A nurse is caring for a postpartum person who is breastfeeding. What is the most important factor for successful breastfeeding?

Correct Answer: B

Rationale: The correct answer is B: proper positioning. Proper positioning is crucial for successful breastfeeding as it ensures the baby latches on effectively, leading to efficient milk transfer and preventing nipple pain or damage. Incorrect answers: A: frequent breastfeeding - While important, proper positioning is more critical for successful breastfeeding. C: supportive communication - While important for overall well-being, it is not the most crucial factor for successful breastfeeding. D: promote rest and hydration - While important for the postpartum person's health, proper positioning is key for successful breastfeeding.

Correct Answer: B

Rationale: The correct answer is B: Healthy People 2020. This is because Healthy People 2020 provides specific objectives related to maternal and child health, including reducing fetal death outcomes during delivery. The goals and targets outlined in Healthy People 2020 are evidence-based and nationally recognized, making it a reliable guide for setting healthcare goals. A: WHO Maternal care guidelines focus more broadly on global maternal health issues and may not provide specific goals related to reducing fetal death outcomes during delivery. C: AWHONN white papers may offer valuable insights and recommendations, but they are not as comprehensive or widely recognized as the goals outlined in Healthy People 2020. D: State Practice Acts govern the scope of practice for healthcare providers in a specific state, but they do not typically include specific goals related to reducing fetal death outcomes during delivery.

Correct Answer: A

Rationale: The primary purpose of performing an episiotomy during delivery is to reduce the risk of perineal trauma. Episiotomy is a surgical incision made in the perineum to widen the vaginal opening during childbirth, which can help prevent severe tearing of the perineal tissue. This procedure is performed to provide controlled and precise incision, reducing the likelihood of extensive tears that may lead to complications such as infection or prolonged healing time. It is not done to promote faster delivery, facilitate fetal descent, or provide immediate fetal oxygenation. These choices do not accurately reflect the main goal of episiotomy, which is to minimize perineal trauma.

Correct Answer: A

Rationale: The correct answer is A: Increase fluid intake and avoid standing for long periods. This recommendation is appropriate for the patient's symptoms of lightheadedness and fainting, which could be due to dehydration or low blood pressure common in pregnancy. Increasing fluid intake can help maintain adequate blood volume and pressure. Avoiding prolonged standing can prevent pooling of blood in the lower extremities, reducing the risk of dizziness. Choices B, C, and D are incorrect: B: Taking deep breaths and rising quickly may worsen symptoms by causing a sudden drop in blood pressure. C: Complete rest and avoiding physical activity may not address the underlying issue of hydration or blood pressure. D: Sitting upright and avoiding bending forward may not directly address the need for increased fluid intake and reduced standing time.

Correct Answer: B

Rationale: The correct answer is B: Check for cord prolapse. This is the first priority action because a prolapsed cord is a life-threatening emergency that requires immediate intervention to prevent fetal hypoxia and distress. The nurse should quickly assess for cord presentation by performing a vaginal exam and relieving pressure on the cord if present. Incorrect choices: A: Assess for signs of infection - While infection is a concern with ruptured membranes, it is not the immediate priority over checking for cord prolapse. C: Perform a vaginal exam to assess cervical dilation - Assessing cervical dilation can wait until after ruling out cord prolapse. D: Perform a vaginal examination to check for fetal descent - Fetal descent assessment is not urgent compared to checking for cord prolapse in this scenario.