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RN maternal Newborn 2019 with NGN
ATI RN maternal Newborn 2019 with NGN
Total Questions : 66
Showing 10 questions Sign up for moreAfter completing post anesthesia recovery assessments, the registered nurse (RN) asks the practical nurse (PN) to transfer four clients, each two hours post-birth, to the postpartum unit. Which client should the PN ask the RN to reassess prior to transfer?
Explanation
This client should be reassessed by the RN prior to transfer, as worsening perineal pain may indicate a hematoma, infection, or inadequate pain management. The RN should inspect the perineum, check the vital signs, and evaluate the effectiveness of the medication.
The other options are not correct because:
B .A multigravida whose peri-pad is 1/4 saturated with lochia rubra after one hour does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Lochia rubra is the red-colored vaginal discharge that contains blood and debris from the placental site, and it usually lasts for 3 to 4 days after delivery. A peri-pad that is 1/4 saturated after one hour is within the expected range of blood loss.
C. A multigravida complaining of strong afterbirth pains when breastfeeding does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Afterbirth pains are cramps caused by uterine contractions that help shrink the uterus and prevent bleeding. They are more common and intense in multiparous women and during breastfeeding, as oxytocin is released and stimulates the contractions.
D. A primigravida who passed a small clot when she sat up on the edge of the bed does not need to be reassessed by the RN, as this is a normal finding for a client two hours post-birth. Small clots may form in the uterus or vagina due to pooling of blood during rest or anesthesia, and they are usually expelled when changing position or ambulating. As long as the clot is smaller than a plum and there is no excessive bleeding or pain, it is not a cause for concern.
A nurse is discussing risk factors of postpartum hemorrhage with a newly licensed nurse.
Which of the following conditions is a risk factor for postpartum hemorrhage that the nurse should include in the teaching?
Explanation
Retained placental fragments is a risk factor for postpartum hemorrhage. After delivery, the uterus continues to contract to deliver the placenta.
Contractions also help to compress the blood vessels where the placenta was atached to the uterine wall.
Postpartum hemorrhage can happen if parts of the placenta stay atached to the
uterine wall.
Choice A is incorrect because pregnancy-induced hypertension is a risk factor for
postpartum hemorrhage.
Choice B is incorrect because meconium-stained fluid is not mentioned as a risk factor for postpartum hemorrhage in my sources.
Choice D is incorrect because oligohydramnios is not mentioned as a risk factor for postpartum hemorrhage in my sources.
A nurse is planning care for a client who is pregnant and has HIV.
Which of the following actions should the nurse include in the plan of care?
Explanation
Bathing the newborn before initiating skin-to-skin contact is an action that the nurse should include in the plan of care for a client who is pregnant and has HIV.
Choice A is incorrect because using a fetal scalp electrode during labor and delivery is not mentioned as an action that should be included in the plan of care for a client who is pregnant and has HIV in my sources.
Choice C is incorrect because instructing the client to stop taking antiretroviral medications at 32 weeks of gestation is not mentioned as an action that should be included in the plan of care for a client who is pregnant and has HIV in my sources.
Choice D is incorrect because administering a pneumococcal immunization to the newborn within 4 hours following birth is not mentioned as an action that should be included in the plan of care for a client who is pregnant and has HIV in my sources.
A nurse is teaching a client and her partner about the technique of counterpressure during labor.
Which of the following statements by the nurse is appropriate?
Explanation
Answer: D
Rationale:
(A) "Your partner will apply continuous, firm pressure between your thumb and index finger": This statement is not appropriate for describing counterpressure during labor. Counterpressure typically involves applying pressure to areas such as the lower back or sacrum, not between the thumb and index finger.
(B) "Your partner will apply pressure to the top of your uterus during contractions": This statement is not appropriate. Applying pressure to the top of the uterus during contractions could be harmful and is not recommended as a counterpressure technique during labor. Counterpressure is generally applied to the lower back or hips to alleviate pain.
(C) "Your partner will apply steady pressure with a tennis ball to your finger": This statement is not correct. Counterpressure during labor involves applying pressure to the lower back or hips, not to the fingers. A tennis ball may be used, but it is applied to the lower back or sacral area, not the fingers.
