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Ati rn maternal newborn 2023
Ati rn maternal newborn 2023
Total Questions : 61
Showing 10 questions Sign up for moreA nurse is caring for a client who is experiencing a postpartum hemorrhage. Which of the following actions should the nurse take?
Explanation
A. Administering methylergonovine (Methergine) intramuscularly is appropriate for treating postpartum hemorrhage, as it stimulates uterine contractions to help control bleeding.
B. The knee-chest position is not indicated for postpartum hemorrhage and does not address the underlying cause.
C. Oxygen may be necessary if the client is unstable, but 2 L/min via nasal cannula is not the primary intervention and may not be sufficient in a critical situation.
D. Dextrose water is not appropriate for fluid resuscitation during hemorrhage; isotonic fluids like normal saline or lactated Ringer’s are preferred to restore volume.
A nurse is teaching a client about potential adverse effects of oral contraceptives. For which of the following adverse effects should the nurse instruct the client to notify the provider immediately?
Explanation
A. Nausea is a common and generally mild side effect of oral contraceptives and does not typically require immediate medical attention.
B. Persistent headaches may indicate an increased risk of stroke or hypertension, especially in clients with other risk factors. This could be a sign of a serious adverse effect and should be reported to the provider immediately.
C. Breast tenderness is a common and usually benign side effect of hormonal contraceptives.
D. Abdominal bloating may occur but is not typically dangerous or an urgent concern.
A nurse is assessing a client who has a grade 2 placental abruption. Which of the following findings should the nurse expect?
Explanation
A. A grade 2 placental abruption typically presents with a firm or rigid abdomen due to concealed bleeding, not a soft one.
B. Maternal tachycardia (heart rate 120/min) is expected due to blood loss and compensatory response to hypovolemia.
C. A fetal heart rate of 150/min with moderate variability is a reassuring sign and would not typically be expected in a significant abruption, where fetal distress is more common.
D. Vaginal bleeding from placental abruption is typically painful, and may be concealed. Painless bleeding is more characteristic of placenta previa.
A nurse is providing discharge teaching to a new mother about newborn care. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
A. The umbilical cord typically dries and falls off within 1 to 2 weeks after birth, which is a normal expectation.
B. Newborns do not need daily tub baths; a sponge bath 2–3 times a week is usually sufficient until the cord falls off.
C. Babies should always be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS), not on their sides.
D. The correct technique for using a bulb syringe is to compress it before inserting it into the baby’s mouth or nose, then release to suction out secretions.
A nurse is providing discharge teaching to a new guardian about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?
Explanation
A. The car seat should remain rear-facing until at least age 2, or until the child reaches the maximum height and weight limit specified by the manufacturer, not just until 12 months.
B. The retainer (chest) clip should be positioned at the level of the infant's armpits, not the abdomen, to ensure proper restraint.
C. Positioning the car seat at a 45° angle helps keep the infant’s airway open and reduces the risk of aspiration or airway obstruction.
D. For rear-facing seats, the harness straps should be at or below the baby's shoulders, not above.
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)
Explanation
A. The car seat should remain rear-facing until at least age 2, or until the child reaches the maximum height and weight limit specified by the manufacturer, not just until 12 months.
B. The retainer (chest) clip should be positioned at the level of the infant's armpits, not the abdomen, to ensure proper restraint.
C. Positioning the car seat at a 45° angle helps keep the infant’s airway open and reduces the risk of aspiration or airway obstruction.
D. For rear-facing seats, the harness straps should be at or below the baby’s shoulders, not above.
A nurse is caring for a client who is in active labor. The nurse notes late decelerations in the FHR on the fetal monitor tracing. Which of the following actions should the nurse take first?
Explanation
A. Assessing for tachysystole is important, but intervention is needed immediately to improve fetal oxygenation.
B. Internal monitoring may provide more accurate data, but it does not address the immediate fetal distress.
C. The first action should be to reposition the client to a left lateral position to improve uteroplacental blood flow and oxygenation to the fetus.
D. Increasing IV fluids can help with placental perfusion, but positioning is faster and more immediately effective.
A nurse is planning care for a client who is scheduled for an amniocentesis and is Rh negative. Which of the following actions should the nurse plan to take?
Explanation
A. Irrigating the insertion site with sterile water is not a standard part of the procedure.
B. Rh-negative clients are at risk for isoimmunization if fetal blood mixes with maternal blood during the procedure. Rh(D) immune globulin should be administered after the procedure to prevent Rh sensitization.
C. The client is usually positioned supine with a slight tilt to prevent vena cava compression, not strictly in a left lateral position.
D. Amniocentesis does not require the client to be NPO.
A nurse is caring for a client who had a vaginal birth 4 hr ago and had a 3rd-degree perineal laceration with repair. The client has been unable to void since giving birth. Which of the following findings indicates the need for straight catheterization?
Explanation
A. A pain rating of 3 is relatively mild and does not indicate urinary retention.
B. A boggy, deviated fundus suggests bladder distention, which can occur when the bladder is full and displaces the uterus. This is an indication for straight catheterization to relieve urinary retention.
C. Moderate lochia rubra is expected 4 hours postpartum and does not indicate urinary retention.
D. While edema and bruising are common after delivery, they do not alone indicate a need for catheterization.
A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination, the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?
Explanation
A. A transvaginal fetal Doppler is not commonly used for continuous monitoring and is typically reserved for early pregnancy.
B. An external ultrasound transducer is appropriate for continuous fetal monitoring when the membranes are intact. It is noninvasive and safe for use during labor.
C. A DeLee Hillis fetoscope is used for intermittent auscultation, not continuous monitoring.
D. An internal fetal scalp electrode requires ruptured membranes and cervical dilation; it is contraindicated with intact membranes.
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