ATI RN
Postpartum Hormonal Changes Questions
Question 1 of 5
The nurse is caring for a postpartum patient who delivered by the vaginal route 12 hours ago. Which assessment finding should the nurse report to the health care provider?
Correct Answer: A
Rationale: Correct Answer: A - Pulse rate of 50 Rationale: 1. A normal postpartum pulse rate is 60-100 bpm. 2. A pulse rate of 50 is below normal range, indicating potential bradycardia. 3. Bradycardia can be a sign of postpartum hemorrhage or other complications. 4. Reporting this finding promptly can help in early intervention. Summary: B: A temperature of 38C (100.4F) could indicate infection but is within normal postpartum range. C: A firm fundus with excessive lochia may indicate uterine atony, but is not as urgent as bradycardia. D: Feeling lightheaded when changing positions is common postpartum but not as concerning as a low pulse rate.
Question 2 of 5
The nurse is providing care to a patient who delivered a 3525-g infant 14 hours ago. The nurse palpates the fundus of the uterus as firm and at the umbilicus. What is the nurse’s priority action related to this finding?
Correct Answer: D
Rationale: The correct answer is D: Document the finding in the patient’s chart. The fundus being firm and at the umbilicus indicates normal involution after delivery. Documenting this finding is essential for accurate assessment and continuity of care. Informing the health care provider (choice A) is not necessary as the finding is normal. Encouraging the patient to urinate (choice B) is important for postpartum care but not the priority in this situation. Massaging the uterus to expel clots (choice C) is not indicated as the fundus is already firm, indicating proper contraction.
Question 3 of 5
The nurse includes the addition of ice sitz baths for the postpartum patient. Which assessment finding indicates the treatment has been effective?
Correct Answer: A
Rationale: The correct answer is A because the absence of swelling or edema to the perineal area indicates that the ice sitz baths have been effective in reducing inflammation and promoting healing. Swelling and edema are common postpartum, and the use of ice sitz baths can help reduce these symptoms. Choice B is incorrect because the patient complaining that the sitz bath is too cold does not provide information on the effectiveness of the treatment, only the patient's comfort level. Choice C is incorrect because the frequency of sitz baths does not necessarily indicate effectiveness. It is more important to assess the outcomes of the treatment rather than the number of baths taken. Choice D is incorrect because the approximation of perineal laceration edges may be influenced by other factors such as suturing technique, rather than the effectiveness of the ice sitz baths.
Question 4 of 5
The postpartum patient who continually repeats the story of her labor, birth, and recovery experiences is performing which of the following tasks?
Correct Answer: A
Rationale: The correct answer is A: Making the birth experience "real." This choice aligns with the concept of emotional processing and integration in the postpartum period. By continually repeating her birth story, the patient is trying to make sense of and come to terms with her experience, making it feel more "real" to her. This process helps her emotionally process the events and transitions she has gone through during labor and birth. Choices B, C, and D are incorrect: B: Accepting her response to labor and birth - This choice focuses more on the patient's emotional response rather than the act of repeating the story. C: Providing others with her knowledge of events - This choice is more about sharing information rather than the internal emotional processing the patient is likely engaging in. D: Taking hold of the events leading to her labor and birth - This choice suggests a sense of control over the events, which may not necessarily be the primary motivation behind the patient's behavior.
Question 5 of 5
The nurse observes a patient on her first postpartum day sitting in bed while her newborn lies awake in the bassinet. Which action is most appropriate for the nurse to take at this time?
Correct Answer: B
Rationale: The correct answer is B: Explain "taking-in" to the woman. This action allows the nurse to educate the woman on the normal postpartum adjustment period. By explaining "taking-in," the nurse helps the woman understand her current need for rest and reflection without feeling guilty about not immediately attending to her newborn. This approach promotes bonding by reducing anxiety and enhancing the mother's confidence in her abilities. Summary of other choices: A: Hand the baby to the woman - This choice may not address the woman's emotional needs and understanding of her current state. C: Offer to hand the baby to the woman - While offering is a good gesture, it may not address the underlying need for education and reassurance. D: No action, because this situation is perfectly acceptable - Ignoring the opportunity to provide guidance and support may lead to confusion and insecurity for the woman.