LPN LPN
Maternal Newborn ATI Proctored Exam 2023
1. A client is postpartum and has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect?
- A. Decreased platelet count
- B. Increased erythrocyte sedimentation rate (ESR)
- C. Decreased megakaryocytes
- D. Increased WBC
Correct answer: A
Rationale: Idiopathic thrombocytopenic purpura (ITP) is characterized by an autoimmune response that leads to a decreased platelet count. This condition increases the risk of bleeding due to the low platelet levels. Monitoring the platelet count is crucial in managing ITP, as it helps determine the risk of bleeding and guides treatment decisions. Therefore, the correct finding to expect in a client with ITP is a decreased platelet count. Choice B, an increased erythrocyte sedimentation rate (ESR), is not typically associated with ITP. Choice C, decreased megakaryocytes, may be seen in conditions like aplastic anemia but are not a typical finding in ITP. Choice D, an increased white blood cell count (WBC), is not a characteristic feature of ITP.
2. A client who is at 15 weeks of gestation, is Rh-negative, and has just had an amniocentesis. Which of the following interventions is the nurse's priority following the procedure?
- A. Check the client's temperature.
- B. Observe for uterine contractions.
- C. Administer Rho(D) immune globulin.
- D. Monitor the fetal heart rate (FHR).
Correct answer: D
Rationale: After an amniocentesis, the priority nursing intervention is to monitor the fetal heart rate (FHR) as the greatest risk to the client and fetus is fetal death. This monitoring helps in early identification of any fetal distress or compromise, allowing prompt intervention to ensure fetal well-being. Checking the client's temperature (Choice A) is not the priority as monitoring the fetus is crucial for immediate assessment. Observing for uterine contractions (Choice B) is important but not the priority after an amniocentesis. Administering Rho(D) immune globulin (Choice C) is typically done to Rh-negative clients after procedures that may lead to fetal-maternal hemorrhage, not immediately after an amniocentesis.
3. 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.
4. A caregiver is learning about newborn safety. Which of the following statements by a parent indicates an understanding of the teaching?
- A. I will dress my baby in flame-retardant clothing.
- B. I will ensure a bib on my baby at night to keep her clothing dry.
- C. I will warm my baby's formula using the lowest setting in the microwave.
- D. I will cover the crib mattress with plastic to prevent staining.
Correct answer: A
Rationale: The correct answer is A. Dressing a baby in flame-retardant clothing is crucial to prevent injuries, especially in case of accidental exposure to fire sources. This safety measure can provide an added layer of protection for the newborn. The other options do not directly address newborn safety concerns or best practices. Option B focuses on keeping clothing dry, which is not a primary safety concern. Option C poses a risk of overheating the formula, which can be dangerous for the baby. Option D, covering the crib mattress with plastic, may pose a suffocation hazard to the baby.
5. A nurse is caring for a client who is at 40 weeks of gestation and is in early labor. The client has a platelet count of 75,000/mm3 and is requesting pain relief. Which of the following treatment modalities should the nurse anticipate?
- A. Epidural analgesia
- B. Naloxone hydrochloride
- C. Attention-focusing
- D. Pudendal nerve block
Correct answer: C
Rationale: Attention-focusing and distraction techniques are types of nonpharmacological care that are effective in relieving labor pain.
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