Obstetrics 3 Welcome to your Postpartum A nurse is assessing a postpartum client's uterus for involution. Which finding indicates normal uterine involution? Fundus palpable at the level of the umbilicus Fundus firm and located 2 cm above the umbilicus Fundus deviated to the right side of the abdomen Fundus boggy and difficult to palpate None During a routine postpartum assessment, the nurse notes that a client's uterus is displaced to the right side of the abdomen. What is the most appropriate action by the nurse? Document the finding as a normal variation. Assist the client to an upright position to promote uterine repositioning. Encourage the client to empty her bladder and reassess the uterine position. Administer uterotonic medications to promote uterine contractions. None A nurse is performing an assessment of the endometrium in a postpartum client. What finding should the nurse expect as a normal characteristic of the endometrium during the early postpartum period? Thickened and hyperemic endometrium Presence of blood clots in the endometrial cavity Absence of uterine contractions upon palpation Irregular and jagged contours of the endometrial lining None A postpartum client reports persistent, severe cramping pain in the lower abdomen despite receiving pain medication. What action should the nurse take in response to this complaint? Reassure the client that cramping is a normal postpartum experience. Administer an additional dose of pain medication as ordered. Perform a focused assessment of the uterine fundus. Document the complaint as an expected side effect of labor. None A nurse is assessing a postpartum client's perineum and vagina. Which finding should be reported to the healthcare provider as it may indicate a potential complication? Perineal edema and bruising Fundus palpable at the level of the umbilicus Lochia serosa with a foul odor Presence of clear, mucoid discharge None A primigravida who delivered vaginally asks the nurse about the changes in her vagina postpartum. Which response by the nurse is accurate? "Your vagina will remain elongated and widened after childbirth." "The vagina usually returns to its pre-pregnancy size and tone within a few weeks." "It's common for the vagina to become narrower and shorter after giving birth." "The changes in the vagina are permanent and cannot be reversed." None A nurse is performing a perineal assessment on a postpartum client who had an episiotomy during delivery. Which finding should be reported to the healthcare provider as it may indicate a potential complication? Ecchymosis (bruising) along the episiotomy site Mild swelling and tenderness of the perineum Approximated edges of the episiotomy incision Purulent discharge from the episiotomy site None A postpartum client who had a spontaneous vaginal delivery is experiencing discomfort and difficulty with sitting. During the perineal assessment, the nurse observes a small, superficial tear in the perineal tissue. What is the appropriate nursing intervention? Apply a warm compress to the tear. Administer a prescribed analgesic before ambulation. Encourage the client to perform Kegel exercises. Document the finding as an expected postpartum chang None A nurse is assessing a postpartum client's breasts. The client reports tenderness and warmth in one breast. On examination, the nurse notes an area of localized redness. What action should the nurse take based on these findings? Instruct the client to apply cold compresses to the affected breast. Encourage the client to continue breastfeeding on the affected side. Initiate contact precautions to prevent the spread of infection. Notify the healthcare provider for further evaluation None A postpartum client is concerned about breast engorgement and requests guidance on alleviating discomfort. What should the nurse recommend? Apply a warm compress to the breasts before breastfeeding. Limit breastfeeding sessions to every 4-6 hours. Use a breast pump to empty the breasts completely. Wear a tight-fitting bra to provide support. None A nurse is caring for a pregnant client at 32 weeks gestation during a routine prenatal visit. The client reports feeling dizzy and lightheaded when changing positions. Which assessment finding should the nurse prioritize in response to the client's symptoms? Blood pressure measurement Fetal heart rate monitoring Capillary refill time assessment Maternal oxygen saturation measurement None A postpartum client who delivered via cesarean section is at risk for deep vein thrombosis (DVT). What is the most appropriate nursing action to assess for signs of DVT in this client? Measure calf circumference bilaterally. Auscultate lung sounds for crackles. Assess the incision site for redness and swelling. Palpate the pedal pulses in both feet. None A postpartum client who delivered vaginally is at risk for respiratory complications due to a prolonged second stage of labor. What respiratory assessment finding should the nurse prioritize in this client? Increased respiratory rate Decreased breath sounds Occasional coughing Complaints of nasal congestion None A pregnant client at 28 weeks gestation reports experiencing shortness of breath when lying down. What is the most appropriate action for the