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A breastfeeding woman, 1 1/2 months postdelivery, calls the nurse in the obstetrician 's office and states, 'I am very embarrassed but I need help. Last night I had an orgasm when my husband and I were making love. You should have seen the milk. We were both soaking wet. What is wrong with me? ' The nurse should base the response to the client on which of the following?
- A. The woman is exhibiting signs of pathological galactorrhea.
- B. The same hormone stimulates orgasms and the milk ejection reflex.
- C. The woman should have a serum galactosemia assessment done.
- D. The baby is stimulating the woman to produce too much milk.
Correct Answer: B
Rationale: The hormone oxytocin is responsible for both milk ejection during breastfeeding and uterine contractions during orgasm, which explains the milk release.
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A young mother is excited about her first baby. Choose the best teaching to help her obtain adequate rest after discharge.
- A. Plan to sleep or rest any time the infant sleeps.
- B. Do all housecleaning while the infant sleeps.
- C. Cook several meals at once and freeze for later use.
- D. Tell family and friends not to visit for the first month.
Correct Answer: A
Rationale: Encouraging the mother to rest when the baby sleeps is the best way to ensure adequate rest.
When referring to the 4 T’s of PPH, what does tissue refer to?
- A. Placental tissue or membranes are retained.
- B. Tissue of the perineum is torn.
- C. Tissue of the uterus is torn.
- D. Tissue is not perfused.
Correct Answer: A
Rationale: The correct answer is A because in the context of Postpartum Hemorrhage (PPH), the 4 T’s stand for Tone, Trauma, Tissue, and Thrombin. Tissue refers to placental tissue or membranes being retained, leading to excessive bleeding. This can be a common cause of PPH.
Option B is incorrect because it refers to perineal tears, which are related to trauma and not specifically related to tissue retention causing PPH. Option C is incorrect as it refers to uterine tissue tears, which is more related to trauma rather than retained tissue. Option D is incorrect because it refers to tissue not being perfused, which is not directly related to the concept of tissue retention causing PPH.
The labor and delivery unit nurses are adopting methods to reduce the number of women who develop postpartum depression. Research from Dennis and Dowswell (2013) provides evidence-based suggestions regarding beneficial interventions. Which suggestions do the nurses consider? Select all that apply.
- A. Telephone-based peer support
- B. Partner report of symptoms
- C. Interpersonal psychotherapy
- D. Teaching for self-recognition of problems
Correct Answer: C
Rationale: The correct answer is C: Interpersonal psychotherapy. This is supported by research as an evidence-based intervention for reducing postpartum depression. It focuses on improving relationships and communication skills, which can help women cope with the challenges of motherhood.
A: Telephone-based peer support may be helpful, but it is not specifically mentioned in the research by Dennis and Dowswell (2013) as a beneficial intervention.
B: Partner report of symptoms can be useful in identifying postpartum depression, but it is not a recommended intervention according to the research.
D: Teaching for self-recognition of problems is important, but it is not as effective as interpersonal psychotherapy in reducing postpartum depression according to the research.
During a home visit, the nurse assesses a client 2 weeks after delivery. Which of the following signs/symptoms should the nurse expect to see?
- A. Diaphoresis.
- B. Lochia alba.
- C. Cracked nipples.
- D. Hypertension.
Correct Answer: B
Rationale: By the second week postpartum, lochia typically transitions to alba (white or yellowish discharge).
What nursing intervention does the nurse include in the plan of care for a person with a perineal laceration infection?
- A. Demonstrate the use of a urinary catheter.
- B. Provide an abdominal binder.
- C. Encourage use of the peri-bottle for cleaning front to back.
- D. Discourage use of pain medications.
Correct Answer: C
Rationale: The peri-bottle helps maintain cleanliness and reduce infection risk in perineal lacerations.