Nokea
What is a symptom of engorgement?
- A. protuberant nipples
- B. shiny, hard breast
- C. insufficient milk production
- D. soft, lumpy breast
Correct Answer: B
Rationale: The correct answer is B: shiny, hard breast. Engorgement is characterized by a significant increase in blood and lymph fluid in the breast tissue, causing the breasts to become swollen, shiny, and hard. This occurs when milk production exceeds removal, leading to congestion and inflammation. Protuberant nipples (A) may be a result of engorgement but are not a defining symptom. Insufficient milk production (C) is not a symptom of engorgement but rather a separate issue related to milk supply. Soft, lumpy breast (D) is more indicative of a blocked duct or mastitis, not engorgement.
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What important assessment should the nurse perform on all postpartum persons?
- A. Screen for PPD with the EPDS.
- B. Screen for drug use with a urine drug screen.
- C. Screen for breast-feeding failure.
- D. Screen for contraception contraindications.
Correct Answer: A
Rationale: The correct answer is A because screening for Postpartum Depression (PPD) with the Edinburgh Postnatal Depression Scale (EPDS) is crucial for the well-being of postpartum individuals. PPD is a common and serious condition that can affect the mother's mental health and bonding with the baby. Early detection and intervention are key to ensuring proper support and treatment.
Choice B, screening for drug use, is not a routine assessment for all postpartum persons unless there are specific risk factors present. Choice C, screening for breast-feeding failure, is important but not the most critical assessment to perform on all postpartum individuals. Choice D, screening for contraception contraindications, is important for family planning but is not as immediate or essential as screening for PPD.
The nurse places one hand above the symphysis pubis during uterine massage to:
- A. Make the massage more comfortable for the woman.
- B. Increase the effectiveness of the procedure.
- C. Help prevent the uterus from inverting.
- D. Help determine the firmness of the uterus.
Correct Answer: C
Rationale: By placing a hand above the symphysis pubis, the nurse can help prevent uterine inversion and provide better support during the massage.
The nurse on a postpartum unit observes a patient who delivered 2 days ago. The nurse notices extreme agitation and depressed mood. The patient states, “I think that my baby is deformed inside and we have to fix him.” Which risk factor is most strongly related to possible postpartum psychosis (PPP)?
- A. Separation from the baby’s father
- B. Personal history of bipolar disorder
- C. Prolonged labor resulting in cesarean
- D. Loss of first child from a heart defect
Correct Answer: B
Rationale: A patient history of either bipolar disorder or affective disorder can result in postpartum psychosis (PPP).
What symptom differentiates baby blues from PPD?
- A. Baby blues last longer than 14 days.
- B. Baby blues cause hallucinations.
- C. Baby blues occur in the first few days of the postpartum period.
- D. Baby blues are treated with inpatient therapy.
Correct Answer: A
Rationale: The correct answer is A: Baby blues last longer than 14 days. Baby blues typically resolve within 1-2 weeks postpartum. If symptoms persist for more than 14 days, it may indicate postpartum depression (PPD). Choice B is incorrect as hallucinations are not a common symptom of baby blues. Choice C is incorrect because baby blues can occur within the first few weeks postpartum, not just the first few days. Choice D is incorrect because baby blues are usually managed with support, counseling, and self-care, not inpatient therapy.
The nurse palpates a distended bladder on a woman who delivered vaginally 2 hours earlier. The woman refuses to go to the bathroom, 'I really don 't need to go. ' Which of the following responses by the nurse is appropriate?
- A. Okay. I must be palpating your uterus.
- B. I understand but I still would like you to try to urinate.
- C. You still must be numb from the local anesthesia.
- D. That is a problem. I will have to catheterize you.
Correct Answer: B
Rationale: A distended bladder can lead to complications such as uterine atony. The nurse should encourage the woman to attempt urination, but if she refuses, further action may be necessary.