A nurse is caring for a client who is 12 hours postpartum following a vaginal delivery. Which of the following findings should the nurse expect?

Fundus soft, 1 cm to the right of the umbilicus.

Fundus firm, at the level of the umbilicus.

Fundus soft, 2 cm above the umbilicus.

Fundus present, to the left of the umbilicus.

Answer and Explanation

The Correct Answer is B

Choice a reason:
The fundus being soft and to the right of the umbilicus could indicate that the bladder is full and displacing the uterus. This is not an expected finding and would require the nurse to encourage the client to empty her bladder to help the uterus contract and return to its normal position.

Choice b reason:
The expected finding for a client who is 12 hours postpartum is for the fundus to be firm and at the level of the umbilicus. A firm fundus indicates good uterine tone and that the uterus is contracting as it should to return to its pre-pregnancy size. This helps to prevent excessive bleeding and promotes recovery.

Choice c reason:
A fundus that is soft and 2 cm above the umbilicus is not an expected finding at 12 hours postpartum. This could suggest that the uterus is not contracting properly, which could lead to postpartum hemorrhage. The nurse would need to assess further and possibly provide interventions such as fundal massage or medication to encourage uterine contractions.

Choice d reason:
The fundus being present to the left of the umbilicus may indicate that the uterus is not contracting symmetrically or that there is a full bladder displacing the uterus. This finding would prompt the nurse to assess for bladder distention and encourage the client to void to help the uterus contract properly.

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Correct Answer is ["A","C","D"]

Explanation

Choice a) Reason: History of migraines
Women with a history of migraines may experience an improvement or worsening of their migraine symptoms during pregnancy. Hyperemesis gravidarum, a condition characterized by severe nausea and vomiting, can be associated with migraines due to hormonal changes, stress, or dehydration that pregnancy may exacerbate.

Choice b) Reason: History of gestational hypertension
Gestational hypertension typically develops after 20 weeks of gestation, so it would not be expected in a client at 8 weeks of gestation. Additionally, there is no direct correlation between gestational hypertension and hyperemesis gravidarum.

Choice c) Reason: Twin gestations
Twin or multiple gestations can increase the likelihood of hyperemesis gravidarum due to higher levels of hCG (human chorionic gonadotropin) and other pregnancy-related hormones. These elevated hormone levels are associated with more severe nausea and vomiting.

Choice d) Reason: Nulliparous
Nulliparity (having never given birth) is not directly associated with an increased risk of hyperemesis gravidarum. However, first-time pregnancies can be unpredictable, and the condition can occur regardless of parity.

Choice e) Reason: Oligohydramnios
Oligohydramnios refers to a decreased amount of amniotic fluid and is not typically associated with hyperemesis gravidarum. It is more commonly related to conditions affecting the placenta or fetal kidneys.

A. Amniotic fluid volume B. Fetal breathing C. Fetal motion D. Fetal neck translucency E. Fetal gender

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

Explanation

Choice A reason:
Amniotic fluid volume is one of the components evaluated during a biophysical profile. It is assessed because adequate amniotic fluid is essential for fetal development and can indicate the health of the pregnancy. A normal amniotic fluid volume suggests that the fetus's kidneys are functioning well and that there is no leakage or rupture of membrane.

Choice B reason:
Fetal breathing is another key component of the biophysical profile. The presence of fetal breathing movements is a positive sign, indicating that the central nervous system is functioning and the fetus is getting enough oxygen.

Choice C reason:
Fetal motion is also assessed during a biophysical profile. Multiple discrete body or limb movements within a certain time frame are considered normal and indicate good fetal health and activity levels.

Choice D reason:
Fetal neck translucency is not evaluated in a biophysical profile. This measurement is typically assessed during the first trimester as part of screening for chromosomal abnormalities, not as a part of the biophysical profile.

Choice E reason:
Fetal gender is not a component of the biophysical profile. The biophysical profile focuses on the well-being of the fetus rather than determining its sex.

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A nurse is caring for a client who is 12 hours postpartum following a vaginal delivery. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a clinic is assessing a client who is at 8 weeks of gestation and has hyperemesis gravidarum. Which of the following findings should the nurse expect? (Select all that apply)

Correct Answer is ["A","C","D"]

Explanation

A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. The nurse should include the following:

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

Explanation

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