Question

Which of the following post-partum affective disorders exhibits mild depressive symptoms of anxiety. irritability, mood swings? This disorder peaks postpartum days 4-5 and usually resolve by day 10,

Answer 1

Correct Answers:

Post-partum baby blues

Rationale :

✅ Occurs postpartum days 4–5 — Hormonal fluctuations (estrogen, progesterone) trigger mood swings.

✅ Mild depressive symptoms — Presents with anxiety, irritability, and tearfulness, not severe depression.

✅ Resolves by day 10 — Symptoms are self-limiting; no medical treatment needed.

✅ Common in primiparas — Associated with sleep deprivation and infant care adjustment.

✅ Supportive care effective — Rest and reassurance improve recovery.

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Answer 2

Correct Answers:

Methylergonovine 0.2 mg 1M now,

Rationale :

✅ Contraindicated in hypertension — Raises vascular tone and blood pressure.

✅ Risk of hypertensive crisis — Client’s BP 146/94 mm Hg makes use unsafe.

✅ Used only for uterine atony — Safe when normotensive.

✅ Oxytocin safer choice — Preferred for postpartum hemorrhage with high BP.

✅ Clarification mandatory — Prevents adverse cardiovascular events.

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Answer 3

Correct Answers:

Apply an ice pack to the affected area.

Rationale :

✅ Reduces perineal edema — Vasoconstriction decreases swelling.

✅ Provides pain relief — Ice numbs nerve endings.

✅ First 24 hours post-delivery — Heat avoided to prevent bleeding.

✅ Improves healing — Less swelling promotes tissue perfusion.

✅ Non-invasive — Safe first-line comfort measure.

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Answer 4

Correct Answers:

24-48 hours

Rationale :

✅ Normal meconium passage — Occurs within 24 hrs, latest 48 hrs.

✅ Confirms GI patency — Indicates bowel motility and no obstruction.

✅ Delayed passage serious — After 48 hrs, suspect Hirschsprung’s or ileus.

✅ Green-black tarry stool — Composed of amniotic fluid, bile, mucus.

✅ Colostrum promotes passage — Acts as natural laxative.

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Answer 5

Correct Answers:

Variable decelerations

Rationale :

✅ Indicates cord compression — Hallmark umbilical cord issue.

✅ Abrupt onset/recovery — Seen as V-shaped pattern on FHR tracing.

✅ Position change relieves pressure — Use side-lying or knee-chest.

✅ Not placental insufficiency — Late decels indicate placental issue.

✅ Prompt correction prevents hypoxia — Maintains fetal oxygenation.

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Answer 6

Correct Answers:

Suction the mouth with a bulb syringe,

Rationale :

✅ Airway priority — Follow ABC sequence.

✅ Mouth before nose — Prevents aspiration of oral secretions.

✅ Decreases risk of pneumonia — Clears secretions before breathing.

✅ Bulb syringe preferred — Gentle negative pressure avoids mucosal trauma.

✅ Essential in obligate nose breathers — Clears oral cavity for effective breathing.

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Answer 7

Correct Answers:

Elevate her leg.

Rationale :

✅ Improves venous return — Decreases stasis and swelling.

✅ Prevents embolus dislodgment — Massage avoided in thrombophlebitis.

✅ Relieves pain — Elevation reduces inflammation.

✅ Supports clot stability — Prevents migration to lungs.

✅ Conservative measure until review — Essential until provider visit.

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Answer 8

Correct Answers:

Vastus lateralis

Rationale :

✅ Preferred site in newborns — Largest muscle mass for IM injections.

✅ Lower nerve injury risk — Safer than dorsogluteal.

✅ Rapid absorption — Rich vascular supply.

✅ Easy access — Convenient during swaddling or restraint.

✅ CDC recommended — Standard for vitamin K prophylaxis.

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Answer 9

Correct Answers:

Insert a gloved hand into the vagina to relieve pressure on the cord.

Rationale :

✅ Immediate priority — Restores fetal oxygenation by relieving pressure.

✅ Manual lifting of presenting part — Decreases cord occlusion.

✅ Prevents severe hypoxia — Maintains circulation until delivery.

✅ Followed by repositioning — Use knee-chest or Trendelenburg.

