A nurse is providing care for a postpartum client.
The client’s medical history includes Gravida 1, Para 1, and a spontaneous vaginal birth. The nurse’s notes indicate that the client is at 39 weeks of gestation and is breastfeeding.
Which of the following statements made by the client would suggest that they have understood the discharge instructions?
Which of the following statements made by the client would suggest that they have understood the discharge instructions?
“I should ensure that my baby feeds 8 to 12 times per day.”.
“Given my baby’s weight loss, I need to supplement with formula after breastfeeding.”.
“I should protect my sore nipples with plastic-lined breast pads after each feeding.”.
“I can boost my milk supply by drinking more water.”. .
The Correct Answer is A
Choice A rationale
This statement is correct. It is recommended that newborns be breastfed 8 to 12 times per day, which is about every 2 to 3 hours.
Choice B rationale
Supplementing with formula after breastfeeding is not typically recommended unless there is a medical reason. Supplementing can interfere with the supply and demand process that increases milk supply.
Choice C rationale
Using plastic-lined breast pads can trap moisture and exacerbate sore nipples. It is recommended to use 100% cotton breast pads and to change them frequently to keep the nipples dry.
Choice D rationale
While staying hydrated is important for overall health, there is no definitive evidence that drinking more water will increase milk supply. However, some mothers find that staying well- hydrated helps with their overall comfort and well-being during breastfeeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Monitoring axillary temperature is important for all newborns to prevent hypothermia. However, it is not the priority intervention for a newborn who is small for gestational age (SGA). These newborns are at a higher risk for hypoglycemia due to decreased stores of glycogen and a lower rate of gluconeogenesis.
Choice B rationale
Monitoring weight is important for all infants, and ongoing monitoring is important for infants who are SGA. However, it is not the priority intervention for this client at this time.
Choice C rationale
This is the correct answer. Newborns who are SGA are at a higher risk for hypoglycemia. Therefore, monitoring of blood glucose levels is a priority intervention.
Choice D rationale
Providing age-appropriate stimulation is important for all newborns. However, it is not the priority intervention for a newborn who is SGA2.
Correct Answer is D
Explanation
Choice A rationale
The largest fetal diameter passing through the pelvic outlet is not what is indicated by the presenting part being at 0 station. This would be more indicative of a positive station, such as
+31.
Choice B rationale
The position of the fetal head, such as left occiput posterior, is not determined by the station of the presenting part. The station refers to the level of the presenting part in relation to the mother’s ischial spines.
Choice C rationale
The palpability of the posterior fontanel is not related to the station of the presenting part. The fontanels are soft spots on the baby’s head which allow for compression during birth and brain growth after birth.
Choice D rationale
This is the correct interpretation of the clinical finding. The presenting part is at 0 station when its lowermost portion is at the level of an imaginary line drawn between the client’s ischial spines.
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