The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

A primiparous adolescent living at home with her parents and significant other.

A multiparous female with a large family living in the community.

A primiparous woman who has recently immigrated to the U.S. with her spouse.

A multiparous client who lives with her husband and his family members.

Answer and Explanation

The Correct Answer is C

A. A primiparous adolescent living at home with her parents and significant other: While being a young, first-time mother may pose challenges, the support system of living with parents and a significant other may help mitigate psychological risks.

B. A multiparous female with a large family living in the community: A woman with multiple children and a support system in the community is less likely to experience significant psychological difficulties, as she may be more experienced and have more resources to draw from.

C. A primiparous woman who has recently immigrated to the U.S. with her spouse: This woman is at high risk for psychological difficulties, such as postpartum depression, due to potential isolation, lack of support, cultural differences, and challenges adjusting to a new environment without an extended support network.

D. A multiparous client who lives with her husband and his family members: While living with extended family can sometimes present stress, this client has a support system, including both her husband and family members, which may help reduce the risk of psychological difficulties.

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Correct Answer is C

Explanation

A. Alert the charge nurse to the patient's condition: While it may be necessary to notify the charge nurse depending on the severity of the situation, the priority action is to address the immediate cause of the tachysystolic or tetanic contractions by turning off the oxytocin.

B. Reposition the fetal monitor transducers: Repositioning the transducers may be helpful for improving the quality of fetal heart rate monitoring but does not address the underlying issue of excessive uterine contractions and fetal distress.

C. Turn off the oxytocin infusion: The first action in response to tachysystolic or tetanic contractions and variable decelerations is to turn off the oxytocin infusion. Overstimulation of the uterus with oxytocin can cause uterine hyperstimulation, leading to fetal distress, and stopping the infusion can help resolve this.

D. Decrease the rate of the oxytocin infusion: Decreasing the oxytocin rate is less effective than completely turning off the infusion in the case of excessive contractions and fetal decelerations. Stopping the infusion entirely addresses the issue more directly.

A. Request hospital security to come to the department. B. Invite a colleague to document during the interview. C. Close the examination room door for privacy. D. Ask the client to describe the history of the injuries.

Correct Answer is D

Explanation

A. Request hospital security to come to the department: While security may be needed if the nurse perceives a threat, the immediate priority is to address the client’s concerns and gather a full history of the injuries. Security should only be considered if there are signs of imminent danger.

B. Invite a colleague to document during the interview: While it may be helpful to have a colleague present to document, the most important immediate action is to ensure the client feels comfortable and safe in disclosing the details of the injury. The nurse can ask the client about the history of the injuries first.

C. Close the examination room door for privacy: Ensuring privacy is important, but the nurse should first focus on gathering the client's account of the injury. Closing the door may not address the potential safety concerns or the need for a full and honest assessment of the situation.

D. Ask the client to describe the history of the injuries: This first action allows the nurse to assess whether there are signs of abuse, and it gives the client an opportunity to provide critical information. It is important to listen carefully and provide a safe, supportive environment for the client to disclose any concerns.

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The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is receiving oxytocin to augment early labor begins to experience tachysystolic or tetanic contractions with variable fetal heart decelerations. Which action should the nurse implement?

Correct Answer is C

Explanation

The nurse is initiating an interview with a client in the emergency department (ED) who presents with a fractured ulna and swollen, red lips and nose. The client's spouse is pacing outside the door of the examination room. Which action should the nurse take?

Correct Answer is D

Explanation

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