OB exam 4

A nurse is caring for a postpartum client with urinary tract infection. Which instruction would the nurse include in the teaching plan for the client to help prevent future infections? a. "empty your bladder frequently" b. "wear your elastic compression stockings" c. "avoid foods that are salty" d. "apply ice to the infected area"

a. "empty your bladder frequently"

A nurse is caring for a client who gave birth about 10 hours earlier. The nurse observes perineal edema in the client. What intervention should the nurse perform to decrease the swelling caused by perineal edema? a. apply ice b. use ointments locally c. apply moist heat d. use a warm sitz bath or tub bath

a. apply ice

On a follow-up visit to the clinic, a nurse suspects that a postpartum client is experiencing postpartum psychosis. Which finding would most likely lead the nurse to suspect this condition? a. delusional beliefs b. feelings of anxiety c. sadness d. insomnia

a. delusional beliefs

About 10 days following birth, a new mother visits her primary care provider with localized symptoms of redness, swelling, warmth, and a hard, inflamed vessel in one leg. The nurse should suspect which condition? a. femoral thrombophlebitis b. uterine atony c. mastitis d. subinvolution

a. femoral thrombophlebitis

A nurse is providing discharge instructions to a postpartum client about possible complications after returning home. For which finding will the client contact the health care provider? a. increasing amount and darkening of the color of lochia b. passing clots smaller than 1 inch (2.5cm) c. decreasing amount and lightening of the color of lochia d. palpating a firm fundus

a. increasing amount and darkening of the color of lochia

When monitoring a postpartum client 2 hours after birth, the nurse notices heavy bleeding with large clots. Which response is most appropriate initially? a. massaging the fundus firmly b. performing bimanual compressions c. adminsitering ergonovine d. notifying the primary care provider

a. massaging the fundus firmly

During pregnancy a woman's cardiovascular system expands to care for the growing fetus. After birth, during the early postpartum period, the woman eliminates the additional fluid volume she has been carrying. What is one way she does this? a. urinary elimination b. elimination of solid wastes c. being too tied to eat d. breathing off fluid vapor

a. urinary elimination

A woman presents to the clinic at 1-month postpartum and reports her left breast has a painful, reddened area. On assessment, the nurse discovers a localized red and warm area. The nurse predicts the client has developed which disorder? a. breast yeast b. mastitis c. plugged milk duct d. engorgement

b. mastitis

The LPN has reported that uterine massage is ineffective on a client. The nurse anticipates the health care provider will prescribe which medication to address this issue? a. ibuprofen b. oxytocin c. penicillin d. digoxin

b. oxytocin

The nurse is preparing discharge instructions for a postpartum woman who has developed DVT after a long and difficult birthing process. The nurse will include instruction on which medication for this client? a. NSAIDS b. anticoagulants c. opioid analgesics d. beta-blockers

b. anticoagulants

A nurse is assigned to care for a client with lacerations. The nurse knows that which factor would be the most likely cause of lacerations of the genital tract? a. history of hypertension b. birth of a large newborn c. excessive traction on umbilical cord d. development of endometritis

b. birth of a large newborn

The LVN/LPN will be assessing a postpartum client for danger signs of infection after a vaginal birth. What assessment finding would the nurse assess as a possible sign of infection for this client? a. presence of lochia rubra b. fever more than 100.4F c. fundus is above the umbilicus d. fundus is firm

b. fever more than 100.4F

When assessing a client's uterine fundus during the fourth stage of labor, the nurse palpates a soft, uncontracted fundus. Which of the following would the nurse do next? a. instruct the client to exercise b. gently massage the boggy fundus c. suggest complete bed rest d. suggest avoiding lifting weight

b. gently massage the boggy fundus

When planning the care for a client during the first 24 hours postpartum, the nurse expects to monitor the client's pulse and blood pressure frequently based on the understanding that the client is at risk for which condition? a. hemorrhoids b. hemorrhage c. thromboembolism d. cervical laceration

