When reviewing postpartum nutrition needs with breastfeeding clients, which statement indicates an understanding of the teaching?

Correct Answer: D

Rationale: The correct answer is D because it demonstrates an understanding of the importance of calcium intake for breastfeeding mothers. Calcium is essential for both the mother's health and the baby's bone development. Continuing calcium supplements shows a commitment to meeting nutritional needs. Incorrect choices: A: Having coffee is fine, but it's not directly related to postpartum nutrition needs. B: Folic acid is important for pregnancy but not specifically for increasing milk supply. C: While additional calories are needed during breastfeeding, the specific amount varies and is not always 330 calories per day.

Correct Answer: C

Rationale: The correct action is to assist the client to the hands and knees position. This position, also known as the all-fours position, can help alleviate back pain by encouraging the baby to rotate into a more favorable position for delivery. By being on hands and knees, gravity assists in the rotation of the baby. This position can also help relieve pressure on the mother's back and potentially facilitate a smoother labor progress. Effleurage (choice A) may provide comfort but doesn't address the positional issue. Placing the client in lithotomy position (choice B) can worsen the occiput posterior position. Applying a scalp electrode to the fetus (choice D) is not indicated in this scenario.

Correct Answer: D

Rationale: The correct answer is D: All of the Above. Implantable progestins are hormonal contraceptives known to cause common adverse effects such as nausea, irregular vaginal bleeding, and weight gain. Nausea is a common side effect due to hormonal changes. Irregular vaginal bleeding can occur as a result of hormonal imbalance. Weight gain is a known side effect associated with progestin use. Therefore, all of the listed adverse effects should be included in the client education. Other choices are incorrect because they do not encompass the full range of potential adverse effects associated with implantable progestins.

Correct Answer: D

Rationale: The correct answer is D: Decreased urine output. At 26 weeks of gestation, decreased urine output can be a sign of potential complications like preeclampsia or dehydration, which require immediate medical attention to prevent harm to the mother and baby. Leukorrhea (choice A) is a common pregnancy symptom and not typically concerning. Supine hypotension (choice B) is a known issue in pregnancy but usually occurs later in the third trimester due to pressure on the vena cava when lying on the back. Periodic numbness of the fingers (choice C) can be related to carpal tunnel syndrome, which is common in pregnancy but not typically urgent at 26 weeks unless severe and persistent.

Correct Answer: B

Rationale: Rationale: Massaging the client's fundus helps to stimulate uterine contractions and control postpartum hemorrhage caused by uterine hypotonicity. This action helps prevent further blood loss and promotes uterine tone. Checking capillary refill would not directly address the immediate issue of hemorrhage. Inserting a urinary catheter is not a priority in managing postpartum hemorrhage. Preparing for a blood transfusion may be necessary later, but addressing the uterine hypotonicity and hemorrhage is the priority.

Correct Answer: D

Rationale: The correct answer is D: Report of severe shoulder pain. In a ruptured ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube. As the tube ruptures, there is internal bleeding which can irritate the diaphragm, causing referred pain to the shoulder. This phenomenon is known as Kehr's sign. The other choices are incorrect because with a ruptured ectopic pregnancy, there would typically be altered menses due to the pregnancy disruption, a transvaginal ultrasound would not show a fetus in the uterus, and blood progesterone levels would not be elevated.

Correct Answer: C

Rationale: The correct answer is C: Attention-focusing. At 40 weeks gestation with a platelet count of 75,000/mm3, epidural analgesia is contraindicated due to the risk of epidural hematoma. Naloxone hydrochloride is an opioid antagonist used for opioid overdose, not for labor pain relief. Pudendal nerve block is used for local anesthesia during the second stage of labor, not for early labor pain relief. Attention-focusing techniques can help the client manage pain without pharmacological interventions, ensuring safety for both the client and the baby.

Correct Answer: D

Rationale: The correct answer is D because all options are relevant when teaching a client about medroxyprogesterone. A, weight fluctuations can occur due to hormonal changes. B, irregular vaginal spotting is a common side effect of medroxyprogesterone. C, increasing calcium intake is important to prevent bone density loss associated with long-term medroxyprogesterone use. Therefore, all options are essential for comprehensive client education. Other choices are incorrect because excluding any of these key points could lead to incomplete information and potential misunderstandings regarding the medication's effects and management.

Correct Answer: C

Rationale: The correct action is to administer opioid analgesic medication (Choice C). At 40 weeks gestation with contractions every 3-5 minutes, 3 cm dilated, 80% effaced, and -1 station, the client is in active labor. Pain medication is appropriate to manage discomfort during labor. Opioid analgesics can help reduce pain intensity while still allowing the client to remain alert and participate in labor. Ice chips (Choice A and D) are not directly related to pain management in labor. Inserting a urinary catheter (Choice B) is not indicated unless there are specific concerns about bladder distention.