A nurse is assessing a client who is 8 hr postpartum and multiparous. Which of the following findings should alert the nurse to the client's need to urinate?

Correct Answer: B

Rationale: A fundus three fingerbreadths above the umbilicus indicates that the uterus is not adequately contracting, which can obstruct the flow of urine from the bladder. Postpartum clients often experience urinary retention due to decreased sensation in the bladder, trauma from delivery, and decreased bladder tone. Failure to empty the bladder promptly can lead to urinary retention and potential complications such as urinary tract infections or bladder distention. Therefore, the nurse should be alert to the client's need to urinate when assessing the fundal height.

Correct Answer: C

Rationale: Gestational diabetes increases the risk of fetal macrosomia, which can complicate delivery.

Correct Answer: D

Rationale: The LNG-IUC, or levonorgestrel-releasing intrauterine system, works primarily by thickening the cervical mucus, which inhibits the passage of sperm through the cervix. This mechanism reduces the likelihood of fertilization occurring. Additionally, LNG-IUC also causes atrophic changes in the endometrium, which makes it less conducive for implantation of a fertilized egg, further decreasing the chance of pregnancy.

Correct Answer: B

Rationale: Leopold's maneuvers are used to assess fetal position, presentation, and engagement.

Correct Answer: A

Rationale: Long-term HRT increases endometrial cancer risk.