✅ Emergency prep — Immediate cesarean anticipated.

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Answer 10

Correct Answers:

Palpate the client's uterine fundus,

Rationale :

✅ First assessment in bleeding — Checks uterine tone (boggy vs firm).

✅ Identifies uterine atony — Leading cause of postpartum hemorrhage.

✅ Guides intervention — If boggy, start fundal massage.

✅ Prevents hypovolemic shock — Rapid identification reduces blood loss.

✅ Prioritizes circulation — Part of ABCs in postpartum care.

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Custom RN~Maternity Assessment 3, Taylor College FL-ADN

No.

1 :
Which of the following post-partum affective disorders exhibits mild depressive symptoms of anxiety. irritability, mood swings? This disorder peaks postpartum days 4-5 and usually resolve by day 10,

3 :
A nurse is caring for a client who reports unrelieved episiotomy pain 8 hr following a vaginal birth. Which of the following actions should the nurse take?

4 :
The newborn's first stool is called meconium. It is composed of amniotic fluid, shed mucous cells, intestinal secretions, and blood. It is green-black in color and tarry consistency. When should the first stool (meconium) passed after birth?

5 :
A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

6 :
A nurse is caring for a client who has just delivered a newborn. The nurse notes secretions bubbling out of the newborn's nose and mouth. Which of the following actions is the nurse's priority?

7 :
A nurse is caring for a client who is 7 days postpartum and calls the clinic to report pain and redness of her left calf. Besides seeing her provider, which of the following interventions should the nurse suggest?

8 :
A nurse is preparing to administer vitamin K by 1M injection to a newborn. The nurse should administer the medication into which of the following muscles?

9 :
A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?

10 :
A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period.
Which of the following is the priority nursing intervention at this time?

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Custom RN~Maternity Assessment 3, Taylor College FL-ADN

No.

1 : Which of the following post-partum affective disorders exhibits mild depressive symptoms of anxiety. irritability, mood swings? This disorder peaks postpartum days 4-5 and usually resolve by day 10,

3 : A nurse is caring for a client who reports unrelieved episiotomy pain 8 hr following a vaginal birth. Which of the following actions should the nurse take?

4 : The newborn's first stool is called meconium. It is composed of amniotic fluid, shed mucous cells, intestinal secretions, and blood. It is green-black in color and tarry consistency. When should the first stool (meconium) passed after birth?

5 : A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

6 : A nurse is caring for a client who has just delivered a newborn. The nurse notes secretions bubbling out of the newborn's nose and mouth. Which of the following actions is the nurse's priority?

7 : A nurse is caring for a client who is 7 days postpartum and calls the clinic to report pain and redness of her left calf. Besides seeing her provider, which of the following interventions should the nurse suggest?

8 : A nurse is preparing to administer vitamin K by 1M injection to a newborn. The nurse should administer the medication into which of the following muscles?

9 : A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?

10 : A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period.Which of the following is the priority nursing intervention at this time?

1 :
Which of the following post-partum affective disorders exhibits mild depressive symptoms of anxiety. irritability, mood swings? This disorder peaks postpartum days 4-5 and usually resolve by day 10,

3 :
A nurse is caring for a client who reports unrelieved episiotomy pain 8 hr following a vaginal birth. Which of the following actions should the nurse take?

4 :
The newborn's first stool is called meconium. It is composed of amniotic fluid, shed mucous cells, intestinal secretions, and blood. It is green-black in color and tarry consistency. When should the first stool (meconium) passed after birth?

5 :
A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?

6 :
A nurse is caring for a client who has just delivered a newborn. The nurse notes secretions bubbling out of the newborn's nose and mouth. Which of the following actions is the nurse's priority?

7 :
A nurse is caring for a client who is 7 days postpartum and calls the clinic to report pain and redness of her left calf. Besides seeing her provider, which of the following interventions should the nurse suggest?

8 :
A nurse is preparing to administer vitamin K by 1M injection to a newborn. The nurse should administer the medication into which of the following muscles?

9 :
A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?

10 :
A nurse is caring for a client 2 hr after a spontaneous vaginal birth and the client has saturated two perineal pads with blood in a 30-min period.
Which of the following is the priority nursing intervention at this time?