Nokea
If the postpartum uterine fundus is boggy on palpation, the nurse does which of the following?
- A. notifies the physician immediately
- B. massages the uterus until it feels firm
- C. re-examines the fundus in 15-20 minutes
Correct Answer: B
Rationale: Massaging a boggy fundus helps stimulate uterine contractions and prevent postpartum hemorrhage.
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The stimulation of initial milk production and release in the breast is accomplished by which hormones? Select all that apply.
- A. Oxytocin
- B. Progesterone
- C. Prolactin
- D. Luteinizing hormone
Correct Answer:
Rationale: Correct Answer: A (Oxytocin), C (Prolactin)
Rationale:
1. Oxytocin stimulates milk ejection (let-down reflex) by contracting the muscles around the alveoli, releasing milk.
2. Prolactin is responsible for the production of milk in the mammary glands.
Summary of Other Choices:
- Progesterone: Plays a role in preparing the breast for lactation but doesn't directly stimulate milk production.
- Luteinizing hormone: Primarily involved in ovulation and corpus luteum formation, not milk production.
A 58-year-old postmenopausal woman presents with a sensation of pelvic heaviness and states she feels like something is sitting in her vagina. On examination, the provider notes a visible protrusion of the bladder into the anterior vaginal wall. What structural disorder of the female reproductive system is consistent with these findings?
- A. pelvic floor prolapse
- B. DES exposure
- C. vaginal septum
- D. bladder fistula
Correct Answer: A
Rationale: The correct answer is A: pelvic floor prolapse. This condition is characterized by weakening of the pelvic floor muscles and ligaments, leading to descent of pelvic organs such as the bladder into the vagina. The patient's symptoms of pelvic heaviness and sensation of something in her vagina are classic signs of pelvic floor prolapse. Examination findings of visible protrusion of the bladder into the anterior vaginal wall further support this diagnosis.
Explanation of incorrect choices:
B: DES exposure - This is not a structural disorder of the female reproductive system. DES exposure is associated with adverse effects on reproductive health but does not present with visible bladder protrusion.
C: Vaginal septum - This is a congenital anomaly where the vagina is divided by a septum. It does not typically present with bladder protrusion.
D: Bladder fistula - This is an abnormal connection between the bladder and another structure. While it can cause urinary symptoms, it does not typically present with visible bladder protrusion into the vagina.
If a quad screen shows high AFP, and normal hCG, uE3 and INH-A, this indicates
- A. neural tube defect
- B. trisomy 21
- C. multiple gestation
Correct Answer: A
Rationale: Elevated AFP suggests open neural tube defects or abdominal wall defects.
Which of the following statements about the nurse's medical record documentation is correct?
- A. it provides an accurate account of patient status and response to care
- B. it consists of both objective and subjective notes regarding the patient and care provided
- C. the physician's medical record documentation is more important than the nurse's medical record documentation in legal proceeding
Correct Answer: A
Rationale: Accurate documentation is crucial for legal and clinical purposes, providing a clear record of patient care.
When assisting with the lumbar puncture of a preterm neonate, the correct position for the neonate is
- A. lateral with trunk flexed
- B. lateral with trunk in neutral position
- C. sitting with head supported
Correct Answer: A
Rationale: Flexing the trunk maximizes space between vertebrae, facilitating needle insertion.