LPN LPN
Maternal Newborn ATI Proctored Exam 2023
1. A healthcare professional is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the professional use to help minimize the pain of the procedure for the newborn?
- A. Apply a cool pack to the heel for 10 minutes prior to the puncture.
- B. Request a prescription for IM analgesic.
- C. Use a manual lancet to pierce the skin.
- D. Place the newborn skin-to-skin on the mother's chest.
Correct answer: D
Rationale: Placing the newborn skin-to-skin on the mother's chest is an effective technique to significantly decrease the newborn's pain level and anxiety during a heel stick procedure. This approach provides comfort, warmth, and familiarity to the newborn, promoting a sense of security and reducing distress. It is important for the healthcare professional to implement this technique before, during, and after the procedure to optimize pain management and support newborn well-being. The other options, such as applying a cool pack, requesting an IM analgesic prescription, and using a manual lancet, are not appropriate for minimizing pain in a newborn during a heel stick procedure. Applying a cool pack may cause vasoconstriction and increase pain, requesting an IM analgesic for a routine heel stick is excessive, and using a manual lancet without additional comforting measures may not adequately address the newborn's pain and anxiety.
2. When a client states, 'My water just broke,' what is the nurse's priority intervention?
- A. Perform Nitrazine testing.
- B. Assess the fluid.
- C. Check cervical dilation.
- D. Begin FHR monitoring.
Correct answer: D
Rationale: The correct answer is D: Begin FHR monitoring. The priority intervention when a client's water breaks is to assess the fetal well-being due to the risk of umbilical cord prolapse. Monitoring the fetal heart rate (FHR) will help the nurse ensure the fetus's well-being. Performing Nitrazine testing (choice A) or assessing the fluid (choice B) may provide information about the rupture of membranes but does not directly address fetal well-being. Checking cervical dilation (choice C) is important but not the priority when the client's water has broken.
3. During a weekly prenatal visit, a nurse is assessing a client at 38 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Blood pressure 136/88 mm Hg
- B. Report of insomnia
- C. Weight gain of 2.2 kg (4.8 lb)
- D. Report of Braxton-Hicks contractions
Correct answer: C
Rationale: A weight gain of 2.2 kg (4.8 lb) in a week is above the expected reference range for a client at 38 weeks of gestation and could indicate complications such as preeclampsia or gestational hypertension. Rapid weight gain at this stage requires immediate attention and should be reported to the provider for further evaluation and management. Choices A, B, and D are not the priority findings to report to the provider at this stage of gestation. Blood pressure of 136/88 mm Hg is within normal limits in pregnancy, insomnia is common in the third trimester, and Braxton-Hicks contractions are expected in the third trimester as the body prepares for labor.
4. 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.
5. When teaching a new mother how to use a bulb syringe to suction her newborn's secretions, which of the following instructions should the nurse include?
- A. Insert the syringe tip after compressing the bulb.
- B. Suction each nare before suctioning the mouth.
- C. Insert the tip of the syringe at the center of the newborn's mouth.
- D. Stop suctioning when the newborn's cry sounds clear.
Correct answer: D
Rationale: The correct instruction for using a bulb syringe to suction a newborn's secretions is to stop suctioning when the newborn's cry no longer sounds like it is coming through a bubble of fluid or mucus. This indicates that the airways are clear, and further suctioning is not needed to prevent irritation or damage to the delicate tissues of the newborn's nose and throat. Choices A, B, and C are incorrect because inserting the syringe tip before compressing the bulb, suctioning each nare before the mouth, and inserting the tip at the center of the mouth can potentially harm the newborn and are not recommended practices for using a bulb syringe in this context.
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