(D) "Your partner will apply upward pressure on you": This statement is appropriate. During labor, counterpressure is often applied by the partner to the lower back or hips, pressing upward or in a direction that helps alleviate the pain caused by contractions, particularly in cases of back labor. This technique can help relieve discomfort by counteracting the pressure from the baby's head against the mother's spine.
A nurse is providing dietary teaching to a client who is at 32 weeks of gestation and has cholelithiasis.
Which of the following foods should the nurse recommend for the client to include in her diet?
Explanation
Baked chicken is a food that the nurse should recommend for a client who is at
32 weeks of gestation and has cholelithiasis to include in her diet.
Eating healthy fats, like those found in lean meats such as chicken, can help the gallbladder contract and empty on a regular basis.
Choice B is incorrect because French fries are not a food that the nurse should recommend for a client who is at 32 weeks of gestation and has cholelithiasis to include in her diet.
Unhealthy fats, like those often found in fried foods, should be avoided.
Choice C is incorrect because whole milk is not a food that the nurse should recommend for a client who is at 32 weeks of gestation and has cholelithiasis to include in her diet.
Unhealthy fats, like those often found in whole milk, should be avoided.
Choice D is incorrect because a bacon cheeseburger is not a food that the nurse should recommend for a client who is at 32 weeks of gestation and has cholelithiasis to include in her diet.
Unhealthy fats, like those often found in bacon and cheeseburgers, should be avoided.
A nurse is providing discharge instructions to a client who is 24 hours postpartum and has decided not to breastfeed.
Which of the following instructions should the nurse include in the teaching?
Explanation
“Apply ice packs to your breasts using a 15 minutes on, 45 minutes off schedule.”
This can help reduce swelling and relieve discomfort from engorgement.
Choice B is incorrect because warm water can increase blood flow and may worsen engorgement.
Choice C is incorrect because a supportive bra can help reduce discomfort from engorgement.
Choice D is incorrect because pumping can stimulate milk production and may worsen engorgement.
A nurse is performing a heel stick on a newborn. Which of the following actions should the nurse take?
Explanation
“Use an automatic puncture device on the heel.” This is the most common and minimally invasive method to draw capillary blood from an infant for medical testing.
Choice A is incorrect because the heel should be punctured on the outer aspect of the foot to avoid damaging the calcaneus bone.
Choice C is incorrect because the heel should be cleansed with an alcohol swab
before, not after, the procedure.
Choice D is incorrect because there is no need to place an ice pack on the newborn’s heel before the procedure.
A nurse is assessing a full-term newborn upon admission to the nursery.
Which of the following clinical findings should the nurse report to the provider?
Explanation
Rust-stained urine.
Rust-stained urine in a newborn can be a sign of a serious medical condition and should be reported to the provider.
Choice B is not the answer because subconjunctival hemorrhage in a newborn is usually normal and harmless.
It may be caused by pressure changes during vaginal delivery and will disappear on its own after two or three weeks.
Choice C is not the answer because single palmar creases develop while a baby
is growing in the womb and appear in about 1 out of 30 people.
While some single palmar creases may indicate problems with development and be linked with certain disorders, it is not necessarily a cause for concern.
Choice D is not the answer because transient circumoral cyanosis refers to blue discoloration around the mouth only and is usually seen in infants.
It’s often considered a type of acrocyanosis which happens when small blood vessels shrink in response to cold.
This is very normal in infants during the first few days after birth.
A nurse is caring for a client who is at 30 weeks of gestation and is receiving magnesium sulfate for preeclampsia.
The nurse should recognize which of the following manifestations as an adverse reaction to the medication?
Explanation
This can be a sign of magnesium toxicity and should be reported to the provider.
Choice A is incorrect because magnesium sulfate is used to treat hypertension associated with preeclampsia.
Choice B is incorrect because a respiratory rate of 16/min is within normal range.
Choice D is incorrect because hyperglycemia is not a known adverse reaction to magnesium sulfate.
A nurse is caring for a client who has a placenta previa.
Which of the following findings should the nurse expect?
Explanation
This is the most common symptom of placenta previa and can occur after 20 weeks of gestation.
Choice B is incorrect because a persistent headache is not a known symptom of placenta previa.
Choice C is incorrect because uterine hypertonicity is not a known symptom of placenta previa.
Choice D is incorrect because a firm, rigid abdomen is not a known symptom of placenta previa.
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