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A nurse is caring for a postpartum person who is experiencing excessive bleeding. What should the nurse assess first?
- A. perform uterine massage
- B. perform a vaginal examination
- C. evaluate blood loss
- D. perform a uterine check
Correct Answer: A
Rationale: The correct answer is A: perform uterine massage. This is the priority because uterine massage helps to stimulate uterine contractions, which can help control bleeding in postpartum individuals. It is crucial to address the source of bleeding first. Performing a vaginal examination (choice B) may exacerbate bleeding. Evaluating blood loss (choice C) is important but not the initial step. Performing a uterine check (choice D) is vague and not as specific as uterine massage in addressing postpartum bleeding.
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A nurse is assisting with a vaginal delivery. What is the most important action when the fetal head begins to crown?
- A. apply gentle downward pressure
- B. perform perineal massage
- C. perform a vaginal exam
- D. assist with breathing exercises
Correct Answer: A
Rationale: The correct answer is A: apply gentle downward pressure. This action helps prevent rapid delivery, reducing the risk of tearing and allowing the perineum to stretch gradually. It also helps control the delivery, ensuring a safe and controlled birth process. Performing perineal massage (B) is beneficial during the pushing stage but is not the most important action when the head crowns. Performing a vaginal exam (C) is unnecessary and may increase the risk of infection. Assisting with breathing exercises (D) is important during labor but not specifically when the head crowns.
A pregnant woman who is 28 weeks gestation reports that she feels dizzy and faint when she stands up. What should the nurse instruct the patient to do?
- A. Lie down flat on your back immediately.
- B. Stand up quickly to prevent dizziness from worsening.
- C. Drink a large amount of water to alleviate the dizziness.
- D. Get up slowly and avoid standing for long periods.
Correct Answer: D
Rationale: The correct answer is D, instructing the pregnant woman to get up slowly and avoid standing for long periods. This is because during pregnancy, blood pressure can drop when standing up quickly, leading to dizziness and fainting. Getting up slowly allows the body to adjust gradually, preventing a sudden drop in blood pressure. Standing for long periods can worsen these symptoms, so it is important to avoid prolonged standing.
A: Lying down flat on the back immediately can worsen symptoms in this case by reducing blood flow to the brain.
B: Standing up quickly can exacerbate dizziness and fainting by causing a sudden drop in blood pressure.
C: Drinking a large amount of water may not address the underlying issue of postural hypotension and could potentially worsen symptoms by increasing blood volume without addressing the drop in blood pressure.
How should the nurse respond to a concern about alcohol exposure during conception?
- A. Inform the doctor
- B. Reassure it's unlikely the baby was affected
- C. Suggest abortion
- D. Recommend ultrasound
Correct Answer: B
Rationale: Occasional alcohol exposure around conception is unlikely to cause significant harm, though ongoing abstinence is advised.
A nurse is preparing a postpartum person for discharge after a vaginal birth. What is the most important aspect of discharge teaching?
- A. offer emotional support
- B. assist with breastfeeding immediately
- C. assist with positioning the person
- D. provide non-pharmacological pain relief
Correct Answer: A
Rationale: The correct answer is A: offer emotional support. This is crucial as postpartum can be a challenging time emotionally. Providing emotional support helps the person cope with any feelings of anxiety, sadness, or overwhelm. Breastfeeding (B) and positioning assistance (C) are important but not the most critical aspect of discharge teaching. Non-pharmacological pain relief (D) is important but not as crucial as emotional support for overall well-being.
The following four changes occur during pregnancy. Which of them usually increases the father’s interest and involvement in the pregnancy?
- A. Learning the results of the pregnancy test.
- B. Attending childbirth education classes.
- C. Hearing the fetal heartbeat.
- D. Meeting the obstetrician or midwife.
Correct Answer: C
Rationale: Hearing the fetal heartbeat is a significant moment that often increases the father’s interest and involvement in the pregnancy. The other options may also increase involvement but are less impactful.