35-year-old postpartum client.

Select the condition, risk factors and assessment findings that the client may be experiencing.

Answer and Explanation

The Correct Answer is []

Condition: Postpartum Hemorrhage (PPH)

Postpartum hemorrhage is defined as blood loss ≥ 500 mL after vaginal delivery or ≥ 1000 mL after cesarean delivery. In this case, the client has heavy bleeding, large clots, and lightheadedness, which are key indicators of excessive postpartum blood loss.

Risk Factors

1. Fetal Macrosomia: The baby weighs 9 lbs 4 oz (4196 grams), which is considered macrosomia (birth weight > 4000 g). Large fetal size increases the risk of uterine overdistension, which can impair uterine contractions and lead to uterine atony, the most common cause of postpartum hemorrhage.

2. Uterine Atony: The nurse initially noted a boggy uterus that required massage to become firm. Uterine atony occurs when the uterus fails to contract effectively after delivery, leading to excessive bleeding. This is the leading cause of PPH.

3. Prolonged Labor: A prolonged labor can cause uterine fatigue, reducing the uterus's ability to contract properly after delivery, thereby increasing the risk of uterine atony and PPH.

Assessment Findings

1. Heavy vaginal bleeding: The client has heavy bleeding with three quarter-sized clots, which is abnormal postpartum and indicates excessive blood loss.

2. Blood pressure: The client’s BP is 150/86 mmHg, which may indicate compensatory vasoconstriction due to ongoing blood loss. If hemorrhage continues, hypotension may develop.

3. Urine output: The client did not feel the urge to void, and catheterization drained 450 mL of urine. A full bladder can prevent proper uterine contraction, worsening uterine atony and bleeding.

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Correct Answer is C

Explanation

A. "Presence of late decelerations with each contraction during monitoring."
Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia and distress. This is not a reassuring sign.

B. "Increased fetal movement between contractions."
While fetal movement is a positive sign, it is not the best indicator of fetal well-being in labor. Continuous FHR monitoring provides a better assessment.

C. "Fetal heart rate of 160 beats per minute with moderate variability."
A normal fetal heart rate (FHR) is 110–160 bpm, and moderate variability (6–25 bpm fluctuations) indicates a well-oxygenated fetus with an intact autonomic nervous system.

D. "Fetal heart rate consistently below 120 beats per minute with no accelerations."
A persistent FHR below 110 bpm (bradycardia) or minimal variability suggests possible fetal compromise.

A. The client's level of sexual stimulation B. If taken with a high fat meal, the medication is more effective C. The client's recent consumption of caffeine D. If client took an additional dose to achieve an erection

Correct Answer is A

Explanation

A. The client's level of sexual stimulation
Sildenafil requires sexual stimulation to be effective. It enhances blood flow to the penis but does not automatically cause an erection. The client should be educated that adequate sexual arousal is necessary for the medication to work.

B. If taken with a high-fat meal, the medication is more effective
Taking sildenafil with a high-fat meal can actually delay its absorption and reduce effectiveness. Clients should be advised to take it on an empty stomach or with a light meal for optimal results.

C. The client's recent consumption of caffeine
Caffeine intake does not interfere with sildenafil’s effectiveness. However, excessive caffeine consumption may contribute to vasoconstriction, which could indirectly affect erectile function.

D. If client took an additional dose to achieve an erection
Taking an extra dose of sildenafil is not recommended and can increase the risk of serious side effects such as hypotension, priapism (prolonged erection), and cardiovascular complications. The client should follow prescribed dosing guidelines.

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35-year-old postpartum client. Select the condition, risk factors and assessment findings that the client may be experiencing.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

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35-year-old postpartum client.

Select the condition, risk factors and assessment findings that the client may be experiencing.