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Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?

A.

Pain.

B.

Bleeding.

C.

Warmth.

D.

Redness.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Vaginal hematomas are usually associated with severe pain due to the accumulation of blood in the tissues.

 

Choice B rationale

Bleeding might be visible, but hematomas often cause internal accumulation, not external bleeding.

 

Choice C rationale

Warmth is not typically associated with hematomas; instead, pain and swelling are more common.

 

Choice D rationale

Redness may occur, but pain is the most consistent symptom.


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Correct Answer is B

Explanation

Choice A rationale

Administering oxytocin during shoulder dystocia can exacerbate the problem by increasing uterine contractions, making it harder to deliver the baby's shoulder.

Choice B rationale

Flexing the client's thighs sharply toward her abdomen, known as the McRoberts maneuver, helps to widen the pelvis and can often resolve shoulder dystocia by changing the angle of the pelvic bones.

Choice C rationale

While applying oxygen is a standard practice to improve maternal and fetal oxygenation, it does not specifically address shoulder dystocia and is not a primary intervention.

Choice D rationale

Applying downward pressure on the fundus is contraindicated as it can worsen shoulder dystocia by further impacting the shoulder against the pelvic bone.

Correct Answer is C

Explanation

Choice A rationale

Prolonged labor is not directly linked to drug use and does not present as an immediate complication.

Choice B rationale

Prolapsed cord is not associated with substance abuse and lacks direct connection to this scenario.

Choice C rationale

Cocaine use heightens the risk of abruptio placentae, a serious condition where the placenta detaches prematurely.

Choice D rationale

Retained placenta is a concern but less likely than abruptio placentae in the context of cocaine use.

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