ATI LPN
Maternal Newborn ATI Proctored Exam 2023
1. A parent is receiving discharge teaching from a nurse regarding caring for their newborn after a circumcision. Which instruction should the nurse include?
- A. Apply slight pressure with a sterile gauze pad for mild bleeding.
- B. Inspect the circumcision site every 6 to 8 hours.
- C. Avoid using baby wipes containing alcohol to cleanse the penis with each diaper change.
- D. Clean the circumcision site daily using a warm, wet washcloth.
Correct answer: A
Rationale: The correct answer is to apply slight pressure with a sterile gauze pad for mild bleeding. This helps to stop bleeding. If the bleeding persists, the parent should contact the healthcare provider for further guidance. While inspecting the circumcision site is important, checking every 6 to 8 hours might be too frequent and could disrupt healing. Using baby wipes containing alcohol can irritate the sensitive skin, so it is advised to avoid them. Cleaning the circumcision site daily is crucial, but excessive cleaning by removing yellow exudate daily is not necessary unless advised by the healthcare provider.
2. A client in a family planning clinic requests oral contraceptives. Which of the following findings in the client's history should be recognized as contraindications to oral contraceptives? (Select all that apply.)
- A. Cholecystitis
- B. Hypertension
- C. Migraine headaches
- D. All of the above
Correct answer: D
Rationale: Cholecystitis is a correct answer. A history of gallbladder disease, such as cholecystitis, is a contraindication for the use of oral contraceptives. Hypertension is a correct answer. Hypertension is also a contraindication for the use of oral contraceptives due to the increased risk of complications. Migraine headaches are a correct answer. A history of migraine headaches is a contraindication for the use of oral contraceptives, especially for those with aura. Selecting 'All of the above' is correct as all the mentioned conditions (cholecystitis, hypertension, and migraine headaches) are contraindications for oral contraceptives. Human papillomavirus and anxiety disorder are incorrect choices as they are not contraindications for the use of oral contraceptives.
3. When teaching a new mother how to use a bulb syringe to suction her newborn's secretions, which of the following instructions should the nurse include?
- A. Insert the syringe tip after compressing the bulb.
- B. Suction each nare before suctioning the mouth.
- C. Insert the tip of the syringe at the center of the newborn's mouth.
- D. Stop suctioning when the newborn's cry sounds clear.
Correct answer: D
Rationale: The correct instruction for using a bulb syringe to suction a newborn's secretions is to stop suctioning when the newborn's cry no longer sounds like it is coming through a bubble of fluid or mucus. This indicates that the airways are clear, and further suctioning is not needed to prevent irritation or damage to the delicate tissues of the newborn's nose and throat. Choices A, B, and C are incorrect because inserting the syringe tip before compressing the bulb, suctioning each nare before the mouth, and inserting the tip at the center of the mouth can potentially harm the newborn and are not recommended practices for using a bulb syringe in this context.
4. A nurse is assisting with an in-service for newly licensed nurses about neonatal abstinence syndrome in newborns. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?
- A. The newborn will have decreased muscle tone.
- B. The newborn will have a continuous high-pitched cry.
- C. The newborn will sleep for 2 to 3 hours after a feeding.
- D. The newborn will have mild tremors when disturbed.
Correct answer: B
Rationale: The correct answer is B. A continuous high-pitched cry is a characteristic sign of neonatal abstinence syndrome, indicating withdrawal from drugs. Choices A, C, and D are incorrect because decreased muscle tone, sleeping for 2 to 3 hours after a feeding, and mild tremors when disturbed are not specific indicators of neonatal abstinence syndrome.
5. A client in the delivery room just delivered a newborn, and the nurse is planning to promote parent-infant bonding. What should the nurse prioritize?
- A. Encourage the parents to touch and explore the newborn's features
- B. Limit noise and interruptions in the delivery room
- C. Place the newborn at the client's breast
- D. Position the newborn skin-to-skin on the client's chest
Correct answer: D
Rationale: Positioning the newborn skin-to-skin on the client's chest is the priority action to promote warmth, regulate the newborn's heart rate and breathing, and enhance parent-infant bonding. This method facilitates early bonding, stabilizes the baby's temperature, and encourages breastfeeding initiation. Encouraging parents to touch and explore the newborn's features is important but not the priority at this moment. Limiting noise and interruptions can be beneficial but not as crucial as skin-to-skin contact for bonding. Placing the newborn at the client's breast is essential for breastfeeding but should come after the initial skin-to-skin contact for bonding and temperature regulation.
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