Nokea
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.
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What is the appropriate way to assess the fundus of the postpartum patient?
- A. Using the side of one hand moving down from the umbilicus
- B. Using one hand over the lower segment of the uterus
- C. Using one hand pushing upward from the lower uterus
- D. Using one hand on the lower uterine segment while the other hand locates the fundus of the uterus
Correct Answer: D
Rationale: The proper way to assess the fundus of a mother who has just given birth is by placing one hand on the lower uterine segment while the other hand locates the fundus of the uterus.
Within the first hour following a vaginal delivery the nurse assesses the mother and finds the fundus is firm and there is a trickle of bright red blood. What should be the nurse's reaction to the assessment?
- A. This is a normal occurrence.
- B. This is abnormal and should be reported.
- C. The patient should be administered a blood thinner.
- D. The patient should be restricted to bed rest.
Correct Answer: A
Rationale: A bright red drainage is normal immediately after delivery. The patient should be monitored at regular intervals. Bed rest is not indicated. A blood thinner would not be given.
Which newborn assessment finding can suggest a chromosomal disorder?
- A. Epstein pearls
- B. Gynecomastia
- C. Babinski reflex
- D. Simian crease
Correct Answer: D
Rationale: A simian crease may indicate a chromosomal disorder.
When assessing a mother 12 hours following the delivery of a baby where should the nurse expect to palpate the fundus?
- A. 2 cm below the umbilicus
- B. At the umbilicus
- C. 1 cm below the umbilicus
- D. Halfway between the umbilicus and the symphysis pubis
Correct Answer: B
Rationale: Within 12 hours, the fundus rises to the level of the umbilicus. The fundus should be firm. Immediately following delivery, the fundus will be felt halfway between the umbilicus and the symphysis.
A new mother asks for advice on how to quiet her fussy newborn. Which responses would be appropriate to suggest to the mother?
- A. Prewarm the crib sheets with a hot water bottle
- B. Swaddle the newborn tightly in a receiving blanket
- C. Place the baby in a larger crib or infant bed
- D. Offer a pacifier or allow the infant to suckle at the breast
- E. Take the infant for a ride in the car
Correct Answer: A,B,D,E
Rationale: Oftentimes, infants are comforted by warm sheets. Infants tend to like to be swaddled snugly. Many infants find comfort sucking a pacifier; breast-fed infants can suckle at the breast. Car rides are often soothing for infants. A large sleeping space is not soothing for infants. The opposite is true. A small sleeping space, such as a bassinette, tends to comfort a fussy baby.