The most effective and least expensive treatment of puerperal infection is prevention. What is the most important strategy for the nurse to adopt?

Correct Answer: C

Rationale: Rationale: Choice C is correct because strict aseptic technique, including hand washing, is crucial in preventing puerperal infection by minimizing the transmission of pathogens. Proper hand hygiene is a fundamental practice in infection control. Choices A, B, and D are incorrect because large doses of vitamin C, prophylactic antibiotics, and limited protein and fat intake do not directly address the primary mode of infection transmission and prevention for puerperal infection. Vitamin C, antibiotics, and dietary restrictions are not the primary strategies in preventing puerperal infections compared to the importance of proper hand hygiene and aseptic technique.

Correct Answer: D

Rationale: The correct answer is D: Placenta abruptio. Placenta abruptio is not a type of abnormal adherence pattern; instead, it refers to the premature detachment of a normally implanted placenta. Placenta accreta, increta, and percreta are abnormal adherence patterns where the placenta attaches too deeply into the uterine wall. Accreta is when it attaches but does not penetrate, increta is when it penetrates into the myometrium, and percreta is when it penetrates through the myometrium. Therefore, Placenta abruptio is the correct answer as it does not fall under the category of abnormal adherence patterns like the other choices.

Correct Answer: C

Rationale: The correct initial treatment for vWD client with PPH is desmopressin (Choice C) because it stimulates the release of von Willebrand factor and factor VIII from storage sites, helping to improve clotting. Cryoprecipitate (Choice A) contains multiple clotting factors and is usually reserved for severe bleeding. Factor VIII and vWf (Choice B) can be used for severe cases but are not typically the initial treatment. Hemabate (Choice D) is a medication used for postpartum hemorrhage due to uterine atony, not specifically for vWD-related bleeding.

Correct Answer: A

Rationale: The correct answer is A: Hysterectomy. Hysterectomy is the appropriate surgical procedure for late postpartum hemorrhage (PPH) when nonsurgical treatments fail. It involves the removal of the uterus, which can effectively stop the bleeding. Other choices like Laparoscopy (B) and Laparotomy (C) are surgical techniques used to access the abdomen but do not address the underlying cause of PPH. Dilation and curettage (D&C) (D) is a procedure to remove tissue from the uterus and would not be effective in treating late PPH.

Correct Answer: A

Rationale: The correct answer is A because operative and precipitate births increase the risk of obstetric lacerations due to the rapid delivery or use of instruments. Operative births involve interventions like forceps or vacuum extraction, which can cause trauma. Precipitate births, characterized by rapid labor and delivery, may lead to tearing of the lower genital tract. Choices B, C, and D are incorrect as they do not directly influence the causes and incidence of obstetric lacerations. Adherent retained placenta, abnormal fetal presentation, and congenital abnormalities of maternal soft tissue are not primary factors contributing to lacerations during childbirth.