Question 1

What is the first secretion produced by the breast?

Accepted Answer

The first secretion produced by the breast is colostrum, a nutrient-rich fluid that contains antibodies and important growth factors for the newborn. Prolactin is a hormone that stimulates milk production, but it is not the first secretion. False milk and whey are not terms commonly used in relation to breast milk production.

Question 2

A mother delivered her baby at midnight and it is now 9 a.m.She wants to sleep and asks the nurse to take care of the baby.What is this considered?

Accepted Answer

The mother's request for the nurse to take care of the baby is a normal "taking in" response. This is when the mother is focused on her own physical recovery after delivery and is more willing to depend on others to take care of her baby's needs. It is important for healthcare professionals to encourage rest and recuperation during this time.

Question 3

Within the first hour following a vaginal delivery,the nurse assesses the mother and finds the fundus is firm and there is a trickle of bright red blood.What should be the nurse's reaction to the assessment?

Accepted Answer

A firm fundus and a trickle of bright red blood in the first hour following vaginal delivery is a normal occurrence. This is due to the shedding of the placental site, and the uterine contractions help to minimize bleeding. It is important to continue to monitor the bleeding and fundal tone regularly.

Question 4

What is the name of the vaginal discharge that occurs immediately following delivery?

Accepted Answer

Lochia rubra is the name of the vaginal discharge that occurs immediately following delivery. Lochia serosa is a later stage of postpartum discharge, Lochia alba is the final stage of postpartum discharge, and Lochia palatine is not a term used in obstetrics.

Question 5

The new mother has decided not to breastfeed the baby.How should the nurse correctly instruct the mother to suppress her milk supply?

Accepted Answer

To suppress milk supply, the best choice is to apply a firm bra and ice packs. This will help reduce milk production and relieve discomfort. Pumping the breasts to remove milk will only stimulate further milk production. Applying warm, moist compresses can actually increase milk production. Restricting oral fluids can lead to dehydration and is not a safe or recommended method to suppress milk supply.

Question 6

During the immediate postpartum period,the mother has a temperature of 100.2°F (37.8°C),pulse 52,respirations 18,BP 138/84.What should the nurse do?

Accepted Answer

The vital signs presented are within normal limits for a postpartum mother. A slight elevation in temperature can be normal due to dehydration or exertion during labor, and a lower pulse rate is also common post-delivery.

Question 7

When is breast engorgement most likely to occur?

Accepted Answer

Breast engorgement is most likely to occur when the breast tissue becomes congested, often in the first few days after birth when milk production increases rapidly and the breasts are not emptied completely. Other contributing factors can include infrequent feeding or ineffective latch by the infant. Surrounding the areola, grasping the nipple firmly, or emptying the breast completely do not necessarily lead to engorgement.

Question 8

A new Native American mother tells the nurse that when she goes home,her mother-in-law will be caring for the baby while she rests.The nurse has concerns.What should the nurse do?

Accepted Answer

It is important for the nurse to respect and honor the cultural practices of the patient while also ensuring the safety and well-being of the mother and baby. The nurse can explore ways to blend cultural practices with safe health teaching and provide education on the importance of maternal-infant bonding and ambulation for recovery. This approach shows cultural competence and supports the patient's values while also promoting optimal postpartum recovery and care for the baby.

Question 9

Before initially feeding an infant,what reflex should the nurse assess?

Accepted Answer

The nurse should verify that the infant is able to swallow normally before feeding.

Question 10

Which of the following would be considered a normal assessment finding in a 1-day postpartum patient?

Accepted Answer

The common discomfort of after pains is a normal assessment finding at 1-day postpartum.The normal discharge 1-day postpartum would be lochia rubra,which is made up of mostly blood.The fundus would be palpated at the level of the umbilicus.Frequent voiding would be considered abnormal.

Question 11

The postpartum mother with a third degree laceration tells the nurse she is afraid to have a bowel movement because of her painful episiotomy.What should the nurse do?

Accepted Answer

Stool softeners are available to ease the pain of defecation caused by hemorrhoids and birth trauma.Suppositories or enemas are contraindicated in mothers with third or fourth degree lacerations.Pain medications can often cause constipation.Ambulation may aid in defecation,but will not soften the stool.

Question 12

What should be included in a teaching plan regarding breast engorgement?

Accepted Answer

Breast engorgement often starts in the axillary region (the area under the arms) because this area contains a lot of breast tissue. Engorgement can affect all breastfeeding women, not just those who choose not to breastfeed, and it typically occurs a few days after birth, not just on the first day or only near the nipple.

Question 13

What is the term for the cream cheese-like substance that protects the infant's skin from amniotic fluid?

Accepted Answer

Vernix caseosa is the creamy, cheese-like substance that covers an infant's skin in utero, protecting it from the amniotic fluid. Lanugo refers to the fine hair that covers a developing fetus, meconium is the first stool that a newborn passes, and desquamation refers to the shedding of dead skin cells.

Question 14

A new mother had spinal anesthesia during a cesarean delivery.She now has a desire to void and can wiggle her toes.What should be the nurse's response when the mother asks to go the bathroom?

Accepted Answer

The nurse should check that the mother is wearing slippers to ensure better footing.If the mother has a desire to void and can move her toes,there is no need for her to remain bedridden.

Question 15

What is the appropriate way to assess the fundus of the postpartum patient?

Accepted Answer

Using one hand on the lower uterine segment while the other hand locates the fundus of the uterus is the appropriate and recommended way to assess the fundus of the postpartum patient. This technique allows for the healthcare provider to accurately locate the position, tone, and consistency of the uterus. It also helps to identify any potential complications such as uterine atony or retained products of conception.

Question 16

Following delivery of the newborn,which nursing intervention should be carried out immediately?

Accepted Answer

The immediate nursing intervention after delivery of the newborn should be to warm the infant to prevent hypothermia which can cause respiratory distress and hypoglycemia. Weighing the infant can wait until after the initial stabilization, bathing can wait for at least 6 hours after delivery, and inoculations are not usually given immediately after birth.

Question 17

The nurse identifies that the newborn is jaundiced within the first 24 hours of birth,with jaundice occurring over bony prominences of the face and the mucous membrane.What type of jaundice does this represent?

Accepted Answer

Jaundice occurring within the first 24 hours of birth and over bony prominences of the face and mucous membrane is indicative of pathologic jaundice. Physiologic jaundice typically presents within the first week, while normal jaundice is not a recognized medical term. Transitory jaundice is also not a recognized medical term.

Question 18

Which statement would be a correct description of colostrum?

Accepted Answer

Colostrum is a slightly yellow fluid produced by mammary glands during the first few days after giving birth. It is higher in protein and lower in fat and carbohydrates compared to regular milk, and it also contains important antibodies to help protect the newborn from infection.

Question 19

When assessing a mother 12 hours following the delivery of a baby,where should the nurse expect to palpate the fundus?

Accepted Answer

After delivery, the uterus should be palpated to assess for firmness and height. The fundus should be at the level of the umbilicus immediately after delivery and should descend 1-2 cm every 24 hours. Therefore, 12 hours after delivery, the nurse should expect to palpate the fundus at the umbilicus.

Question 20

Where would acrocyanosis be assessed on a newborn?

Accepted Answer

Acrocyanosis is a blue or purple discoloration of the hands and feet commonly seen in newborns. It is most commonly assessed on the feet.

Quiz 28: Care of the Mother and Newborn