A nurse is caring for a postpartum person during the fourth stage of labor. The nurse is assessing uterine involution to ensure that the uterus is returning to its prepregnancy size and position. Which finding is indicative of normal uterine involution during this stage?

Correct Answer: B

Rationale: The correct answer is B because during the fourth stage of labor, the uterine fundus should be firm and at the level of the umbilicus. This indicates proper involution as the uterus is contracting and reducing in size. Choice A is incorrect as the uterus should not be palpable at the level of the umbilicus during normal involution. Choice C is incorrect as the uterus should not be displaced to the right side of the abdomen. Choice D is incorrect as the uterus should not be above the level of the umbilicus, as this would suggest inadequate involution.

Correct Answer: C

Rationale: The correct answer is C: Call the healthcare provider immediately to report the symptoms. This is the first step because sudden, severe abdominal pain and vaginal bleeding in a pregnant patient at 38 weeks gestation could indicate a serious complication such as placental abruption or preterm labor. Notifying the healthcare provider promptly allows for timely intervention and appropriate management. Choice A is incorrect as assessing the fetal heart rate and preparing for delivery should not be the first action without consulting the healthcare provider. Choice B is incorrect as encouraging the patient to rest is not appropriate in this emergent situation. Choice D is incorrect as providing pain relief and monitoring vital signs should not take precedence over notifying the healthcare provider for further evaluation and management.

Correct Answer: A

Rationale: The correct answer is A (30-60 seconds) for delayed cord clamping in an uncomplicated delivery. Delaying cord clamping for 30-60 seconds allows more blood to flow from the placenta to the baby, increasing the baby's hemoglobin levels and improving circulation. This extra blood transfer can provide the baby with essential nutrients and oxygen, reducing the risk of anemia and improving overall health outcomes. Choice B (15-30 seconds) may not provide enough time for sufficient blood transfer compared to the optimal window of 30-60 seconds. Choice C (30 seconds) is within the recommended range, but 30-60 seconds is considered more beneficial for maximizing blood flow to the newborn. Choice D (Delayed cord clamping is not recommended) is incorrect as delayed cord clamping has been shown to have various benefits for newborns when done in uncomplicated deliveries.

Correct Answer: A

Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus. Step 2: Spinal cord defects are a type of neural tube defect. Step 3: Statement A directly links folic acid to preventing spinal cord defects. Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.

Correct Answer: A

Rationale: The correct answer is A: offer emotional support. This is crucial as postpartum can be a challenging time emotionally. Providing emotional support helps the person cope with any feelings of anxiety, sadness, or overwhelm. Breastfeeding (B) and positioning assistance (C) are important but not the most critical aspect of discharge teaching. Non-pharmacological pain relief (D) is important but not as crucial as emotional support for overall well-being.