water after the first dose of anesthetic solution.
- C. Monitor the client's blood pressure every 5 minutes after the first dose of anesthetic solution.
- D. Ensure the client has been NPO for 4 hours before the placement of the epidural and the first dose of anesthetic solution.
Correct answer: C
Rationale: The correct action is to monitor the client's blood pressure every 5 to 10 minutes following the first dose of anesthetic solution to assess for maternal hypotension. This is crucial to detect and manage potential complications associated with the epidural anesthesia. Positioning the client supine for a prolonged period can lead to hypotension; administering dextrose solution is not a standard practice in epidural anesthesia; ensuring NPO status for 4 hours is not necessary before epidural placement.
5. When developing an educational program for adolescents about nutrition during the third trimester of pregnancy, which of the following statements should be included?
- A. Consume three to four servings of dairy each day.
- B. Increase daily caloric intake by 600 to 700 calories.
- C. Limit daily sodium intake to less than 1 gram.
- D. Increase protein intake to 40 to 50 grams per day.
Correct answer: A
Rationale: The correct statement to include when developing an educational program for adolescents about nutrition during the third trimester of pregnancy is to consume three to four servings of dairy each day. Adequate calcium intake is crucial for bone development during pregnancy and helps prevent complications related to inadequate calcium intake. Increasing daily caloric intake by 600 to 700 calories (Choice B) is not necessary during the third trimester; excessive caloric intake can lead to unnecessary weight gain. Limiting daily sodium intake to less than 1 gram (Choice C) is not suitable during pregnancy, as some sodium intake is necessary for maintaining fluid balance. Increasing protein intake to 40 to 50 grams per day (Choice D) is important during pregnancy, but the emphasis in this case should be on calcium from dairy sources for bone development.
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