A nurse is caring for a client who experienced a vaginal delivery 12 hr ago. When palpating the client's abdomen, at which of the following positions should the nurse expect to find the uterine fundus?
- A. At the level of the umbilicus
- B. 2 cm above the umbilicus
- C. One fingerbreadth above the symphysis pubis
- D. To the right of the umbilicus
Correct Answer: C
Rationale: After a vaginal delivery, the uterus typically undergoes involution, which is the process of the uterus returning to its pre-pregnancy size and position. At 12 hours postpartum, the uterine fundus should be palpated approximately one fingerbreadth above the symphysis pubis. This position indicates proper contraction of the uterus and helps prevent postpartum hemorrhage. As time progresses, the uterine fundus will gradually descend back into the pelvis.
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The nurse is assessing a client in labor with variable decelerations on the fetal monitor. What is the priority intervention?
- A. Increase oxytocin infusion.
- B. Reposition the client.
- C. Administer oxygen at 10 L/min.
- D. Notify the healthcare provider.
Correct Answer: B
Rationale: Repositioning the client can alleviate umbilical cord compression, the most common cause of variable decelerations.
A nurse is caring for a client who is in labor and requests nonpharmacological pain management. Which of the following nursing actions promotes client comfort?
- A. Assisting the client into squatting position
- B. Having the client lie in a supine position
- C. Applying fundal pressure during contractions
- D. Encouraging the client to void every 6 hr.
Correct Answer: A
Rationale: Assisting the client into a squatting position can help relieve pain and discomfort during labor. Squatting can open up the pelvis, allowing the baby to descend and progress through the birth canal more effectively. This position can also help with gravity-assisted delivery, decreasing the pressure on the mother's back and helping to reduce labor pains. Encouraging various positions during labor can provide comfort and promote optimal positioning for delivery.
Which of the following best describes the mechanism of action of birth control pills?
- A. They block sperm from reaching the egg.
- B. They prevent ovulation by suppressing hormone levels.
- C. They increase cervical mucus production to block sperm entry.
- D. They reduce the size of the ovaries and fallopian tubes to prevent pregnancy.
Correct Answer: B
Rationale: Birth control pills primarily work by preventing ovulation, thereby inhibiting the release of eggs for fertilization. Choice A is incorrect because birth control pills do not directly block sperm; they prevent ovulation. Choice C is partially correct but is not the main mechanism, as the primary function is to prevent ovulation. Choice D is incorrect because birth control pills do not alter the size of reproductive organs.
The nurse is discussing contraceptive options with a patient who states they want to become pregnant in 1 year. Which contraception choice would be appropriate for them? Select all that apply.
- A. progestin-only contraceptive injections like DMPA
- B. progestin-only oral contraceptive pills
- C. fertility awareness methods
- D. COCs
Correct Answer: C
Rationale: Fertility awareness methods involve tracking a woman's menstrual cycle to identify the fertile window when pregnancy is most likely to occur. This method does not interfere with future fertility and can be used by individuals who plan to become pregnant in the near future. Since the patient expressed a desire to conceive in one year, fertility awareness methods would be the most appropriate contraceptive option for them.
Which health concern is most likely to be an issue for the older mother?
- A. Nutrition and diet planning
- B. Exercise and fitness
- C. Having enough rest and sleep
- D. Effective contraceptive methods
Correct Answer: A
Rationale: As women age, their nutritional needs may change, and they may require more specific nutrients to support their health. Older mothers may be more susceptible to health concerns related to inadequate nutrition and diet planning, such as osteoporosis or heart disease. Proper nutrition is essential for both the mother's well-being and the health of her child. Therefore, nutrition and diet planning are more likely to be an issue for an older mother compared to exercise, rest, or contraceptive methods, especially during pregnancy and postpartum periods.