A nurse is caring for a postpartum client who just delivered a newborn weighing 4.5 kg (10 lb). Which of the following signs should the nurse recognize as a potential indication of hemorrhage?

Blood pressure 88/40 mm Hg

Moderate rubra lochia

Heart rate 90/min

Urinary output 40 mL/hr

Answer and Explanation

The Correct Answer is A

Choice A rationale
A blood pressure of 88/40 mm Hg is significantly lower than the normal range, which could indicate hemorrhage. Hypotension is a common sign of significant blood loss.
Choice B rationale
Moderate rubra lochia is normal within the first few days postpartum and does not necessarily indicate hemorrhage.
Choice C rationale
A heart rate of 90/min is within the normal range and does not indicate hemorrhage.

Choice D rationale
A urinary output of 40 mL/hr is within the normal range and does not indicate hemorrhage.

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Correct Answer is B

Explanation

Choice A rationale
An absent Moro reflex is not typically associated with neonatal abstinence syndrome (NAS), a condition that can occur in newborns exposed to opioids in utero.
Choice B rationale
A weak cry is a common symptom of NAS. Newborns with this syndrome often have high- pitched or weak cries.
Choice C rationale
Poor feeding is a symptom of NAS, but it is not the most specific symptom in this context.
Choice D rationale
A respiratory rate of 30/min is within the normal range for a newborn and is not indicative of NAS5.

A. Feed the newborn 5 to 10 min per breast. B. Expect two to four wet diapers every 24 hr. C. Allow the baby to feed at least every 3 hr. D. Offer the newborn 30 mL (1 oz) of water between feedings.

Correct Answer is C

Explanation

Choice A rationale
Feeding the newborn 5 to 10 minutes per breast may not be sufficient for the baby to get all the necessary nutrients. It is generally recommended to allow the baby to feed until they naturally let go of the breast.
Choice B rationale
Expecting two to four wet diapers every 24 hours is not accurate for a breastfeeding newborn. A well-fed newborn will typically have at least six wet diapers a day.
Choice C rationale
This is the correct answer. It is generally recommended to allow the baby to feed at least every 3 hours. This ensures that the baby gets enough nutrients and helps stimulate milk production.
Choice D rationale
Offering the newborn 30 mL (1 oz) of water between feedings is not recommended. Breast milk or formula should be the primary source of hydration for a newborn.

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