On the first postpartum day, the nurse examines a new mother’s breasts.
What condition is the nurse most likely to find?
Soft, with no change from before delivery.
Filling and secreting colostrum.
Slightly firm with an immediate let-down response.
Firm, larger, and very tender to touch.
Firm, larger, and very tender to touch.
The Correct Answer is B
Choice A rationale
Immediately after delivery, the breasts of a new mother are not likely to remain the same as before delivery. Hormonal changes during pregnancy prepare the breasts for lactation, and these changes do not typically revert immediately after delivery.
Choice B rationale
On the first postpartum day, the breasts of a new mother are most likely to be filling and secreting colostrum. Colostrum is the first form of milk produced by the mammary glands, and it usually starts to be produced during pregnancy and continues during the early days of breastfeeding.
Choice C rationale
An immediate let-down response is not typically observed on the first postpartum day. The letdown reflex, which releases milk from the breast, usually becomes more pronounced after the first few days of breastfeeding.
Choice D rationale
While the breasts may become larger due to milk production, they are not typically very tender to touch on the first postpartum day. Tenderness may occur later, especially if complications like engorgement or mastitis develop.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While multiple gestation can cause an increase in maternal serum alpha-fetoprotein (MS-AFP) levels, it is not the most likely cause of an elevated MS-AFP level at 17 weeks.
Choice B rationale
Fetal hypoxia, or lack of oxygen to the fetus, is not typically associated with an increase in MSAFP levels.
Choice C rationale
Down syndrome is typically associated with lower, not higher, levels of MS-AFP891011.
Choice D rationale
An elevated level of MS-AFP at 17 weeks is most commonly associated with a neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord that occur during the first month of pregnancy.
Correct Answer is B
Explanation
Choice A rationale
Immunocompromised children are generally not given live virus vaccines due to the risk of developing the disease the vaccine is meant to prevent.
Choice B rationale
This is the correct statement. If a child has a fever or is ill, vaccination may be postponed.
Choice C rationale
Second doses of vaccines are generally not given to children who have had allergic reactions to the first dose.
Choice D rationale
Breastfeeding does not interfere with the effectiveness of vaccines. In fact, breastfeeding can enhance the response to certain vaccine antigens.
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