ATI LPN
ATI Maternal Newborn Proctored
1. A client who is 6 hours postpartum and Rh-negative has an Rh-positive newborn. The client asks why an indirect Coombs test was ordered. Which of the following is an appropriate response by the healthcare provider?
- A. It determines if kernicterus will occur in the newborn.
- B. It detects Rh-negative antibodies in the newborn's blood.
- C. It detects Rh-positive antibodies in the mother's blood.
- D. It determines the presence of maternal antibodies in the newborn's blood.
Correct answer: C
Rationale: The indirect Coombs test is performed to detect Rh-positive antibodies in the mother's blood. In cases where the mother is Rh-negative and the baby is Rh-positive, the mother may develop antibodies against the baby's blood cells, which can lead to hemolytic disease of the newborn. Choice A is incorrect because kernicterus is a complication of severe jaundice, not directly assessed by the indirect Coombs test. Choice B is incorrect as the test aims to detect Rh-positive antibodies, not Rh-negative antibodies in the newborn's blood. Choice D is incorrect as the test is focused on detecting antibodies in the mother's blood, not the newborn's.
2. A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?
- A. Hypertension
- B. Hypothermia
- C. Constipation
- D. Muscle weakness
Correct answer: A
Rationale: The correct answer is A: Hypertension. Carboprost is a vasoconstrictor medication used to control postpartum hemorrhage by contracting the uterus. One of the adverse effects of carboprost is hypertension due to its vasoconstrictive properties. Hypertension can occur as a result of increased peripheral vascular resistance. Choices B, C, and D are incorrect. Hypothermia, constipation, and muscle weakness are not typically associated with the administration of carboprost. It is crucial for the nurse to monitor the client's blood pressure closely while on carboprost to promptly detect and manage hypertension.
3. A client who is postpartum has a slightly boggy and displaced fundus to the right. Which of the following actions should the nurse take based on these findings?
- A. Encourage the client to perform Kegel exercises.
- B. Encourage the client to move to the left lateral position.
- C. Ask the client to rate her pain.
- D. Assist the client to the bathroom to void.
Correct answer: D
Rationale: A displaced and boggy fundus in a postpartum client typically indicates a full bladder, which can impede uterine contractions and increase the risk of postpartum hemorrhage. Assisting the client to the bathroom to void helps ensure the bladder is empty, aiding the fundus to contract and reducing the risk of complications. Encouraging Kegel exercises, changing positions, or assessing pain would not directly address the issue of the boggy fundus caused by a full bladder.
4. A client who is at 6 weeks of gestation is being educated about common discomforts of pregnancy. Which of the following findings should the individual include? (Select all that apply)
- A. Breast tenderness
- B. Urinary frequency
- C. Epistaxis
- D. All of the above
Correct answer: D
Rationale: During early pregnancy, common discomforts include breast tenderness due to hormonal changes, urinary frequency caused by increased blood flow to the kidneys, and epistaxis (nosebleeds) due to increased blood volume and hormonal changes. Educating the client about these discomforts helps them understand what to expect during this stage. Choice D, 'All of the above,' is the correct answer because all the listed findings are common discomforts experienced during early pregnancy. Choices A, B, and C are individually correct as well, as breast tenderness, urinary frequency, and epistaxis are all common discomforts that pregnant individuals may encounter.
5. A healthcare provider is assisting with the care for a client who reports manifestations of preterm labor. Which of the following findings are risk factors for this condition? (Select all that apply)
- A. Urinary tract infection
- B. Multifetal pregnancy
- C. Oligohydramnios
- D. All of the Above
Correct answer: D
Rationale: The correct answer is D: All of the Above. Multiple risk factors can contribute to preterm labor, including urinary tract infection, multifetal pregnancy, and oligohydramnios. These factors can lead to the uterus being irritated or overstimulated, potentially triggering early labor. Urinary tract infections can cause inflammation and contractions, multifetal pregnancies have a higher risk of preterm labor due to increased uterine stretching, and oligohydramnios can lead to poor fetal growth and premature contractions. Therefore, clients presenting with these conditions require close monitoring and management to prevent preterm birth. Choices A, B, and C are all correct risk factors for preterm labor, making option D the correct answer.
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