Nokea
A 25-year-old client who had a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit. The nurse knows that assessment for what complication has the highest priority for this client?
- A. Placenta accreta
- B. Hard, painful uterine afterpains.
- C. Postpartum psychosis.
- D. Disseminated intravascular coagulation
Correct Answer: D
Rationale: Severe postpartum hemorrhage increases the risk of disseminated intravascular coagulation (DIC), a life-threatening condition requiring urgent assessment.
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The nurse is reviewing a woman's health care record during her first prenatal visit. The client has a history of chicken pox as a child and syphills as a teenager. Which action is most important for the nurse to take?
- A. Obtain blood and urine for prenatal screens
- B. Explain common complications of pregnancy
- C. Obtain baseline blood pressure and weight
- D. Schedule prenatal visits to occur monthly
Correct Answer: A
Rationale: Given the history of syphilis, obtaining blood and urine for prenatal screens is critical to assess for active infection or other risks that could impact the pregnancy.
The nurse is caring for a client who is 24-weeks gestation and reports increased thirst and urination. Which diagnostic test result should the nurse report to the healthcare provider?
- A. Hemoglobin A1C.
- B. Postprandial blood glucose test
- C. Fasting blood glucose
- D. Oral glucose tolerance test
Correct Answer: C
Rationale: Increased thirst and urination at 24 weeks suggest possible gestational diabetes. Fasting blood glucose is a standard initial screening test to detect abnormal glucose levels.
A client who delivered vaginally 2 days ago states that she wants to resume using her diaphragm for birth control. What information should the nurse share with her?
- A. The diaphragm must be refitted after childbirth
- B. The most effective form of contraception is a diaphragm
- C. The diaphragm should be inserted 2 to 4 hours before intercourse.
- D. Vaseline lubricant can be used when inserting the diaphragm
Correct Answer: A
Rationale: Childbirth can alter vaginal and cervical anatomy, requiring the diaphragm to be refitted for effective contraception.
Which physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum?
- A. Unilateral lower leg pain.
- B. Soft, spongy fundus
- C. Saturating two perineal pads per hour.
- D. Pulse rate of 56 beats/minute
Correct Answer: D
Rationale: A pulse rate of 56 beats/minute is within the normal range for a resting postpartum client. The other options indicate potential complications like DVT, uterine atony, or excessive bleeding.
The nurse is assessing a 38-week gestation newborn infant immediately following a vaginal birth. Which assessment finding best indicates that the infant is transitioning well to extrauterine life?
- A. Cries vigorously when stimulated
- B. A positive Babinski reflex
- C. Heart rate of 220 beats/minute
- D. Flexion of all four extremities
Correct Answer: A
Rationale: Vigorous crying indicates effective breathing and responsiveness, key signs of successful transition to extrauterine life.