Nokea
Which resource should the nurse recommend for additional prenatal education?
- A. Reputable pregnancy websites
- B. Social media forums
- C. Unverified blogs
- D. Television advertisements
Correct Answer: A
Rationale: Reputable pregnancy websites provide evidence-based information, ensuring accurate and reliable prenatal education.
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The laboring client presents with ruptured membranes, frequent contractions, and bloody show. She reports a greenish discharge for 2 days. Place the nurse’s actions in the order that they should be completed.
- A. Perform a sterile vaginal exam
- B. Assess the client thoroughly
- C. Obtain fetal heart tones
- D. Notify the health care provider
Correct Answer: C,A,B,D
Rationale: Obtain FHT should be first. The client has ruptured membranes with greenish fluid, and the fetus could be experiencing nonreassuring fetal status. Perform a sterile vaginal exam to determine labor progression. Assess the client thoroughly. This needs to be completed prior to notifying the HCP with the information. Notify the HCP is last of the options. Assessment findings would need to be reported to the HCP. The client should then be moved into an inpatient room.
Two hours after delivery, the mother tells the nurse that she will be bottle feeding. She asks what she can do to prevent the terrible pain experienced when her milk came in with her last baby. Which response by the nurse is most appropriate?
- A. “Once you have recovered from the birth, I will help you bind your breasts.”
- B. “Engorgement is familial. If you had it with your last baby, it is inevitable.”
- C. “I can help you put on a supportive bra; wear one constantly for 1 to 2 weeks.”
- D. “Engorgement occurs right after birth; if you don’t have it yet, it won’t occur.”
Correct Answer: C
Rationale: In comparison studies between breast binders and bras, mothers using binders experienced more engorgement and discomfort. Engorgement is not familial and not inevitable in bottle-feeding mothers. Wearing a supportive, well-fitting bra within 6 hours after birth can suppress lactation. The bra should be worn continuously, except for showering, until lactation is suppressed (usually 7 to 14 days). Signs of engorgement usually occur on the third to fifth postpartum day (not right after birth), and engorgement will spontaneously resolve by the tenth day postpartum.
The nurse instructs the client with hyperemesis gravidarum to avoid which trigger?
- A. Eating small, frequent meals
- B. Strong odors
- C. High-protein foods
- D. Adequate hydration
Correct Answer: B
Rationale: Strong odors can exacerbate nausea and vomiting in hyperemesis gravidarum, worsening symptoms.
On the basis of this finding, the nurse can assume that the client is at least how many months' pregnant?
- A. 5 months
- B. 6 months
- C. 7 months
- D. 8 months
Correct Answer: A
Rationale: Ballottement, the rebound of the fetus when the cervix is tapped, is typically detectable around 4-5 months, indicating at least 5 months' gestation.
After delivering the full-term infant, the breastfeeding mother asks the nurse if there is any contraceptive method that she should avoid while she is breastfeeding. Which contraceptive should the nurse advise the client to avoid?
- A. A diaphragm
- B. An intrauterine device (IUD)
- C. The combined oral contraceptive (COC) pill
- D. The progesterone-only mini pill
Correct Answer: C
Rationale: Because a diaphragm must be fitted to the individual female cervix, the diaphragm must be rechecked for correct size after each childbirth; however, use of the diaphragm will not affect breast milk production. An IUD will not affect breast milk production unless the IUD is inserted within the first 48 hours postpartum; insertion should be delayed until 4 weeks postpartum. Birth control pills containing progesterone and estrogen (COC) can cause a decrease in milk volume and may affect the quality of the breast milk. The progesterone-only mini pill may be used by breastfeeding clients because it does not interfere with breast milk production. However, it is recommended that the mother wait 6 to 8 weeks before starting this method of contraception.