Maternal Lipp Questions

A nurse is caring for a woman who gave birth to her baby boy 2 hours ago. The nurse notes that the woman's perineal pad contains some small clots and a moderate amount of lochia has accumulated under her buttocks. What is the first action the nurse should take at this time? 1. request a prescription to administer oxytocin 2. perform an in and out catheter immediately 3. measure blood loss by measuring perineal pad 4. check fundus for position and consistency

4. check fundus for position and consistency

A multigravida 30 year old woman has given cesarean birth to a healthy term neonate due to an abnormal fetal heart rate tracing. At 2 hours postpartum, the nurse assesses the client's urinary catheter and observes the client urine is slightly red-tinged. What should the nurse do next? 1. continue to monitor the client's input and output 2. palpate the client's fundus gently every 15 minutes 3. assess the placement of the foley catheter 4. contact the HCP for further instructions

4. contact the HCP for further instructions

A multiparous client at 24 hours postpartum is found to have swelling and pain in her right leg. She demonstrates a positive Homans sign with discomfort. What should the nurse do next? 1. Place a cold pack on the clients perineal area 2. Place the client in semi-Fowlers position 3. Notify the clients HCP immediately 4. ask the client to ambulate around the room

3. Notify the clients HCP immediately

A nurse is explaining basic principles of asepsis and infection control to a client who has a respiratory tract infection following birth. The nurse determines the client understands principles of infection control to follow when the client makes which statement? 1. "I must ask visitors to wear a mask" 2. "I must wear gloves when I handle my baby" 3. "I must use individual client care equipment" 4. "I must practice frequent handwashing"

4. "I must practice frequent handwashing"

Carboprost was injected into the uterus of a client to treat uterine atony during a cesarean birth. In preparing to care for this client postpartum, the nurse should assess the client for which common adverse effects of the medication? 1. vertigo an confusion 2. nausea and diarrhea 3. restlessness and increased vaginal bleeding 4. headache and hypertension

2. nausea and diarrhea

After teaching a primaparous client about treatment and self care of mastitis of the right breast, the nurse determines that the client needs further instruction when she makes which statement? 1. I can apply localized heat to the infected area 2. I should increase my fluid intake to 2000 ml/day 3. I will need to take antibiotics for 7 to 10 days before I am cured 4. I should begin breastfeeding on the right side to decrease the pain

4. I should begin breastfeeding on the right side to decrease the pain

A postpartum woman has unrelenting pain in her rectum after vaginal birth despite administration of pain medications. Which action is most indicated? 1. administering additional pain medications 2. assessing the perineum 3. reassuring the client that the pain is normal after vaginal birth 4. preparing a warm sitz bath for the client

2. assessing the perineum

Which intervention would be most important for the nurse to encourage in a primaparous client diagnosed with endometritis who is receiving IV antibiotic therapy? 1. Ambulate to the bathroom frequently 2. discontinue breastfeeding temporarily 3. maintain bed rest in semi fowler's position 4. restrict visitors to prevent contamination

3. maintain bed rest in semi fowler's position

A primiparous client diagnosed with cystitis at 48 hours postpartum who is receiving IV ampicillin asks the nurse "can I still continue to breastfeed my baby?" What should the nurse tell the client? 1. You can continue to breastfeed as long as you want to do so 2. Alternate your breastfeeding with formula feeding to help you rest 3. you will need to discontinue breastfeeding until the antibiotic therapy is stopped. 4. you will need to modify your technique by manually pumping your breasts

1. You can continue to breastfeed as long as you want to do so

The nurse is caring for a woman who gave birth vaginally 4 hours ago. Which factors would likely contribute to the development of endometritis in this woman? Select all that apply 1. manual removal of placenta 2. in and out catheterization during labor 3. epidural use 4. prolonged labor 5. placement of fetal scrap electrode

1. manual removal of placenta 4. prolonged labor 5. placement of fetal scrap electrode

