Nokea
What theory developed by Ramona Mercer focused on the process of becoming a mother?
- A. Maternal Role Attainment
- B. Postpartum Adapting
- C. Postpartum Maternal Change
- D. Maternal Encouragement
Correct Answer: A
Rationale: Ramona Mercer's theory of Maternal Role Attainment focuses on how women adapt and assume the maternal role following childbirth.
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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: The correct answer is D, an elevated temperature greater than 100.4°F. Endometritis, an infection of the uterine lining, commonly caused by beta-hemolytic streptococcus, often presents with a fever. This is a key sign of infection, indicating the presence of an inflammatory process. The other choices are incorrect because:
A: Scant amount of odorless lochia is indicative of normal postpartum discharge, not necessarily endometritis.
B: Headache, malaise, and chills are non-specific symptoms that could be present in various conditions, not specific to endometritis.
C: Pain or discomfort in the midline lower abdomen could be related to postpartum uterine contractions or other causes, but it is not a specific finding for endometritis.
What is a risk factor for uterine atony?
- A. small for gestational age
- B. primipara
- C. multiple gestation
- D. intrauterine growth restriction
Correct Answer: C
Rationale: Risk factors for uterine atony include multiple gestation and large infants.
The nurse is caring for a client who had a cesarean section under spinal anesthesia less than 2 hours ago. Which of the following nursing actions is appropriate at this time?
- A. Elevate the head of the bed 60 degrees.
- B. Report absence of bowel sounds to the physician.
- C. Have her turn and deep breathe every 2 hours.
- D. Assess for patellar hyperreflexia bilaterally.
Correct Answer: C
Rationale: Post-spinal anesthesia, it is important to encourage the patient to change positions to prevent complications such as atelectasis and improve circulation.
The nurse is providing care for a patient who is 1 day postpartum and exhibiting symptoms of postpartum psychosis. Which medical management does the nurse expect for this patient?
- A. Prescriptions for antidepressant/antipsychotic drugs
- B. Discharge to home with 24-hour observation in place
- C. Immediate hospitalization in a psychiatric unit
- D. Prescribed neonate visits during in-patient treatment
Correct Answer: C
Rationale: Step 1: Postpartum psychosis is a psychiatric emergency requiring immediate intervention.
Step 2: Immediate hospitalization in a psychiatric unit ensures safety and specialized care.
Step 3: Hospitalization allows for close monitoring, medication management, and therapy.
Step 4: Discharge to home or prescribed neonate visits are not appropriate due to the severity of symptoms in postpartum psychosis.
If nonsurgical treatment for late PPH is ineffective, which surgical procedure would be appropriate to correct the cause of this condition?
- A. Hysterectomy
- B. Laparoscopy
- C. Laparotomy
- D. Dilation and curettage (D&
Correct Answer: A
Rationale: The correct answer is A: Hysterectomy. Hysterectomy is the appropriate surgical procedure for late postpartum hemorrhage (PPH) when nonsurgical treatments fail. It involves the removal of the uterus, which can effectively stop the bleeding. Other choices like Laparoscopy (B) and Laparotomy (C) are surgical techniques used to access the abdomen but do not address the underlying cause of PPH. Dilation and curettage (D&C) (D) is a procedure to remove tissue from the uterus and would not be effective in treating late PPH.