Postpartum NCLEX

Postpartum NCLEX 11 studiers today 4.9 (14 reviews) Students also studied Terms in this set (40) Milwaukee Area Technical College NRSPN 305 Save OB Postpartum NCLEX Questions 52 terms ashley_coots7 Preview Postpartum NCLEX Style Questions 20 terms christa_hintonPreview Maternal - Post-Partum 86 terms Lauren_Forrester8 Preview Antepa 50 terms smb Rubin identified a series of changes that a new mother makes during the postpartum period. The correct sequence of these changes is

a) Taking-in, taking-hold, letting-go

b) Taking, holding-on, letting-go

c) Taking-in, holding-on, letting-go

d) Taking-in, taking-on, letting-go

Taking-in, taking-hold, letting-go Correct

Explanation:

The new mother makes progressive changes to know her infant, review the pregnancy and labor, validate her safe passage through these phases, learn the initial tasks of mothering, and let go of her former life to incorporate this new child.A postpartum client complains of stress incontinence.What information should the nurse suggest to the client to overcome stress incontinence?

a) Perform aerobic exercises

b) Frequently empty the bladder

c) Reduce fluid intake

d) Perform Kegel's exercises

Perform Kegel's exercises Correct

Explanation:

The nurse should ask the client to perform the Kegel's exercises in which the client needs to alternately contract and relax the perineal muscles. Aerobic exercises will not help to strengthen perineal muscles. Reduced fluid intake and frequent emptying of the bladder will not help the client overcome stress incontinence.A nurse is monitoring the vital signs of a client 24 hours after childbirth. She notes that the client's blood pressure is 100/60 mm Hg. Which of the following postpartum complications should the nurse most suspect in this client, based on this finding?

a) Postpartal gestational hypertension

b) Bleeding

c) Diabetes

d) Infection

Bleeding Correct

Explanation:

Blood pressure should also be monitored carefully during the postpartal period, because a decrease in this can also indicate bleeding. In contrast, an elevation above 140 mm Hg systolic or 90 mm Hg diastolic may indicate the development of postpartal gestational hypertension, an unusual but serious complication of the puerperium. An infection would best be indicated by an elevated oral temperature. Diabetes would be indicated by an elevated blood glucose level.

Bonding between a mother and her infant can be defined how?

a) An ongoing process in the year after delivery

b) The skin to skin contact that occurs in the delivery

room

c) A process of developing an attachment and becoming

acquainted with each other

d) Family growing closer together after the birth of a new

baby A process of developing an attachment and becoming acquainted with each other Correct

Explanation:

Bonding in the maternal-newborn world is the attachment process that occurs between a mother and her newborn infant. This is how the mother and infant become engaged with each other and is the foundation for the relationship.Because bonding is a process and not a single event, option B is incorrect. The process of bonding is not a year-long process, so option C is incorrect. The family growing closer together after the birth of a new baby is not bonding, so option D is incorrect.The process by which the reproductive organs return to the nonpregnant size and function is termed what?

a) Evolution

b) Involution

c) Decrement

d) Progression

Involution Correct

Explanation:

Involution is the term used to describe the process of the return to nonpregnancy size and function of reproductive organs. Evolution is change in the genetic material of a population of organisms from one generation to the next. Decrement is the act or process of decreasing . Progression is defined as movement through stages such as the progression of labor. Options A, C, and D are distracters for this question.The nurse is caring for a client in the postpartum period.The client has difficulty in voiding and is catheterized. The nurse then would monitor the client for which of the following?

a) Loss of pelvic muscle tone

b) Stress incontinence

c) Urinary tract infection

d) Increased urine output

Urinary tract infection Correct

Explanation:

The nurse would need to monitor the client for signs and symptoms of a urinary tract infection, a risk associated with catheterization. Stress incontinence is caused due to loss of pelvic muscle tone after birth. Increased urinary output is observed in diuresis. Catheterization does not cause loss of pelvic muscle tone, increased urine output, or stress incontinence.The nurse is providing education to a mother who is going to bottle feed her infant. What information will the nurse provide to this mom regarding breast care?

a) Wear a tight, supportive bra

b) Massage the breast when they are painful

c) Express small amounts of milk when they are too full

d) Run warm water over the breast in the shower

Wear a tight, supportive bra

Explanation:

The patient trying to dry up her milk supply should do as little stimulation to the breast as possible. She needs to wear a tight, supportive bra and use ice. Running warm water over the breasts in the shower will only stimulate the secretion, and therefore the production, of milk. Massaging the breasts will stimulate them to expel the milk and therefore produce more milk, as will expressing small amounts of milk when the breasts are full.

A new mother is concerned because it is 24 hours after childbirth and her breasts have still not become engorged with breast milk. How should the nurse respond to this concern?

• "You are experiencing lactational amenorrhea. It may

be several weeks before your milk comes in."

• "You may have developed mastitis. I'll ask the physician

to examine you."

• "I'm sorry to hear that. There are some excellent

formulas on the market now, so you will still be able to provide for your infant's nutritional needs."