The nurse is assessing a client who had a cesarean birth 12 hours ago. Findings include a distended abdomen with faint bowel sounds x 1 quadrant, fundus firm at umbilicus, lochia scant, rubra, and pain rated at 2 on a scale of 1 to 10. The IV and Foley catheter have been discontinued and the client received medication 3 hours ago for the pain. The client can have pain medication every 3 to 4 hours. What should the nurse do first? 1. give the client pain medication 2. have the client use the incentive spirometry 3. ambulate the client from the bed to the hallway and back 4. encourage the client to begin caring for her baby

3. ambulate the client from the bed to the hallway and back

The nurse places inflatable compression sleeves on the legs of a client undergoing a cesarean birth under regional anesthetic. When does the nurse tell the client that the sleeves will be removed? 1. after sensation returns to the lower extremities 2. when the platelet levels return to normal 3. when the client resumes ambulating 4. just prior to the clients discharge

3. when the client resumes ambulating

A primaparous client who underwent a cesarean birth 30 minutes ago is to receive Rho(D) immune globulin. The nurse should administer the medication within which time frame after birth? 1. 12 hours 2. 24 hours 3. 48 hours 4. 72 hours

4. 72 hours

A primaparous client 3 days postpartum is to be discharged on heparin therapy. After teaching her about possible adverse effects of heparin therapy, the nurse determines that the client needs further instruction when she states that the adverse effects include which symptom? 1. epistaxis 2. bleeding gums 3. slow pulse 4. petechiae

3. slow pulse

A breastfeeding postpartum client experiencing breast engorgement tells the nurse that she has applied cabbage leaves to decrease her breast discomfort. What is the nurse's best response? 1. Using cabbage leaves to relieve engorgement is considered a folk remedy 2. I'm concerned that the cabbage leaves may harm your nursing baby 3. I need to notify your HCP immediately that your using cabbage leaves 4. let me know if you get relief using the cabbage leaves

4. let me know if you get relief using the cabbage leaves

A nurse is walking down the hall in the main corridor of a hospital when the infant security alert system sounds and a code for an infant abduction is announced. The first responsibility of the nurse when this situation occurs is to do which of the following? 1. move to the entrance of the hospital and check each person leaving 2. go to the ob unit to determine if they need help with the situation 3. call the nursery to ask which baby is missing 4. observe individuals in the area for large bags or oversized coats

4. observe individuals in the area for large bags or oversized coats

During the first hour postpartum, assessment for a multiparous client who gave cesarean birth to a neonate weighing 10 lbs, 2 oz reveals a soft fundus with excessive lochia rubra. The nurse should include which interventions in the client's plan of care? 1. administration of IV oxytocin 2. placement of the client in a side lying position 3. rigorous fundal massage every five minutes 4. preparation for an emergency hysterectomy

1. administration of IV oxytocin

While the nurse is caring for a primiparous client with celphalopelvic disproportion 4 hours after a cesarean birth, the client requests assistance in breastfeeding. To promote maximum maternal comfort, which position would be most appropriate for the nurse to suggest? 1. football hold 2. scissors hold 3. cross cradle hold 4. cradle hold

1. football hold

A primiparous client who was diagnosed with hydramnios and breech presentation while in early labor is diagnosed with early postpartum hemorrhage at 1 hour after a cesarean birth. The client asks "Why am I so much?" The nurse responds based on the understanding that the most likely cause of the uterine atony in this client is which factor? 1. trauma during labor and birth 2. moderate fundal massage after birth 3. lengthy and prolonged second stage of labor 4. overdistention of the uterus from hydramnios

4. overdistention of the uterus from hydramnios

The night nurse has completed the change of shift report. As the day nurse makes rounds on a postpartum client receiving magnesium sulfate, it is noted the client developed significantly elevated blood pressure during the past shift. Further assessment reveals the magnesium sulfate rate is infusing well below the prescribed rate. In addition to adjusting the infusion rate and notifying the HCP, what is the most important action by the nurse? 1. Complete an incident report 2. Discuss the matter with the nurse the next time she works. 3. Ask the charge nurse if an incident report is necessary. 4. Evaluate the client's BP for 4 hours before making a decision

