Maternal Newborn ATI Proctored Exam

Maternal Newborn ATI Proctored Exam Related

Review Maternal Newborn ATI Proctored Exam related questions and content

A nurse is assessing a client who is 3 days postpartum and is breastfeeding. The nurse notes that the fundus is three fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and warm to palpation. Which of the following interpretations of these findings should the nurse make?

  • A. The client is exhibiting early indications of mastitis.
  • B. Additional interventions are not indicated at this time.
  • C. Application of a heating pad to the breasts is indicated.
  • D. The client should be advised to remove her nursing bra.
Correct Answer: B

Rationale: Correct Answer: B - Additional interventions are not indicated at this time.

Rationale:
1. Fundus location: Three fingerbreadths below the umbilicus is within normal range for 3 days postpartum.
2. Lochia rubra: Moderate lochia rubra is expected at this stage postpartum.
3. Breasts: Hard and warm breasts are indicative of engorgement, a common issue in breastfeeding mothers.

Summary:
A: Early indications of mastitis would include redness, warmth, and tenderness in the breasts, along with flu-like symptoms.
C: Application of a heating pad to the breasts can worsen engorgement and increase the risk of mastitis.
D: Removing a nursing bra may offer some relief for engorgement, but it is not the priority intervention at this time.

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A nurse is caring for a client who experienced a cesarean birth due to dysfunctional labor. The client states that she is disappointed that she did not have natural childbirth. Which of the following responses should the nurse make?

  • A. "It sounds like you are feeling sad that things didn't go as planned."
  • B. "At least you know you have a healthy baby."
  • C. "Maybe next time you can have a vaginal delivery."
  • D. "You can resume sexual relations sooner than if you had delivered vaginally."
Correct Answer: A

Rationale: Step 1: Empathy - The nurse acknowledges the client's feelings of disappointment, showing empathy and understanding.
Step 2: Validation - By stating "It sounds like you are feeling sad that things didn't go as planned," the nurse validates the client's emotions, making her feel heard and supported.
Step 3: Therapeutic Communication - This response encourages the client to express her feelings further, promoting open communication and trust in the nurse-client relationship.

Summary:
Choice B is incorrect as it dismisses the client's emotional concerns and focuses solely on the baby's health. Choice C is incorrect as it minimizes the client's current experience and may increase feelings of inadequacy. Choice D is incorrect as it is not relevant to the client's emotional needs and may be perceived as insensitive.

The nurse is assessing a client in the third trimester with suspected gestational diabetes. What symptom is most concerning?

  • A. Increased thirst and urination.
  • B. Fasting blood glucose of 100 mg/dL.
  • C. Weight gain of 1 pound in a week.
  • D. Proteinuria of +1.
Correct Answer: A

Rationale: The correct answer is A: Increased thirst and urination. In gestational diabetes, increased thirst and urination can indicate uncontrolled blood sugar levels, which can harm the fetus. This symptom suggests hyperglycemia and requires immediate intervention.

B: Fasting blood glucose of 100 mg/dL is within the normal range for pregnancy and not concerning.

C: Weight gain of 1 pound in a week can be normal in the third trimester and not specific to gestational diabetes.

D: Proteinuria of +1 is more concerning for preeclampsia rather than gestational diabetes.

A client at 10 weeks' gestation reports frequent nausea. What dietary recommendation should the nurse provide?

  • A. Avoid eating salty snacks.
  • B. Drink fluids between meals.
  • C. Consume three large meals a day.
  • D. Avoid eating protein-rich foods.
Correct Answer: B

Rationale: The correct answer is B: Drink fluids between meals. This recommendation helps manage nausea during pregnancy by preventing dehydration, which can worsen symptoms. Consuming fluids between meals also helps maintain hydration and prevents an empty stomach, which can trigger nausea. A: Avoiding salty snacks is not directly related to managing nausea. C: Consuming three large meals a day may worsen nausea due to overeating. D: Avoiding protein-rich foods is not recommended as they are important for fetal development and overall nutrition during pregnancy.

The nurse is assessing a client in labor and notes persistent late decelerations on the monitor. What is the priority action?

  • A. Reposition the client to her left side.
  • B. Administer oxygen via face mask.
  • C. Increase IV fluids.
  • D. Notify the healthcare provider.
Correct Answer: A

Rationale: The correct answer is A: Reposition the client to her left side. This is the priority action because late decelerations indicate uteroplacental insufficiency, possibly due to compression of the umbilical cord. Repositioning the client to her left side can help improve blood flow to the placenta by reducing pressure on the vena cava, thus optimizing fetal oxygenation. Administering oxygen (B) is important but not the immediate priority. Increasing IV fluids (C) may not directly address the cause of late decelerations. Notifying the healthcare provider (D) is important but should come after immediate interventions.

A client at 20 weeks' gestation asks about fetal movements. What is the nurse's best response?

  • A. Fetal movements are rarely felt before 24 weeks.
  • B. You should feel strong, regular movements at this stage.
  • C. You may feel fluttering movements, known as quickening.
  • D. It is too early to feel any fetal movements.
Correct Answer: C

Rationale: The correct answer is C because quickening, described as fluttering movements, is typically felt by pregnant individuals around 18-20 weeks of gestation. This indicates fetal movement and is an important milestone in pregnancy. Choices A and D are incorrect as fetal movements can be felt as early as 18-20 weeks. Choice B is incorrect as feeling strong, regular movements is not expected until later in the pregnancy.

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