b. hemorrhage

The nurse is assisting a new mother who is several hours postpartum. Which reaction by the new mother should be of concern to the nurse? a. returns baby to the nursery because of fatigue b. ignores the newborn crying c. cuddles her baby close to her while feeding d. is hesitant to change the diaper

b. ignores the newborn crying

A nurse is developing a program to help reduce the risk of late postpartum hemorrhage in clients in the labor and birth unit. Which measure would the nurse emphasize as part of this program? a. administering broad-spectrum antibiotics b. inspecting the placenta after delivery for intactness c. manually removing the placenta at birth d. applying pressure to the umbilical cord to remove the placenta

b. inspecting the placenta after delivery for intactness

A nurse is caring for a client who has had a cesarean birth and has developed a wound infection. What precautions should be taken by the nurse as a primary prevention measure? a. apply ice packs every 12 to 24 hours b. keep the incisions clean and dry c. use a sitz bath once every 24 hours d. apply ice and heat alternatively

b. keep the incisions clean and dry

The nurse is assessing a client who is 14 hours postpartum and notes very heavy lochia flow with large clots. Which action should the nurse prioritize? a. assess her blood pressure b. palpate her fundus c. have her turn to her left side d. assess her perineum

b. palpate her fundus

Which finding would lead the nurse to suspect that a postpartum client is developing thrombophlebitis? a. edema in perineal area b. redness in lower legs c. diaphoresis d. increased lochia

b. redness in lower legs

What is the primary rationale for monitoring a new mother every 15 minutes for the first hour after delivery? a. to monitor the mother's blood pressure to note any elevations b. to check for postpartum hemorrhage c. to determine if the mother's milk is coming in d. to answer questions the new parents may have

b. to check for postpartum hemorrhage

A postpartum client reports urinary frequency and burning. What cause would the nurse suspect? a. uterine atony b. urinary tract infection c. subinvolution d. stress incontinence

b. urinary tract infection

The nursing instructor is leading a discussion exploring the various conditions that can result in postpartum hemorrhage. The instructor determines the session is successful when the students correctly choose which condition is most frequently the cause of postpartum hemorrhage? a. hematoma b. uterine atony c. perineal lacerations d. disseminated intravascular coagulation

b. uterine atony

When assessing a postpartum client who was diagnosed with a cervical laceration that has been repaired, what sign should the nurse report as a possible development of hypovolemic shock? a. warm and flushed skin b. weak and rapid pulse c. elevated blood pressure d. decreased respiratory rate

b. weak and rapid pulse

Which instruction would the nurse include in the teaching plan for a postpartum client with a history of thromboembolism to reduce the risk of a recurrence? a. refrain from performing leg exercises b. wear support hose or antiembolic stockings c. flex the muscles at the groin d. avoid pressure on the thigh muscles

b. wear support hose or antiembolic stockings

Which instruction would the nurse include in the teaching plan for a postpartum woman with mastitis? a. "Stop breastfeeding until the pain and swelling subside." b. "You'll need to take this medication to stop the milk from being produced." c. "Try applying warm compresses to your breasts to encourage the milk to be released." d. "Limit the amount of fluid you drink so your breasts don't get much fuller."

c. "Try applying warm compresses to your breasts to encourage the milk to be released."

