PN ATI Capstone Maternal Newborn

Correct Answer: C

Rationale: Displacement of the uterus from the midline is often a sign of bladder distention. A full bladder can prevent the uterus from contracting properly, which could increase the risk of postpartum hemorrhage. The nurse should assist the client to void and then reassess the position and firmness of the fundus to ensure appropriate uterine contraction.

Correct Answer: B

Rationale: The nurse should inform the client that the nonstress test typically takes about 30 minutes and is used to assess fetal well-being by monitoring fetal heart rate in response to movements.

Correct Answer: B

Rationale: Moderate tremors of the extremities are a common sign of opioid withdrawal in newborns. Other signs may include irritability, feeding difficulties, and gastrointestinal disturbances.

Correct Answer: D

Rationale: If the baby is Rh positive and the mother is Rh negative, the mother may develop antibodies against the baby's blood. RhoGAM is administered to prevent the mother's immune system from becoming sensitized to Rh-positive blood.

Correct Answer: B

Rationale: An excessive high-pitched cry is a classic sign of neonatal abstinence syndrome, indicating withdrawal from substances such as methadone. Other signs may include irritability and tremors.