A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

“Because you're not eating enough iron-rich foods like meat."

"Because you are hemoconcentrated the hematocrit dropped after delivery."

"Because your blood volume has doubled, your hematocrit is lower."

"This change in hematocrit indicates a postpartum hemorrhage."

Answer and Explanation

The Correct Answer is C

A. A decrease in hematocrit after delivery is more likely due to physiological changes rather than dietary factors alone, though iron intake is important for overall recovery.

B. Hemoconcentration refers to an increase in hematocrit due to a decrease in plasma volume, but this is not the reason for a decreased hematocrit postpartum.

C. During pregnancy, blood volume increases to support both the mother and fetus. After delivery, plasma volume returns to pre-pregnancy levels, which can cause a relative decrease in hematocrit.

D. A significant drop in hematocrit could indicate postpartum hemorrhage, but a slight drop can be expected as part of normal post-delivery physiology.

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

Explanation

A. A G3 P2 laboring patient with a current vaginal exam of 8/100%/0: This patient is in advanced labor (transition phase) and IV pain medication is typically avoided due to the proximity to delivery, which could affect the newborn.

B. A G1 P0 laboring patient with a Category 1 strip and a current vaginal exam of 4/80%/-1: This patient is in active labor with normal fetal heart tracing, making her a suitable candidate for IV pain medication.

C. A G1 P0 laboring patient with the FHT showing no variability and late decelerations: This patient has non-reassuring fetal heart tracings, indicating potential fetal distress, making IV pain medication inappropriate as it could further compromise the fetus.

D. A G1 P0 laboring patient who has a vaginal exam of 5/100%/0 and contractions every 4 minutes: This patient is also in active labor with normal fetal heart tracings, making her a suitable candidate for IV pain medication.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

Performing a vaginal examination is contraindicated in cases of unexplained vaginal bleeding, especially if placenta previa is suspected. It could disrupt the placenta, leading to severe hemorrhage.

Since the client is Rh-negative and there is a risk of fetal-maternal hemorrhage, administering RhoGAM is necessary to prevent Rh sensitization, which could affect future pregnancies.

While prenatal counseling is generally beneficial, it is non-essential in the acute management of vaginal bleeding and doesn't directly address the immediate clinical issue.

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A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A laboring woman asks for IV pain medication. Which of the following patients would be a candidate for IV pain medication in labor? (Select all that apply)

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

Explanation

A nurse on an antepartum unit has been caring for a client who is G2 P1 at 34 weeks gestation who has been admitted for vaginal bleeding. Which action is contraindicated dropdownand what action should the nurse implement dropdown?

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

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