ATI LPN
ATI Maternal Newborn Proctored
1. A client who is postpartum received methylergonovine. Which of the following findings indicates that the medication was effective?
- A. Increase in blood pressure
- B. Fundus firm to palpation
- C. Increase in lochia
- D. Report of absent breast pain
Correct answer: B
Rationale: Methylergonovine is used to prevent or treat postpartum hemorrhage by contracting the uterus. A firm fundus indicates effective uterine contraction and less bleeding. Therefore, the correct answer is a firm fundus to palpation. The increase in blood pressure (Choice A) is not a typical finding associated with the effectiveness of methylergonovine. Increase in lochia (Choice C) may indicate excessive bleeding rather than the medication's effectiveness. Absence of breast pain (Choice D) is not directly related to the medication's effectiveness in treating postpartum hemorrhage.
2. Which of the following medications should the provider prescribe for a client with gonorrhea?
- A. Ceftriaxone
- B. Fluconazole
- C. Metronidazole
- D. Zidovudine
Correct answer: A
Rationale: Ceftriaxone is the preferred medication to treat gonorrhea, a bacterial infection. It is essential to promptly treat gonorrhea to prevent complications such as pelvic inflammatory disease, infertility, and the spread of the infection to others. Fluconazole is used for fungal infections, Metronidazole treats certain bacterial and parasitic infections, and Zidovudine is an antiretroviral medication used in HIV treatment; none of these are appropriate for gonorrhea.
3. A nurse is caring for a preterm newborn who is in an incubator to maintain a neutral thermal environment. The father of the newborn asks the nurse why this is necessary. Which of the following responses should the nurse make?
- A. Preterm newborns have a smaller body surface area than normal newborns.
- B. The added brown fat layer in a preterm newborn reduces his ability to generate heat.
- C. Preterm newborns lack adequate temperature control mechanisms.
- D. The heat in the incubator rapidly dries the sweat of preterm newborns.
Correct answer: C
Rationale: The correct answer is C because preterm newborns have immature temperature regulation mechanisms, making it difficult for them to maintain their body temperature. An incubator helps maintain a stable thermal environment. Choice A is incorrect as the body surface area is not the primary reason for needing an incubator. Choice B is incorrect because brown fat in preterm newborns actually helps generate heat. Choice D is incorrect as the purpose of the incubator is not to dry sweat but to regulate the newborn's temperature.
4. During the third trimester of pregnancy, which of the following findings should a nurse recognize as an expected physiologic change?
- A. Gradual lordosis
- B. Increased abdominal muscle tone
- C. Posterior neck flexion
- D. Decreased mobility of pelvic joints
Correct answer: A
Rationale: During pregnancy, gradual lordosis is a common adaptation to the growing fetus. Lordosis refers to an increased lumbar curve in the spine, which helps to shift the center of gravity forward, supporting the enlarging uterus. This change is necessary to maintain balance and reduce strain on the back muscles as the pregnancy progresses. Increased abdominal muscle tone, posterior neck flexion, and decreased mobility of pelvic joints are not typical physiological changes during pregnancy. Increased abdominal muscle tone is not expected as the abdominal muscles tend to stretch and separate to accommodate the growing fetus. Posterior neck flexion is not a common finding and decreased mobility of pelvic joints is not an expected change and can cause discomfort.
5. A client reports unrelieved episiotomy pain 8 hours following a vaginal birth. Which of the following actions should the nurse take?
- A. Apply an ice pack to the affected area.
- B. Offer a warm sitz bath.
- C. Provide a squeeze bottle of antiseptic solution.
- D. Place a hot pack on the perineum.
Correct answer: A
Rationale: The correct answer is to apply an ice pack to the affected area. Ice packs help reduce swelling, inflammation, and provide pain relief post-episiotomy. Applying heat, as in a hot pack or warm sitz bath, can increase swelling and discomfort. Providing antiseptic solution in a squeeze bottle is not the first-line intervention for managing episiotomy pain, as the priority is pain relief and comfort.
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