Nokea
What statement made by a new mother indicates she needs additional information about breastfeeding?
- A. I let the baby nurse 10 to 15 minutes on the first breast and then switch to the other breast.'
- B. The baby needs to nurse at least 5 minutes on the breast to get the hindmilk.'
- C. The baby has been nursing every 2 to 3 hours.'
- D. If the baby gets fussy between feedings, I give her a bottle of water.'
Correct Answer: D
Rationale: Supplemental feedings of formula or water should not be offered to a healthy newborn who is breastfeeding.
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The nurse is caring for a woman of Middle Eastern descent on the first postpartum day. Education is provided regarding instruction on use of a sitz bath. What documentation best indicates that the woman has understood the provided instruction?
- A. Patient correctly performed return demonstration.
- B. Patient indicated understanding by nodding head with instruction.
- C. Patient verbalizes 'I understand.'
- D. Family member indicates patient understands procedure.
Correct Answer: A
Rationale: The nurse may need an interpreter to understand and provide optimal care to the woman and her family. A return demonstration is the most reliable indicator of understanding, especially considering cultural nuances where nodding may reflect courtesy rather than comprehension.
What postpartum exercises should the nurse teach a patient who had a vaginal delivery yesterday? (Select all that apply.)
- A. Abdominal tighteners
- B. Head lift
- C. Pelvic tilt
- D. Kegel exercises
- E. Leg lifts
Correct Answer: A,B,C,D
Rationale: Exercises for postpartum involution such as abdominal tighteners, head lifts, pelvic tilts, and Kegel exercises are acceptable. Leg lifts are too strenuous early in the postpartum period.
A primipara tells the nurse, 'My afterpains get worse when I am breastfeeding.' What is the most appropriate nursing response?
- A. I'll get you some aspirin to relieve the cramping that you feel.'
- B. Afterpains are more intense with your first baby.'
- C. Breastfeeding releases a hormone that causes your uterus to contract.'
- D. A change of position when you're breastfeeding might help.'
Correct Answer: C
Rationale: Breastfeeding mothers may have more afterpains because infant suckling causes the posterior pituitary to release oxytocin, which is a hormone that contracts the uterus.
The nurse instructed a postpartum woman about storing and freezing breast milk. What statement by the woman leads the nurse to determine that the teaching was effective?
- A. I can thaw frozen breast milk in the microwave.'
- B. I'll put enough breast milk for one day in a container.'
- C. Breast milk can be stored in glass containers.'
- D. Breast milk can be kept in the refrigerator for up to 3 months.'
Correct Answer: C
Rationale: Breast milk can be safely stored in glass or clear hard plastic containers.
The nurse is instructing a woman at 6 months postpartum on weaning her infant from breastfeeding. What interventions will the nurse suggest? (Select all that apply.)
- A. Omit newborn's favorite feeding first.
- B. Eliminate one feeding at a time.
- C. Expect the need for comfort feeding.
- D. Formula will need to be provided to substitute for feeding.
- E. Pump breasts in place of eliminated feeding.
Correct Answer: B,C,D
Rationale: When weaning a newborn from breastfeeding, the mother should eliminate the favorite feeding last. One feeding should be eliminated at a time, and the need for comfort feeding should be expected. In younger infants formula will need to be substituted. The mother should not be instructed to pump in place of eliminated feeding or the breasts will continue to produce milk.