A nurse is conducting a home visit on a client who is 5 weeks postpartum. The client says they are still experiencing a "yellow-ish white vaginal discharge.’’ What should the nurse include in the teaching to the client about this type of discharge?

A postpartum individual can have lochia rubra at 5 weeks postpartum.

A postpartum individual should not have any lochia at 5 weeks postpartum.

A postpartum individual can have lochia serosa up to 6 weeks postpartum.

A postpartum individual can have lochia alba ranging from 10 to 14 days and up to weeks postpartum.

Answer and Explanation

The Correct Answer is D

A) A postpartum individual can have lochia rubra at 5 weeks postpartum:
Lochia rubra is the first stage of lochia, consisting of bright red blood and tissue, and is typically seen in the first 3-4 days postpartum. By 5 weeks postpartum, the lochia should no longer be in the rubra phase, and the discharge should have progressed to lochia serosa or alba. If the client is still experiencing lochia rubra at 5 weeks, this could indicate a problem, such as retained placental tissue or infection, and requires further evaluation.

B) A postpartum individual should not have any lochia at 5 weeks postpartum:
While it is true that lochia should be minimal or absent by 5 weeks postpartum, it is not uncommon for some women to still experience small amounts of lochia, particularly in the form of lochia alba, which can last up to 6 weeks. The type of discharge should be assessed, and if the discharge is abnormal (such as foul-smelling or accompanied by other symptoms), the nurse should investigate further. However, some amount of discharge, especially lochia alba, can be normal at this stage.

C) A postpartum individual can have lochia serosa up to 6 weeks postpartum:
Lochia serosa, which is pinkish or brownish in color and consists of blood, mucus, and uterine tissue, usually occurs between 4 to 10 days postpartum. It is not typically seen at 5 weeks postpartum unless there is a delay in the normal progression of lochia stages. By 5 weeks postpartum, lochia serosa should have already transitioned to lochia alba, a whitish or yellowish discharge.

D) A postpartum individual can have lochia alba ranging from 10 to 14 days and up to weeks postpartum:
Lochia alba is the final stage of lochia and typically starts around 10–14 days postpartum, lasting up to 6 weeks in some women. It consists mainly of leukocytes, epithelial cells, and mucus, and it is usually white or yellowish in color. This type of discharge is normal in the later weeks postpartum, and its presence at 5 weeks is considered a normal finding as long as it is not accompanied by foul odor, significant odor, or other signs of infection.

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

Explanation

A) Fusion of labia in female genitalia:
Fusion of the labia in a female newborn is not an expected finding. This could indicate a condition such as labial adhesion or an abnormality in the development of the genitalia. Normally, the labia in a female newborn are separated. Any signs of fusion would require further evaluation by the healthcare provider.

B) Erythema toxicum on newborn's skin:
Erythema toxicum is a common and expected finding in newborns, usually appearing within the first 2–3 days of life. It consists of small, red papules or pustules on a red base, often described as a "flea-bitten" appearance. This rash is benign and resolves on its own within a few days to weeks. It is not associated with any infection or underlying health issues.

C) Hypospadias is noted in the male newborn:
Hypospadias, a condition where the urethral opening is located on the underside of the penis rather than at the tip, is not an expected finding in all newborn males. While it occurs in a small percentage of male infants, it is a congenital anomaly that would require further assessment and possibly surgical correction. It is not considered a normal finding in a newborn.

D) Presence of syndactyly in extremities:
Syndactyly, the condition where two or more fingers or toes are fused together, is not a normal finding in newborns. While it is a congenital anomaly that can occur in some infants, it is not expected and requires further evaluation and possibly surgical intervention depending on the severity.

E) Negative Ortolani sign:
A negative Ortolani sign is an expected and normal finding in a newborn. The Ortolani maneuver is used to assess for hip dislocation, and a negative result indicates that the hip is stable and not dislocated. If the Ortolani sign were positive, it would suggest the presence of a developmental hip dysplasia, which would require further diagnostic evaluation. A negative sign is considered typical and reassuring.

A. Contractions that increase in intensity B. Leakage of fluid from the vagina C. increased bladder pressure D. Blood-tinged vaginal mucus E. Uterine contractions that decrease with rest

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

Explanation

A) Contractions that increase in intensity:
This is a hallmark sign of true labor. In true labor, contractions become progressively more intense, frequent, and regular. They also do not subside with rest or changes in activity. The intensity of contractions gradually increases as the cervix dilates and effaces, signaling the onset of labor.

B) Leakage of fluid from the vagina:
Leakage of fluid from the vagina, particularly if it is clear and odorless, is indicative of rupture of membranes, which can occur in true labor. If the membranes rupture and there is a continuous leakage of fluid, it is important for the client to contact the healthcare provider as it may signal the onset of labor. This is a significant sign of labor, especially if accompanied by contractions.

C) Increased bladder pressure:
Increased bladder pressure can occur in pregnancy, especially as the uterus grows and presses on the bladder. However, bladder pressure alone is not a definitive sign of true labor. It can also be a common complaint during late pregnancy, even before labor begins. This symptom would not be specific to true labor.

D) Blood-tinged vaginal mucus:
A bloody show, or blood-tinged mucus, is another classic sign of true labor. This happens as the cervix begins to soften, dilate, and efface, causing small blood vessels in the cervix to break. The bloody show is typically a pink or brownish mucus discharge and can occur just before labor starts, signaling that the cervix is changing in preparation for delivery.

E) Uterine contractions that decrease with rest:
This is a characteristic of false labor (Braxton Hicks contractions). In false labor, contractions tend to decrease or stop when the woman changes position, rests, or hydrates. On the other hand, in true labor, contractions persist and increase in intensity and frequency even with rest or hydration. Therefore, this is not a sign of true labor.

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A nurse is conducting a home visit on a client who is 5 weeks postpartum. The client says they are still experiencing a "yellow-ish white vaginal discharge.’’ What should the nurse include in the teaching to the client about this type of discharge?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn on the first day of life. Which of the following is an expected finding? (Select All that Apply.)

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

Explanation

A nurse Is caring for a primigravid client who is at 36 weeks of gestation and asks, "How will I know if I am in labor?" Which of the following manifestations of true labor should the nurse discuss with the client? (Select All that Apply.)

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

Explanation

A client who is primiparous at 40 weeks of gestation calls the labor and delivery unit to ask about coming in to be evaluated for labor. The client reports having contractions every 6 to 8 min, which feels slightly painful. Which of the following questions should the nurse ask the client next?

A nurse is analyzing a fetal heart monitor strip and identifies a sinusoidal fetal heart rate pattern, which has been occurring for 30 min. Which of the following actions should the nurse take at this time?

A nurse is working with a client who is 6 hour postpartum following a vaginal birth with first -degree laceration. Which of the following, actions is an example of the nurse providing a stepwise approach to manage the client's pain?

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor?

A nurse is conducting a home visit on a client who is 5 weeks postpartum. The client says they are still experiencing a "yellow-ish white vaginal discharge.’’ What should the nurse include in the teaching to the client about this type of discharge?

Which of the following is an example of a primitive reflex that is present in newborns and typically disappears by 3-4 months of age?

A nurse is caring for a client in the second stage of labor who does not want any tools used to assist with the vaginal birth. Which of the following interventions should the nurse understand will help prevent an assisted vaginal birth? (Select All that Apply.)