Nokea
A new Native American mother tells the nurse that when she goes home her mother-in-law will be caring for the baby while she rests. The nurse has concerns. What should the nurse do?
- A. Explain the importance of ambulating to recover.
- B. Explain the importance of maternal-infant bonding.
- C. Explore ways to blend this with safe health teaching.
- D. Encourage this cultural behavior.
Correct Answer: C
Rationale: Follow principles that facilitate nursing practice within transcultural situations.
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Which tests are performed to detect inborn errors of metabolism in the newborn?
- A. Blood glucose
- B. Phenylketonuria (PKU)
- C. Blood urea nitrogen (BUN)
- D. Prothrombin time (PT)
Correct Answer: B
Rationale: State law requires certain diagnostic tests be performed on the newborn, including PKU, which detects an inborn error of metabolism.
The new mother has decided not to breastfeed the baby. How should the nurse correctly instruct the mother to suppress her milk supply?
- A. Pump the breasts to remove milk
- B. Apply warm moist compresses
- C. Restrict oral fluids
- D. Apply a firm bra and ice packs
Correct Answer: D
Rationale: If a patient is not breastfeeding, compress the breasts with a firm bra and wrapped ice packs to suppress the milk supply. Pumping the breasts and applying warm, moist compresses are instructions for the breast-feeding mother to deal with the painful symptoms of engorgement.
The postpartum mother with a third degree laceration tells the nurse she is afraid to have a bowel movement because of her painful episiotomy. What should the nurse do?
- A. Offer a suppository or enema.
- B. Encourage ambulation.
- C. Offer stool softeners as prescribed.
- D. Offer pain medication before defecating.
Correct Answer: C
Rationale: Stool softeners are available to ease the pain of defecation caused by hemorrhoids and birth trauma. Suppositories or enemas are contraindicated in mothers with third or fourth degree lacerations. Pain medications can often cause constipation. Ambulation may aid in defecation, but will not soften the stool.
During the immediate postpartum period the mother has a temperature of 100.2°F (37.8°C) pulse 52 respirations 18 BP 138/84. What should the nurse do?
- A. Report the temperature as abnormal.
- B. Continue to monitor every 15 minutes.
- C. Report the pulse as abnormal.
- D. Nothing as the vital signs are normal.
Correct Answer: D
Rationale: The vital signs are normal for a new postpartum patient.
When is breast engorgement most likely to occur?
- A. When the infant's mouth surrounds the areola when feeding
- B. When the breast tissue becomes congested
- C. When the breast is emptied completely at each feeding
- D. When the infant's mouth grasps the nipple firmly
Correct Answer: B
Rationale: Engorgement is the result of venous and lymphatic stasis (congestion). Emptying the breast at each feeding, the infant grasping the nipple firmly, and the infant's mouth surrounding the areola when feeding are all measures that will aid in decreasing engorgement.