A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

two fingerbreadths above the umbilicus

two fingerbreadths below the umbilicus

at the level of the umbilicus

four fingerbreadths below the umbilicus

Answer and Explanation

The Correct Answer is C

A. Two fingerbreadths above the umbilicus would be abnormal and may indicate uterine distension due to retained placental fragments or a full bladder, especially this long after delivery.

B. Two fingerbreadths below the umbilicus is typically expected 24 hours or more after delivery, not at 12 hours postpartum.

C. At the level of the umbilicus is normal and expected at about 12 hours postpartum. After delivery, the uterus rises slightly and is generally found at or near the umbilicus before it begins to descend (involute) by about 1 fingerbreadth per day.

D. Four fingerbreadths below the umbilicus would be expected several days postpartum, not within the first 12 hours.

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Correct Answer is B

Explanation

A. Polyhydramnios refers to an excessive amount of amniotic fluid and typically presents with maternal discomfort, dyspnea, and possibly preterm labor, but not with vaginal bleeding as a primary symptom.

B. Placenta previa is the most likely diagnosis based on the assessment findings. It typically presents with painless, bright red vaginal bleeding in the second or third trimester, a soft, nontender uterus, no contractions, and a normal fetal heart rate. The bleeding may start spontaneously and often recurs. This fits the client's clinical picture precisely.

C. Placental abruption usually involves painful vaginal bleeding, a firm or tender uterus, and may be associated with uterine contractions or abnormal fetal heart rate patterns. The absence of pain and uterine tenderness in this case makes placental abruption less likely.

D. Ruptured ectopic pregnancy would not be expected at 33 weeks’ gestation. Ectopic pregnancies typically present in the first trimester and are accompanied by severe abdominal pain, vaginal bleeding, and signs of hypovolemic shock if ruptured.

A. nonshivering thermogenesis B. cold stress C. convection D. bilirubin conjugation

Correct Answer is A

Explanation

A. Nonshivering thermogenesis is the primary method of heat production in newborns. Unlike adults, newborns do not generate heat through shivering. Instead, they rely on the metabolism of brown adipose tissue (brown fat) to produce heat. This process is triggered by exposure to cold and helps maintain body temperature.

B. Cold stress is a condition, not a heat production mechanism. It occurs when the newborn is exposed to cold temperatures, leading to increased oxygen and energy demands as the body attempts to produce heat — which can be dangerous.

C. Convection is a method of heat loss, not production. It occurs when heat is lost from the body surface to cooler surrounding air (e.g., drafts in the room).

D. Bilirubin conjugation is related to the liver's processing of bilirubin and has nothing to do with thermoregulation.

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A primipara client gave birth vaginally to a healthy newborn girl 12 hours ago. The nurse palpates the client's fundus. Which finding would the nurse identify as expected?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

After teaching an in-service program to a group of nurses working in newborn nursery about a neutral thermal environment, the nurse determines that the teaching was successful when the group identifies which process as the newborn's primary method of heat production?

Correct Answer is A

Explanation

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