nurse? Document the client's report as an expected pregnancy symptom. Instruct the client to elevate the head of the bed while resting. Administer supplemental oxygen to relieve dyspnea. Assess for signs of hyperventilation and anxiety. None A pregnant client is scheduled for a rubella vaccine during the prenatal visit. What action should the nurse take before administering the vaccine? Confirm the client's rubella immunity status. Obtain a written waiver from the client. Administer the vaccine without further assessment. Check the client's blood type. None A postpartum client with human immunodeficiency virus (HIV) infection is breastfeeding her newborn. What nursing intervention is essential to support the infant's immune health? Encourage the mother to discontinue breastfeeding. Administer prophylactic antibiotics to the infant. Promote exclusive breastfeeding for the first 6 months. Arrange for the infant to receive passive immunization. None A postpartum client who delivered vaginally reports difficulty emptying her bladder and complains of lower abdominal discomfort. The nurse observes that the client's bladder is distended. What is the most appropriate nursing action? Encourage the client to drink more fluids to stimulate urine production. Perform intermittent catheterization to empty the client's bladder. Instruct the client to bear down and attempt to void while sitting on the toilet. Administer diuretics to increase urine output. None A pregnant client at 36 weeks gestation reports a sudden onset of intense pain in the flank area. The nurse suspects renal calculi. What assessment finding supports this suspicion? Elevated blood pressure Presence of ketones in the urine Hematuria Decreased urinary frequency None A pregnant client at 32 weeks gestation is diagnosed with gestational diabetes mellitus (GDM). The client asks the nurse about the importance of monitoring blood glucose levels. What is the nurse's best response? "Monitoring blood glucose levels is not necessary during pregnancy." "Regular monitoring helps ensure that your blood sugar stays within a healthy range." "You only need to monitor blood glucose if you experience symptoms of high or low blood sugar." "Blood glucose monitoring is important only after delivery." None A postpartum client is diagnosed with postpartum thyroiditis. What assessment finding is consistent with this condition? Hypertension Bradycardia Weight gain Palpitations None A postpartum client who delivered vaginally is experiencing persistent perineal pain and difficulty ambulating. During the assessment, the nurse notes a separation of the rectus abdominis muscles. What term best describes this condition? Diastasis recti Symphysis pubis dysfunction Perineal laceration Episiotomy dehiscence None A pregnant client in the third trimester reports persistent lower back pain. The nurse notes a deviation in the client's spine, creating a swayback appearance. What term is commonly used to describe this postural change in pregnancy? Lordosis Kyphosis Scoliosis Ankylosis None A postpartum client reports a persistent headache and visual disturbances following an epidural administration for pain relief during labor. The nurse should assess for which potential neurological complication? Postpartum depression Intracranial hemorrhage Migraine headache Postdural puncture headache None A newborn is assessed for neurological development during a well-baby checkup. The nurse observes that the baby's Moro reflex is absent. What action should the nurse take based on this finding? Document the absence of the Moro reflex as a normal variation. Reassure the parents that the Moro reflex will develop later. Refer the baby for further neurological evaluation. Perform the Moro reflex test again after 24 hours. None A postpartum client who delivered via cesarean section complains of abdominal distension and discomfort. On assessment, the nurse notes diminished bowel sounds. What is the nurse's priority action? Administer a laxative to promote bowel movement. Encourage the client to ambulate and increase oral fluids. Perform a focused assessment of the incision site. Notify the healthcare provider for possible bowel obstruction. None A pregnant client at 20 weeks gestation reports persistent nausea and vomiting, especially in the morning. The nurse should assess for signs of: Gastroenteritis Preeclampsia Hyperemesis gravidarum Appendicitis None A postpartum client is preparing to initiate breastfeeding. During discharge teaching, the nurse emphasizes the importance of proper latch-on. What instruction should the nurse provide to support successful latch-on? "Ensure the baby's lips are tightly closed around the nipple." "Place the entire areola into the baby's mouth." "Allow the baby to self-latch without any guidance." "Hold the breast with two fingers near the nipple." None A breastfeeding mother expresses concern about her newborn's sleep patterns and frequency of feedings. What is the nurse's best response regarding newborn feeding and sleep? "It's essential to wake the baby every 4 hours to ensure adequate feeding." "Feeding the baby more frequently during the day may improve nighttime sleep." "Newborns typically sleep for 8-12 hours straight during