Nokea
A client at 4 weeks postpartum tells the nurse that she can't cope any longer and is overwhelmed by her newborn. The baby has old formula on her clothes and under her neck. The mother does not remember when she last bathed the baby and states she does not want to care for the infant. The nurse should encourage the client and her husband to call their health care provider because the mother should be evaluated further for?
- A. Postpartum blues.
- B. Postpartum depression.
- C. Poor bonding.
- D. Infant abuse.
Correct Answer: B
Rationale: Postpartum depression involves feelings of being overwhelmed and unable to care for the infant.
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A client is considering the withdrawal method. Which of the following client statements indicates understanding?
- A. It requires careful timing and control.
- B. It is more effective than oral contraceptives.
- C. It provides protection against STIs.
- D. It is 100% effective with perfect use.
Correct Answer: A
Rationale: The withdrawal method requires careful timing and control to be effective. It is less effective than oral contraceptives, does not protect against STIs, and is not 100% effective, even with perfect use.
A multigravid client is admitted at 4-cm dilation and requesting pain medication. The nurse gives the client Nubain 15 mg and Phenergan 25 mg slow I.V. push. Within 5 minutes, the client tells the nurse she feels like she needs to have a bowel movement. The nurse should first:
- A. Have naloxone hydrochloride (Narcan) available in the delivery room.
- B. Perform a vaginal examination to determine dilation, effacement, and station.
- C. Prepare for delivery.
- D. Document the client's relief due to pain medication.
Correct Answer: B
Rationale: A sudden urge to have a bowel movement in labor often indicates rapid progression to full dilation or fetal descent. A vaginal examination confirms dilation and station to guide next steps (e.g., preparing for delivery). Naloxone, preparation, or documentation are premature without assessment.
When caring for a multiparous client who is human immunodeficiency virus (HIV)-positive and asking to breast-feed her neonate as soon as possible, which of the following instructions about breast milk should the nurse include in the teaching plan?
- A. It does not help prevent the spread of the HIV virus.
- B. It contains antibodies that can protect the neonate from HIV.
- C. It can be beneficial for the bonding process.
- D. It has been found to contain the contain the retrovirus HIV.
Correct Answer: D
Rationale: Breast milk from an HIV-positive mother can transmit the virus to the neonate, so breastfeeding is contraindicated to prevent HIV transmission.
The nurse is explaining to a primagravida in labor that her baby is in a breech presentation, with the baby’s presenting part in a left, sacrum, posterior (LSP) position. Which illustration should the nurse use to help the client understand how her baby is positioned?
- A. primagravida-1.png
- B. primagravida-2.png
- C. primagravida-3.png
- D. primagravida-4.png
Correct Answer: A
Rationale: This figure shows the client’s baby in a breech presentation with the baby facing the pelvis on the left, the sacrum as the presenting part, and the presenting part (sacrum) is posterior in the pelvis. Figure 2 shows a vertex presentation with the baby in a left, occiput, anterior position (LOA). Figure 3 shows a vertex presentation, left, occipit, posterior (LOP). Figure 4 shows a face position with the babyin a left, mentum, transverse position (LMT).
Following a cesarean delivery for abruptio placentae, a multigravid client tells the nurse, "I feel like such a failure. None of my other deliveries were like this." The nurse's response to the client is based on the understanding of which of the following?
- A. The client will most likely have postpartum blues.
- B. Maternal-infant bonding is likely to be difficult.
- C. The client's feeling of grief is a normal reaction.
- D. This type of delivery was necessary to save the client's life.
Correct Answer: C
Rationale: Grief is a normal reaction to a complicated delivery.