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What symptom can partners of persons with PPD experience?
- A. depression
- B. psychosis
- C. bipolar disorder
- D. mania
Correct Answer: B
Rationale: Depression is a common symptom in partners of individuals with PPD.
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The day after delivery, a woman, whose fundus is firm at 1 cm below the umbilicus and who has moderate lochia, tells the nurse that something must be wrong: 'All I do is go to the bathroom. ' Which of the following is an appropriate nursing response?
- A. Catheterize the client per doctor 's orders.
- B. Measure the client 's next voiding.
- C. Inform the client that polyuria is normal.
- D. Check the specific gravity of the next voiding.
Correct Answer: C
Rationale: Polyuria, or frequent urination, is a normal phenomenon during the postpartum period as the body expels excess fluid.
The nurse is admitting a 38-year-old patient to triage in early labor with ruptured membranes. Her history includes a previous vaginal delivery 4 years ago and the presence of a uterine fibroid. What interventions are appropriate based on the hemorrhage risk for this patient?
- A. The patient is a moderate hemorrhage risk, so a type and screen should be ordered.
- B. The patient is a high hemorrhage risk, so 4 units of packed red blood cells should be ordered.
- C. The patient is a low hemorrhage risk, so a hold tube should be drawn.
- D. The patient is a moderate hemorrhage risk, but blood is not drawn at this time.
Correct Answer: A
Rationale: Since the patient has a previous history of delivery and uterine fibroids, she is considered at moderate hemorrhage risk and a type and screen should be ordered.
The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?
- A. Scant amount of odorless lochia
- B. Presence of headache, malaise, and chills
- C. Pain or discomfort in the midline lower abdomen
- D. Elevated temperature greater than 100.4°F (38°C)
Correct Answer: D
Rationale: Endometritis from beta-hemolytic streptococcus specifically exhibits scant, odorless lochia in addition to the more universal signs of infection.
A postpartum patient calls the clinic 4 days after the birth of her newborn because she is extremely tired and her vaginal bleeding is heavier. Which does the nurse anticipate when advising her to come in to the office right now?
- A. A hematocrit will be drawn, and the licensed provider will check for retained placental fragments.
- B. Her stress level and sleep deprivation will be evaluated, and a prescription for sleeping medication will be given.
- C. The perineum will be evaluated for lacerations that were missed.
- D. Reassure the client that this is all normal and provide a prescription for slow-release iron tablets.
Correct Answer: A
Rationale: The correct answer is A. The nurse anticipates that a hematocrit will be drawn and the provider will check for retained placental fragments because heavy vaginal bleeding and extreme fatigue could indicate postpartum hemorrhage due to retained placental tissue. This is a serious complication that requires immediate medical attention to prevent further complications such as infection or hemorrhagic shock.
Choice B is incorrect because prescribing sleeping medication does not address the underlying cause of the symptoms. Choice C is incorrect because lacerations would typically have been evaluated and repaired during delivery, and would not likely be missed. Choice D is incorrect because reassuring the client without further evaluation could lead to potential serious consequences if the underlying issue of retained placental fragments is not addressed promptly.
A 3-day-breastfeeding client who is not immune to rubella is to receive the rubella vaccine at discharge. Which of the following must the nurse include in her discharge teaching regarding the vaccine?
- A. The woman should not become pregnant for at least 4 weeks.
- B. The woman should pump and dump her breast milk for 1 week.
- C. Surgical masks must be worn by the mother when she holds the baby.
- D. Antibodies transported through the breast milk will protect the baby.
Correct Answer: A
Rationale: The rubella vaccine is a live vaccine, and it is contraindicated during pregnancy. Women should avoid pregnancy for at least 4 weeks after receiving the vaccine to ensure no risk to the developing fetus.