The nurse is conducting discharge teaching with a postpartum woman. What would be an important instruction for this client? a. call her caregiver if amount of lochia decreases b. call her caregiver if lochia moves from serosa to alba c. call her caregiver if lochia moves from serosa to rubra d. call her caregiver if lochia moves from rubra to serosa

c. call her caregiver if lochia moves from serosa to rubra

The nurse is questioning the effective bonding of a client and her 2-day-old infant after noting signs of impaired bonding and attachment. Which actions does the nurse find concerning? a. making eye contact with the baby b. breastfeeding the infant on demand c. calling the baby "it" or "they" d. asking for assistance changing a diaper

c. calling the baby "it" or "they"

The nurse is performing an assessment for a client in the immediate postpartum period. Which assessment finding should the nurse prioritize? a. infection b. dehydration c. hemorrhage d. bladder distention

c. hemorrhage

The nurse is assessing a client 48 hours postpartum and notes on assessment: temperature 101.2oF (38.4oC), HR 82, RR 18, BP 125/78 mm Hg. The nurse should suspect the vital signs indicate which potential situation? a. dehydration b. normal vital signs c. infection d. shock

c. infection

A 17-year-old woman is living with a 21-year-old man. The man often comes home drunk and then becomes jealous. He refers to the woman as lazy, stupid, and useless and makes accusations about her talking with people while he is working to support her. He rarely hits her. Given this history, the nurse recognizes this client is at risk for which condition associated with pregnancy? a. gestational diabetes b. molar pregnancy c. postpartum depression d. postterm pregnancy

c. postpartum depression

When caring for a client with postpartum blues, which intervention would be most appropriate? a. recommend the client to a support group or to a mental health professional b. avoid allowing contact between the newborn and the client c. validate the client's emotions, allowing her to express them freely d. administer antidepressants as prescribed to lessen postpartum blues

c. validate the client's emotions, allowing her to express them freely

When developing a plan of care for a postpartum client, the nurse would identify which of the following as an expected outcome? a. difficulty providing care for the newborn b. foul-smelling lochia c. vital signs within acceptable limits d. evidence of urinary retention

c. vital signs within acceptable limits

A woman who delivered her infants 2 days ago asks the nurse why she wakes up at night drenched in sweat. She is concerned that this is a problem. The nurse's best reply would be a. "Many women sweat after delivery but you seem to be perspiring far more than normal. I'll call the doctor." b. "Often, when a postpartum woman perspires like you are reporting, it means that they have an infection." c. "I need to get your vital signs and check your fundus to be sure you are not going into shock." d. "Sweating is very normal for the first few days after childbirth because your body needs to get rid of all the excess water from pregnancy."

d. "Sweating is very normal for the first few days after childbirth because your body needs to get rid of all the excess water from pregnancy."

A client who is breastfeeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate? a. "your uterus is still shrinking in size; that's why you are feeling this pain" b. "let me check your vaginal discharge just to make sure everything is fine" c. "your body is responding to the events of labor, just life after a tough workout" d. "the baby's sucking releases a hormone that causes the uterus to contract"

d. "the baby's sucking releases a hormone that causes the uterus to contract"

The nurse is monitoring the woman who is 1 hour postpartum and notes on assessment the uterine fundus is boggy, to the right, and approximately 2 cm above the umbilicus. The nurse would conclude this is most likely related to which potential complication? a. urinary infection b. excessive bleeding c. a ruptured bladder d. bladder distention

d. bladder distention

A postpartum client calls the nurse into her room and asks her what to do with the "squirt bottle" she found in the bathroom. The client is referring to the peribottle used to clean her perineum. What instructions would the nurse provide the client to explain how to use it? a. fill the bottle with hot, sudsy water and wash the perineum four times per day b. fill the peribottle with sterile water and cleanse area after stooling c. fill the peribottle with one-quarter strength vinegar water and clean the perineum after voiding d. fill the peribottle with warm water and squeeze it so water flows from front to back after using the restroom

d. fill the peribottle with warm water and squeeze it so water flows from front to back after using the restroom

When doing a health assessment, at which location would the nurse expect to palpate the fundus in a woman on the second postpartum day and how should it feel? a. fundus height 4cm below umbilicus and midline b. fundus two fingerbreadths above symphysis pubis and hard c. fudus 4cm above symphysis pubis and firm d. fundus two fingerbreadths below umbilicus and firm

d. fundus two fingerbreadths below umbilicus and firm