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The nurse is discussing contraception with a couple before discharge following the birth of a first child. The couple are uncertain about the method but are certain about avoiding pregnancy for at least 2 years. Which method does the nurse recommend?
- A. Emergency contraceptives
- B. Oral estrogen/progesterone pill
- C. Depo-Provera
- D. Natural family planning
Correct Answer: C
Rationale: The correct answer is C: Depo-Provera.
Rationale:
1. Long-acting: Depo-Provera is a highly effective contraceptive method lasting for 3 months.
2. High efficacy: It has a very low failure rate (<1%).
3. Reversible: Fertility returns after discontinuation.
4. Patient certainty: The couple's certainty about avoiding pregnancy for 2 years aligns well with the 3-month duration of Depo-Provera.
Summary:
A: Emergency contraceptives are for immediate post-coital use, not long-term contraception.
B: Oral estrogen/progesterone pills require daily adherence, not suitable for long-term certainty.
D: Natural family planning relies on timing of ovulation, not as reliable for couples seeking certainty.
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The nurse is preparing to do a morning assessment on a 24-hour postpartum patient. Which nursing intervention is most appropriate initially?
- A. Massage the fundus until it is firm.
- B. Instruct the mother to void prior to the assessment.
- C. Assess the lochia flow while massaging the fundus.
- D. Lower the head of the bed and have the mother lie flat.
Correct Answer: B
Rationale: The correct answer is B: Instruct the mother to void prior to the assessment. This is the most appropriate initial nursing intervention because a full bladder can impede proper assessment of the fundus and lochia flow. Voiding before assessment ensures accurate findings and reduces the risk of discomfort for the patient.
A: Massaging the fundus until it is firm is important but should not be the initial step as assessing the bladder status is crucial first.
C: Assessing the lochia flow while massaging the fundus is important but should come after ensuring the bladder is empty.
D: Lowering the head of the bed and having the mother lie flat does not address the immediate need to empty the bladder for accurate assessment.
A G1P1 has just experienced a 24-hour labor that included a 3-hour second stage. The woman states to the nurse, "I just can't feed my baby now. All I want to do is sleep." What is the appropriate response from the nurse?
- A. Discuss with the woman that the needs of her infant should come first
- B. Recognize this as a behavior of the taking-hold stage
- C. Record the behavior as ineffective bonding/attachment
- D. Reassure the woman that it is okay for her to rest at this time
Correct Answer: D
Rationale: The correct answer is D: Reassure the woman that it is okay for her to rest at this time.
Rationale:
1. The woman has just undergone a 24-hour labor with a 3-hour second stage, which is physically and emotionally exhausting.
2. It is important for the nurse to prioritize the woman's well-being and allow her to rest to recover.
3. Rest is crucial for the woman's recovery and ability to care for her baby effectively.
4. By reassuring her that it is okay to rest, the nurse promotes self-care and maternal well-being.
Other choices:
A: Discuss with the woman that the needs of her infant should come first - This is not the appropriate response as the woman's well-being should also be considered.
B: Recognize this as a behavior of the taking-hold stage - This is incorrect as the woman's exhaustion is likely due to the physically demanding labor.
C: Record the behavior as ineffective bonding/attachment - This is not appropriate
The nurse on a postpartum unit focuses on how to assist the father in identifying his role with the neonate. Which intervention by the nurse is most helpful?
- A. Encourage the couple to identify mutual expectations of the fathering role.
- B. Critique the father's methods of providing physical care for the neonate.
- C. Provide written materials about the physical and emotional role of a father.
- D. Observe for a competitive attitude between the parents about providing baby care.
Correct Answer: A
Rationale: The correct answer is A because it promotes open communication and mutual understanding between the couple. By encouraging the couple to identify mutual expectations of the fathering role, the nurse helps establish a supportive environment for the father to understand his role with the neonate. This intervention fosters collaboration and shared responsibility, which are crucial for a healthy parent-child relationship.
Incorrect choices:
B: Critiquing the father's methods can be discouraging and may create tension between the parents.
C: Providing written materials is informative but may not address the unique dynamics of the couple's relationship.
D: Observing for a competitive attitude does not actively involve the nurse in facilitating the father's understanding of his role.
The nurse is preparing to do a morning assessment on a 24-hour postpartum patient. Which nursing intervention is most appropriate initially?
- A. Massage the fundus until it is firm.
- B. Instruct the mother to void prior to the assessment.
- C. Assess the lochia flow while massaging the fundus.
- D. Lower the head of the bed and have the mother lie flat.
Correct Answer: B
Rationale: Correct Answer: B - Instruct the mother to void prior to the assessment.
Rationale:
1. Voiding before assessment prevents inaccurate findings due to bladder distension.
2. Empty bladder facilitates fundal assessment and reduces discomfort.
3. Ensures accurate assessment of postpartum lochia flow.
4. Promotes patient comfort and satisfaction.
Summary of Other Choices:
A - Massaging the fundus is important but should not be the initial step.
C - Assessing lochia flow is crucial, but voiding should be prioritized first.
D - Lowering the head of the bed is unnecessary and may cause discomfort.
As a result of the previously mentioned research study, the nurses in a postpartum facility will implement which evidence-based change?
- A. Continue to assess the level of fatigue for the mother during postpartum period.
- B. Assist fathers in recognizing and managing stress and depressive symptoms.
- C. Encourage the father to go home and rest while the mother is hospitalized.
- D. Promote strategies to decrease fatigue during both prenatal and postnatal periods.
Correct Answer: D
Rationale: The correct answer is D because promoting strategies to decrease fatigue during both prenatal and postnatal periods aligns with evidence-based practice to improve maternal health outcomes. By addressing fatigue proactively, nurses can support the well-being of mothers before and after childbirth. Choice A focuses solely on assessing fatigue without addressing strategies for improvement. Choice B, assisting fathers with stress and depressive symptoms, although important, is not directly related to the research study's findings. Choice C, encouraging the father to go home and rest, does not address the mother's needs or provide strategies to reduce fatigue. Overall, Choice D is the most appropriate as it directly addresses the research findings and promotes maternal health.