ATI LPN
Maternal Newborn ATI Proctored Exam 2023
1. A client presents with uterine hypotonicity and postpartum hemorrhage. Which action should the nurse prioritize?
- A. Check the client's capillary refill.
- B. Massage the client's fundus.
- C. Insert an indwelling urinary catheter for the client.
- D. Prepare the client for a blood transfusion.
Correct answer: B
Rationale: In a client with uterine hypotonicity and postpartum hemorrhage, the priority is to address the risk of hypovolemic shock, which can lead to vital organ perfusion compromise and potentially death. Massaging the client's fundus helps to control bleeding by promoting uterine contraction and reducing blood loss, making it the nurse's priority intervention in this situation. Checking capillary refill may be important in assessing perfusion status but is not the priority over controlling the hemorrhage. Inserting an indwelling urinary catheter is not the priority in managing postpartum hemorrhage. Although preparing for a blood transfusion may be necessary, addressing the primary cause of bleeding by massaging the fundus takes precedence to stabilize the client's condition.
2. When assessing a 5-year-old boy with major trauma, his blood pressure is 70/40 mm Hg, and his pulse rate is 140 beats/min and weak. The child's blood pressure:
- A. indicates decompensated shock.
- B. reflects adequate compensation.
- C. suggests increased intracranial pressure.
- D. is appropriate based on his age.
Correct answer: A
Rationale: In a 5-year-old boy with major trauma, a blood pressure of 70/40 mm Hg and a pulse rate of 140 beats/min, and weak, indicate decompensated shock. This presentation signifies inadequate perfusion, leading to compensatory mechanisms being overwhelmed, resulting in decompensated shock. Choice B is incorrect as the vital signs suggest the body is unable to adequately compensate for the trauma. Choice C is incorrect as the vital signs are more indicative of shock rather than increased intracranial pressure. Choice D is incorrect as such low blood pressure is not appropriate for a child of this age and indicates a critical condition.
3. How should a healthcare provider respond to a patient with a suspected pulmonary embolism?
- A. Administer oxygen and call for emergency assistance
- B. Position the patient in a prone position and give fluids
- C. Administer anticoagulants and elevate the patient's legs
- D. Administer thrombolytics and perform chest physiotherapy
Correct answer: A
Rationale: Administering oxygen and calling for emergency assistance are the immediate priorities when managing a suspected pulmonary embolism. Oxygen helps support the patient's respiratory function, while emergency assistance is crucial for further evaluation and treatment. Positioning the patient in a prone position or giving fluids can worsen the condition by impeding blood flow. Administering anticoagulants may be part of the treatment plan but is not the initial response. Thrombolytics and chest physiotherapy are not first-line treatments for suspected pulmonary embolism and can even be harmful without prior evaluation.
4. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?
- A. I understand methadone slows my breathing.
- B. I understand methadone may cause me to have trouble sleeping.
- C. I will avoid alcohol while I’m taking this medication.
- D. I’ll change positions slowly, especially when standing.
Correct answer: B
Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.
5. Plasma lipoproteins contain varying amounts of:
- A. ascorbic acid.
- B. triglycerides.
- C. lecithin.
- D. glucose.
Correct answer: B
Rationale: The correct answer is B: triglycerides. Plasma lipoproteins, such as LDL and HDL, contain triglycerides, cholesterol, and other fats. Ascorbic acid (choice A) is not typically found in plasma lipoproteins; it is a form of vitamin C. Lecithin (choice C) is a phospholipid found in cell membranes but is not a major component of plasma lipoproteins. Glucose (choice D) is a type of sugar and is not a primary component of plasma lipoproteins.
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