A client who is two weeks postpartum calls her obstetrician’s nurse and states that she has had a white discharge for about a week but today she is bleeding and saturating one pad about every 30 minutes. Which of the following is the appropriate response from the nurse?
“That is normal; you may have loosened your stitches.”.
“You may be starting to menstruate again.”.
“Go to the emergency department.”.
“You should stay on complete bed rest until the bleeding subsides.”.
The Correct Answer is C
Choice A rationale
Stating the bleeding is normal and linking it to stitches being loosened downplays the severity. Postpartum bleeding that saturates one pad in 30 minutes requires urgent evaluation to prevent complications like hypovolemic shock.
Choice B rationale
Menstruation typically resumes several weeks to months postpartum, depending on lactation. Heavy bleeding in this scenario is unlikely to be menstrual and requires medical attention to rule out hemorrhage or uterine atony.
Choice C rationale
Significant postpartum bleeding exceeding normal lochia patterns suggests a possible hemorrhage or retained products of conception, warranting immediate emergency department evaluation for prompt treatment and stabilization.
Choice D rationale
Bed rest is not appropriate in this case, as the heavy bleeding could indicate a life-threatening condition that demands immediate medical intervention rather than conservative management like rest.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Tight swaddling does not address hypoglycemia but may increase the infant’s stress. Hypoglycemia requires immediate correction through feeding or IV glucose, as low glucose levels can impair neonatal neurologic function.
Choice B rationale
Feeding provides immediate glucose replenishment, correcting hypoglycemia, which manifests as trembling. Rechecking glucose ensures effective correction. Normal neonatal glucose levels are 45–65 g/dL, with intervention needed below 40 g/dL.
Choice C rationale
Monitoring urinary output is insufficient for managing neonatal hypoglycemia. Trembling indicates an acute need for glucose, requiring prompt feeding or IV glucose rather than passive observation of output.
Choice D rationale
Immediate NICU transfer is unnecessary unless hypoglycemia remains uncorrected or other complications arise. Prompt feeding and glucose recheck are adequate to stabilize the neonate in most cases.
Correct Answer is ["C","D"]
Explanation
Choice A rationale
Bottle feeding does not impact recovery from postpartum hemorrhage. Breastfeeding promotes oxytocin release, aiding uterine contractions to minimize bleeding risk, unlike bottle feeding, which has no therapeutic impact.
Choice B rationale
Aspirin is contraindicated postpartum as it increases bleeding risk due to its antiplatelet effects. Analgesic alternatives like acetaminophen are preferred for pain relief in hemorrhage recovery settings.
Choice C rationale
Frequent fundal assessments monitor for uterine atony, a leading hemorrhage cause. Ensuring the uterus remains firm and contracted is critical in preventing recurrent excessive blood loss postpartum.
Choice D rationale
A CBC after six hours checks hemoglobin, hematocrit, and platelet levels, identifying ongoing bleeding or anemia. Timely lab evaluation ensures appropriate interventions like transfusions or iron supplementation.
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