LPN LPN
Maternal Newborn ATI Proctored Exam 2023
1. A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?
- A. Apply slight pressure with a sterile gauze pad for mild bleeding.
- B. Inspect the circumcision site every 6 to 8 hours.
- C. Avoid using baby wipes containing alcohol to cleanse the penis with each diaper change.
- D. Clean the circumcision site daily using a warm, wet washcloth.
Correct answer: A
Rationale: The correct answer is to apply slight pressure with a sterile gauze pad for mild bleeding. This helps to stop bleeding. If the bleeding persists, the parent should contact the healthcare provider for further guidance. While inspecting the circumcision site is important, checking every 6 to 8 hours might be too frequent and could disrupt healing. Using baby wipes containing alcohol can irritate the sensitive skin, so it is advised to avoid them. Cleaning the circumcision site daily is crucial, but excessive cleaning by removing yellow exudate daily is not necessary unless advised by the healthcare provider.
2. A client is being educated by a healthcare provider about the physiological changes that occur during pregnancy. The client is at 10 weeks of gestation and has a BMI within the expected reference range. Which of the following client statements indicates an understanding of the teaching?
- A. I should gain more than 15 to 20 pounds during my pregnancy.
- B. I will likely need to use alternative positions for sexual intercourse.
- C. I'm glad I had a breast reduction years ago so they will not enlarge with my pregnancy.
- D. I'm glad I have a light complexion and will not get any stretch marks.
Correct answer: B
Rationale: During pregnancy, weight gain is expected. The client's understanding is demonstrated by acknowledging the need for alternative sexual positions due to the physiological changes, such as weight gain and a growing abdomen. This statement reflects comprehension of the teaching provided by the healthcare provider.
3. A client in active labor reports back pain while being examined by a nurse who finds her to be 8 cm dilated, 100% effaced, -2 station, and in the occiput posterior position. What action should the nurse take?
- A. Perform effleurage during contractions.
- B. Place the client in lithotomy position.
- C. Assist the client to the hands and knees position.
- D. Apply a scalp electrode to the fetus.
Correct answer: C
Rationale: The nurse should assist the client into the hands and knees position during contractions to help relieve her back pain and facilitate the rotation of the fetus from the posterior to an anterior occiput position. This position can aid in optimal fetal positioning for delivery. Choice A, performing effleurage, is a massage technique that may provide comfort but does not address the fetal position. Placing the client in lithotomy position (Choice B) may not be ideal for a client experiencing back pain due to the occiput posterior position. Applying a scalp electrode to the fetus (Choice D) is not indicated solely for addressing the client's back pain.
4. A healthcare professional in a provider's office is reviewing the medical record of a client who is in her first trimester of pregnancy. Which of the following findings should the healthcare professional identify as a risk factor for the development of preeclampsia?
- A. Singleton pregnancy
- B. BMI of 20
- C. Maternal age of 32 years
- D. Pregestational diabetes mellitus
Correct answer: D
Rationale: Pregestational diabetes mellitus is a significant risk factor for the development of preeclampsia in pregnant individuals. Preeclampsia is more common in women with preexisting conditions such as diabetes, hypertension, renal disease, lupus, or rheumatoid arthritis. Singleton pregnancy, a BMI of 20, or maternal age of 32 years are not considered significant risk factors for developing preeclampsia.
5. 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.
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