The nurse is assessing her patient, who is 1 day postpartum. The nurse notes that the fundus is firm and at midline, the lochia is moderate in amount, and the presence of rubra with two dime-sized clots is on her peri-pad. What should the nurse determine from these assessment findings?

Correct Answer: A

Rationale: Rationale: A: These assessment findings are normal for a patient 1 day postpartum. A firm, midline fundus indicates proper uterine involution. Moderate lochia is expected at this stage, and small clots are common. B: There are no signs of infection present in the scenario, such as foul odor or abnormal color of lochia. C: The findings are within the expected range for a patient 1 day postpartum, so there is no need to notify the physician. D: Increasing fluid intake is always important postpartum, but it is not specifically indicated based on the assessment findings provided.

Correct Answer: C

Rationale: The correct answer is C because washing hands before and after performing peri-care is crucial to prevent infection. Beforehand, it reduces the risk of introducing harmful bacteria into the perineal area. Afterward, it prevents potential contamination of hands. This action demonstrates understanding of maintaining proper hygiene during peri-care. Explanation of other choices: A: Applying the peri-pad from back to front is incorrect as it can introduce bacteria from the rectal area to the vaginal area, increasing the risk of infection. B: Performing peri-care three times a day is not necessarily an indication of understanding proper technique and hygiene. Frequency alone does not ensure correct practice. D: Mixing tap water and hydrogen peroxide in the peri-bottle is not recommended as it can disrupt the natural flora in the perineal area and cause irritation.

Correct Answer: D

Rationale: The correct answer is D: To prevent uterine inversion. Placing a hand just above the symphysis pubis helps support the uterus and prevent it from turning inside out. This is crucial postpartum to avoid complications such as hemorrhage and shock. Choices A, B, and C are incorrect as palpating the uterus in this manner is specifically aimed at preventing uterine inversion, not prolapse, movement, or hemorrhage.

Correct Answer: B

Rationale: The correct answer is B. A postpartum WBC level of 30,000/mm is expected due to the physiological response to labor and delivery, known as leukocytosis. This is a normal finding as the body increases white blood cell production to fight off potential infections postpartum. A: Patient feeling cold related to blood loss is more indicative of hypovolemia, a result of excessive blood loss, not a normal cardiovascular response postpartum. C: Risk for hemorrhage due to decrease in clotting factors is incorrect as postpartum women actually have an increase in circulating clotting factors to prevent excessive bleeding. D: A normal postpartum hemoglobin level of less than 11 g/dL is incorrect because a hemoglobin level below 11 g/dL would indicate anemia, not a normal postpartum finding.

Correct Answer: D

Rationale: The correct answer is D because general soreness is not a typical source of pain that postpartum patients experience. Uterine contractions, perineal trauma, and breast engorgement are common sources of pain in postpartum patients due to the physiological changes and processes associated with childbirth. General soreness is too vague and nonspecific to specifically assess for in this context. It is important for the nurse to focus on assessing and managing the more common sources of postpartum pain to provide effective care and support for the patient's recovery.