ATI LPN
Maternal Newborn ATI Proctored Exam
1. A newborn was delivered vaginally and experienced a tight nuchal cord. Which of the following clinical manifestations should the nurse expect to observe?
- A. Bruising over the buttocks
- B. Hard nodules on the roof of the mouth
- C. Petechiae over the head
- D. Bilateral periauricular papillomas
Correct answer: C
Rationale: When a newborn experiences a tight nuchal cord during delivery, it can lead to petechiae, which are small red or purple spots on the skin caused by bleeding under the skin. These petechiae may appear over the head, face, and neck due to the pressure of the cord. It is essential for the nurse to recognize this as a possible consequence and monitor the newborn for any signs of complications. Bruising over the buttocks (Choice A) is not typically associated with a tight nuchal cord. Hard nodules on the roof of the mouth (Choice B) are more indicative of Epstein pearls or Bohn's nodules, which are considered normal findings in newborns. Bilateral periauricular papillomas (Choice D) are not related to a tight nuchal cord but are seen in congenital syphilis.
2. A nurse in a health clinic is reinforcing teaching about contraceptive use with a group of clients. Which of the following client statements demonstrates understanding?
- A. Using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and STIs.
- B. A diaphragm should be removed 2 hours after intercourse.
- C. Oral contraceptives can worsen a case of acne.
- D. A contraceptive patch is replaced once a month.
Correct answer: A
Rationale: The correct answer is A because using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and sexually transmitted infections (STIs). This statement demonstrates the client's understanding of the importance of proper condom use to maximize protection. Choice B is incorrect because a diaphragm should be left in place for at least 6 hours after intercourse to ensure contraceptive effectiveness. Choice C is incorrect as oral contraceptives are known to improve acne in some cases. Choice D is incorrect because a contraceptive patch is typically replaced weekly, not monthly.
3. A healthcare provider is instructing a client who is taking an oral contraceptive about manifestations to report. Which of the following manifestations should the healthcare provider include?
- A. Reduced menstrual flow
- B. Breast tenderness
- C. Shortness of breath
- D. Increased appetite
Correct answer: C
Rationale: Shortness of breath is a symptom that can indicate a serious side effect of oral contraceptives, such as a potential blood clot in the lungs. This condition requires immediate medical attention to prevent complications. Choices A, B, and D are not typically associated with serious side effects of oral contraceptives and are considered normal or common side effects that do not require urgent medical attention.
4. A client is being educated by a healthcare provider about potential adverse effects of implantable progestins. Which of the following adverse effects should the healthcare provider include? (Select all that apply)
- A. Nausea
- B. Irregular vaginal bleeding
- C. Weight gain
- D. All of the Above
Correct answer: D
Rationale: When educating a client about implantable progestins, it is important to discuss potential adverse effects. Nausea, irregular vaginal bleeding, and weight gain are common side effects associated with implantable progestins. Therefore, clients should be informed about these possibilities to ensure they are aware of what to expect and when to seek medical attention if needed. Choice D, 'All of the Above,' is the correct answer because all of the listed adverse effects (nausea, irregular vaginal bleeding, and weight gain) should be included in the client education. Choices A, B, and C are incorrect because they individually do not encompass all the potential adverse effects that the healthcare provider should discuss with the client.
5. A client in an obstetrical clinic is discussing using an IUD for contraception with a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?
- A. An IUD should be replaced annually during a pelvic exam.
- B. I cannot get an IUD until after I've had a child.
- C. I should plan on regaining fertility 5 months after the IUD is removed.
- D. I will check to ensure the strings of the IUD are still present after my periods.
Correct answer: D
Rationale: Checking for the presence of IUD strings after each period is crucial to ensure the IUD is correctly positioned and functioning. This practice helps in confirming the effectiveness of the contraceptive method and timely detection of any displacement or issues with the IUD. Choice A is incorrect as IUDs have varying durations of effectiveness, but they do not need to be replaced annually as a routine. Choice B is incorrect as women can get an IUD even if they haven't had a child. Choice C is incorrect as fertility typically returns shortly after IUD removal, not necessarily after a specific timeframe like 5 months.
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