the night." "Allow the baby to sleep as long as desired between feedings." None A postpartum client has decided to bottle-feed her newborn. What instruction should the nurse provide during discharge teaching to promote safe and effective bottle feeding? "Hold the bottle at a 45-degree angle to ensure proper milk flow." "Warm the formula in the microwave to a comfortable temperature." "Propping the bottle with a blanket can help the baby feed independently." "Check the nipple regularly to ensure it is the correct size for your baby." None A postpartum client is concerned about choosing the right formula for her newborn. What information should the nurse include in the teaching about formula selection? "Select a formula with added honey for extra sweetness." "Choose a formula based on your baby's weight and age." "Opt for soy-based formulas to prevent allergies." "Experiment with different formulas until you find the one your baby likes." None A postpartum client is preparing to bottle-feed her newborn using formula. What instruction should the nurse provide during discharge teaching to ensure proper formula preparation? "Boil the formula before every feeding to eliminate bacteria." "Mix the formula with tap water to save time and ensure freshness." "Follow the manufacturer's instructions for formula preparation." "Add extra formula powder to make the feeding more nutrient-rich." None A postpartum client expresses concern about the safety of using well water to prepare formula for her newborn. What is the nurse's best response regarding formula preparation with well water? "Well water is safe for formula preparation without any special considerations." "Boil the well water before using it to eliminate potential contaminants." "Use well water only if it has been tested and approved by a laboratory." "Mixing well water with bottled water ensures optimal formula safety." None A couple is preparing for discharge after the birth of their first child. They express anxiety about the transition to parenthood. What advice should the nurse provide during discharge teaching to support a positive transition? "Expect to have all aspects of parenting figured out within the first week." "Maintain rigid schedules for feeding, sleeping, and diaper changes." "Communicate openly with your partner about your feelings and concerns." "Minimize outside support and rely solely on your immediate family." None A postpartum client is worried about balancing her new role as a mother with her personal needs. What guidance should the nurse provide during discharge teaching to promote self-care? "Prioritize your baby's needs over your own to ensure their well-being." "Delegate all household responsibilities to focus solely on your baby." "Schedule regular breaks for self-care activities and rest." "Expect to manage everything on your own without seeking assistance." None A postpartum client expresses concerns about the physical changes she is experiencing after childbirth and asks when she can expect to feel "normal" again. What information should the nurse include in the discharge teaching regarding the maternal phases after childbirth? "You should feel back to normal within a week after delivery." "The involution process may take several weeks to a few months." "Expect to resume your pre-pregnancy routine immediately." "Maternal phases have no impact on postpartum well-being." None A postpartum client is concerned about the emotional changes she is experiencing and asks when her mood will stabilize. What should the nurse emphasize during discharge teaching regarding the emotional phases after childbirth? "You should not experience any emotional changes after childbirth." "Emotional changes typically resolve within a day or two." "It's common to experience a range of emotions, and they may take weeks to months to stabilize." "Seek professional help immediately if you experience any emotional changes." None A new father expresses concerns about his ability to bond with his newborn. What guidance should the nurse provide during discharge teaching to support the paternal phases of bonding? "It's essential for fathers to spend most of their time with the baby to establish a strong bond quickly." "Bonding is an automatic process, and you should not worry about actively engaging with your baby." "Participate in caregiving activities, such as feeding and diaper changes, to enhance bonding." "Leave most of the baby care to the mother to ensure a strong maternal bond." None A postpartum client has chosen to bottle-feed her newborn. What information should the nurse include in the feeding initiation teaching for safe and effective bottle feeding "Hold the bottle at a 45-degree angle to ensure a slow and controlled flow of formula." "Allow the baby to suck on the bottle nipple without any assistance to promote self-feeding." "Use a bottle with a fast-flow nipple to ensure the baby gets enough formula quickly." "Hold the baby close during feedings, cradling the head and allowing for eye contact." None A new father is worried about balancing work responsibilities with caregiving for the newborn. What advice should the nurse provide during discharge teaching to support the paternal phases of adjusting to