NCLEX Test-Taking Strategy Tip

Tip #5: Before considering the options, think about the characteristics of the condition and critical nursing concepts.

Example: A woman who gave birth 3 days ago returns to the clinic with complaints of soreness and fullness in her breasts and states that she wants to stop breastfeeding her infant until her breasts feel better. What is the best nursing response?

This is a positive question. The answer will be a true statement. Think about breastfeeding and the common discomforts and problems the client encounters. Don't look at the options yet. Think, 'Is it normal to have fullness and soreness in the breasts during the first 3 days of lactation, and what happens if she stops breastfeeding the infant?" Now evaluate the options:

1. Show the client how to apply a breast binder to decrease the discomfort and the production of milk.
2. Tell the client that breast fullness may be a sign of infection and she will not be able to continue breastfeeding.
3. Suggest to the client that she decrease her fluid intake for the next 24 hours to temporarily suppress lactation.
4. Explain to the client that the breast discomfort is normal and that the infant's sucking will promote the flow of milk.

In this question, option 4 is correct. Initially, breast soreness may occur for about 2 to 3 minutes at the beginning of each feeding until the let-down reflex is established. Options 1, 2, and 3 would decrease her milk production; the question did not state that she wanted to quit breastfeeding permanently.

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