1. Complete an incident report

A multigravida prenatal client with a history of postpartum depression tells the nurse that she is taking measures to make sure that she does not suffer that complication, including taking St. John's wort. What is the most important assessment for the nurse to make? 1. current medications 2. fetal growth 3. liver functions 4. mood status

1. current medications

A primaparous client who had a vaginal birth 1 hour ago voices anxiety because she has a nephew with Down syndrome. After teaching the client about Down syndrome, which client statement indicates the need for additional teaching? 1. down syndrome is an abnormality that can result from a missing chromosome 2. down syndrome usually results in some degree of mental retardation 3. there are several methods available to determine whether my baby has down syndrome 4. older mothers are more likely to have a baby with chromosomal abnormalities

1. down syndrome is an abnormality that can result from a missing chromosome

While caring for a postpartum client who is receiving treatment with bed rest and IV heparin therapy for a deep vein thrombosis, the nurse should contact the client's HCP immediately if the client exhibits which symptom? 1. pain in her calf 2. dyspnea 3. hypertension 4. bradycardia

2. dyspnea

Which measure would the nurse expect to include in the teaching plan for a mulitparous client who gave birth 24 hours ago and is receiving IV antibiotic therapy for cystitis? 1. limiting fluid intake to 1 L daily to prevent overload 2. emptying the bladder every 2 to 4 hours while awake 3. washing the perineum with povidone-iodine after voiding 4. avoiding the intake of acidic fruit juices until the treatment is discontinued

2. emptying the bladder every 2 to 4 hours while awake

A 26 year old primiparous client is seen in the urgent care clinic two weeks after giving birth. The client, who is breastfeeding, is diagnosed with mastitis of the right breast. The client asks the nurse, "can I continue breast feeding?" What should the nurse tell the client? 1. you can continue to breastfeed, feeding your baby more frequently 2. you can continue once your symptoms begin to decrease 3. you must discontinue breastfeeding until antibiotic therapy is completed 4. you must stop breastfeeding because the breast is contaminated

1. you can continue to breastfeed, feeding your baby more frequently

A teen client, who is 1 week postpartum, is concerned about the possibility of postpartum depression because she has a history of depression. Which comment by the client would indicate that she understood the nurse's teaching about the postpartum period and her risks for postpartum depression? 1. sleep should not be too much of a problem because the baby will soon start to sleep through the night 2. since I am breastfeeding, I can eat all the food I want and not feel fat. The baby will use all of the calories 3. If I'm feeling guilty or not capable of caring for the baby and am not sleeping or eating well, I need to contact the office 4. I'm going to give the baby the best care possible without asking anyone for help to show all the people who think I can't do it

3. If I'm feeling guilty or not capable of caring for the baby and am not sleeping or eating well, I need to contact the office

A 15 year old primaparous client is being cared for in the hospitals birthing center after vaginal birth of a viable neonate. The neonate is being placed for adoption through a social service agency. Four hours postpartum, the client asks if she can feed her baby. What response would be most appropriate? 1. I'll bring the baby to you for feeding 2. I think we should ask your HCP if this is a good idea for you 3. it's not a good idea for you to have any contact with the baby 4. I'll check with the social worker to see if the adopting parent will allow this

1. I'll bring the baby to you for feeding

4 hours after cesarean birth of a neonate weighing 8 lbs, 13 oz, the primaparous client asks "If I get pregnant again will I need to have a cesarean?" When responding to the client, the nurse should base the response to the client about VBAC on which standard of practice? 1. VBAC may be possible if the client has not had a classic uterine incison 2. a history of rapid labor is a necessary criteria for VBAC 3. A low transverse incision contraindicates the possibility for VBAC 4. VBAC is not possible because the neonate was large for gestational age

