Maternal Nwebron ATI

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Sample questions from Maternal Nwebron ATI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In a postpartum unit, a 24-year-old client who gave birth 1 hour ago has a boggy uterus, heavy lochia, and a heart rate of 118/min. Which action should the nurse take first?

   • A.Prepare discharge teaching about warning signs
   • B.Ask the client to ambulate to the bathroom
   • C.Document the amount of lochia and reassess in 30 minutes
   • D.Massage the fundus while calling for assistance

   Rationale: A boggy uterus with heavy bleeding and tachycardia suggests uterine atony and possible postpartum hemorrhage, so fundal massage is an immediate nursing action while help is summoned. Waiting to reassess delays treatment of potentially life-threatening blood loss. Ambulation is unsafe with active bleeding and tachycardia, and discharge teaching is not the priority.

2. 2.During a home visit, a 3-day-old newborn is sleepy and feeding poorly; the parent reports only one wet diaper in the past 24 hours. Which action should the visiting nurse take?

   • A.Reassure the parent that low urine output is expected during the first month
   • B.Recommend offering water between breastfeeds
   • C.Arrange prompt medical evaluation and notify the newborn's primary care provider
   • D.Schedule another home visit in 1 week

   Rationale: Poor feeding, sleepiness, and markedly decreased urine output in a newborn require prompt evaluation for dehydration, inadequate intake, or illness. Water is not an appropriate substitute for breast milk or formula and can be harmful to a newborn. Waiting a week or reassuring the parent could delay necessary assessment and treatment.

3. 3.Refer to the client's chart. Which actions should the nurse take now for this postpartum client? Select all that apply.

   • A.Encourage the client to ambulate in the hallway before notifying the provider
   • B.Administer the prescribed broad-spectrum antibiotic promptly after cultures are obtained
   • C.Document the findings and wait until the next scheduled vital-sign check to report them
   • D.Obtain the prescribed blood and urine cultures before the first antibiotic dose if this does not delay treatment
   • E.Notify the obstetric provider promptly about the fever and uterine tenderness

   Rationale: The temperature of 39.0 C, increasing heart rate, and uterine tenderness documented at 1000 are concerning for postpartum infection and require prompt provider notification. Cultures should be obtained before antibiotics when feasible, and the prescribed antibiotic should then be given promptly. Ambulation does not address the suspected infection, and delaying notification or treatment risks deterioration.

4. 4.At a prenatal clinic, a 31-year-old client at 38 weeks is scheduled for a cesarean birth. The client says, "I do not understand why I need this surgery." The consent form is unsigned. Which action should the nurse take?

   • A.Pause preparation and ask the provider to explain the procedure and answer the client's questions
   • B.Witness the client's signature after reassuring the client that the procedure is routine
   • C.Explain the surgical risks and benefits, then ask the client to sign
   • D.Ask the client's partner to sign the consent form

   Answer and rationale are in the full material.

5. 5.At change of shift in a labor and delivery unit, an RN is assigning tasks to a practical nurse and an unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?

   • A.Evaluate a newborn's response to a prescribed glucose gel dose
   • B.Obtain routine vital signs for a stable client 6 hours after an uncomplicated vaginal birth
   • C.Teach a client how to use a breast pump before discharge
   • D.Assess a client reporting new shortness of breath after cesarean birth

   Answer and rationale are in the full material.