• "It takes about 3 days after birth for milk to begin

forming." "It takes about 3 days after birth for milk to begin forming." Correct

Explanation:

The formation of breast milk (lactation) begins in a postpartal woman regardless of her plans for feeding. For the first 2 days after birth, an average woman notices little change in her breasts from the way they were during pregnancy as, since midway through pregnancy, she has been secreting colostrum, a thin, watery, prelactation secretion. On the third day post birth, her breasts become full and feel tense or tender as milk forms within breast ducts and replaces colostrum.There is no need to recommend formula feeding to the mother. Mastitis is inflammation of the lactiferous (milk-producing) glands of the breast; there is no indication that the client has this condition. Lactational amenorrhea is the absence of menstrual flow that occurs in many women during the lactation period.A woman who has just given birth seems to be bonding with her newborn, despite the fact that earlier in labor she had expressed an intent to give the baby up for adoption. In this case, the nurse should encourage the mother to keep her baby.

a) True

b) False

False Correct

Explanation:

Do not attempt to change a woman's mind about keeping her child or placing the child for adoption during the postpartal period as she is extremely vulnerable to suggestion at this time, and such decisions are too long range and too important to be made at such an emotional time. Her earlier conclusion may be the sound one. Instead, offer nonjudgmental support. Be especially aware of your own feelings about this issue, to avoid influencing a woman's decision making unnecessarily.When caring for a postpartum client who has given birth vaginally, the nurse assesses the client's respiratory status, noting that it has quickly returned to normal. The nurse understands that which of the following is responsible for this change?

a) Decreased bladder pressure

b) Increased progesterone levels

c) Decreased intra-abdominal pressure

d) Use of anesthesia during delivery

Decreased intra-abdominal pressure Correct

Explanation:

The nurse should identify decreased intra-abdominal pressure as the cause of the respiratory system functioning normally. Progesterone levels do not influence the respiratory system. Decreased bladder pressure does not affect breathing.Anesthesia used during delivery causes the respiratory system to take a longer time to return to normal.A nurse is caring for a client in the postpartum period.The nurse observes that distention of the abdominal muscles during pregnancy has resulted in separation of the rectus muscles. What intervention should the nurse perform to assist in healing the distended abdominal muscles?

a) Applying warm compresses

b) Massaging the muscles

c) Applying moist heat

d) Suggesting proper exercise

Suggesting proper exercise Correct

Explanation:

The nurse should suggest proper exercise to the client to heal the distended abdominal muscles. Application of warm compresses, application of moist heat, and massaging the muscles gently are not suggested for distended abdominal muscles.

A woman who gave birth to a healthy newborn 2 months ago comes to the clinic and reports discomfort during sexual intercourse. Which suggestion by the nurse would be most appropriate?

• "You might try using a water-soluble lubricant to ease

the discomfort."

• "This is entirely normal, and many women go through it.

It just takes time."

• "It takes a while to get your body back to its normal

function after having a baby."

• "Try doing Kegel exercises to get your pelvic muscles

back in shape." "You might try using a water-soluble lubricant to ease the discomfort." Correct

Explanation:

Coital discomfort and localized dryness usually plague most postpartum women until menstruation returns. Water-soluble lubricants can reduce discomfort during intercourse. Although it may take some time for the woman's body to return to its prepregnant state, telling the woman this does not address her concern. Telling her that dyspareunia is normal and that it takes time to resolve also ignores her concern. Kegel exercises are helpful for improving pelvic floor tone but would have no effect on vaginal dryness.A woman is bottle-feeding her baby. When the nurse comes into the room the woman says that her breasts are painful and engorged. Which nursing intervention is appropriate?

a) Ask if she wants a breast pump to empty her breasts

b) Assist the woman in placing ice packs on her breasts

c) Assist the woman into the shower and have her run

cold water over her breasts

d) Explain to the woman that she should breastfeed

because she is producing so much milk Assist the woman in placing ice packs on her breasts Correct

Explanation:

If the breasts are engorged and the woman is bottle-feeding her newborn, instruct her to keep a support bra on 24 hours per day. Cool compresses or an ice pack wrapped in a towel will usually be soothing and help to suppress milk production.A client gave birth to a healthy boy 2 days ago. Both mother and baby have had a smooth recovery. The nurse enters the room and tells the client that she and her baby will be discharged home today. The client states, "I do not want to go home." Which of the following is the nurse's most appropriate response?

a) Tell the client that she must go home as per hospital

policy.

b) Ask the client if she has any support in the home.

c) Inform the physician that the client does not want to

go home.

d) Ask the client why she does not want to go home.

Ask the client why she does not want to go home.Correct

Explanation:

It is important for the nurse to identify the client's concerns and reasons for wanting to stay in the hospital. Open-ended questioning facilitates both effective and therapeutic communication and allows the nurse to address concerns appropriately. Asking about supports at home implies that the nurse has made assumptions about why the client may not want to go home. Informing the physician or telling the client that discharge is hospital policy is not appropriate at this time, because the nurse has not addressed the underlying reason for the client's comment. The client may have safety-related concerns, undisclosed fears, or a need for increased support before discharge. It is imperative that the nurse not make assumptions but further explore concerns.