ATI LPN Maternal Newborn 2023 IV

ATI LPN Maternal Newborn 2023 IV Related

Review ATI LPN Maternal Newborn 2023 IV related questions and content

Nurses' Notes (Postpartum Assessment) 1200: The client successfully delivered a viable newborn via vaginal delivery. 1300: The client reports feeling tired and anxious. Assessment reveals the fundus is deviated to the left, boggy, and located 1 cm above the umbilicus. The perineal pad is saturated with lochia rubra, indicating excessive bleeding. The client reports an inability to ambulate to the bathroom due to residual numbness from the labor epidural. Pain is reported as 0 on a scale of 0 to 10. Fundal massage performed during assessment has yielded no improvement in uterine tone. A nurse is caring for a 36-year-old female client in the labor and delivery unit at 39 weeks of gestation admitted for evaluation of postpartum bleeding following a vaginal delivery.

Select the 2 interventions the nurse should perform immediately.

  • A. Weigh the client’s perineal pad.
  • B. Insert a straight catheter for the client.
  • C. Administer methylergonovine 0.2 mg IM.
  • D. Draw a complete blood count.
  • E. Apply oxygen via nasal cannula.
Correct Answer: B,C

Rationale: Inserting a catheter empties the bladder, aiding uterine contraction; methylergonovine stimulates contractions to reduce bleeding from a boggy uterus.

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The nurse should first address the client's blood pressure followed by the client's platelet count.

Which of the following options correctly prioritizes these actions?

  • A. Blood pressure should be checked before platelet count.
  • B. Platelet count is more important than blood pressure.
  • C. Address both simultaneously.
  • D. Ignore blood pressure.
Correct Answer: A

Rationale: Blood pressure should be checked first as it indicates immediate hemodynamic status, critical in acute settings, followed by platelet count for bleeding risk.

A nurse is reinforcing teaching with a newly licensed nurse concerning a client on a postpartum unit following a cesarean birth.

Which of the following measures should the nurse include in the instructions to prevent thrombophlebitis?

  • A. Have the client ambulate as often as possible.
  • B. Apply warm, moist packs to the client's lower legs.
  • C. Apply elastic stockings before the client gets out of bed.
  • D. Administer NSAIDs every 6 to 8 hours.
Correct Answer: A

Rationale: Early ambulation prevents blood stasis, a key measure to reduce thrombophlebitis risk post-cesarean.

A nurse is reinforcing discharge instructions about breastfeeding with a client.

Which of the following statements should the nurse make?

  • A. You should recognize that your baby sucking on his hands is a hunger cue.
  • B. You should feed your baby six times a day.
  • C. You should feed your baby for 10 minutes on each breast.
  • D. You should wake your baby at least every 6 hours at night for feedings.
Correct Answer: A

Rationale: Recognizing hand-sucking as a hunger cue ensures timely breastfeeding, supporting nutritional needs and feeding success.

A nurse is reviewing the facility protocol about newborn identification and safety with a new parent.

Which of the following information should the nurse include?

  • A. We will scan your baby's identification bracelet each time we check on him.
  • B. You should check the identity of individuals who come to remove your baby from the room.
  • C. We will match the bracelet on your baby with his footprint record each shift.
  • D. Your baby will wear an electronic bracelet when he is out of your room.
Correct Answer: B

Rationale: Parents should verify the identity of anyone taking the baby from the room. This prevents unauthorized individuals from removing the baby, enhancing security and safety.

A nurse is assisting with the care of a client who is in labor and has an epidural infusion for pain management. The client's blood pressure is 80/40 mm Hg.

Which of the following actions should the nurse take?

  • A. Place the client in knee-chest position.
  • B. Give a bolus of lactated Ringer's.
  • C. Administer methylergonovine IM.
  • D. Assist the client to empty her bladder.
Correct Answer: B

Rationale: Giving a bolus of lactated Ringer's solution can help increase the client's blood pressure by expanding the intravascular volume, a common intervention for hypotension caused by epidural anesthesia.

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