Nokea
Which assessment finding 24 hours after vaginal birth would indicate a need for further intervention?
- A. Pain level 5 on scale of 0 to 10
- B. Saturated pad over a 2-hour period
- C. Urinary output of 500 mL in one voiding
- D. Uterine fundus 2 cm above the umbilicus
Correct Answer: B
Rationale: The correct answer is B because a saturated pad over a 2-hour period 24 hours after vaginal birth could indicate postpartum hemorrhage, a serious complication requiring immediate intervention. Excessive bleeding can lead to hypovolemic shock and endanger the mother's life. Monitoring and managing postpartum bleeding is crucial to prevent complications.
A: Pain level of 5 is subjective and may vary among individuals. It does not necessarily indicate a need for immediate intervention.
C: Urinary output of 500 mL in one voiding is within the normal range for postpartum women and does not suggest an immediate need for intervention.
D: Uterine fundus 2 cm above the umbilicus is within the expected range for 24 hours postpartum and does not indicate a need for immediate intervention.
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What percentage of weight loss did the baby experience? Calculate to the nearest hundredth.
- A. 5.55%
- B. 7.20%
- C. 6.85%
- D. 6.90%
Correct Answer: B
Rationale: Calculation: (3,278 - 3,042) / 3,278 * 100 = 7.20%
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: The correct answer is A: Maternal Role Attainment. Mercer's theory emphasizes the process through which a woman acquires the maternal role, including changes in behavior, attitudes, and values. Choice B, Postpartum Adapting, is vague and doesn't specifically address the process of becoming a mother. Choice C, Postpartum Maternal Change, is too general and lacks the focus on role attainment. Choice D, Maternal Encouragement, is not a theory developed by Ramona Mercer and does not capture the essence of the maternal role attainment process.
Which action should the nurse take in order to provide support and encouragement to the new postpartum patient?
- A. Recount how she solved her own problems.
- B. Correct the new mother at every opportunity.
- C. Praise the mother’s early attempts at infant car
- D. Explain to the new mother that everything will be fine
Correct Answer: C
Rationale: The correct answer is C: Praise the mother’s early attempts at infant care. This choice focuses on positive reinforcement, which can boost the new mother's confidence and encourage her in her new role. By acknowledging and praising her efforts, the nurse can help build the mother's self-esteem and foster a supportive environment.
Choices A and D do not directly provide support and encouragement to the new mother. Recounting how the nurse solved her own problems (Choice A) may come off as self-centered and not helpful to the new mother's situation. Explaining that everything will be fine (Choice D) may minimize the new mother's feelings and concerns.
Choice B, correcting the new mother at every opportunity, is not supportive or encouraging. It can undermine the mother's confidence and create a negative dynamic. It is important for the nurse to focus on positive reinforcement and support to help the new mother navigate the challenges of postpartum care.
Which patient would be most likely to have severe afterbirth pains and request a narcotic analgesic?
- A. Gravida 5, para 5
- B. Primipara who delivered a 7-lb boy
- C. Patient who is bottle feeding her first child
- D. Patient who is breastfeeding her second child
Correct Answer: A
Rationale: The correct answer is A - Gravida 5, para 5. Afterbirth pains are caused by uterine contractions as the uterus returns to its pre-pregnancy size. The more pregnancies a woman has had, the more stretched and prone to stronger contractions her uterus becomes. In this case, a gravida 5, para 5 patient has had multiple pregnancies and deliveries, leading to a higher likelihood of severe afterbirth pains. The other choices are incorrect because a primipara (B) would have less uterine stretching, a patient bottle feeding her first child (C) would still experience afterbirth pains due to uterine contractions, and a patient breastfeeding her second child (D) would experience milder afterbirth pains due to the release of oxytocin during breastfeeding which helps the uterus contract and reduce bleeding.
During which stage of role attainment do the parents become acquainted with their baby and combine parenting activities with cues from the infant?
- A. Formal
- B. Informal
- C. Personal
- D. Anticipatory
Correct Answer: A
Rationale: The correct answer is A: Formal. During the formal stage of role attainment, parents become acquainted with their baby and combine parenting activities with cues from the infant. This stage involves learning and adapting to the responsibilities and expectations associated with parenting through formal education, guidance, and support. In this stage, parents seek information and guidance from healthcare providers, parenting classes, and other formal sources to develop their parenting skills.
Summary of other choices:
B: Informal - This stage involves informal learning and interactions with the baby, not the formal education and guidance mentioned in the question.
C: Personal - This stage focuses on the parents' personal feelings and experiences, rather than the formal acquisition of parenting skills.
D: Anticipatory - This stage involves preparing for the arrival of the baby, rather than actively engaging in parenting activities and cues from the infant.