Lochia progresses in the following order:
Rubra, serosa, alba.
Rubra, alba, serosa.
Serosa, alba, rubra.
Alba, rubra, serosa.
The Correct Answer is A
A) Rubra, serosa, alba:
The normal progression of lochia, the vaginal discharge after childbirth, follows a predictable sequence of stages. Lochia rubra is the initial stage, occurring within the first few days postpartum. It is bright red and consists primarily of blood, tissue, and debris from the placenta. After 3-4 days, the discharge changes to lochia serosa, which is pinkish-brown and contains a mixture of blood, serous fluid, and mucous. After 10-14 days, it progresses to lochia alba, which is white or pale yellow and consists mostly of leukocytes (white blood cells), mucus, and epithelial cells. This is the expected progression, which marks the natural healing process after childbirth.
B) Rubra, alba, serosa:
This order is incorrect because lochia serosa comes before lochia alba in the normal sequence. Lochia alba occurs after lochia serosa, not before. This progression would not accurately reflect the typical stages of lochia.
C) Serosa, alba, rubra:
This sequence is incorrect as lochia rubra is the first stage, not lochia serosa. The initial discharge following childbirth is always red and blood-tinged, which is lochia rubra. Serosa and alba come later in the progression, so this order does not follow the correct timeline.
D) Alba, rubra, serosa:
This order is completely incorrect. Lochia rubra (red blood discharge) is the first stage, not lochia alba (white discharge). After childbirth, rubra occurs first, followed by serosa, and then finally alba. This sequence does not reflect the normal postpartum discharge process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) "I'll walk you to the bathroom and stay with you."
After delivery, the patient is at risk for orthostatic hypotension and falling, especially within the first few hours postpartum. Even though the patient feels alert and active, her body is still adjusting after childbirth, and she may be unsteady. The nurse should assist her to the bathroom and provide supervision for her safety. Walking the patient to the bathroom ensures she can safely get there while allowing the nurse to assess her mobility and vital signs if necessary.
B) "I will get a bedpan for you."
While a bedpan may be appropriate if the patient is unable to get out of bed, this response does not prioritize the patient's expressed desire to go to the bathroom. Since she is alert, active, and able to communicate, walking her to the bathroom is a safer and more appropriate option than offering a bedpan. Using a bedpan would also restrict her mobility unnecessarily.
C) "Leave your peri-pad in place after you use the restroom so I can check your bleeding when you get back."
This does not address the immediate concern of the patient’s safety in getting to the bathroom. The nurse's priority should be her safety and mobility right after delivery, especially as the patient is still recovering and may be at risk for fainting or falling.
D) "Wait until I have had a chance to assess you first."
While it is important to assess the patient’s physical state postpartum, the response here should focus on immediate safety rather than delaying her need to use the restroom. A full assessment can be conducted later, but it is not appropriate to restrict the patient's autonomy when she has already indicated the need to go to the bathroom.
Correct Answer is D
Explanation
A) Axillary temp of 96.9F (36.0 C) after 30 minutes of skin-to-skin contact with the mother:
A temperature of 96.9°F (36.0°C) is lower than the expected normal range for a newborn, which is typically between 97.7°F (36.5°C) and 99.5°F (37.5°C). However, after 30 minutes of skin-to-skin contact with the mother, the temperature is likely to increase as the infant benefits from the warmth of the mother's body. If the temperature does not rise or if it continues to decrease, further intervention would be necessary.
B) Respiratory rate of 58 during assessment at beginning of shift:
Newborns may have slightly irregular and rapid breathing patterns, especially right after birth, but this is not a cause for concern unless accompanied by signs of respiratory distress, such as retractions, flaring, or grunting.
C) Heart rate of 162 while crying vigorously after a diaper change:
It is not uncommon for a newborn to have an elevated heart rate when upset or crying. A heart rate of 162 while crying is expected and does not indicate a problem. Once the baby calms down, the heart rate will likely return to its baseline.
D) No void after 8 hours of life:
The absence of a urine output within the first 8 hours of life is concerning and requires immediate follow-up. Newborns typically void within the first 24 hours, and if there is no urine output by 8 hours, it could indicate a potential problem such as dehydration, urinary tract obstruction, or renal dysfunction. A healthcare provider should be notified promptly for further assessment and intervention.
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