Which patient would be at the highest risk for postpartum hemorrhage?

One who births in the lithotomy position.

One who receives uterine massage postpartum.

One whose third stage lasts less than 10 minutes.

One who gives birth to an infant weighing 9 pounds (4310 grams).

Answer and Explanation

The Correct Answer is D

Choice A rationale

While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.

Choice B rationale

Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.

Choice C rationale

A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.

Choice D rationale

Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.

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Correct Answer is B

Explanation

Choice A rationale

Elastic stockings help improve venous return, reducing clot propagation in thrombophlebitis. Proper usage minimizes symptoms like pain and swelling, and supports overall vein health, crucial for recovery and preventing complications.

Choice B rationale

Massaging an affected leg with thrombophlebitis is contraindicated as it increases the risk of clot dislodgement, potentially leading to a life-threatening pulmonary embolism. This misconception highlights the need for further client education.

Choice C rationale

Avoiding prolonged sitting prevents venous stasis and encourages circulation, which is vital in thrombophlebitis management to prevent worsening of clotting and associated complications such as pain or swelling.

Choice D rationale

Elevating the affected leg reduces swelling and promotes venous drainage, alleviating discomfort associated with thrombophlebitis. This intervention supports the resolution of inflammation in the superficial veins.

A. Sleep deeply. B. Have a high-pitched cry. C. Not feed well. D. Have some shaking. E. Sweat a lot.

Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale

Deep sleep is not a characteristic of neonatal abstinence syndrome; rather, infants tend to exhibit irritability and disturbed sleep patterns due to central nervous system hyperirritability caused by opioid withdrawal.

Choice B rationale

A high-pitched cry occurs due to central nervous system overstimulation and hyperirritability, which are hallmark features of neonatal abstinence syndrome and a direct result of opioid withdrawal in neonates.

Choice C rationale

Poor feeding is common in neonatal abstinence syndrome due to uncoordinated suck reflexes and gastrointestinal disturbances, leading to difficulty maintaining adequate nutrition and hydration in affected neonates.

Choice D rationale

Neonates with neonatal abstinence syndrome often exhibit tremors or shaking as a result of central nervous system hyperirritability, which is a hallmark symptom of opioid withdrawal in newborns.

Choice E rationale

Excessive sweating is a manifestation of autonomic nervous system dysregulation caused by opioid withdrawal in neonates, commonly observed in infants with neonatal abstinence syndrome.

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Which patient would be at the highest risk for postpartum hemorrhage?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse caring for the postpartum client who has developed thrombophlebitis is providing instructions in the management of this condition. Which client statement indicates the need for further instruction?

Correct Answer is B

Explanation

Correct Answer is ["B","C","D","E"]

Explanation

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:

Medications used to manage postpartum hemorrhage (PPH) include: (Select all that apply)

The nurse is educating her G5P5 postpartum patient at discharge after experiencing a postpartum hemorrhage post-delivery. Which education topics are appropriate for this patient?

Your postpartum patient is experiencing a hemorrhage. Vital signs are 156/94, heart rate 87, O2 saturation 95%. You increase the Pitocin drip wide open and prepare to give what medication to the patient next?

One of the greatest immediate risks to an infant with a myelomeningocele is:

When inserting a Foley catheter for a patient with a postpartum hemorrhage who is allergic to betadine, what should the nurse use?

Which instruction should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?

A client who is two weeks postpartum calls her obstetrician’s nurse and states that she has had a white discharge for about a week but today she is bleeding and saturating one pad about every 30 minutes. Which of the following is the appropriate response from the nurse?