A nurse is caring for a client who had a vaginal delivery 2 hr ago and is reporting increasing perineal pain and pressure.The nurse examines the client's perineum and sees a 4 cm (1.6 in) area of purplish discoloration with swelling.
The nurse should interpret these findings as which of the following?

A hematoma.

Retained placental fragments.

A laceration.

Ecchymosis.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A hematoma presents as a localized collection of blood outside the blood vessels, causing a purplish discoloration and swelling, often resulting from trauma during delivery.

Choice B rationale

Retained placental fragments may cause postpartum hemorrhage and infection but would not present as a localized purplish swelling on the perineum.

Choice C rationale

A laceration would involve a tear in the tissue, causing bleeding and pain, but not necessarily a purplish discoloration with localized swelling unless associated with a hematoma.

Choice D rationale

Ecchymosis refers to bruising but is typically a more diffuse discoloration rather than a localized swelling and purplish area as seen with a hematoma.

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Correct Answer is A

Explanation

Choice A rationale

Methadone is often prescribed to pregnant women with opioid use disorder and is considered safe for breastfeeding. Breastfeeding can provide additional benefits such as bonding and transferring antibodies to the infant.

Choice B rationale

Methamphetamine use during pregnancy is linked to fetal growth restriction, preterm birth, and low birth weight, not fetal macrosomia (large body size).

Choice C rationale

Reducing environmental stimuli is essential for neonates exposed to substances in utero. Increased stimuli can overwhelm their underdeveloped nervous systems, leading to stress and adverse outcomes.

Choice D rationale

Fetal alcohol syndrome is characterized by growth deficiencies, facial abnormalities, and central nervous system dysfunction. An increased head circumference is not a typical feature; rather, microcephaly (small head circumference) is more common.

A. The parent should hold the newborn during the initial visit with the older sibling. B. The parent should plan to spend individual time with the older sibling. C. The parent should have the older sibling purchase a gift for the newborn. D. The parent should postpone introducing the older sibling to the newborn until discharge.

Correct Answer is B

Explanation

Choice A rationale

Holding the newborn during the initial visit may make the older sibling feel left out or jealous. Encouraging involvement with the new baby may be more beneficial.

Choice B rationale

Spending individual time with the older sibling helps them feel valued and ensures they do not feel neglected, facilitating better acceptance of the newborn.

Choice C rationale

Having the older sibling purchase a gift for the newborn can create a positive association, but it is less impactful than ensuring individual time and attention.

Choice D rationale

Postponing the introduction until discharge can increase feelings of jealousy or resentment, as the older sibling might feel excluded from the new family dynamic during a crucial time.

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Naxlex Comprehensive Predictor Exams

A charge nurse is teaching a newly licensed nurse about substance use disorders during pregnancy.Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is teaching a prenatal class to a group of parents and is discussing facilitation of sibling acceptance of the newborn.Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is assessing a 1-hour-old newborn.Which of the following findings should the nurse report to the provider?

A nurse is providing teaching about nifedipine for a client who is at 34 weeks of gestation and has gestational hypertension.For which of the following adverse effects should the nurse instruct the client to notify the provider?

A nurse on an antepartum unit is caring for a 28-year-old gravida 1 para 0 female client at 32 weeks of gestation. Exhibits Complete the following sentence by using the list of options. The nurse should identify that _______ are findings that require follow-up.

A nurse is admitting a client who is at 9 weeks of gestation and in active labor when screened at 6 weeks of gestation.Which of the following actions should the nurse take?

A nurse is reviewing the results of a nonstress test for a client who is at 37 weeks of gestation.Which of the following findings indicates a reactive nonstress test?

A nurse is developing a plan of care for a client who is in the latent phase of labor.Which of the following interventions should the nurse include in the plan to manage the client's pain?

A nurse is assessing a client who has placenta previa and is receiving fetal monitoring.Which of the following clinical findings should the nurse expect?

A nurse is caring for a postpartum client who is breastfeeding their newborn and reports that their nipples have become sore and cracked.Which of the following statements should the nurse make?