A nurse is assessing a client who is 8 hours postpartum.
Where should the nurse expect to find the fundus?

At a non-palpable depth.

Just below the umbilicus.

At the umbilicus.

Just above the symphysis pubis.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Immediately postpartum, the fundus is typically palpable. It gradually descends into the pelvic cavity over the following days.

Choice B rationale

By 6 to 12 hours postpartum, the fundus is usually located at the level of the umbilicus or slightly below it. It descends approximately one fingerbreadth (1 cm) per day.

Choice C rationale

In the immediate postpartum period, within the first few hours after delivery, the nurse should expect to find the fundus at the level of the umbilicus. This indicates that the uterus is contracting to control bleeding at the placental site.

Choice D rationale

Immediately after delivery, the fundus is typically higher than the symphysis pubis. It descends into the abdomen as the uterus contracts and the placental site begins to heal. .

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Correct Answer is ["A","B"]

Explanation

Choice A rationale

Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. Symptoms can include unilateral abdominal pain, light to heavy vaginal bleeding, and a positive pregnancy test. An ectopic pregnancy is a serious condition requiring prompt medical attention.

Choice B rationale

Molar pregnancy, also known as gestational trophoblastic disease, is characterized by abnormal growth of trophoblasts, the cells that normally develop into the placenta. It can present with symptoms such as vaginal bleeding (ranging from spotting to heavy bleeding), pelvic pain or pressure, and a uterus that may be larger than expected for the gestational age. The absence of a fetal heartbeat and elevated hCG levels are also characteristic.

A. "Because blood pressure often increases early in the second trimester of pregnancy.”. B. "You are at an increased risk for high blood pressure since you've had several pregnancies.”. C. "Your age is a risk factor for developing high blood pressure during pregnancy.”. D. "No need to worry about that, let's talk about how you're feeling.”.

Correct Answer is C

Explanation

Choice A rationale

While blood pressure can increase during the second trimester due to changes in the maternal cardiovascular system, it doesn't typically increase *early* in the second trimester. Physiologic changes usually lead to a slight decrease in blood pressure during the first and early second trimester before gradually returning to pre-pregnancy levels or potentially increasing later.

Choice B rationale

While multiparous women can develop gestational hypertension or preeclampsia, having had "several pregnancies" in the past does not inherently increase the risk of high blood pressure at 14 weeks gestation in the current pregnancy, especially if previous pregnancies were normotensive. Risk factors like age, pre-existing conditions, and family history are more significant.

Choice C rationale

Advanced maternal age, generally considered 35 years or older, is a known risk factor for developing gestational hypertension and preeclampsia during pregnancy. Physiological changes associated with aging can affect vascular function and increase susceptibility to hypertensive disorders.

Choice D rationale

While addressing the client's feelings is important for therapeutic communication, it avoids answering her direct question about why her blood pressure is being taken. The nurse has a responsibility to provide accurate information regarding routine assessments during pregnancy.

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A nurse is assessing a client who is 8 hours postpartum.Where should the nurse expect to find the fundus?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is being admitted to the labor and delivery unit.Client reports mild abdominal pain and light vaginal bleeding.Reports last menstrual period was 11 weeks ago.

Correct Answer is ["A","B"]

Explanation

A nurse is caring for a 37-year-old G3P2 client who is at 14 weeks of gestation. The client asks, "why are you taking my blood pressure? It's always been normal.”. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

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A nurse is assessing a client who is 8 hours postpartum.
Where should the nurse expect to find the fundus?