Which woman is most likely to experience strong afterpains?
A woman who experienced oligohydramnios.
A woman who has had three previous births.
A woman who is bottle feeding her infant.
A woman whose infant weighed 5 pounds, 3 ounces.
The Correct Answer is B
Choice A rationale
Oligohydramnios refers to a decreased amount of amniotic fluid during pregnancy. Although it may relate to fetal or placental issues, it does not directly affect the uterine muscle tone or the involution process after birth, which is the primary cause of afterpains (painful uterine contractions).
Choice B rationale
Multiparity (having had multiple births, e.g., three previous births) significantly increases the likelihood of strong afterpains. With each subsequent pregnancy, the uterus loses some of its muscle tone and must contract more vigorously to involute and compress blood vessels, which leads to more intense and noticeable painful uterine cramping.
Choice C rationale
Breastfeeding stimulates the release of oxytocin from the posterior pituitary gland, a hormone that causes strong, frequent uterine contractions (afterpains). A woman who is bottle-feeding is less likely to experience strong afterpains compared to a breastfeeding mother because of the absence of this powerful hormonal stimulation.
Choice D rationale
Large infant size (macrosomia, often >4000 grams or ≈ 8 lb, 13 oz) or uterine overdistention (e.g., from multiple gestation or polyhydramnios) are known risk factors for increased afterpains because the uterus has been stretched more. A 7-lb, 3-oz infant is an average birth weight and does not predispose to stronger afterpains. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice C rationale
Seldom making eye contact with the newborn can indicate a lack of emotional engagement and difficulty forming an attachment bond, which is a critical process for healthy infant development. Direct eye contact is a foundational element in early parent-infant communication and bonding, signaling maternal interest and availability, making its absence a potential sign of a maladaptive attachment behavior requiring further assessment and intervention by the nurse.
Choice A rationale
Telling visitors how well her son is feeding demonstrates that the mother is actively observing and engaging with her infant's basic care and well-being. This behavior reflects a healthy maternal focus on the baby's needs and a proud, positive perception of her infant, which are all characteristics associated with the development of a secure and adaptive parent-infant attachment bond.
Choice B rationale
Talking and cooing to her son is a normal, adaptive, and positive communication behavior that encourages infant sensory development and reciprocal interaction. This use of "motherese" or baby-talk is instinctively designed to capture the infant's attention, facilitate language development, and strengthen the emotional connection necessary for a secure attachment to form between the parent and the infant.
Choice D rationale
Cuddling her son close to her is an integral tactile bonding behavior that provides the infant with essential physical closeness, warmth, and a feeling of security. This physical proximity promotes the release of oxytocin, a hormone critical for maternal feelings and bonding, and signifies a healthy desire for physical contact, which is highly indicative of an adaptive and affectionate attachment. —.
Correct Answer is B
Explanation
Choice A rationale
PPROM stands for Preterm Premature Rupture of Membranes, meaning the rupture occurs before 37 weeks of gestation (preterm) and before the onset of labor (premature). This patient is at 37 weeks, which is considered full term (or early term), and the rupture of membranes (SROM) occurred after the onset of contractions, which is termed rupture of membranes (ROM) or SROM.
Choice B rationale
PPROM is the rupture of the amniotic sac (bag of waters) occurring before 37 weeks of gestation (preterm) and before the onset of labor (premature). This patient is at 36 weeks (preterm, as the normal range is 37-42 weeks), and the membranes ruptured at 21: at home, suggesting it happened before the onset of active, regular uterine contractions that mark labor initiation.
Choice C rationale
This describes a possible urinary tract infection (UTI) or pyelonephritis (flank pain). While infection is a risk factor for PPROM and preterm labor, the symptoms described are not the definition of PPROM, which is a rupture of the membranes (often described as a gush or trickle of fluid) before 37 weeks gestation. The symptoms relate to maternal health, not specifically the membrane status.
Choice D rationale
This patient is at 39 weeks of gestation, which is considered full term. Even if the membranes ruptured before the onset of labor (PROM), it is not preterm rupture of membranes (PPROM). The term used for membrane rupture at or after 37 weeks is typically Premature Rupture of Membranes (PROM), or simply SROM if labor has started. —. ##
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