Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
57. A client, who is gravida 5, para 4, delivered a 6-pound, 5-ounce infant 2 hours ago. The client is complaining of severe uterine cramping while breastfeeding. A nurse knows that these symptoms are most likely due to:
Test-Taking Tip
Cramping is a sign of contracting of the uterus, not uterine atony, which is the opposite (a lack of cramping). Therefore, eliminate that option.
Content Area: Maternity, Postpartum; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Ante/Intra/Postpartum and Newborn Care
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is incorrect because mastitis is an infection of the breast that occurs postpartum, but is unrelated to uterine cramping. Answer 2 is correct because breastfeeding causes the release of prolactin and oxytocin. Oxytocin is a hormone that causes uterine contractions. The release of oxytocin while breastfeeding speeds uterine involution. This may also cause cramps while breastfeeding in the postpartum period. Cramping is more severe in clients who are multiparous. Answer 3 is incorrect because uterine atony is the failure of the uterine muscles to contract normally after the baby and placenta are delivered; there is no cramping with uterine atony. Answer 4 is incorrect because postpartum endometritis is an infection of the endometrium or decidua, extending into the myometrium and parametrial tissues, which is the most common cause of postpartum fever. It does not cause cramping during breastfeeding.
