NUR 4455 Care of Families- Childbearing Nursing Exam 2 Fall 2025 at Florida International University
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Free NUR 4455 Care of Families- Childbearing Nursing Exam 2 Fall 2025 at Florida International University Questions
A nurse is teaching a postpartum client about breastfeeding. Which statement best describes the relationship between prolactin and oxytocin?
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Prolactin produces milk; oxytocin releases the milk during feeding.
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Prolactin decreases as milk supply increases.
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Prolactin causes milk ejection; oxytocin causes milk production.
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Both prolactin and oxytocin are released only when the baby cries.
Explanation
Prolactin and oxytocin work together to regulate breastfeeding. Prolactin, secreted by the anterior pituitary gland, stimulates the production of milk in the alveolar cells of the breasts. Oxytocin, released from the posterior pituitary gland in response to nipple stimulation, triggers the let-down reflex (milk ejection) by causing contraction of the myoepithelial cells surrounding the milk ducts. Together, these hormones ensure a continuous milk supply and effective feeding.
A postpartum woman at day 8 reports that her vaginal discharge has turned yellow-white and has no foul odor. The client denies pain or any urinary discomforts. Which interpretation is correct?
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Retained products of conception
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Early return of menstruation
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Normal progression to lochia alba
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Infection developing
Explanation
Lochia alba is the normal vaginal discharge that occurs from about day 7 to week 6 postpartum. It is typically yellow-white in color, has a fleshy or non-foul odor, and indicates normal healing of the uterine lining. The absence of pain, fever, or foul odor confirms that this is a normal physiological finding, showing proper uterine involution and no infection.
A nurse is educating a new and excited mother about breastfeeding. The nurse explains that the best time to initiate breastfeeding is:
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Within the first hour after birth which is considered the "golden hour"
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After the newborn’s first bath
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When the newborn is 24 hours old
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When the mother feels fully rested
Explanation
The first hour after birth, known as the “golden hour,” is the optimal time to begin breastfeeding. During this period, the newborn is awake, alert, and has a strong sucking reflex, making it the ideal time to establish the first latch. Early initiation promotes bonding, thermoregulation, and stimulation of oxytocin release, which helps the uterus contract and reduce postpartum bleeding. It also enhances long-term breastfeeding success and colostrum intake for the infant’s immune protection.
Which statement by a newly delivered woman who is breastfeeding indicates that she understands what to expect regarding her menstrual activity after childbirth?
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The client’s first menstrual cycle will be lighter upon return
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The client will not have a menstrual cycle for 6 months after birth
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Breastfeeding with formula supplementation will delay ovulation
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Breastfeeding frequency and duration influences the return of menstruation
Explanation
The return of menstruation after childbirth varies among breastfeeding women and is influenced by how often and how long the infant nurses. Frequent, exclusive breastfeeding delays the return of ovulation and menstruation through suppression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) due to elevated prolactin levels. However, once breastfeeding frequency decreases or formula is introduced, hormonal suppression lessens, and menstruation may return sooner.
A newborn is lying naked on a cold mattress near a drafty window. Which two types of heat loss are occurring simultaneously?
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Radiation and convection
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Conduction and evaporation
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Radiation and conduction
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Convection and evaporation
Explanation
In this scenario, the newborn is exposed to two mechanisms of heat loss:
●Radiation: Heat is lost from the baby’s body to nearby cooler surfaces, such as the cold window or wall, even without direct contact.
●Convection: Heat is lost to the cool air currents moving around the baby, such as from the drafty window.
Both processes occur when a newborn is unclothed in a cool environment, putting the baby at risk for hypothermia. The nurse should immediately dry, wrap, and move the newborn away from drafts or cold surfaces to prevent further heat loss.
The nurse is giving instructions for formula preparation. Which statement from the client indicates teaching was effective?
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"Formula can last up to 24 hours after being mixed with sterile water."
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"I can store an unopened bottle of formula at room temperature."
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"I can feed the baby leftover formula from the last feeding 3 hours ago."
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"I can warm the formula in the microwave because it's faster."
Explanation
Prepared infant formula should be refrigerated immediately after mixing and can be safely stored for up to 24 hours before feeding. This prevents bacterial growth and ensures nutritional safety for the newborn. Formula should be discarded after 24 hours if unused. When ready to feed, it should be warmed in a bowl of warm water, not microwaved.
A nurse is caring for a postpartum client and is explaining the process of involution. Which of the following statements is true?
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Postpartum uterus returns to its pre-pregnancy size by 8 weeks postpartum
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At the end of the third stage of labor, the postpartum uterus is positioned 3 cm above the umbilicus
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The decline of estrogen and progesterone causes self-destruction of excess uterine tissue
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After 2 weeks postpartum, the uterus can be palpated above the symphysis pubis
Explanation
Involution is the process by which the uterus returns to its pre-pregnancy size and condition after childbirth. The drop in estrogen and progesterone levels after delivery triggers autolysis, a process where excess hypertrophied uterine muscle cells self-digest and shrink. This hormonal shift enables the uterus to contract, decrease in size, and shed remaining tissue. By about 6 weeks postpartum, the uterus has typically returned to its pre-pregnancy size.
A postpartum client who delivered 24 hours ago continues to complain of severe perineal pain after being medicated with pain medication. The client’s vital signs are stable. The uterus is firm and midline. Which of the following assessments should the nurse perform?
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Reassess the fundus
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Reassess need for Oxytocin
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Assess client’s temperature
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Assess the perineum for hematomas
Explanation
A firm, midline uterus with severe, unrelieved perineal pain suggests the presence of a vaginal or vulvar hematoma rather than uterine atony or infection. Hematomas occur when blood collects under the tissues due to injury of blood vessels during delivery, often presenting with intense localized pain, pressure, and possible swelling or discoloration at the perineal site. Vital signs may remain stable initially despite significant blood loss into the tissue. The nurse should inspect and palpate the perineum carefully, report findings to the provider, and prepare for possible evacuation if the hematoma is large.
A postpartum mother is diagnosed with mastitis. Which of the following symptoms should the nurse identify as a common sign of mastitis?
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Continuous leakage of milk from both breasts
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Painful, swollen lymph nodes in the neck
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Severe pain in both breasts, with no redness or swelling
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Fever, redness, and swelling of the affected breast
Explanation
Mastitis is a bacterial infection of breast tissue, most commonly caused by Staphylococcus aureus, that typically develops in breastfeeding women, usually within the first 2–4 weeks postpartum. Classic symptoms include fever, localized redness, warmth, swelling, and pain in one breast. The affected area may feel hard or tender, and the mother may experience flu-like symptoms such as chills and fatigue. Prompt treatment with antibiotics, continued breastfeeding or pumping, and warm compresses is essential to prevent abscess formation.
A nurse is caring for a client who is breastfeeding and states that her nipples are sore. Which of the following interventions should the nurse recommend?
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Teach proper breastfeeding techniques and positions
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Keep the nipples covered between breastfeeding sessions
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Apply petroleum jelly to the nipples between feedings
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Advise mother to stop breastfeeding until nipple soreness resolves
Explanation
Nipple soreness is most often caused by improper latch or positioning during breastfeeding. The priority nursing intervention is to teach and correct breastfeeding techniques—ensuring the baby takes in both the nipple and part of the areola for a deep latch. Changing feeding positions (e.g., football hold, cradle hold, side-lying) also helps distribute pressure on the nipples. The nurse can additionally recommend expressing colostrum or breast milk and letting it air-dry on the nipples to promote healing.
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