parenthood? "Prioritize work over family to ensure financial stability." "Avoid taking any time off from work during the initial months of parenthood." "Communicate with your employer about the need for a flexible work schedule." "Leave all caregiving responsibilities to the mother to reduce stress." None None A postpartum client is concerned about her milk supply during breastfeeding. What advice should the nurse provide during breastfeeding initiation teaching to support milk production? "Limit the duration of each feeding to prevent overstimulation of milk production." "Use a breast pump between feedings to increase milk supply." "Ensure a proper latch and feed on demand to establish and maintain milk production." "Supplement with formula to ensure the baby gets enough milk." None A postpartum client is concerned about the safety of formula preparation for bottle feeding. What advice should the nurse provide during feeding initiation teaching to ensure safe formula preparation? "Use tap water to mix formula as it is convenient and readily available." "Prepare formula in advance and refrigerate for up to 24 hours." "Sterilize all bottle-feeding equipment before every use." "Follow the manufacturer's instructions for formula preparation and storage." None A postpartum client is preparing to initiate formula feeding for her newborn. What guidance should the nurse provide during feeding initiation teaching to ensure safe and effective formula preparation? "Boil tap water for at least 5 minutes before mixing it with formula to eliminate potential contaminants." "Add extra formula powder to make the feeding more nutrient-rich and support the baby's growth." "Refrigerate any unused formula for up to 48 hours to minimize waste and save time." "Follow the manufacturer's instructions for formula preparation, using the recommended water-to-powder ratio." None A postpartum client expresses concern about the safety of using well water to prepare formula for her newborn. What advice should the nurse provide during feeding initiation teaching regarding the use of well water? "Well water is safe for formula preparation without any special considerations." "Boil the well water before using it to eliminate potential contaminants." "Use well water only if it has been tested and approved by a laboratory." "Mixing well water with bottled water ensures optimal formula safety." None None A postpartum client is concerned about the impact of post-partum blues on her ability to bond with her newborn. What guidance should the nurse provide to support parent-infant bonding during this emotional period? "Limit physical contact with your baby to avoid overwhelming yourself with emotions." "Delay initiating breastfeeding until your emotional state stabilizes." "Engage in skin-to-skin contact and cuddling with your baby to enhance bonding." "Delegate all caregiving responsibilities to family members until your emotions subside." None A postpartum client is diagnosed with postpartum depression and expresses concern about her ability to bond with her newborn. What guidance should the nurse provide to support parent-infant bonding during this challenging time? "Avoid spending too much time with your baby to reduce stress and emotional burden." "Delegate all caregiving responsibilities to family members to minimize your involvement." "Engage in small, positive interactions with your baby, such as cuddling and talking softly." "Delay seeking professional help, as postpartum depression will likely resolve on its own." None A postpartum client with depression is struggling with sleep disturbances and fatigue. What advice should the nurse provide to support parent-infant bonding while managing these symptoms? "Prioritize catching up on sleep over spending time with your baby to improve your overall well-being." "Follow a strict schedule, including designated times for caregiving and bonding activities." "Enlist the help of a night nurse or family member to care for the baby during the night." "Limit physical contact with your baby to conserve energy and reduce fatigue." None A postpartum client expresses feelings of sadness and tearfulness, particularly in the evenings, following the birth of her baby. She is unsure if these emotions are related to post-partum blues or depression. What information should the nurse provide to help differentiate between post-partum blues and depression? "Post-partum blues are characterized by intense and prolonged feelings of sadness, while depression is typically short-lived." "Depression is a normal response to the challenges of new parenthood, while post-partum blues are more transient." "Post-partum blues are a temporary and common emotional response, usually resolving within a few weeks." "Depression is often accompanied by feelings of joy and connection with the newborn, while post-partum blues involve detachment." None A postpartum client reports feelings of overwhelming sadness, changes in appetite, and difficulty sleeping. How should the nurse differentiate between post-partum blues and postpartum depression? "Post-partum blues are characterized by physical symptoms, while postpartum depression primarily involves emotional changes." "Postpartum depression is more