The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:

Retained placenta fragments.

Vaginal hematoma.

Uterine atony.

Uterine inversion.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Retained placental fragments lead to delayed, not immediate, postpartum hemorrhage as they prevent complete uterine contraction over time.

Choice B rationale

Vaginal hematomas cause concealed, localized bleeding with minimal external blood loss, differing from profuse hemorrhage presentations.

Choice C rationale

Uterine atony, the most common cause, occurs when the uterus fails to contract effectively, leading to uncontrolled and excessive bleeding.

Choice D rationale

Uterine inversion, though serious, is rare and typically accompanied by visible uterine prolapse, not commonly causing profuse bleeding in the immediate postbirth period.

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Correct Answer is A

Explanation

Choice A rationale

Narcan (naloxone) is contraindicated as it can precipitate acute withdrawal symptoms in neonates exposed to opioids in utero, leading to seizures and severe distress due to sudden opioid receptor blockade.

Choice B rationale

Phenobarbital is used to manage neonatal abstinence syndrome by reducing central nervous system hyperexcitability and seizures. It is not contraindicated as it provides symptomatic relief for withdrawal symptoms.

Choice C rationale

Methadone is used to treat neonatal abstinence syndrome by stabilizing opioid levels and preventing withdrawal symptoms. It is not contraindicated and helps manage symptoms effectively in opioid-exposed neonates.

Choice D rationale

Morphine is a first-line treatment for neonatal abstinence syndrome, reducing withdrawal symptoms by mimicking the effects of opioids. It is not contraindicated and is commonly used in neonatal care.

A. Encourage the parents to join a support group for NICU families. B. Suggest that the parents limit their visits to avoid stress. C. Advise the parents to avoid attachment until the baby is discharged. D. Provide regular updates and include them in the baby’s care.

Correct Answer is D

Explanation

Choice A rationale

Support groups provide emotional connection, but they do not address immediate concerns like the parents' involvement in care, which is essential for fostering confidence and bonding with the baby.

Choice B rationale

Limiting visits could increase parental anxiety and hinder their emotional connection to their baby. Parental involvement in care improves attachment and reduces stress, making this suggestion counterproductive to emotional health.

Choice C rationale

Advising parents to avoid attachment disregards the importance of early bonding in the neonatal period, which plays a key role in long-term emotional and psychological development for both the child and the parents.

Choice D rationale

Regular updates and including parents in the baby’s care empower them, promoting attachment and reducing feelings of helplessness. Parent-infant interaction has been shown to enhance coping mechanisms and improve family dynamics.

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The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

There is a baby in the neonatal intensive care unit (NICU) who is exhibiting signs of neonatal abstinence syndrome. Which of the following medications are contraindicated for this neonate?

Correct Answer is A

Explanation

A family whose baby is in the NICU may suffer anxiety and loss due to not being able to take their baby home like other parents would. Which action by the nurse is most supportive?

Correct Answer is D

Explanation

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