Nokea
The nurse is providing care for a new mother during a follow-up visit 6 weeks after a vaginal delivery. The mother begins to cry and reports difficulty with eating and sleeping. The nurse identifies postpartum blues and cites which reason as the most likely cause?
- A. Fatigue related to a 'fussy' baby
- B. Frustration over physical appearance
- C. Changes in hormonal levels
- D. Stress related to new mother role
Correct Answer: C
Rationale: Correct Answer: C - Changes in hormonal levels
Rationale:
1. Postpartum blues typically occur due to fluctuating hormone levels after childbirth.
2. Estrogen and progesterone levels drop significantly after delivery, leading to mood changes.
3. Symptoms like crying, difficulty eating, and sleeping align with hormonal imbalance postpartum.
Summary:
A: Fatigue related to a 'fussy' baby - Not directly related to hormonal changes causing postpartum blues.
B: Frustration over physical appearance - Not a primary cause of postpartum blues, which is more hormone-related.
D: Stress related to new mother role - While stress can contribute, hormonal changes are the primary cause.
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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. After a long and exhausting labor, it is crucial for the woman to rest and recover. Encouraging rest will promote her well-being and ability to care for her baby later. Choice A is incorrect as it may add unnecessary pressure on the woman. Choice B is incorrect as it refers to a different stage of maternal adaptation. Choice C is incorrect as it labels the behavior negatively without considering the context of the situation.
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 initial nursing intervention is to instruct the mother to void prior to the assessment (choice B). This is important as a full bladder can interfere with the accuracy of the fundal assessment. By ensuring the mother voids first, the nurse can accurately assess the fundus for any signs of excessive bleeding or abnormalities. This step is crucial in monitoring the postpartum patient's well-being.
Choice A is incorrect as massaging the fundus should come after assessing the lochia flow to prevent potential complications. Choice C is also incorrect as assessing the lochia flow should occur before massaging the fundus. Choice D is incorrect as lowering the head of the bed and having the mother lie flat is not necessary for a postpartum assessment.
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 encouraging the couple to identify mutual expectations of the fathering role promotes open communication and mutual understanding. This intervention fosters collaboration and unity in parenting. Choice B is incorrect because critiquing the father's methods may create tension and hinder his confidence. Choice C is incorrect because providing written materials alone may not address the unique dynamics of the couple's relationship. Choice D is incorrect as it focuses on potential conflict rather than fostering a positive and supportive environment for the father to identify 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: 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.
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. The rationale is as follows:
1. Depo-Provera is a long-acting reversible contraceptive method that provides effective contraception for up to 3 months.
2. The couple's certainty about avoiding pregnancy for at least 2 years aligns with the duration of protection offered by Depo-Provera.
3. Compared to other methods, such as emergency contraceptives, oral estrogen/progesterone pill, and natural family planning, Depo-Provera provides a more reliable and sustained contraceptive effect.
4. Emergency contraceptives are not suitable for long-term contraception. The oral pill requires daily adherence, which may not be ideal for the couple's situation. Natural family planning relies on cycle tracking and may not provide the desired level of effectiveness for the couple's goal.