ATI MATERNAL-NEWBORN NURSING EXAM PREP: POSTPARTUM & NEWBORN CARE – 200 PRACTICE QUESTIONS WITH DETAILED RATIONALES

ATI MATERNAL-NEWBORN NURSING EXAM PREP: POSTPARTUM & NEWBORN CARE – 200 PRACTICE QUESTIONS WITH DETAILED RATIONALES Question 1: A postpartum nurse is assessing a client who delivered vaginally 2 hours ago. The client's fundus is firm at the umbilicus and deviated to the right. What is the nurse's priority action? A. Document the finding as normal. B. Massage the fundus firmly. C. Reassess in 30 minutes. D. Assist the client to void. CORRECT ANSWER: D. Assist the client to void. Rationale: A firm fundus that is deviated to the side is a classic sign of a distended bladder displacing the uterus. The priority is to assist the client to void, which will allow the uterus to return to midline. Massaging a firm fundus is unnecessary and can cause pain. ________________________________________ Question 2: A newborn is 12 hours old and has a respiratory rate of 68 breaths per minute with mild grunting. Which of the following actions should the nurse take first? A. Place the newborn in a prone position. B. Assess the newborn's temperature. C. Suction the newborn's mouth and nose. D. Notify the pediatrician immediately. CORRECT ANSWER: B. Assess the newborn's temperature. Rationale: Grunting can be a sign of respiratory distress, but in a newborn, it may also be caused by cold stress, which increases oxygen consumption. The first action is to assess temperature to rule out hypothermia before escalating. ________________________________________ Question 3: A postpartum client asks the nurse why she is having heavy bleeding with large clots 4 days after delivery. Which response is most appropriate? A. "This is likely due to a urinary tract infection." B. "You may have a retained placental fragment, so we will monitor your vitals." C. "This is called late postpartum hemorrhage and we need to call the doctor." D. "This is a sign of a normal postpartum recovery." CORRECT ANSWER: C. "This is called late postpartum hemorrhage and we need to call the doctor." Rationale: Late postpartum hemorrhage occurs 24 hours to 6 weeks postpartum and is often caused by retained placental fragments or infection. Heavy bleeding with large clots at 4 days postpartum is not normal and requires immediate evaluation. ________________________________________ Question 4: A nurse is teaching a new mother about breastfeeding. Which statement indicates a need for further teaching? A. "I should hear swallowing sounds during feeding." B. "My baby should have 6-8 wet diapers a day by day 5." C. "I can use a warm compress before feeding to stimulate let-down." D. "I will feed my baby every 4 hours to ensure adequate rest." CORRECT ANSWER: D. "I will feed my baby every 4 hours to ensure adequate rest." Rationale: Breastfed newborns should be fed on demand, typically every 2-3 hours (8-12 times in 24 hours). Feeding every 4 hours is too infrequent and may lead to poor weight gain and decreased milk supply. ________________________________________ Question 5: A newborn is receiving phototherapy for hyperbilirubinemia. Which intervention is a priority? A. Apply lotion to the skin to prevent dryness. B. Shield the newborn's feet with blankets. C. Monitor the newborn's temperature frequently. D. Keep the newborn dressed in warm clothing. CORRECT ANSWER: C. Monitor the newborn's temperature frequently. Rationale: Phototherapy lights can increase the newborn's temperature, leading to hyperthermia. Frequent temperature monitoring is a priority. Lotions should not be used as they can cause burns, and the infant should be minimally dressed. ________________________________________ Question 6: A postpartum client is Rh-negative and her newborn is Rh-positive. The nurse anticipates administering which of the following? A. Vitamin K injection to the newborn. B. Iron supplements to the newborn. C. Antibiotics to the mother. D. Rho(D) immune globulin within 72 hours of birth. CORRECT ANSWER: D. Rho(D) immune globulin within 72 hours of birth. Rationale: Rh-negative mothers who deliver an Rh-positive infant require Rho(D) immune globulin (RhoGAM) to prevent maternal sensitization and hemolytic disease in future pregnancies. It should be given within 72 hours of birth. ________________________________________ Question 7: A nurse is assessing a newborn's reflexes. Which finding would be considered abnormal for a 24-hour-old newborn? A. Moro reflex present. B. Stepping reflex absent. C. Babinski reflex present. D. Rooting reflex absent. CORRECT ANSWER: D. Rooting reflex absent. Rationale: The rooting reflex should be present at birth. Absence at 24 hours could indicate neurologic impairment, prematurity, or CNS depression. The stepping reflex may be absent in some healthy newborns. ________________________________________ Question 8: Which finding in a postpartum client on the 3rd day postpartum is most concerning for a potential infection? A. Fundus firm at 2 fingerbreadths below umbilicus. B. Lochia rubra with a fleshy odor. C. Temperature of 100.2°F (37.9°C). D. Breast engorgement. CORRECT ANSWER: C. Temperature of 100.2°F (37.9°C). Rationale: A temperature of 100.4°F (38°C) or higher on two consecutive days (excluding the first 24 hours) is a sign of puerperal infection. A temp of 100.2°F is nearing that threshold and warrants further assessment. ________________________________________ Question 9: A newborn's parent asks the nurse about bathing. Which recommendation is most appropriate? A. Sponge bathe the newborn until the cord falls off. B. Bathe the newborn daily with soap. C. Use alcohol to clean the cord. D. Immerse the newborn in a tub of warm water. CORRECT ANSWER: A. Sponge bathe the newborn until the cord falls off. Rationale: Until the umbilical cord stump falls off, sponge baths are recommended to prevent infection. Tub baths should be avoided until the cord is completely detached.