1 :

Hint : Snug diaper supports healing 🤱

Correct Answers:

  • Ensure the newborn's diaper is snug.


Rationale :

👶 After a Plastibell circumcision, keeping the diaper snug helps maintain gentle pressure on the surgical site to promote clotting and healing.

👶 A loose diaper could allow movement or friction, leading to bleeding or displacement of the Plastibell ring.

👶 The Plastibell device naturally falls off within 5–8 days as healing progresses.


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2 :

Hint : Tubes tied, but eggs stay 🧬

Correct Answers:

  • Ovulation will remain the same.


Rationale :

🥚 Tubal ligation is a permanent method of contraception by blocking or sealing the fallopian tubes, but it does not affect ovulation.

🥚 The ovaries continue to release an egg each month; the egg just cannot travel to meet sperm.

🥚 Menstrual cycles and hormonal levels also remain unchanged.


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3 :

Hint : Atony needs contraction meds 🔥

Correct Answers:

  • Anticipate a prescription for misoprostol.


Rationale :

💊 Misoprostol is a uterotonic medication that promotes uterine contractions to treat uterine atony and prevent postpartum hemorrhage.

💊 It is used when the uterus fails to contract adequately after birth, leading to excessive bleeding.

💊 Early administration can stabilize the client's condition before it worsens.


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4 :

Hint : Add 7 days, back 3 months 🗓️

Correct Answers:

  • May 13


Rationale :

📅 Using Nägele’s Rule:

❄First day of last menstrual period = August 10

❄Add 7 days ➔ August 17

❄Subtract 3 months ➔ May 17

📅 This calculation estimates the delivery date based on a 40-week pregnancy.


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5 :

Hint : Create memories for grieving hearts 💔

Correct Answers:

  • Provide the patient with photos of the fetus.


Rationale :

📸 Providing photos or keepsakes offers emotional support and helps families with grieving and memory making after a stillbirth.

📸 Parents may not be ready immediately but often value having these memories later.

📸 Respectful, supportive care during loss fosters healthy bereavement.


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6 :

Hint : Trauma, overstimulation, and prior atony = hemorrhage risk 🚨

Correct Answers:

  • Vacuum-assisted delivery
  • Labor induction with oxytocin
  • History of uterine atony


Rationale :

Vacuum-assisted delivery 🌀

🌀 Vacuum-assisted births increase the risk of trauma to the genital tract, leading to uterine atony and postpartum hemorrhage.

🌀 The mechanical stress applied during assisted delivery can cause uterine muscle fatigue, impairing its ability to contract effectively postpartum.

🌀 Therefore, women who have undergone vacuum extraction must be closely monitored for excessive bleeding and uterine tone after birth.

Labor induction with oxytocin 💉

💉 Oxytocin induction can cause uterine hyperstimulation, which leads to muscle fatigue and subsequent uterine atony.

💉 Overuse or prolonged use of oxytocin may impair the uterus’s natural ability to maintain effective contractions after delivery.

💉 Clients who undergo oxytocin induction are at higher risk for postpartum hemorrhage and should be assessed carefully for uterine tone and bleeding.

History of uterine atony 🧷

🧷 A previous history of uterine atony is one of the strongest risk factors for recurrent postpartum hemorrhage.

🧷 Once the uterine musculature has shown an inability to contract effectively, the chance of repeat atony in future births increases significantly.

🧷 Vigilant monitoring, early fundal massage, and possibly prophylactic administration of uterotonics are critical in these patients.


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7 :

Hint : Oxygen is priority with late decels 🎈

Correct Answers:

  • Administer oxygen at 10 L/min via non-rebreather face mask.


Rationale :

🌬️ Persistent late decelerations indicate fetal hypoxia due to placental insufficiency.

🌬️ After stopping oxytocin, oxygen at 10 L/min improves maternal oxygenation and supports fetal oxygen needs.

🌬️ This is a priority emergency action while preparing for further interventions if necessary.


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8 :

Hint : Check protein first on vegan diets 🥦

Correct Answers:

  • How much protein do you eat in a day?


Rationale :

🍛 Vegans are at risk of protein deficiency because they do not consume animal products.

🍛 Adequate protein is critical for fetal growth, maternal blood volume expansion, and tissue development.

🍛 Protein intake should be closely assessed and supplemented if needed.


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9 :

Hint : Hands-knees helps back pain 💪

Correct Answers:

  • Has your back labor improved?


Rationale :

🦴 The hands-and-knees position helps to relieve back labor, especially in occipitoposterior fetal positions.

🦴 Shifting fetal position can reduce direct pressure on the mother's lower back, easing discomfort.

🦴 This is a key non-pharmacological pain management strategy during labor.


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10 :

Hint : Cool first for deep tears ❄️

Correct Answers:

  • Provide the client with a cool sitz bath.


Rationale :

🧊 For a fourth-degree perineal laceration, applying a cool sitz bath helps reduce pain, swelling, and promotes comfort.

🧊 Moist warm compresses are inappropriate initially; cold therapy is better for acute injury management in the first 24 hours.

🧊 Sitz baths can greatly improve postpartum perineal healing and comfort.


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Total Questions: 10

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