ATI LPN
PN ATI Capstone Maternal Newborn
1. A nurse on a postpartum unit is receiving change-of-shift report for four clients. Which of the following clients should the nurse see first?
- A. A client who gave birth 1 day ago and needs Rho(D) immune globulin
- B. A client who gave birth 3 days ago and reports breast fullness
- C. A client who gave birth 12 hours ago and reports an increase in urinary output
- D. A client who gave birth 8 hours ago and is saturating a perineal pad every hour
Correct answer: D
Rationale: The nurse should see the client saturating a perineal pad every hour first. This client may be experiencing postpartum hemorrhage, which is a medical emergency requiring immediate assessment and intervention. The other options describe clients with less urgent needs. The client needing Rho(D) immune globulin can wait, the breast fullness in the client who gave birth 3 days ago can be addressed after managing the postpartum hemorrhage, and an increase in urinary output in a client who gave birth 12 hours ago is not indicative of an immediate emergency like postpartum hemorrhage.
2. A healthcare professional is assessing a late preterm newborn. Which of the following clinical manifestations is an indication of hypoglycemia?
- A. Hypertonia
- B. Increased feeding
- C. Hyperthermia
- D. Respiratory distress
Correct answer: D
Rationale: The correct answer is D, respiratory distress, as it is a clinical manifestation of hypoglycemia in newborns. Other signs of hypoglycemia include an abnormal cry, jitteriness, lethargy, poor feeding, apnea, and seizures. Hypertonia, increased feeding, and hyperthermia are not typically associated with hypoglycemia in newborns. Hypertonia is more indicative of neurological issues, increased feeding is not a common sign of hypoglycemia, and hyperthermia is not a typical symptom of low blood sugar.
3. The nurse is caring for a client with hypertension who is prescribed a thiazide diuretic. The nurse should check which parameter before administering the medication?
- A. Serum potassium level
- B. Blood pressure
- C. Heart rate
- D. Serum sodium level
Correct answer: B
Rationale: Before administering a thiazide diuretic to a client with hypertension, the nurse should check the blood pressure. Thiazide diuretics are prescribed to lower blood pressure, so assessing the client's blood pressure prior to administration helps to monitor the effectiveness of the medication and to ensure the client's safety. Checking the serum potassium level (Choice A), heart rate (Choice C), or serum sodium level (Choice D) are also important parameters in the care of a client on a thiazide diuretic, but the priority assessment before administering the medication is the blood pressure to evaluate the drug's effectiveness in managing hypertension.
4. In an underdeveloped country, the nurse observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from which items?
- A. Pathogens and genetics
- B. Evil spirits
- C. Tides and planets
- D. Plants and animals
Correct answer: B
Rationale: The behavior of lighting fires and pounding on drums to promote recovery suggests a belief in evil spirits causing illness. In many cultures, rituals like these are performed to ward off evil spirits or negative energies that are thought to be the cause of sickness. Choices A, C, and D are incorrect as the described behavior aligns more with spiritual or supernatural beliefs rather than scientific explanations related to pathogens, genetics, tides, planets, plants, or animals.
5. In monitoring the effectiveness of warfarin therapy for a client with a history of atrial fibrillation, which laboratory value should the nurse monitor?
- A. Activated partial thromboplastin time (aPTT)
- B. Prothrombin time (PT) and international normalized ratio (INR)
- C. Platelet count
- D. Erythrocyte sedimentation rate (ESR)
Correct answer: B
Rationale: Prothrombin time (PT) and international normalized ratio (INR) are crucial laboratory values to monitor the effectiveness of warfarin therapy in clients with atrial fibrillation. These values help ensure that the client is within the therapeutic range and that the anticoagulant effect of warfarin is appropriate. Monitoring aPTT, platelet count, or ESR is not directly related to assessing the effectiveness of warfarin therapy in these cases.
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