A nurse is providing care to a postpartum woman. Which of the following behavior by the client would indicate the client is in the Taking in phase?

The client talks frequently about her labor and delivery

The client hesitates to initiate contact with the baby

The client questions the nurse about the amount of formula for baby

The client request between meals snacks

Answer and Explanation

The Correct Answer is A

A. The client talks frequently about her labor and delivery is a characteristic behavior of the Taking In phase, which occurs during the first few days postpartum. During this phase, the mother is primarily focused on her own needs and recovering from childbirth. She may want to discuss her labor and delivery experience and may be more focused on rest and reflection rather than engaging with the baby.

B. The client hesitates to initiate contact with the baby is more characteristic of the Taking Hold phase, which comes after the Taking In phase. In the Taking Hold phase, the mother begins to take more responsibility for her baby’s care, though she may still seek guidance.

C. The client questions the nurse about the amount of formula for the baby indicates a more active engagement in learning about infant care, which is typical of the Taking Hold phase, where the mother starts to focus on baby care and becomes more involved.

D. The client requests between meals snacks is a sign of physical recovery and possibly an increased need for nourishment, but it does not specifically indicate being in the Taking In phase. This behavior may occur in any phase but is not a defining characteristic.

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Correct Answer is A

Explanation

A. Elevated liver enzymes is a key indicator of HELLP syndrome, which stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. HELLP syndrome is a severe form of preeclampsia and can lead to liver damage. Elevated liver enzymes, such as AST and ALT, are a hallmark of this condition, indicating liver dysfunction.

B. Elevated platelet count would be the opposite of what is expected in HELLP syndrome. In HELLP syndrome, there is typically low platelet count (thrombocytopenia), not an elevated one.

C. Leukocytosis refers to an increased white blood cell count, which can be indicative of an infection or inflammation, but it is not a hallmark of HELLP syndrome. HELLP syndrome primarily involves hemolysis, liver enzyme elevation, and low platelets.

D. Hyperglycemia is not a characteristic finding of HELLP syndrome. While it can occur in some pregnancy-related conditions, it is not specifically associated with HELLP syndrome. This condition is more associated with elevated liver enzymes and low platelets.

A. oligohydramnios B. chorioamnionitis C. preeclampsia D. post-term labor

Correct Answer is C

Explanation

A. Oligohydramnios is more commonly associated with conditions like fetal growth restriction or placental insufficiency, and it is less common in twin pregnancies, which are actually more prone to polyhydramnios, especially in cases of twin-to-twin transfusion syndrome.

B. Chorioamnionitis is an infection of the fetal membranes, which can occur in any pregnancy, particularly with prolonged rupture of membranes, but it is not uniquely or especially linked to twin pregnancies.

C. Preeclampsia is correct. Women carrying twins (or other multiples) are at significantly higher risk for developing preeclampsia due to the increased placental mass and associated vascular demands. Nurses should be particularly vigilant in monitoring for signs like elevated blood pressure, proteinuria, edema, and headaches in these clients.

D. Post-term labor is less likely in twin pregnancies, as multiples are more often born preterm, not post-term, due to uterine overdistension and other complications.

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A nurse is providing care to a postpartum woman. Which of the following behavior by the client would indicate the client is in the Taking in phase?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is reviewing the laboratory test results of a pregnant client. Which finding would alert the nurse to the development of HELLP syndrome?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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