A pregnant patient at 32 weeks gestation reports difficulty breathing, especially when lying flat. What should the nurse recommend first?

Correct Answer: C

Rationale: The correct answer is C because encouraging the patient to rest in an upright position helps improve lung expansion and oxygenation, relieving the difficulty in breathing. By monitoring symptoms, the nurse can assess for any worsening signs or the need for further intervention. A: Administering oxygen and preparing for delivery is premature without assessing the patient further. B: Lying on the left side may alleviate pressure on the diaphragm but does not address the underlying cause of difficulty breathing. D: Instructing to take deep breaths and elevate legs may not be beneficial and could potentially worsen the symptoms.

Correct Answer: A

Rationale: The correct answer is A: every 15 minutes. During the first hour of the fourth stage of labor, immediate postpartum assessment is crucial to monitor for any signs of complications such as hemorrhage or shock. Assessing vital signs every 15 minutes allows for early detection of any abnormalities and prompt intervention. This frequency ensures close monitoring of the birthing person's condition and helps in early identification of any potential issues. Choices B, C, and D are incorrect because less frequent assessments may delay the identification of complications, potentially leading to serious consequences. Option C, in particular, is dangerous as it suggests delaying assessments when immediate postpartum monitoring is essential.

Correct Answer: A

Rationale: The correct answer is A: place the person in the knee-chest position. Placing the person in this position helps alleviate pressure on the umbilical cord, reducing the risk of compression and improving fetal oxygenation. Other choices like repositioning the laboring person or administering oxygen via mask do not directly address the issue of cord prolapse. Applying pressure to the cord can further compromise blood flow to the fetus. The knee-chest position is the most appropriate intervention as it helps relieve pressure on the cord and is crucial in managing umbilical cord prolapse effectively.

Correct Answer: A

Rationale: The correct answer is A: uterine overdistention. Uterine atony is when the uterus fails to contract effectively after childbirth. Overdistention, such as from multiple gestation or large baby, can stretch the uterus, leading to poor muscle tone. This results in inadequate contractions to control bleeding. Excessive uterine contractions (B) are not a common cause but rather can lead to other issues like uterine rupture. Placental abruption (C) is the premature separation of the placenta from the uterus, causing bleeding but not directly related to atony. Infection or retained placenta (D) can contribute to uterine atony but are not common primary causes.

Correct Answer: C

Rationale: The most appropriate intervention for pain management in a postpartum person with a second-degree perineal tear is administering non-pharmacological pain relief (Choice C). This includes methods such as sitz baths, warm compresses, and positioning techniques. These interventions are effective in reducing pain and promoting healing without the side effects associated with medications or invasive procedures. Oral pain medication (Choice A) may not be sufficient for managing the specific pain in this case. Administering an epidural analgesic (Choice B) is not appropriate postpartum, as it is typically used during labor for pain relief. Ice packs (Choice D) may provide temporary relief but do not address the underlying pain and healing process as effectively as non-pharmacological methods.