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Question 1 of 5.

The client, who is 20 days postpartum, telephones the perinatal clinic to tell the nurse that she is having heavy, bright red bleeding since hospital discharge 18 days ago. Which instruction to the client is correct?

A. “You need to come to the clinic immediately.”

B. “Decrease physical activity until the bleeding stops.”

C. “There is no need for concern; this is expected after birth.”

D. “Call next week if the bleeding has not stopped by then.”

Explanation: Lochia rubra that persists for longer than 2 weeks is suggestive of subinvolution of the uterus, which is the most common cause of delayed postpartum hemorrhage. The client should be seen in the clinic immediately to determine what is causing her abnormal lochial discharge. Increased physical activity can lead to increased lochial discharge, but the client is reporting continuous lochia rubra, which is abnormal. Lochia rubra is expected to last for up to 3 days after birth, not 20 days. Waiting until next week to be seen only delays determining the cause for her abnormal bleeding and increases the risk of the client for other complications.

Question 2 of 5.

Which explanation by the nurse correctly describes the occurrence of identical twins?

A. Two separate ova are fertilized by identical sperm.

B. The mother releases two identical ova.

C. One fertilized ovum divides into two identical halves.

D. Two identical ova are fertilized by two identical sperm.

Explanation: Identical twins result from one fertilized ovum splitting into two identical embryos, sharing the same genetic material.

Question 3 of 5.

In the primigravid client, when is fetal movement typically felt for the first time?

A. Between 10 and 14 weeks' gestation

B. Between 16 and 20 weeks' gestation

C. Between 22 and 26 weeks' gestation

D. Between 28 and 32 weeks' gestation

Explanation: Primigravid women typically feel fetal movement (quickening) between 16 and 20 weeks, later than multigravida women.

Question 4 of 5.

Which method best promotes client comfort during the pelvic examination?

A. Have the client lift her head off the table.

B. Have the client press her back into the examination table.

C. Have the client tighten her buttocks.

D. Tell the client to let her knees fall outward.

Explanation: Letting the knees fall outward relaxes the pelvic muscles, reducing discomfort during the pelvic examination.

Question 5 of 5.

Which nursing instructions concerning exercise during pregnancy are accurate? Select all that apply.

A. Avoid exercising during hot, humid weather.

B. Avoid exercises involving bouncing or jumping movements.

C. Drink plenty of fluids before and after exercising.

D. Limit strenuous activity to no more than 60 minutes a session.

E. Perform exercises only in the supine position.

F. Limit exercising to once per week.

Explanation: Exercising in hot weather risks overheating, bouncing movements may strain joints, and hydration is crucial. Supine exercises are avoided late in pregnancy.

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