1. VBAC may be possible if the client has not had a classic uterine incison

During a home visit to a primaparous client who gave birth vaginally 14 days ago, the client says "I have been crying a lot the past two days. I just feel so awful. I am a rotten mother. I just do not have any energy. Plus my husband just got laid off from his job" The nurse observes that the clients appearance is disheveled. What would be the nurse's best response? 1. these feelings commonly indicate symptoms of postpartum blues and are normal. They will go away in a few days. 2. I think you're probably overreacting to the labor and birth process. You're doing the best you can as a mother 3. it's not unusual for some mothers to feel depressed after the birth of a baby. I'm going to contact your HCP 4. This may be a symptom of a serious mental illness. I think you should probably go to the hospital

3. it's not unusual for some mothers to feel depressed after the birth of a baby. I'm going to contact your HCP

A mulitparous client visits the urgent care center 5 days after a vaginal birth, experiencing persistent lochia rubra in a moderate to heavy amount. The client asks the nurse "why am I continuing to bleed like this?" The nurse should instruct the client that this type of postpartum bleeding is most likely caused by which problem? 1. uterine atony 2. cervical lacerations 3. vaginal lacerations 4. retained placental fragments

4. retained placental fragments

Prophylactic heparin therapy is prescribed to treat thrombophlebitis in a multiparous client who gave birth 24 hours ago. After instructing the client about the medication, the nurse determines that the client understands the instructions when she states which as the purpose of the drug? 1. to thin the blood clots 2. to increase the lochial flow 3. to increase the perspiration for diuresis 4. to prevent further blood clot formation

4. to prevent further blood clot formation

The nurse asses a client, who delivered vaginally 6 days ago, during a home visit. Which finding should the nurse report immediately to the HCP? select all that apply 1. foul smelling lochia 2. engorged breasts bilaterally 3. client who cries easily 4. soaking 1 peripad every 3 to 4 hours 5. temperature of 100.8 F

1. foul smelling lochia 5. temperature of 100.8 F

A postpartum multiparous client diagnosed with endometritis is to receive IV antibiotic therapy with ampicillin. Before administering this drug, the nurse must take which action? 1. Ask the client if she has any drug allergies 2. assess the client's pulse rate 3. Place the client in a side lying position 4. check the client's perineal pad

1. Ask the client if she has any drug allergies

The nurse is catheterizing a client who cannot void after a normal birth 8 hours ago. The nurse begins the catheterization process and the client states "I forgot to tell the nurse I get hives to povidone-iodine" The nurse should take which steps in order of priority from first to last? 1. document the incident 2. clean povidone-iodine from the client's vaginal area 3. notify the HCP prescribing catheterization 4. file an incident report.

2,3,1,4

After being treated with heparin therapy for thrombophlebitis, a multiparous client who gave birth 4 days ago is to be discharged on oral warfarin. After teaching the client about the medication and possible effects, which of the following client statements indicates successful teaching? 1. "I can take ibuprofen if I get uterine cramps" 2. "I will need my INR drawn every week" 3. "I should use only waxed dental floss when caring for my teeth" 4. "I need to refrain from eating green leafy vegetables"

3. "I should use only waxed dental floss when caring for my teeth"

Four days after a vaginal birth, a client has excessive lochia rubra with clots. The HCP prescribes carboprost .25 mg intramuscularly. Which statement by client reflects the need for more teaching about carboprost? 1. This medication may cause nausea and vomiting 2. this medication sometimes causes hypotension that leads to dizziness 3. I will also receive medication to help prevent severe diarrhea 4. I may run a fever after being treated with carboprost

2. this medication sometimes causes hypotension that leads to dizziness

thirty six hours after a vaginal birth, a mulitparous client is diagnosed with endometritis. When assessing the client, which symptom would the nurse expect to find? 1. profuse amounts of lochia 2. abdominal distension 3. nausea and vomiting 4. fever >100.4 F

4. fever >100.4 F

A multigravid client gave birth vaginally 2 hours ago. A family member notifies the nurse that the client is pale and shaky. Which are the priority assessments for the nurse to make? 1. blood glucose and vital signs 2. temperature and level of consciousness 3. uterine infection and pain 4. fundus and lochia

4. fundus and lochia