ATI LPN
ATI Maternal Newborn
1. A client who is at 42 weeks gestation and in labor asks the nurse what to expect because the baby is postmature. Which of the following statements should the nurse make?
- A. Your baby will have excess baby fat.
- B. Your baby will have flat areola without breast buds.
- C. Your baby's heels will easily move to his ears.
- D. Your baby's skin will have a leathery appearance.
Correct answer: D
Rationale: The correct answer is D: 'Your baby's skin will have a leathery appearance.' Postmature infants, born after 42 weeks of gestation, may have a leathery appearance of the skin due to prolonged exposure to amniotic fluid. This occurs as the protective vernix caseosa is shed, and the skin loses its protective covering, leading to a wrinkled and dry appearance. Choices A, B, and C are incorrect. Excess baby fat is not a typical characteristic of postmature infants. Flat areola without breast buds and the ability of the baby's heels to easily move to his ears are not associated with postmaturity.
2. A client receives discharge teaching for a new prescription of lithium. Which instruction should be included?
- A. Take the medication with food.
- B. Increase your intake of sodium.
- C. Monitor for signs of hypercalcemia.
- D. Avoid consuming dairy products.
Correct answer: B
Rationale: The correct instruction to include when a client receives discharge teaching for a new prescription of lithium is to increase their intake of sodium. Lithium can lead to decreased sodium levels, putting the individual at risk of developing hyponatremia. By increasing sodium intake, the client can counteract this risk, maintain a proper sodium balance, and prevent complications. Choices A, C, and D are incorrect because taking lithium with food, monitoring for signs of hypercalcemia, and avoiding dairy products are not directly related to managing the side effects or risks associated with lithium therapy.
3. What is the maximum recommended daily intake of cholesterol?
- A. 100 mg.
- B. 200 mg.
- C. 300 mg.
- D. 400 mg.
Correct answer: C
Rationale: The correct answer is C: 300 mg. The recommended maximum daily intake of cholesterol is 300 mg to reduce the risk of heart disease. Option A (100 mg) is too low, which may not provide enough cholesterol for normal bodily functions. Option B (200 mg) is also below the recommended limit. Option D (400 mg) exceeds the recommended daily intake, increasing the risk of heart disease.
4. A 65-year-old woman presents with difficulty swallowing, weight loss, and a history of long-standing heartburn. She has been on proton-pump inhibitors for years, but her symptoms have worsened. What is the most likely diagnosis?
- A. Peptic stricture
- B. Esophageal cancer
- C. Achalasia
- D. Esophageal spasm
Correct answer: B
Rationale: The presentation of difficulty swallowing, weight loss, and worsening symptoms despite long-term use of proton-pump inhibitors raises suspicion for esophageal cancer, especially in a patient with a history of chronic heartburn. Esophageal cancer should be considered in this scenario due to the concerning symptoms and lack of improvement despite appropriate medical management.
5. When responding to a call for a 2-year-old child who fell from a second-story window, with the mechanism of injury and the age of the patient in mind, you should suspect that the primary injury occurred to the child's:
- A. chest.
- B. head.
- C. lower extremities.
- D. abdomen.
Correct answer: B
Rationale: In a scenario where a young child falls from a significant height like a second-story window, the primary injury is more likely to be to the head. This is because young children have proportionately larger head sizes compared to their body, making them more susceptible to head injuries in such falls. The chest (Choice A), lower extremities (Choice C), and abdomen (Choice D) are less likely to sustain the primary injury in this scenario, as the impact of the fall and the child's anatomy predispose the head to be the most affected area.
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