A woman exhibits symptoms that may lead to a possible diagnosis of polycystic ovary syndrome (PCOS). While completing the initial assessment of the client, which clinical finding would the nurse not anticipate?

Correct Answer: A

Rationale: In the context of maternal health issues in the US, understanding polycystic ovary syndrome (PCOS) is crucial for nursing practice. The correct answer, A) Anorexia, is not typically associated with PCOS. PCOS is characterized by symptoms such as hirsutism (excessive hair growth), irregular menses, and infertility due to hormonal imbalances and ovarian dysfunction. Anorexia, a psychological disorder characterized by a distorted body image and fear of gaining weight, is not a common clinical finding in PCOS. Hirsutism, the abnormal growth of hair on a woman's face and body, is often seen in PCOS due to elevated levels of androgens. Irregular menses are a hallmark of PCOS, caused by lack of ovulation. Infertility is a common concern for women with PCOS due to irregular ovulation. Educationally, understanding the clinical manifestations of PCOS is essential for nurses to provide comprehensive care to women of reproductive age. Recognizing the atypical presentation of symptoms like anorexia can help nurses differentiate between potential health conditions and provide timely and effective interventions for their patients.

Correct Answer: D

Rationale: In the postpartum period, lochia is the vaginal discharge that consists of blood, tissue, and mucus as the uterus sheds its lining after childbirth. The correct answer is D) Lochia serosa. Lochia serosa typically appears around days 4-10 postpartum. It is pink to brownish in color and contains serous exudate and leukocytes, indicating a transition from the initial heavy bleeding of Lochia rubra to the final stage of Lochia alba. Option A) Lochia rubra is the initial discharge after childbirth, consisting of mostly blood and tissue. It is expected in the first 3-4 days postpartum. Option B) Lochia sangra is not a recognized term in the context of postpartum lochia. Option C) Lochia alba is the final stage of lochia, occurring around 10-14 days postpartum. It is yellow to white in color and primarily consists of mucus and leukocytes. Understanding the characteristics and timeline of postpartum lochia is crucial for nurses and healthcare providers caring for postpartum women. It helps in assessing the normal progression of healing after childbirth and identifying any abnormal signs that may indicate complications.

Correct Answer: A

Rationale: In this scenario, the vital signs of a woman who recently gave birth are crucial indicators of her postpartum health status. Option A is the correct answer because the vital signs show signs of hypovolemic shock, which is a severe concern after childbirth with significant blood loss. The low blood pressure (90/50 mm Hg) coupled with tachycardia (heart rate 120 bpm) indicates inadequate perfusion to vital organs, necessitating immediate intervention to prevent further complications. Options B, C, and D are incorrect because they do not reflect the typical vital signs associated with hypovolemic shock. Option B shows tachypnea and elevated blood pressure, which are not common findings in hypovolemic shock. Option C demonstrates a slightly elevated temperature but lacks the hallmark signs of shock. Option D presents with a low heart rate and normal blood pressure, which are not consistent with the clinical picture of hypovolemic shock. Educationally, understanding the significance of vital signs in assessing postpartum women is crucial for nurses and healthcare providers involved in maternal care. Recognizing the signs of hypovolemic shock early can help prevent serious complications and improve maternal outcomes. This case underscores the importance of comprehensive postpartum assessments and prompt intervention in addressing maternal health issues.

Correct Answer: D

Rationale: The correct answer is D) The first menstrual flow after childbirth usually is heavier than normal. This statement accurately reflects the physiological changes that occur in a woman's body postpartum. After giving birth, the uterine lining is thicker than usual, leading to a heavier first menstrual flow. Option A is incorrect because the resumption of menstruation is typically delayed in women who breastfeed due to the suppression of ovulation caused by breastfeeding hormones. Therefore, the statement that 75% of non-breastfeeding women resume menstruating within a month is inaccurate. Option B is incorrect because ovulation is actually delayed in breastfeeding women due to the same hormonal effect that suppresses menstruation. This delay in ovulation is a natural contraceptive method known as lactational amenorrhea. Option C is incorrect because contraception considerations should not be postponed until after the puerperium. Women can ovulate as early as 25 days postpartum, even before the resumption of menstruation. Therefore, discussing contraception options early in the postpartum period is crucial to prevent unintended pregnancies. Understanding postpartum ovary function is essential for healthcare providers working in maternal health. By knowing the accurate information about ovulation and menstruation postpartum, they can provide appropriate guidance on family planning and postpartum care to women.

Correct Answer: B

Rationale: The correct answer is option B: "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." This statement indicates an understanding of postpartum menstrual changes. Option A is incorrect because menstrual cycles typically return to normal gradually rather than starting lighter and getting heavier each month. Option C is incorrect as most women resume menstruation within a few months postpartum, not after a 6-month gap. Option D is incorrect as it states the first cycle will be heavier than normal and then light for several months, which is not the typical pattern. In an educational context, understanding postpartum changes in menstrual activity is crucial for maternal health. Educating women about these normal variations can alleviate anxiety and help them make informed decisions about contraception and overall reproductive health post-delivery. It also highlights the importance of regular postpartum follow-up care to monitor these changes and address any concerns that may arise.