Correct Answer: D

Rationale: In the situation described, where the client experienced a prolonged labor and instrumental delivery, there may be physical and emotional factors impacting breastfeeding success. A lactation consultant is a specialized healthcare provider who can assess the client's breastfeeding difficulties, offer individualized support, and provide guidance on techniques to overcome challenges such as latch issues, positioning problems, and milk supply concerns. Referring the client to a lactation consultant will help ensure that she receives expert assistance tailored to her specific needs, thereby increasing the likelihood of successful breastfeeding. This proactive approach focuses on addressing the root causes of breastfeeding difficulties and supporting the client in achieving her breastfeeding goals.

Correct Answer: B

Rationale: When a woman in active labor is receiving intravenous oxytocin for labor augmentation, it is essential to increase the oxytocin infusion rate gradually to prevent oxytocin-induced uterine hyperstimulation. Uterine hyperstimulation can lead to complications such as fetal distress, uterine rupture, and postpartum hemorrhage. By increasing the oxytocin infusion rate gradually, the uterus has more time to adapt to the medication and reduces the risk of hyperstimulation. It is crucial for the healthcare provider to carefully monitor the woman's response to oxytocin and adjust the infusion rate as needed to ensure safe and effective labor augmentation. Monitoring for signs of uterine hyperstimulation, such as persistent contractions close together or excessive uterine activity, is crucial in preventing complications and ensuring the well-being of both the mother and baby.

Correct Answer: C

Rationale: Postpartum hemorrhage is a serious complication that can occur within the first 24 hours after childbirth. It is the leading cause of maternal mortality worldwide. Therefore, during the immediate postpartum period, the first priority nursing intervention should be focused on observing for signs and symptoms of postpartum hemorrhage, such as excessive bleeding, abnormal vital signs, and changes in uterine tone. Early detection and prompt intervention can prevent severe complications and save the mother's life. Monitoring urinary output, taking vital signs, and checking level of responsiveness are important aspects of postpartum care but observing for postpartum hemorrhage takes precedence due to its critical nature.

Correct Answer: C

Rationale: The presentation described in the question (sensation of fullness and pressure in the left ear, hearing loss, occasional tinnitus, retracted tympanic membrane with decreased mobility on pneumatic otoscopy) is suggestive of serous otitis media, also known as otitis media with effusion. Serous otitis media occurs when fluid accumulates in the middle ear without signs of infection. This buildup of fluid in the middle ear space can cause the tympanic membrane to retract and reduce its mobility on pneumatic otoscopy.

Correct Answer: C

Rationale: The analytic approach refers to a method that views factors that influence health and by which interventions to improve health are directed. In this case, utilizing an analytic approach in the research means looking into the root causes of the health problems in the community, analyzing various factors that contribute to the prevalence of obesity and heart ailments, and developing targeted interventions to address these issues effectively. This approach involves identifying underlying reasons for health problems and strategically planning interventions to improve the health outcomes of the community.