A mother who is breastfeeding her baby receives instructions from the nurse. Which instruction is most effective to prevent nipple soreness?

Correct Answer: C

Rationale: The most effective instruction to prevent nipple soreness for a breastfeeding mother is to correctly place the infant on the breast (Option C). This is crucial because proper positioning and latching ensure that the baby is effectively extracting milk without causing damage to the mother's nipples. When the baby is positioned correctly with a deep latch, nipple soreness is minimized as the baby is able to feed efficiently. Option A, wearing a cotton bra, is not directly related to preventing nipple soreness during breastfeeding. While wearing a comfortable bra is important for overall breast health, it does not address the root cause of nipple soreness. Increasing nursing time gradually (Option B) may not necessarily prevent nipple soreness. The key factor is the correct latch and positioning rather than the duration of nursing sessions. Manually expressing a small amount of milk before nursing (Option D) is not as effective as ensuring correct placement of the infant on the breast. While expressing some milk before nursing can help with engorgement or if the baby is having difficulty latching, it is not the primary method to prevent nipple soreness. In an educational context, it is vital for healthcare professionals to emphasize proper breastfeeding techniques to prevent common issues like nipple soreness. By understanding and promoting correct latch and positioning, nurses can support mothers in establishing a successful breastfeeding relationship with their infants, leading to better outcomes for both mother and baby.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) A persistent cold. This is because pediatric clients with AIDS often present with recurrent or persistent infections due to their compromised immune system. A persistent cold is a common manifestation in pediatric patients with AIDS due to their inability to fight off infections effectively. Option A) Shortness of breath is less likely to be the most common presenting symptom in a pediatric client with AIDS compared to recurrent infections like a persistent cold. While respiratory issues can occur in AIDS patients, they are not typically the initial presenting symptom. Option B) Joint pain is not a common presenting symptom of AIDS in pediatric clients. Joint pain is more commonly associated with conditions like arthritis or other rheumatologic disorders. Option D) Organomegaly (enlargement of organs) is also not typically the most likely presenting symptom in a pediatric client with AIDS. While organomegaly can occur in some cases of AIDS, it is not as common or as specific a symptom as recurrent infections like a persistent cold. Educationally, understanding the common presenting symptoms of pediatric clients with AIDS is crucial for healthcare providers working in maternal and reproductive health. This knowledge can help in early identification, timely interventions, and appropriate management of pediatric patients with HIV/AIDS, ultimately improving their outcomes and quality of life.

Correct Answer: C

Rationale: In this scenario, the correct intervention is to monitor bleeding from IV sites (Option C). This choice is appropriate because the client is experiencing dark red vaginal bleeding, which indicates a potential hemorrhage. Monitoring for bleeding from IV sites is crucial as it can help identify if the bleeding is generalized or localized, providing essential information for the healthcare team to manage the situation effectively. Assessing for cervical changes q1h (Option B) is not the priority in this case as the client's vaginal bleeding and uterine tone suggest a more urgent issue related to potential hemorrhage. Inserting an internal fetal monitor (Option A) or performing Leopold's maneuvers (Option D) are also not indicated at this time as the primary concern is addressing the maternal health status. From an educational perspective, this question highlights the importance of prioritizing interventions based on the client's immediate needs. Understanding the significance of assessing and managing maternal hemorrhage is critical for nurses working in labor and delivery units to ensure the safety and well-being of both the mother and the baby. By mastering these principles, nurses can provide high-quality care and potentially save lives in emergency situations.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Transition labor with contractions every 2 minutes, lasting 90 seconds each. This pattern indicates very frequent and prolonged contractions, which can lead to uterine hyperstimulation and potential fetal distress. Discontinuing the oxytocin infusion in this situation is crucial to prevent further complications and allow for adequate uterine relaxation. Option B) Early labor with contractions every 5 minutes, lasting 40 seconds each, represents a normal pattern for early labor and does not warrant discontinuation of oxytocin. Option C) Active labor with contractions every 31 minutes, lasting 60 seconds each, indicates inadequate contractions for progression and would not require stopping oxytocin. Option D) Active labor with contractions every 2 to 3 minutes, lasting 70 to 80 seconds each, also represents a pattern of appropriate contractions for active labor and does not necessitate discontinuation of oxytocin. Educationally, understanding the appropriate management of oxytocin infusion in labor is essential for ensuring maternal and fetal well-being. Nurses must be able to recognize patterns of contractions that may indicate uterine hyperstimulation and take prompt action to prevent adverse outcomes. This rationale emphasizes the importance of monitoring labor progression and responding appropriately to deviations from normal patterns.

Correct Answer: A

Rationale: In the context of client teaching for gravid clients, the factor with the greatest influence on successful teaching is the client's readiness to learn (Option A). This is because a client's willingness and ability to engage with the information being presented significantly impact the effectiveness of the teaching process. When a client is motivated and open to learning, they are more likely to retain and apply the information provided by the maternity nurse. Clients who are ready to learn are more likely to ask questions, participate actively in discussions, and follow through with recommended practices, leading to better maternal and reproductive health outcomes. Regarding the other options: - Option B (The client's educational background) is less influential because regardless of a client's educational level, their readiness to learn can still vary. Education does not always correlate with a person's receptiveness to new information. - Option C (The order in which the information is presented) is important but not as critical as the client's readiness. While presentation order can impact comprehension, if the client is not receptive, the sequencing of information becomes less effective. - Option D (The extent to which the pregnancy was planned) may have some impact on the client's mindset and readiness to engage in learning, but it is not as directly related to the teaching process as the client's actual readiness to learn. In educational context, understanding and assessing the client's readiness to learn is fundamental for a maternity nurse to tailor their teaching strategies effectively. By recognizing and responding to the client's readiness, nurses can optimize the teaching process, promote client engagement, and ultimately enhance the client's maternal and reproductive health outcomes.