After birth, a woman telephones about her 4-day-old infant.

She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well.

Effective breastfeeding is indicated by the newborn who:

Has at least one breastmilk stool every 24 hours.

Gains 1 to 2 ounces per week.

Has at least 6 to 8 wet diapers per day.

Sleeps for 6 hours at a time between feedings.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Having only one breastmilk stool every 24 hours is generally considered insufficient for a 4-day-old infant. By the fourth day of life, as the mother’s milk transitions from colostrum to mature milk, the infant should ideally have multiple yellow, seedy stools daily. A single stool may indicate that the infant is not receiving an adequate volume of milk to stimulate the gastrointestinal tract and clear bilirubin, potentially leading to dehydration or neonatal jaundice in the first week.

Choice B rationale

A weight gain of 1 to 2 ounces per week is significantly below the expected growth parameters for a newborn. After the initial physiological weight loss in the first few days, a healthy, well-fed newborn is expected to gain approximately 0.5 to 1 ounce (15 to 30 grams) per day, or about 4 to 7 ounces per week. Slow weight gain can be a clinical sign of poor milk transfer, low milk supply, or an underlying medical issue requiring assessment.

Choice C rationale

The presence of at least 6 to 8 wet diapers per day is a reliable clinical indicator of adequate hydration and milk intake in a 4-day-old infant. Since breast milk is roughly 88 percent water, frequent voiding demonstrates that the infant is consuming enough volume to maintain renal output. In the clinical setting, fewer than 6 wet diapers by day four may suggest the infant is at risk for dehydration or is not latching effectively to transfer milk.

Choice D rationale

Sleeping for 6 hours at a time is generally inappropriate for a 4-day-old newborn, as they require frequent feedings to meet high metabolic demands and to establish the mother's milk supply. Newborns should typically be fed 8 to 12 times in a 24-hour period. Prolonged sleep intervals at this age can lead to hypoglycemia and a decrease in the stimulation of prolactin, which is necessary for continued milk production. Feeding should occur every 2 to 3 hours.

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Correct Answer is A

Explanation

Choice A rationale

The fundamental technique for performing Kegel exercises involves identifying and isolating the pubococcygeus muscles. An effective way to teach patients how to locate these muscles is to suggest they mimic the action of stopping the flow of urine midstream. This specific muscle contraction helps strengthen the pelvic floor, which supports the bladder, uterus, and bowel. Correct identification ensures that the patient is targeting the right muscle group to improve urinary continence and pelvic health.

Choice B rationale

While Kegel exercises can technically be performed in various positions, including standing, it is often recommended that beginners start while lying down or sitting to better isolate the pelvic floor muscles without the interference of gravity or other muscle groups. Standing is not a requirement for the process to be correct, and suggesting it as a primary method does not necessarily indicate a superior understanding of the exercise compared to identifying the correct muscle action.

Choice C rationale

A common mistake when performing Kegel exercises is the co-contraction of the abdominal, gluteal, and thigh muscles. To be effective, the patient must isolate the pelvic floor muscles specifically. If the patient is contracting her thighs, buttocks, and abdomen, she is not performing the exercise correctly and will not achieve the desired strengthening of the perineal muscles. Proper education emphasizes relaxation of these external muscle groups while focusing solely on the pelvic floor.

Choice D rationale

To achieve significant improvement in pelvic floor strength and muscle tone, consistency and frequency are necessary. Doing only 10 exercises per day is generally insufficient to produce a therapeutic effect. Most clinical guidelines recommend performing multiple sets of 10 contractions several times a day, totaling 30 to 80 repetitions daily. The patient's report of only 10 repetitions indicates an inadequate routine that will likely not lead to the desired healing and strengthening outcomes.

A. Hormonal implants. B. Tubal ligation for the female partner. C. Vasectomy for the male partner. D. Intrauterine device (IUD).

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

Explanation

Choice A rationale

Hormonal implants are long-acting reversible contraception methods that involve the subcutaneous insertion of a rod releasing progestin. While they are highly effective and can last for several years, they are not considered permanent because their effects are completely reversible upon removal. Surgical sterilization implies a permanent anatomical change that prevents the union of sperm and egg, whereas implants simply suppress ovulation and thicken cervical mucus through temporary hormonal manipulation.

Choice B rationale

Tubal ligation is a form of female surgical sterilization that involves cutting, tying, or cauterizing the fallopian tubes. This procedure creates a physical barrier that prevents the ovum from traveling toward the uterus and prevents sperm from reaching the egg. It is considered a permanent method because it requires a surgical intervention and is intended to be non-reversible. It is one of the standard options for couples seeking a final end to childbearing.

Choice C rationale

Vasectomy is a surgical procedure for male sterilization involving the occlusion or severance of the vas deferens. This prevents sperm from entering the ejaculate, thereby making fertilization impossible. It is a highly effective, permanent method of contraception that is typically performed as an outpatient procedure. Like tubal ligation, it is intended for individuals or couples who are certain they do not want any more children and are seeking a definitive, long-term surgical solution.

Choice D rationale

An intrauterine device is a small, T-shaped plastic or copper device inserted into the uterus to prevent pregnancy. While IUDs are incredibly effective and can remain in place for 3 to 10 years depending on the type, they are classified as long-acting reversible contraception. They do not involve surgical sterilization of the reproductive tracts. Once an IUD is removed by a healthcare provider, the client's fertility typically returns to its baseline immediately.

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After birth, a woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who:

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A couple with three children tells the nurse they are certain they do not want more children and asks about permanent contraception options. Which methods should the nurse include when discussing surgical sterilization? Select all that apply.

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

Explanation

A laboring woman asks the nurse, "Is my baby getting enough oxygen when I have these strong contractions?" Which response by the nurse demonstrates accurate understanding of placental physiology during labor?

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A pregnant woman at her prenatal visit mentions that her husband has been experiencing morning nausea, weight gain, and fatigue along with her during the pregnancy. He is worried something is wrong with him. The nurse should explain that these symptoms in expectant fathers are known as:

A nurse is reviewing the diet history of a newly pregnant woman. The woman reports eating mostly processed foods with limited fruits, vegetables, and lean meats. Which supplements should the nurse emphasize as MOST critical for this pregnancy?

The nurse guides the woman into the examination room and asks her to remove her clothes and put on an examination gown with the front open. The woman states "I have special undergarments that I do not remove for religious reasons.”. The most appropriate response from the nurse would be:

After birth, a woman telephones about her 4-day-old infant.

She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well.

Effective breastfeeding is indicated by the newborn who: