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 D

Explanation

A. Jaundice is not typically a primary concern in the case of a ruptured ectopic pregnancy. Jaundice is more associated with liver dysfunction, not hemorrhage or the acute events following an ectopic pregnancy rupture.

B. Depression is an emotional response that could occur after a traumatic event like an ectopic pregnancy, but it is not the priority in an acute situation where physical signs of a life-threatening condition like hemorrhage need immediate attention.

C. Edema may be present in a variety of conditions but is not as urgent or immediately life-threatening as hemorrhage in the case of a ruptured ectopic pregnancy.

D. Hemorrhage is the priority concern in a suspected ruptured ectopic pregnancy. A ruptured ectopic pregnancy can lead to significant internal bleeding, which can cause hypovolemic shock and be life-threatening. Immediate attention to monitoring for signs of hemorrhage (such as hypotension, tachycardia, dizziness, and abdominal pain) is crucial to ensure the client's safety.

A. dark red vaginal bleeding B. absence of pain C. insidious onset D. absent fetal heart tones

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

Explanation

A. Dark red vaginal bleeding is often seen in placental abruption. The blood from an abruption is typically dark red (indicating that it is older blood) and may be mixed with amniotic fluid, making it more challenging to assess. However, the bleeding can sometimes be concealed, especially in complete abruption or retroplacental hemorrhage, where blood accumulates behind the placenta.

B. Absence of pain is incorrect. In fact, placental abruption is typically associated with abdominal pain, which can be severe and often comes on suddenly. Pain occurs due to the detachment of the placenta from the uterine wall and subsequent irritation or bleeding into the uterine cavity.

C. Insidious onset is incorrect. Placental abruption usually has a sudden or acute onset of symptoms, such as vaginal bleeding and abdominal pain. An insidious onset would be more suggestive of other conditions, such as placenta previa.

D. Absent fetal heart tones is a critical finding. Placental abruption can cause fetal distress or fetal death, especially if the abruption is severe. Absent fetal heart tones are a sign of fetal compromise or death resulting from the disruption of placental blood flow.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority?

Correct Answer is D

Explanation

A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply.

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

Explanation

The nurse dries the neonate thoroughly and promptly changes wet linens. The nurse does so to minimize heat loss via which mechanism?

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?

After the birth of a newborn, which action would the nurse do first to assist in thermoregulation?

The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason?

A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate?

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