Choice A rationale
Ensuring the newborn’s diaper is snug is not specific to the Plastibell circumcision technique. It is a general care tip for all newborns.
Choice B rationale
While it’s important to monitor the circumcision site for signs of infection, a dark red tip of the penis is not a specific concern related to the Plastibell circumcision technique.
Choice C rationale
Yellow exudate, which is a normal part of the healing process, will form at the surgical site within 24 hours. This is a normal part of the healing process and should not be mistaken for pus, which would indicate an infection.
Choice D rationale
The Plastibell device is not removed 4 hours after the procedure. Instead, it falls off naturally after about a week.

Choice A rationale
Ovulation will indeed remain the same after a tubal ligation. The procedure blocks or seals the fallopian tubes, which prevents the egg from reaching the uterus. However, the ovaries continue to release eggs.
Choice B rationale
Tubal ligation does not eliminate premenstrual tension. Hormonal changes that cause symptoms like bloating, mood swings, and breast tenderness will still occur.
Choice C rationale
Tubal ligation does not shorten the duration of menstrual periods. It has no effect on menstruation.
Choice D rationale
Hormone replacements are not needed following a tubal ligation. The ovaries continue to produce hormones as they did before the procedure.

Choice A rationale
Obtaining a specimen for a Kleihauer-Betke test is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.
Choice B rationale
Misoprostol is a medication that can be used to treat uterine atony. It helps to contract the uterus and reduce bleeding.
Choice C rationale
Administering betamethasone IM is not the appropriate action. Betamethasone is a steroid medication often used to mature the lungs of a fetus at risk of premature birth, not to treat uterine atony.
Choice D rationale

Avoiding sterile vaginal examinations is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.

Question: Estimated date of delivery using Nägele’s Rule.

Step 1: Add 7 days to the first day of the last menstrual period. August 10 + 7 days = August 17

Step 2: Subtract 3 months from the result. August 17 - 3 months = May 17

Step 3: Add 1 year to the result. May 17 + 1 year = May 17, 2025

Answer: May 17, 2025

Choice A rationale
Providing the patient with photos of the fetus can be a part of memory-making and is often a key component of care after a stillbirth. It allows parents to remember their baby and can aid in the grieving process.
Choice B rationale
While an autopsy can provide information about why a stillbirth occurred, it is not mandatory and should be discussed with the parents. The decision to perform an autopsy should be based on the parents’ wishes.
Choice C rationale
Limiting the amount of time the fetus is in the patient’s room is not necessarily beneficial. Some parents may want to spend time with their baby to say goodbye, which can be therapeutic.
Choice D rationale
Informing the patient that the law requires them to name the fetus is not accurate. The decision to name the fetus is a personal one and varies among individuals.

Choice A rationale
Vacuum-assisted delivery can increase the risk of postpartum hemorrhage. This is because the use of vacuum can cause trauma to the birth canal and uterus, leading to increased bleeding.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal range and does not increase the risk of postpartum hemorrhage.
Choice C rationale
Labor induction with oxytocin can increase the risk of postpartum hemorrhage. Oxytocin can cause the uterus to contract too strongly or too frequently, leading to uterine atony (a condition where the uterus fails to contract after delivery), which can result in heavy bleeding.
Choice D rationale
A history of uterine atony places the patient at risk for postpartum hemorrhage. Uterine atony is a condition in which the uterus fails to contract after the delivery of the baby and the placenta, leading to heavy bleeding.
Choice E rationale

A history of human papillomavirus (HPV) does not increase the risk of postpartum hemorrhage. HPV is a sexually transmitted infection that can cause genital warts and cervical cancer, but it does not affect the uterus’s ability to contract after delivery.

Choice A rationale
Initiating an amnioinfusion is not the first action to take after discontinuing oxytocin infusion due to persistent late decelerations in the FHR. Amnioinfusion is a procedure where a saline solution is infused into the uterus to increase the volume of amniotic fluid. It is typically used to treat variable decelerations in the FHR, not late decelerations.
Choice B rationale
Placing the patient in a supine position is not recommended as it can decrease blood flow to the uterus and fetus, potentially worsening the late decelerations.
Choice C rationale

Instructing the patient to bear down and push with contractions is not appropriate in this situation. Persistent late decelerations in the FHR are a sign of fetal distress, and further contractions could exacerbate this.
Choice D rationale
Administering oxygen at 10 L/min via a non-rebreather face mask is the correct action. This increases the amount of oxygen available to the mother and fetus, potentially improving the FHR pattern.

Choice A rationale
While taking a Vitamin C supplement can be beneficial for overall health, it is not specific to assessing the dietary intake of a vegan client at 6 weeks of gestation.
Choice B rationale
Asking when the client last ate meat is not relevant for a vegan, as vegans do not consume meat.

Choice C rationale
Asking about the client’s daily protein intake is important. Vegans need to ensure they are getting enough protein from plant-based sources, as they do not consume animal products.
Choice D rationale
Asking if the client has considered eating shellfish is not appropriate for a vegan, as vegans do not consume any animal products, including shellfish.

Choice A rationale
Asking if the client’s back labor has improved is a good way to evaluate the effectiveness of the hands-and-knees position. This position has been shown to reduce persistent back pain in laboring women with a fetus in the occipitoposterior position.
Choice B rationale

Feeling relief from pelvic pressure is not specifically associated with the hands-and-knees position.
Choice C rationale
Lessening of suprapubic pain is not specifically associated with the hands-and-knees position.
Choice D rationale
Contractions feeling further apart is not a specific outcome associated with the hands-and- knees position.

Choice A rationale
Applying a moist, warm compress to the perineum is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum.
Choice B rationale

Administering methylergonovine 0.2 mg IM is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum. Methylergonovine is a medication used to prevent or control bleeding of the uterus following childbirth or abortion.
Choice C rationale
Providing the client with a cool sitz bath is the correct action. A sitz bath can help to soothe the perineal area, reduce inflammation, and promote healing.
Choice D rationale
Applying povidone-iodine to the client’s perineum after she voids is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum. Povidone-iodine is an antiseptic used for skin disinfection before and after surgery.