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The nurse is teaching the postpartum client, who is breastfeeding, about returning to sexual activity after vaginal delivery. Which statement should the nurse include?
- A. “Orgasm may decrease the amount of breast milk you produce.”
- B. “You may need to use lubrication when resuming sexual intercourse.”
- C. “You should not have sexual intercourse until two months postpartum.”
- D. “Your HCP will let you know when you can resume sexual activity.”
Correct Answer: B
Rationale: Oxytocin is released when the client has an orgasm and may cause breast milk to leak or squirt from the breasts. The production of breast milk may increase, not decrease. The nurse should inform the client that she may need lubrication with sexual intercourse because the low estrogen levels in the early postpartum period causes vaginal dryness. Women should refrain from sexual intercourse until lochia has ceased, which usually takes about 3 weeks. There is no need to wait two months if the lochia has ceased. The client’s HCP does not need to give approval to return to sexual activity.
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The client tells the nurse that she is using cocoa butter on her abdomen to prevent stretch marks. Which is the most accurate response from the nurse?
- A. “That is wonderful. If you continue to use cocoa butter daily, you should have no stretch marks after delivery.”
- B. “The cocoa butter will not prevent stretch marks completely, but it will help to reduce their number.”
- C. “The cocoa butter will not prevent stretch marks but will decrease the appearance of the linea nigra.”
- D. “Cocoa butter does not prevent stretch marks, but it soothes itching that occurs as your abdomen enlarges.”
Correct Answer: D
Rationale: Cocoa butter is an emollient and provides moisture to the skin, thereby decreasing the itching associated with stretching of the skin as the abdomen enlarges. Cocoa butter does not prevent striae gravidarum. Cocoa butter does not decrease the incidence of striae gravidarum. Cocoa butter does not prevent the appearance of linea nigra.
Which explanation by the nurse accurately identifies the recommended weight gain for a pregnant client who has a normal prepregnancy weight?
- A. Less than 15 pounds (<6.8 kg)
- B. 15 to 20 pounds (6.8 to 9 kg)
- C. 25 to 35 pounds (11.3 to 15.9 kg)
- D. No more than 40 pounds (≤18.1 kg)
Correct Answer: C
Rationale: For a woman with normal prepregnancy weight, the recommended weight gain is 25-35 pounds to support fetal development.
When one participant asks the nurse what can be done to relieve leg cramps while working, which instruction by the nurse is correct?
- A. Increase protein intake to five to six servings per day.
- B. Wear elastic stockings when at work.
- C. Point the toes frequently toward the head.
- D. Massage the leg when a cramp occurs.
Correct Answer: C
Rationale: Pointing toes toward the head (dorsiflexion) relieves leg cramps by stretching the calf muscles, unlike the other options.
Which nursing instruction given to the client complaining about shortness of breath is most appropriate?
- A. Contact your health care provider immediately.
- B. Decrease your activity level to conserve oxygen.
- C. Ask your physician for a mild sedative.
- D. Sleep with your upper body elevated on pillows.
Correct Answer: D
Rationale: Sleeping with the upper body elevated reduces pressure on the diaphragm, easing shortness of breath.
In the primigravid client, when is fetal movement typically felt for the first time?
- A. Between 10 and 14 weeks' gestation
- B. Between 16 and 20 weeks' gestation
- C. Between 22 and 26 weeks' gestation
- D. Between 28 and 32 weeks' gestation
Correct Answer: B
Rationale: Primigravid women typically feel fetal movement (quickening) between 16 and 20 weeks, later than multigravida women.