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OB Prep- U: Chapter 16 Questions With Complete Solutions
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OB Prep- U: Chapter 16 Questions With Complete Solutions
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OB Prep- U: Chapter 16 Questions With Complete SolutionsA client who gave birth by cesarean delivery 3 days ago is
bottle-feeding her neonate. While collecting data the nurse notes
that vital signs are stable, the fundus is four fingerbreadths
below the umbilicus, lochia are small and red, and the client
reports discomfort in her breasts, which are hard and warm to
touch. The best nursing intervention based on this data would
be:
a) Having the client stand facing in a warm shower.
b) Using a breast pump to facilitate removal of stagnant breast
milk.
c) Encouraging the client to wear a supportive bra.
d) Informing the physician that the client is showing early signs
of breast infection. Correct Answer c) Encouraging the client to
wear a supportive bra.
Rationale:
These assessment findings are normal for the third postpartum
day. Hard, warm breasts indicate engorgement, which occurs
approximately 3 days after birth. Vital signs are stable and don't
indicate signs of infection. The client should be encouraged to
wear a supportive bra, which will help minimize engorgement
and decrease nipple stimulation. Ice packs can reduce
vasocongestion and relieve discomfort. Warm water and a breast
pump will stimulate milk production.
A client who gave birth vaginally 16 hours ago states she doesn't
need to void at this time. The nurse reviews the documentation
and finds that the client hasn't voided for 7 hours. Which
response by the nurse is indicated?
a) "If you don't attempt to void, I'll need to catheterize you."
, b) "It's not uncommon after delivery for you to have a full
bladder even though you can't sense the fullness."
c) "I'll check on you in a few hours."
d) "I'll contact your physician." Correct Answer b) "It's not
uncommon after delivery for you to have a full bladder even
though you can't sense the fullness."
Rationale:
After a vaginal delivery, the client should be encouraged to void
every 4 to 6 hours. As a result of anesthesia and trauma, the
client may be unable to sense the filling bladder. It is premature
to catheterize the client without allowing her to attempt to void
first. There is no need to contact the physician at this time,
because the client is demonstrating common adaptations in the
early postpartum period. Allowing the client's bladder to fill for
another 2 to 3 hours might cause overdistention.
A G1 P1001 mother is just home after delivering her first child 5
days ago. Her delivery was complicated by an emergency
cesarean delivery resulting from incomplete cervical dilation
and hemorrhage. The nurse determines that the mother has not
slept longer than 3 hours at one time. The appropriate nursing
diagnosis for this patient care issue is
a) At risk for postpartum depression due to inadequate rest
b) At risk for interruption of tissue integrity
c) At risk for safety due to low hemoglobin
d) At risk for inadequate healing due to decreased nutrition
Correct Answer a) At risk for postpartum depression due to
inadequate rest
Rationale:
,This scenario refers only to the issue of sleep. Information is
insufficient to suggest that the other issues are problematic at
this time.
A mother just delivered 3 hours ago. The nurse enters the room
to continue hourly assessments and finds the patient on the
phone telling the listener about her fear while driving to the
hospital and not making it in time. The mother finishes the call,
and the nurse begins her assessment with which phrase?
a) "If you plan to breastfeed, you need to calm down."
b) "It sounded like you had quite a time getting here. Would
you like to continue your story?"
c) "You have a beautiful baby, why worry about that now?"
d) "I need to assess your fundus now." Correct Answer b) "It
sounded like you had quite a time getting here. Would you like
to continue your story?"
Rationale:
The mother is going through the taking-in phase of relating
events during her pregnancy and delivery. The nurse can
facilitate this phase by allowing the mother to express herself.
Diverting the conversation, admonishing the mother, or warning
of potential problems does not accomplish this facilitation.
A new mother has been reluctant to hold her newborn. A nurse
can promote this mother's attachment to her newborn by
a) Showing a video of parents feeding their babies
b) Talking about how the nurse held her own newborn while on
the delivery table
c) Bringing the newborn into the room
, d) Allowing the mother to pick the best time to hold her
newborn Correct Answer c) Bringing the newborn into the
room
Rationale:
Proximity of the newborn and the mother can promote interest in
the newborn and a desire to hold. Exposure to other mothers and
their behaviors can only serve to set up unrealistic and fearful
situations for a reluctant mother.
A new mother talking to a friend states, "I wish my baby was
more like yours. You are so lucky. My baby has not slept
straight through the night even once. It seems like all she wants
to do is breastfeed. I am so tired of her." This is an example of
which of the following?
a) positive bonding
b) negative bonding
c) negative attachment
d) positive attachment Correct Answer c) negative attachment
Rationale:
Expressing disappointment or displeasure in the infant, failing to
explore the infant visually or physically, and failing to claim the
infant as part of the family are just a few examples of negative
attachment behaviors.
A new mother tells the nurse at the baby's 3 month check-up,
"When she cries, it seems like I am the only one who can calm
her down." This is an example of which of the following?
a) bonding
b) attachment
c) being spoiled
d) none of the above Correct Answer b) attachment
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