A nurse is collecting data from a client who is 48 hours postpartum.
Which of the following findings reported by the client should the nurse identify as a postpartum psychosocial concern?

The client discusses desire to have more children.

The client reports fatigue and desire to sleep.

The newborn reminds the client of themself as a newborn.

The client does not want to feed the newborn.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Discussing a desire for more children is a normal manifestation of a positive postpartum adjustment. This indicates a healthy attachment to the current child and an optimistic outlook on future family expansion, reflecting psychological well-being and a positive coping mechanism in the postpartum period, not a concern.

Choice B rationale

Fatigue and a desire to sleep are common physiological and psychological responses to the physical demands of labor, delivery, and the initial postpartum period, as well as the demands of newborn care. This is a normal physiological recovery process and not indicative of a psychosocial concern.

Choice C rationale

Acknowledging similarities between the newborn and oneself as an infant indicates a healthy process of identification and bonding. This self-referential observation fosters a sense of connection and continuity within the family unit, signifying normal maternal-infant attachment and psychological integration, not a concern.

Choice D rationale

A client's reluctance to feed the newborn can be a significant indicator of potential psychosocial concerns such as postpartum depression, anxiety, or difficulties with maternal-infant bonding. This behavior may suggest a diminished capacity for engaging in essential caregiving activities, warranting further assessment and intervention.

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Correct Answer is C

Explanation

Choice A rationale

Transcutaneous electrical nerve stimulation (TENS) is primarily used during the first and second stages of labor to manage discomfort by interfering with pain signal transmission through nerve stimulation. Its effectiveness significantly diminishes in the third stage, which involves the expulsion of the placenta, as the pain sensation during this stage is distinct and less responsive to superficial nerve modulation.

Choice B rationale

Gestational diabetes itself is not a contraindication for TENS use. TENS therapy works by stimulating sensory nerves to block pain signals or release endorphins. The metabolic changes associated with gestational diabetes do not interfere with the biophysical mechanisms by which TENS alleviates pain, making it a safe option for pain management in this population.

Choice C rationale

Increasing TENS intensity during a contraction aligns with the physiological response to labor pain. As uterine contractions intensify, the perceived pain increases. Manually adjusting the TENS unit's intensity during a contraction allows for a dynamic and responsive pain management strategy, providing greater counter-stimulation when the pain is at its peak, enhancing its efficacy.

Choice D rationale

TENS does not eliminate pain during a contraction but rather reduces its perception. It works by activating large diameter afferent nerve fibers, which inhibits the transmission of nociceptive signals via the gate control theory of pain. It also may stimulate the release of endogenous opioids, modulating pain pathways, leading to a reduction in pain intensity, not complete abolition.

Correct Answer is ["0.5"]

Explanation

Calculation

400 mg ÷ 800 mg = 0.5 tablets.

The nurse should administer 0.5 tablets with each dose.

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A nurse is collecting data from a client who is 48 hours postpartum. Which of the following findings reported by the client should the nurse identify as a postpartum psychosocial concern?

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client about the use of a transcutaneous electrical nerve stimulation (TENS) device for back pain during labor. Which of the following information should the nurse include?

Correct Answer is C

Explanation

A nurse is preparing to administer acyclovir 400 mg tablet PO three times per day. Available are 800 mg tablets. How many tablets should the nurse administer with each dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["0.5"]

Explanation

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A nurse is collecting data from a client who is 48 hours postpartum.
Which of the following findings reported by the client should the nurse identify as a postpartum psychosocial concern?