common in the first week after childbirth, while post-partum blues typically emerge later." "Post-partum blues usually resolve on their own, while postpartum depression requires professional intervention." "Postpartum depression is a normal part of the postpartum period, while post-partum blues are cause for concern." None A postpartum client inquires about natural family-planning methods for contraception. What information should the nurse include in the teaching about these methods? "Natural family-planning methods are highly effective and provide immediate protection against pregnancy." "These methods involve tracking menstrual cycles, basal body temperature, and cervical mucus changes to identify fertile periods." "Natural family-planning methods are suitable for women with irregular menstrual cycles but may not be effective for those with regular cycles." "It's unnecessary to involve the partner in natural family-planning methods; the woman can manage them independently. None A postpartum client is considering natural family-planning methods but is concerned about their reliability. What advice should the nurse provide to address the client's concerns? "Natural family-planning methods are the most reliable form of contraception available." "Combine natural family-planning methods with barrier methods for added protection against pregnancy." "Use natural family-planning methods only if you are actively trying to conceive." "Consider hormonal contraception for a more reliable and effective option." None A postpartum client is considering using barrier methods for contraception and asks the nurse about their effectiveness. What information should the nurse provide about the efficacy of barrier methods? "Barrier methods, such as condoms, are 100% effective in preventing pregnancy when used consistently and correctly." "While barrier methods are effective, their success depends on proper and consistent use, and they may have a failure rate." "Barrier methods are more effective than hormonal contraception, providing a higher level of protection against pregnancy." "Barrier methods, such as diaphragms, do not require any specific application technique for maximum effectiveness." None A postpartum client is concerned about the potential side effects of using barrier methods for contraception. What advice should the nurse provide regarding side effects of these methods? "Barrier methods, such as condoms, are associated with significant hormonal side effects that can impact your health." "Barrier methods generally have minimal side effects, and any discomfort is usually temporary and manageable." "Barrier methods may cause long-term infertility and should be avoided for extended periods." "Using barrier methods increases the risk of sexually transmitted infections (STIs) due to decreased sensitivity." None A postpartum client is considering hormonal methods for contraception and is concerned about potential side effects. What information should the nurse provide regarding the side effects of hormonal methods? "Hormonal methods, such as birth control pills, have no side effects and are well-tolerated by all women." "Hormonal methods may cause temporary side effects such as nausea, breast tenderness, and irregular bleeding." "Hormonal methods are associated with permanent infertility and should be avoided by women planning future pregnancies." "Hormonal methods are more likely to cause weight gain compared to other forms of contraception." None A postpartum client is breastfeeding and inquiring about the use of hormonal methods for contraception. What advice should the nurse provide regarding the compatibility of hormonal methods with breastfeeding? "Hormonal methods are safe to use while breastfeeding and will not affect your milk supply." "It is recommended to avoid hormonal methods while breastfeeding, as they can reduce milk production." "Hormonal methods are only suitable for breastfeeding mothers if their baby is older than six months." "Consider hormonal methods only if you plan to wean your baby from breastfeeding." None A postpartum client is considering long-acting reversible sterilization (LARCS) as a contraceptive option. What information should the nurse provide during the counseling session about LARCS? "LARCS methods, such as tubal ligation, are easily reversible, allowing you to conceive in the future if desired." "LARCS methods are permanent and irreversible, providing a long-term contraceptive solution." "LARCS methods have a high failure rate and are less effective compared to other forms of contraception." "LARCS methods are only suitable for women who have completed their desired number of pregnancies." None A postpartum client is interested in an intrauterine device (IUD) as a form of long-acting reversible sterilization. What counseling should the nurse provide regarding the use of IUDs? "IUDs are only suitable for women who have never given birth." "IUDs offer immediate fertility restoration upon removal." "IUDs do not require regular follow-up visits for maintenance." "IUDs provide effective contraception for an extended period but require proper insertion and removal by a healthcare professional." 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