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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:

breast care teaching because she is predisposed to mastitis.

frequent uterine fundal assessments because she is at risk for developing a prolapsed uterus.

a strict toileting schedule because she is prone to developing a urinary tract infection.

an “as needed” order for an analgesic because she is likely to have pain.

Answer and Explanation

The Correct Answer is B

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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Correct Answer is D

Explanation

The correct answer is choice D. Placing warmed tea bags on the nipples is not a recommended method to avoid nipple soreness while breastfeeding.Tea bags can cause dryness and cracking of the nipples, which can increase the risk of infection and pain.

Choice A is wrong because it is better to use both breasts at each feeding and switch the starting breast at each feeding.This helps to ensure adequate milk production and drainage.

Choice B is correct because rubbing breast milk into the nipple can help to moisturize and protect the nipple from infection.Breast milk has antibacterial and healing properties.

Choice C is correct because washing the nipples with water but no soap can help to prevent irritation and dryness of the nipples.

Soap can remove the natural oils that protect the skin.Letting the nipples air dry can also help to prevent fungal growth.

A. What is the nurse’s best response to the client’s question as to why the amniocentesis test is being done?. B. “To determine fetal lung maturity.”. C. “To assess the degree of fetal renal function.”. D. “To test the amniotic fluid glucose level.”. E. “To detect the presence of fetal congenital anomalies.”.

Correct Answer is A

Explanation

The correct answer is choice A.“To determine fetal lung maturity.” An amniocentesis at 37 weeks of gestation can be done to measure the lecithin/sphingomyelin (L/S) ratio in the amniotic fluid, which indicates the level of surfactant production and the readiness of the fetal lungs for breathing.A low L/S ratio can indicate fetal compromise due to gestational diabetes.

Choice B is wrong because fetal renal function is not assessed by amniocentesis, but by ultrasound or biophysical profile.

Choice C is wrong because amniotic fluid glucose level is not a reliable indicator of fetal well-being or gestational diabetes control.

Choice D is wrong because congenital anomalies are usually detected earlier in pregnancy by ultrasound, maternal serum screening, or chorionic villus sampling.

Normal ranges for L/S ratio are 2:1 or higher for term fetuses and 1.5:1 or higher for preterm fetuses.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse instructs a class of postpartum women on methods to avoid nipple soreness while breastfeeding. Which comment by a class participant indicates the need for further instruction?

Correct Answer is D

Explanation

Question 71. A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise.

Correct Answer is A

Explanation

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