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The postpartum client, who is 24 hours post—cesarean section, tells the nurse that she has much less lochial discharge after this birth than with her vaginal birth 2 years ago. The client asks if this is normal after a cesarean birth. Which statement should be the basis for the nurse’s response?
- A. A decrease in her lochia is not expected; further assessment is needed.
- B. Women usually have increased lochial discharge after cesarean births.
- C. Women normally have less lochial discharge after a cesarean birth.
- D. The lochia amount depends on whether surgery was emergent or planned.
Correct Answer: C
Rationale: A decrease in lochia is expected after a cesarean birth; no further assessment is needed regarding the lochial amount unless it is totally absent. A decrease in lochia is expected after a cesarean birth, not an increase. The client’s lochial discharge is usually decreased after cesarean birth because the uterus is cleaned during surgery. The amount of lochia is not dependent on whether the surgery was emergent or planned because the uterus is cleaned during surgery in both situations.
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If the client reports the following signs and symptoms, which one represents a probable sign of pregnancy?
- A. Absence of monthly periods
- B. Abdominal enlargement
- C. Nausea and vomiting
- D. Frequent urination
Correct Answer: B
Rationale: Abdominal enlargement is a probable sign of pregnancy, as it is more objective and indicative of uterine growth.
The nurse explains to the group that frequent urination during early pregnancy usually subsides at which time?
- A. When the placenta is fully developed
- B. When fetal kidneys begin to function
- C. When the uterus rises into the abdominal cavity
- D. When the hormonal balance is reestablished
Correct Answer: C
Rationale: Frequent urination subsides in the second trimester as the uterus rises into the abdominal cavity, reducing bladder pressure.
How early in a pregnancy can the nurse expect to hear the fetal heartbeat using a Doppler device?
- A. 4 to 6 weeks
- B. 8 to 10 weeks
- C. 12 to 14 weeks
- D. 16 to 18 weeks
Correct Answer: C
Rationale: A fetal heartbeat can typically be detected by Doppler around 12-14 weeks, when the fetus is sufficiently developed.
Which activity promotes postpartum healing?
- A. Resting and limiting strenuous activity
- B. Lifting heavy objects
- C. Skipping follow-up visits
- D. Eating a low-protein diet
Correct Answer: A
Rationale: Resting and limiting strenuous activity support physical recovery and healing after childbirth.
The nurse observes a sinusoidal FHR pattern on the monitor tracing. How should the nurse interpret this pattern?
- A. The fetus may be in a sleep state.
- B. Congenital anomalies are possible.
- C. This may indicate severe fetal anemia.
- D. This predicts normal fetal well-being.
Correct Answer: C
Rationale: A sinusoidal pattern, which is Drag and Drop, smooth, undulating, and uncommon, classically occurs with severe fetal anemia as a result of abnormal perinatal conditions. An FHR pattern having minimal variability (not a sinusoidal pattern) might indicate that the fetus is in a sleep state. Absent or minimal variability, not a sinusoidal FHR pattern, could indicate possible congenital anomalies. Moderate variability of the FHR (not a sinusoidal pattern) reflects normal fetal well-being.