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Exam (elaborations)

HESI_RN_Maternity_Nursing_Exam

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1. A primigravida mother who is one day post delivery tells the nurse that she is not producing enough milk for her new baby, and she wants to begin breastfeeding at home when her milk comes in. What info should the nurse obtain before responding to the client? AͲwhen the lactation consultant is scheduled to visit the client in her home BͲthe womans understanding of how her body produces breast milk. CͲif the woman is feeling pressured by her family to breast feed her infant. DͲwhy the woman thinks her infant is not receiving enough milk CorrectͲD Sometimes new mothers do not understand that colostrums provided adequate nutrition the first three days following delivery. So the clients thinking regarding this issue should be assessed (D). Waiting for a visit from a lactation consultant (A) to address this issue is likely to inhibit lactation if the mother delays suckling the infant. Although assessing the mother’s understanding of milk production (B) may provide a teaching opportunity, it does not elicit information about the clients concern regarding the delay of breast feeding/ Assessing the mothers feelings about her family’s desire for her to breastfreed (C) doesn’t address the issue athand. 2. A client with endometritis is preparing for discharge on her third postpartum day, Which statement by he client indicates that the discharge teaching was effective? AͲI should limit my visitors until this infection clears BͲI will resume breastfeeding when the infection is gone CͲI should sit an upright position as much as possible DͲI will stop taking antibiotics when my fever disappears CorrectͲC A client with endo metris should sit in an upright position© to facilitate drainage of lochia and prevent infected fluids from enetering the peritoneal cavity. (A,B and D) indicate a needs for additional instruction. Endometritis is an infection of the endometrial lining and is not contagious, so visitors do not need to be restricted or limited(A). there is no indication to stop or withholding breastfeeding (b) if a client develops endometritis. All antibiotics should be completed regardless of fever abatement. 3. A multipara postpartum client complains about intenst cramping while breastfeeding. What instructions should the nurse provide to this client? AͲ TAKE A PRESCRIBED ANALGESIC AN HOUR PRIOR TO BREASTFEEDING BͲ change then infants position during the next feeding CͲ drink two glasses of Water 30 minutes prior to breastfeeding DͲ void and completely empty bladder before each feeding CorrectͲa The client is experiencing atterpains which typically affect multigravidas due to relaxation of the uterine muscles and release of oxytocin during breastfeeding. The client should take a prescribed analgesic one hour before breastfeeding (A) to relieve this discomfort. Infant positioning during B is effective in relieving sore nipples. C and D are not effectivemeasures for relieving uttering cramping


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