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The perinatal nurse is teaching the patient about breastfeeding and explains that which of the
following is the most appropriate time to breastfeed?
A. Four to 5 hours after the last feeding
B. Only when her infant exhibits hunger-related crying
C. When her infant is in a quiet alert state
D. When her infant is in an active alert state - CORRECT ANSWER ✔✔ANS: C
The optimal time to breastfeed is when the baby is in a quiet alert state. Crying is usually a late
sign of hunger and achieving satisfactory latch-on at this time is difficult. Latch-on is proper
attachment of the infant to the breast for feeding. The neonate is most alert during the first 1 to
2 hours after an unmedicated birth, and this is the ideal time to put the infant to the breast.
The perinatal nurse demonstrates the correct technique of postpartum uterine palpation for a
student nurse. The nurse explains that support for the lower uterine segment is critical, because
without it there is an increased risk of which complication?
A. Incorrect measurement
B. Intensifying the patient's pain
C. Uterine edema
D. Uterine inversion - CORRECT ANSWER ✔✔ANS: D
The uterine fundus is palpated by placing one hand on the base of the uterus immediately
above the symphysis pubis and the other hand at the level of the umbilicus. The nurse presses
inward and downward with the hand positioned on the umbilicus until the fundus is located.
The uterus should never be palpated without supporting the lower uterine segment. Failure to
do so may result in uterine inversion and hemorrhage.
,A nurse is caring for a woman after a cesarean birth. Prior to ambulating her for the first time,
which action by the nurse takes priority?
A. Assess sensation in the lower extremities.
B. Discontinue the patient's intravenous line.
C. Encourage the patient to cough and deep breathe.
D. Have the patient sit on the edge of the bed. - CORRECT ANSWER ✔✔ANS: A
After a cesarean birth with spinal or epidural anesthesia, the nurse must assess sensation in the
woman's legs. She will not be allowed out of bed until sensation returns. Discontinuing the IV
line may or may not be appropriate. Coughing and deep breathing are always important for a
postoperative patient, but this action is not related to ambulating for the first time. Sitting on
the edge of the bed prior to getting up would only be done if the woman had full sensation in
her legs.
Two days after an uncomplicated vaginal birth, the nurse notes that the patient's hemoglobin is
13 mg/dL and the hematocrit is 48%. What does the nurse conclude about these values?
A. Patient is dehydrated
B. Needs further assessment
C. Normal for this situation
D. Serious anemia - CORRECT ANSWER ✔✔ANS: C
After a vaginal birth, the hemoglobin can drop about 1 gram, or 2 grams following a cesarean
birth (normal for women is 12.1-15.1 mg/dL). Due to diuresis, hemoconcentration can occur,
resulting in a rise in the hematocrit (normal in women is 36.1-44.3%). Therefore, these findings
are normal after an uncomplicated vaginal birth.
A new mother is concerned that her 3-year-old child is not adapting well to the birth of a new
sibling 1 month ago. What suggestion can the nurse provide to best help this mother?
A. Explain to the child that she will always have a special bond with the new sibling.
B. Give the 3-year-old a special chore that only she does to help her mom.
C. Promise the 3-year-old that she can have a pet if she is good to her new sibling.
, D. Tell the child she will need to get used to having a new baby in the house. - CORRECT
ANSWER ✔✔ANS: B
Often siblings have a rough time adapting to the arrival of a new sibling. Some suggestions for
the parents are to talk to the child about her feelings, teach the child how to play with the baby,
praise age-appropriate behaviors and do not criticize regressive behaviors (regression is
common), set aside special time each day for the older child, and give the older child a special
chore to be a "big helper for Mommy." A special chore, such as bringing diapers when the baby
needs changing, can help boost her self-esteem and make her feel important to the family.
A woman has painful hemorrhoids after a vaginal birth. Her husband brings her a donut pillow
to sit on. What response by the nurse is best?
A. "A lot of women get good pain relief from these."
B. "Donut pillows actually increase hemorrhoid pain."
C. "I will have to get permission for her to use this."
D. "That was nice of you, but these don't work well." - CORRECT ANSWER ✔✔ANS: B
Soft surfaces and pillows such as donut rings should not be used by the woman with
hemorrhoids, as they separate the buttocks when the woman sits down and decrease venous
flow, which increases pain. The woman should be instructed to sit on hard surfaces and tighten
the buttocks prior to sitting. The other responses do not give accurate information.
The perinatal nurse listens as the patient describes her labor and emergency cesarean birth.
Providing an opportunity to review this experience may assist the patient in doing which of the
following?
A. Decreasing her ambivalence about her labor and birth
B. Developing more positive feelings about her labor and birth
C. Initiating her role development in the "letting-go" stage
D. Understanding the various demands associated with the maternal role - CORRECT ANSWER
✔✔ANS: B
After a cesarean birth, especially when unplanned, nurses must be aware of the myriad of
potential psychological issues that may arise. Research suggests that women may perceive
cesarean birth to be a less positive experience than a vaginal birth, and for unplanned or