Which patient would be at the highest risk for postpartum hemorrhage?
One who births in the lithotomy position.
One who receives uterine massage postpartum.
One whose third stage lasts less than 10 minutes.
One who gives birth to an infant weighing 9 pounds (4310 grams).
The Correct Answer is D
Choice A rationale
While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.
Choice B rationale
Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.
Choice C rationale
A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.
Choice D rationale
Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Elastic stockings help improve venous return, reducing clot propagation in thrombophlebitis. Proper usage minimizes symptoms like pain and swelling, and supports overall vein health, crucial for recovery and preventing complications.
Choice B rationale
Massaging an affected leg with thrombophlebitis is contraindicated as it increases the risk of clot dislodgement, potentially leading to a life-threatening pulmonary embolism. This misconception highlights the need for further client education.
Choice C rationale
Avoiding prolonged sitting prevents venous stasis and encourages circulation, which is vital in thrombophlebitis management to prevent worsening of clotting and associated complications such as pain or swelling.
Choice D rationale
Elevating the affected leg reduces swelling and promotes venous drainage, alleviating discomfort associated with thrombophlebitis. This intervention supports the resolution of inflammation in the superficial veins.
Correct Answer is C
Explanation
Choice A rationale
Feeling tired and wanting to sleep longer postpartum is common due to disrupted sleep from infant care, but it doesn't specifically indicate postpartum depression, which involves significant mood and emotional changes.
Choice B rationale
Occasional headaches postpartum can result from hormonal changes or stress, resolving with analgesics like Tylenol, and are not indicative of postpartum depression without associated mood disturbances like sadness or crying episodes.
Choice C rationale
Persistent crying and daily sadness are hallmark signs of postpartum depression, linked to hormonal imbalances, disrupted serotonin regulation, and social or emotional factors affecting maternal mental health postpartum.
Choice D rationale
Restlessness may be attributed to anxiety, but it alone doesn't conclusively diagnose postpartum depression, which involves deeper and more pervasive mood changes such as sadness or emotional withdrawal.
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