A nurse is assessing a client for pain following a cesarean birth 24 hours ago. Which should the nurse ask to determine if a PRN pain medication is needed?
Have you noticed any swelling in your feet?
Do you notice increased cramping with breastfeeding?
Do you have any leakage from your incision?
Are you able to pass gas?
The Correct Answer is B
The correct answer is choice b. Do you notice increased cramping with breastfeeding?
Choice A rationale: Swelling in the feet is not directly related to the need for PRN pain medication following a cesarean birth. Swelling can be a common postpartum symptom due to fluid retention and changes in blood chemistry, but it does not specifically indicate pain that requires medication.
Choice B rationale: Increased cramping with breastfeeding is a common occurrence due to the release of oxytocin, which causes uterine contractions. This can be quite painful and may necessitate PRN pain medication to manage the discomfort.
Choice C rationale: Leakage from the incision could indicate a complication such as infection or wound dehiscence. While this is a serious concern that requires medical attention, it is not directly related to the typical pain management needs following a cesarean birth.
Choice D rationale: The ability to pass gas is an important indicator of the return of bowel function after surgery, but it is not directly related to the need for PRN pain medication. It is more relevant to assessing gastrointestinal recovery rather than pain levels.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A rationale
Turning a baby’s car seat forward when they are 1 year old is not recommended. According to the American Academy of Pediatrics, children should ride in a rear-facing car seat as long as possible, until they reach the highest weight or height allowed by their seat. This is because rear-facing car seats provide the best protection for the baby’s head, neck, and spine in a crash.
Choice B rationale
While it’s important to keep a baby warm in the car seat, using a sleep sack is not the safest option. Bulky outerwear and blankets can interfere with the tightness of the harness, which can compromise the safety of the baby. Instead, it’s recommended to dress the baby in lighter layers and place a warm blanket over them and the harness.
Choice C rationale
A car seat challenge test, also known as a car seat trial, is usually performed on babies who were born preterm, not at full term. This test checks whether the baby can sit in a car seat safely without any breathing problems or other complications. Since the newborn in question was delivered at 38 weeks of gestation, which is considered full term, a car seat challenge test is not typically required.
Choice D rationale
The car seat should indeed be positioned at a 45-degree angle. This angle is especially important for newborns and infants who are rear-facing, as it helps to support their head and prevent it from falling forward.
Correct Answer is D
Explanation
Choice A rationale
Aspirin is generally not recommended for postpartum pain management due to its anticoagulant properties, which can increase the risk of bleeding. Furthermore, if the mother is breastfeeding, aspirin can pass into breast milk and potentially harm the baby.
Choice B rationale
Meperidine is a strong opioid medication that is typically reserved for severe pain. It is not usually the first choice for postpartum pain management due to its potential side effects and the risk of dependency.
Choice C rationale
Fentanyl citrate is a potent opioid that is typically used for severe pain and is often used in anesthesia. It is not usually used for routine postpartum pain management due to its potency and the risk of side effects and dependency.
Choice D rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used for postpartum pain management. It is effective for relieving perineal pain and uterine cramping, and it is safe for use in breastfeeding mothers.
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