A patient has decided to bottle-feed her twins.The nurse should give this patient which instruction to help alleviate breast engorgement?

Manually express colostrum as necessary.

Apply hot compresses to the breasts.

Massage the breast tissue surrounding the areola.

Wear a supportive bra.

Answer and Explanation

The Correct Answer is D

The correct answer is choice D. Wear a supportive bra. This will help suppress lactation and reduce the discomfort of engorgement.

The other choices are wrong because:

• Choice A. Manually express colostrum as necessary. This will stimulate milk production and prolong engorgement.

• Choice B. Apply hot compresses to the breasts. This will increase blood flow and swelling in the breasts and worsen engorgement.

• Choice C. Massage the breast tissue surrounding the areola. This will also stimulate milk production and prolong engorgement.

Normal ranges for breast engorgement are not applicable as it is a subjective experience that varies among women. However, some signs of engorgement include firm, tender, swollen breasts, flat or inverted nipples, and low-grade fever. Engorgement usually resolves within 24 to 36 hours after it begins.

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Correct Answer is C

Explanation

The correct answer is choice C. Reminding her that she should be happy that one child survived and is healthy is the least helpful nursing action in supporting the woman as she copes with her loss.

This statement minimizes her grief and implies that she should not feel sad about the deceased twin.

It also disregards her attachment to both babies and her need to mourn the loss of one of them.

Choice A is wrong because offering her the opportunity for counseling to help her grieve is a helpful nursing action that recognizes her emotional distress and provides her with professional support.

Choice B is wrong because encouraging the woman to hold the deceased twin as well as the living twin is a helpful nursing action that allows her to acknowledge and bond with both babies and to create memories that may facilitate healing.

Choice D is wrong because assisting the woman to take pictures of both babies is a helpful nursing action that provides her with tangible mementos of her twins and honors their

A. breast care teaching because she is predisposed to mastitis. B. frequent uterine fundal assessments because she is at risk for developing a prolapsed uterus. C. a strict toileting schedule because she is prone to developing a urinary tract infection. D. an “as needed” order for an analgesic because she is likely to have pain.

Correct Answer is B

Explanation

The correct answer is choice B. A multipara is a woman who has given birth more than once.

After delivery, the uterus contracts to return to its normal size and position.

However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.

This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.

Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.

Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.

Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.

Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.

It is not more common in multiparas.

Choice C is wrong because a strict toileting schedule is not necessary for multiparas.

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.

UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.

Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.

Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.

Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.

Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.

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A patient has decided to bottle-feed her twins.The nurse should give this patient which instruction to help alleviate breast engorgement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A woman gives birth to twin girls, one of whom is stillborn. Which nursing action would be least helpful in supporting the woman as she copes with her loss?

Correct Answer is C

Explanation

In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:

Correct Answer is B

Explanation

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A nurse is caring for a patient who is receiving oxytocin injection intravenously for labor induction.The nurse should monitor this patient for which adverse effect of oxytocin?

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