Nokea
A postpartum patient comes to the clinic for her 6-week postpartum checkup. When assessing the patient's cervix, how should the nurse expect the cervix to appear?
- A. Noticeable small lacerations
- B. Approximately 3 cm dilated
- C. Symmetrically round external os
- D. Firm and thick
Correct Answer: C
Rationale: The correct answer is C: Symmetrically round external os. At 6 weeks postpartum, the cervix should have returned to its normal appearance, which is symmetrically round. This indicates proper healing and involution of the cervix after childbirth. Noticeable small lacerations (A) would suggest incomplete healing or trauma. Approximately 3 cm dilated (B) is not expected at 6 weeks postpartum as the cervix should be closed. Firm and thick (D) would indicate a cervix that has not undergone involution as expected by this time.
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The nurse is providing education to a postpartum woman about exercises to strengthen the pelvis musculature. Which instruction should be included?
- A. "Ambulate three times a day."
- B. "Perform Kegel exercises."
- C. "Enroll in an aerobics class after discharge."
- D. "Do passive range-of-motion exercises while lying in bed."
Correct Answer: B
Rationale: The correct answer is B: "Perform Kegel exercises." Kegel exercises specifically target the pelvic floor muscles, which can help strengthen the pelvis musculature postpartum. This is important for improving pelvic floor support and preventing issues like urinary incontinence. Ambulating (A) is good for overall mobility but does not specifically target the pelvic muscles. Enrolling in an aerobics class (C) may be beneficial for overall fitness but does not address pelvic floor strengthening. Passive range-of-motion exercises (D) focus on joint flexibility rather than pelvic muscle strength.
The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?
- A. The signs and symptoms of uterine infection
- B. The signs and symptoms of secondary hemorrhage
- C. The signs and symptoms of postpartum depression
- D. The signs and symptoms of a boggy uterus
Correct Answer: B
Rationale: The correct answer is B: The signs and symptoms of secondary hemorrhage. This is crucial because it can be life-threatening and requires immediate medical attention. Secondary hemorrhage is excessive bleeding that occurs after the first 24 hours postpartum. It is important for the nurse to educate the patient on recognizing the signs such as increased bleeding, lightheadedness, dizziness, and low blood pressure. Choices A, C, and D are important topics for patient education but do not pose the same level of urgency and immediate risk as secondary hemorrhage.
The nurse on a postpartum unit is acutely aware that cultural influences impact the patient's process of 'becoming a mother.' For which isn't a cultural influence does the nurse assess?
- A. What amount of time the mother spends in each phase
- B. Differences in the mother's expectation related to ability to rest
- C. How the mother physically recovers from labor and delivery
- D. Mother's involvement in decision making for the first few months
Correct Answer: C
Rationale: The correct answer is C because how a mother physically recovers from labor and delivery is primarily influenced by biological and physiological factors rather than cultural influences. The mother's physical recovery is guided by medical interventions, individual health conditions, and postpartum care practices. On the other hand, choices A, B, and D are all influenced by cultural factors. Choice A pertains to cultural variations in rituals or customs related to the duration of each phase of becoming a mother. Choice B involves cultural beliefs around postpartum rest and support systems. Choice D addresses cultural norms regarding maternal autonomy and decision-making in the early stages of motherhood.
Which nursing care goal is the highest priority for a woman who had a vaginal delivery 3 hours earlier?
- A. The client will wear a well-supported bra.
- B. The client will eat 100% of her meals.
- C. The client will have a moderate lochia flow.
- D. The client will ambulate to the bathroom.
Correct Answer: C
Rationale: The correct answer is C: The client will have a moderate lochia flow. This is the highest priority goal because monitoring lochia flow post-vaginal delivery helps assess for excessive bleeding, which is crucial for preventing postpartum hemorrhage. Choice A is not a priority in the immediate postpartum period. Choice B is important but not as critical as monitoring lochia flow. Choice D is also important for preventing complications but not as urgent as assessing for postpartum bleeding.
The nurse is providing education to a postpartum woman about exercises to strengthen the pelvis musculature. Which instruction should be included?
- A. "Ambulate three times a day."
- B. "Perform Kegel exercises."
- C. "Enroll in an aerobics class after discharge."
- D. "Do passive range-of-motion exercises while lying in bed."
Correct Answer: B
Rationale: The correct answer is B: "Perform Kegel exercises." Kegel exercises strengthen the pelvic floor muscles, which can help prevent urinary incontinence and improve pelvic organ support. Ambulating (choice A) is important for overall mobility but does not specifically target the pelvic muscles. Enrolling in an aerobics class (choice C) focuses on cardiovascular fitness and may not specifically strengthen the pelvis. Doing passive range-of-motion exercises (choice D) does not actively engage and strengthen the pelvic muscles. Kegel exercises are the most appropriate choice as they directly target the pelvic musculature to improve strength and function.