ATI RN
Postpartum Hormonal Changes Questions
Question 1 of 5
A client is being discharged on Coumadin (warfarin) post-pulmonary embolism after a cesarean delivery. Which of the following should be included in the patient teaching?
Correct Answer: B
Rationale: The correct answer is B) Avoid overeating dark green, leafy vegetables. Warfarin is an anticoagulant medication that works by inhibiting vitamin K-dependent clotting factors. Dark green, leafy vegetables are high in vitamin K, which can counteract the effects of warfarin, leading to potential fluctuations in the client's international normalized ratio (INR) levels. Therefore, it is crucial for patients on warfarin therapy to maintain consistent levels of vitamin K intake by avoiding sudden increases or decreases in consumption of these foods. Option A) Take only ibuprofen for pain is incorrect because ibuprofen is not typically contraindicated with warfarin therapy. However, it is essential to monitor for bleeding symptoms due to the combined risk of bleeding associated with both medications. Option C) Drink grapefruit juice daily is incorrect as grapefruit juice can interact with various medications, but it does not have a direct impact on warfarin metabolism or efficacy. Option D) Report any decrease in urinary output is not directly related to warfarin therapy post-pulmonary embolism after a cesarean delivery. While monitoring urine output is important for overall health assessment, it is not specifically pertinent to the management of warfarin therapy in this scenario. In an educational context, teaching patients about the dietary considerations while on warfarin therapy is crucial to ensure the medication's effectiveness and reduce the risk of complications. It is essential for healthcare providers to provide comprehensive education to patients to empower them to manage their condition effectively and avoid potential drug interactions or adverse effects.
Question 2 of 5
On admission to the labor and delivery suite, the nurse assesses the discharge needs of a primipara who will be discharged home 4 days after a cesarean delivery. Which of the following questions should the nurse ask the client?
Correct Answer: D
Rationale: The correct answer is D) Are there many stairs in your home? Postpartum care after a cesarean delivery involves considering the physical limitations of the mother. Asking about stairs at home is crucial as climbing stairs can be challenging post-cesarean and can impact the mother's recovery. This question helps assess the client's potential mobility challenges and the need for additional support or modifications at home to ensure a safe and smooth transition post-discharge. A) Asking about previous anesthesia history is important but not as immediately relevant to post-discharge care after a cesarean delivery. B) Inquiring about allergies is essential for medical safety but is not directly related to discharge planning in this context. C) Asking about scarring propensity is not as critical as assessing the client's immediate environment and physical challenges post-cesarean delivery. Educationally, this question highlights the importance of tailoring discharge planning to the individual needs of postpartum mothers, considering their specific circumstances and potential challenges to optimize their recovery and ensure a successful transition to home care.
Question 3 of 5
A nurse is assessing a 1-day postpartum client who had a spontaneous vaginal delivery over an intact perineum. The fundus is firm at the umbilicus, lochia moderate, and perineum edematous. One hour after receiving ibuprofen 600 mg po, the client is complaining of perineal pain at level 9 on a 10-point scale. Based on this information, which of the following is an appropriate conclusion for the nurse to make about the client?
Correct Answer: C
Rationale: In this scenario, option C, "She may have a hidden laceration," is the most appropriate conclusion for the nurse to make about the client. This is because despite the client having a spontaneous vaginal delivery over an intact perineum, the persistence of severe perineal pain (level 9 on a 10-point scale) one hour after taking ibuprofen could indicate a hidden laceration that was not initially detected during the assessment. Option A, "She should be assessed by her doctor," could be considered less urgent compared to the potential of a hidden laceration causing the severe pain. Option B, "She should have a sitz bath," might provide some relief but does not address the underlying cause of the severe pain. Option D, "She needs a narcotic analgesic," is not the first-line treatment for postpartum perineal pain and should be avoided unless absolutely necessary due to potential side effects and risks. From an educational perspective, it is crucial for nurses to understand the significance of persistent severe pain postpartum, especially in the context of perineal discomfort. This case highlights the importance of thorough assessment, including the possibility of hidden lacerations, to ensure appropriate and timely interventions for postpartum clients. Early detection and management of complications can significantly impact the client's recovery and overall postpartum experience.
Question 4 of 5
A woman who wishes to breastfeed advises the nurse that she has had breast augmentation surgery. Which of the following responses by the nurse is appropriate?
Correct Answer: D
Rationale: The appropriate response by the nurse is option D) Women who have implants are often able exclusively to breastfeed. This response is correct because breast implants do not typically interfere with a woman's ability to breastfeed. Breast augmentation surgery usually does not affect the function of the mammary glands responsible for milk production. Option A is incorrect because breast implants do not inherently contaminate breast milk with toxins. Option B is incorrect as it inaccurately suggests that women who need breast implants lack sufficient glandular tissue for breastfeeding. Option C is also incorrect as babies can usually latch onto the nipples of women with breast implants without significant difficulty. Educationally, it is crucial for healthcare providers to have accurate information about the impact of breast augmentation on breastfeeding to provide appropriate support and guidance to women. Understanding that breast implants generally do not impede breastfeeding can help alleviate concerns and encourage women who have had breast augmentation surgery to confidently pursue breastfeeding if they choose to do so.
Question 5 of 5
The nurse is discussing the neonatal blood screening test with a new mother. The nurse knows that the teaching was successful when the mother states that the test screens for the presence in the newborn of which of the following diseases? Select one that doesn't apply
Correct Answer: D
Rationale: In this scenario, option D, "Cerebral palsy," is the correct answer for the neonatal blood screening test. This test is designed to screen for metabolic and genetic disorders present in newborns that may not be apparent at birth. Cerebral palsy is a neurodevelopmental disorder that affects movement and muscle coordination, and it is not detected through a blood screening test. Options A, B, and C are incorrect because they are conditions that can be detected through neonatal blood screening tests. Hypothyroidism, sickle cell disease, and galactosemia are all metabolic disorders that can be identified early through such screening tests, allowing for prompt intervention and management to prevent complications and promote the baby's well-being. Educationally, understanding the purpose of neonatal blood screening tests is crucial for new parents to grasp the importance of early detection and intervention in managing potential health conditions in their newborns. By explaining the rationale behind each answer choice, nurses can enhance parental knowledge and empower them to be proactive in their child's healthcare from the very beginning.