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A client, who is 2 weeks postpartum, calls her obstetrician's nurse and states that she has had a whitish discharge for 1 week but today she is"bleeding and saturating a pad about every 1/2 hour."Which of the following is an appropriate response by the nurse?
- A. That is normal. You are starting to menstruate again.
- B. You should stay on complete bed rest until the bleeding subsides.
- C. Pushing during a bowel movement may have loosened your stitches.
- D. The physician should see you. Please go to the emergency department.
Correct Answer: D
Rationale: Heavy bleeding postpartum requires immediate medical attention.
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Four pregnant women advise the nurse that they wish to breastfeed their babies. Which of the mothers should be advised to bottle feed her child?
- A. The woman with a neoplasm requiring chemotherapy.
- B. The woman with cholecystitis requiring surgery.
- C. The woman with a concussion.
- D. The woman with thrombosis.
Correct Answer: A
Rationale: Chemotherapy agents can harm the baby through breast milk.
A family is concerned about how their 2-year-old son is going to react to the new baby. Which intervention would help facilitate sibling attachment?
- A. Have the mother and father spend individual time with their son to allay potential anxiety over the new baby coming in and displacing his position in the family as the only child.
- B. Make sure that their son is supervised at all times when the baby is brought home
- C. Include the son in helping to take care of the baby and reinforce the label of “big brother” as a special role.
- D. Observe the son’s reaction to the baby and let him decide when he wants to be
Correct Answer: C
Rationale: The correct answer is C because involving the 2-year-old son in caring for the new baby and reinforcing his role as a "big brother" can help facilitate sibling attachment. This intervention promotes bonding, fosters a sense of responsibility, and helps the son feel included in the family dynamic. It also allows the son to feel special in his new role, leading to positive feelings towards the new baby.
Choice A is incorrect as just spending individual time with the son may not address his concerns about the new baby and could potentially reinforce any feelings of displacement. Choice B is incorrect as constant supervision may not necessarily facilitate sibling attachment and could lead to feelings of restriction or resentment. Choice D is incorrect as it puts the onus solely on the son without providing clear guidance or support in navigating the new family dynamic.
The nurse is teaching the parents of a female baby how to change the baby's diapers. Which of the following should be included in the teaching?
- A. Always wipe the perineum from front to back.
- B. Remove any vernix caseosa from the labial folds.
- C. Put powder on the buttocks every time the baby stools.
- D. Weigh every diaper to assess hydration status.
Correct Answer: A
Rationale: Front-to-back wiping prevents urinary tract infections.
A 4-day-old breastfeeding neonate whose birth weight was 2,678 grams has lost 100 grams since the cesarean birth. Which of the following actions should the nurse take?
- A. Nothing because this is an acceptable weight loss.
- B. Advise the mother to supplement feedings with formula.
- C. Notify the neonatologist of the excessive weight loss.
- D. Give the baby dextrose water between breast feedings.
Correct Answer: A
Rationale: Weight loss within 5% is normal.
What is the term for the separation found in the midline of the abdomen after birth?
- A. uterine subinvolution
- B. umbilical hernia
- C. striae
- D. diastasis recti abdominus
Correct Answer: D
Rationale: The correct answer is D: diastasis recti abdominus. This term refers to the separation of the rectus abdominis muscles along the midline of the abdomen. This condition commonly occurs after pregnancy due to the stretching of the abdominal muscles. It is important to differentiate diastasis recti from other conditions such as uterine subinvolution, which is the delayed return of the uterus to its normal size postpartum; umbilical hernia, which is a protrusion of abdominal contents through the umbilical ring; and striae, which are stretch marks caused by rapid stretching of the skin. Diastasis recti is characterized by a visible gap between the muscles, often causing a bulge in the midline of the abdomen. Treatment usually involves specific exercises to strengthen the abdominal muscles and improve the condition.