Nokea
A new mother states her preference to formula feed her newborn. What will the nurse planning discharge instructions tell her to help suppress lactation and promote comfort?
- A. Wear a well-fitting bra continuously for several days.
- B. Stand in a warm shower, letting the water spray over the breasts.
- C. Express small amounts of milk from the breasts several times a day.
- D. Massage the breasts when they ache.
Correct Answer: A
Rationale: When a mother does not wish to breastfeed, a snug bra worn around the clock can help alleviate discomfort from engorgement.
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The nurse instructed a postpartum woman about storing and freezing breast milk. What statement by the woman leads the nurse to determine that the teaching was effective?
- A. I can thaw frozen breast milk in the microwave.'
- B. I'll put enough breast milk for one day in a container.'
- C. Breast milk can be stored in glass containers.'
- D. Breast milk can be kept in the refrigerator for up to 3 months.'
Correct Answer: C
Rationale: Breast milk can be safely stored in glass or clear hard plastic containers.
In what situation will the physician order RhoGAM?
- A. An unsensitized Rh-negative mother has an Rh-positive infant.
- B. An Rh-negative mother becomes sensitized.
- C. A sensitized infant has a rising bilirubin level.
- D. An unsensitized infant exhibits no outward signs.
Correct Answer: A
Rationale: The Rh-negative woman should receive RhoGAM within 72 hours after the birth of an Rh-positive infant.
Which assessments would lead the nurse to determine the gestational age of the infant as preterm? (Select all that apply.)
- A. Thin, transparent skin
- B. Vernix only in the body creases
- C. Folded ear springs back slowly
- D. Breast tissue under the nipple
- E. Creases over entire sole
Correct Answer: A,C
Rationale: The only signs of preterm are the thin skin and the slowly responding ear.
In the recovery room, the nurse checks the newly delivered woman's fundus following a cesarean section. How would the nurse proceed with this assessment?
- A. Palpate from the midline to the side of the body.
- B. Palpate from the symphysis to the umbilicus.
- C. Palpate from the side of the uterus to the midline.
- D. Massage the abdomen in a circular motion.
Correct Answer: C
Rationale: The fundus is checked gently by walking the fingers from the side of the uterus to the midline.
A primipara tells the nurse, 'My afterpains get worse when I am breastfeeding.' What is the most appropriate nursing response?
- A. I'll get you some aspirin to relieve the cramping that you feel.'
- B. Afterpains are more intense with your first baby.'
- C. Breastfeeding releases a hormone that causes your uterus to contract.'
- D. A change of position when you're breastfeeding might help.'
Correct Answer: C
Rationale: Breastfeeding mothers may have more afterpains because infant suckling causes the posterior pituitary to release oxytocin, which is a hormone that contracts the uterus.