O.B. Chapter 28

In which order would the nurse perform a disposable type of sitz bath for a postpartum patient with sever lacerations and hemorrhage?

1) Clamp the tubing and fill the bag with warm water 2) Raise the toilet seat and place the bath in the bowl 3) Place the container above the toilet bowl 4) Attach the tube into the groove at the front of the bath 5) Loosen the tube clamp to regulate the rate of flow

Which instructions would the nurse give to a new mother regarding umbilical cord care? A) "Apply alcohol on the cord stump daily to keep it dry until it falls off" B) "Apply Vaseline to the cord stump several times a day to keep it moist until it comes off" C) "Gently manipulate the cord stump side to side until it loosens and can be easily removed" D) "Place the infant in warm bathwater to help the cord stump soak off over the next 7-10 days"

A) "Apply alcohol on the cord stump daily to keep it dry until it falls off"

Which statement by the postpartum patient would require the nurse to reinforce teaching about self-care after discharge? A) "I can't wait to soak in my jacuzzi tub" B) "I will follow up with my doctor in 6 weeks" C) "I must wipe from front to back when I urinate." D) "I should notify the health care provider if I have a fever."

A) "I can't wait to soak in my jacuzzi tub"

Which physical signs and symptoms might the postpartum patient experience following delivery? Select all that apply. A) A normal bowel movement within 2-3 days B) Increased diaphoresis, most commonly at night C) A low-grade fever the first 48 hours after delivery D) Increased urination beginning 4-6 weeks after delivery E) Bright red vaginal drainage that will saturate one pad every 15 minutes

A) A normal bowel movement within 2-3 days B) Increased diaphoresis, most commonly at night D) Increased urination beginning 4-6 weeks after delivery

While caring for a lactating patient, the nurse suggests that the patient place the infant on her shoulder after feeding. Which reason for this suggestion is best? A) To promote burping in the infant B) To encourage regurgitation of milk C) To prevent constipation in the infant D) To retract excess milk from the infant

A) To promote burping in the infant

Which sign and symptom would indicate to the nurse that a newly postpartum patient may be in shock? Select all that apply. A) Weakness B) Warm Skin C) Tachycardia D) Gray skin tone E) Increased blood pressure

A) Weakness C) Tachycardia D) Gray skin tone

Which statement by the patient indicates that the nurse's instructions about breastfeeding were misunderstood? A) "I will wear a well-fitting and supportive bra." B) "As long as I breast-feed, I can't get pregnant." C) "Taking Tylenol before breastfeeding can help the pain." D) "My breast can become engorged if I do not feed regularly."

B) "As long as I breast-feed, I can't get pregnant."

Which statement by a new mother would warrant a review of the infant's cord care? A) "The cord will come off within 10 days" B) "I must place the cord under the diaper" C) "I will not place the baby in water until the cord comes off." D) "Alcohol should be placed on the cord with diaper changes."

B) "I must place the cord under the diaper"

Which intervention would the nurse institute for a patient who has a pulse rate of 120 bpm, a 60/48 blood pressure, and cool and clammy skin? Seclect all that apply A) Prescribe Oxytocin (pitocin) B) Administer blood as prescribed C) Massage the fundus D) Elevate the legs to 30 degrees E) Give oxygen, if prescribed F) Maintain IV fluids

B) Administer blood as prescribed C) Massage the fundus D) Elevate the legs to 30 degrees E) Give oxygen, if prescribed F) Maintain IV fluids

Which essential information would the nurse include as part of the teaching process when administering the rubella vaccine to a recently delivered mother? A) A consent form will need to be signed B) The patient should avoid conceiving for at least 3 months C) The medication is known to cause a rash D) The injection may cause some discomfort

B) The patient should avoid conceiving for at least 3 months

The nurse is caring for a pt who had a c-section delivery and was administered general anesthesia. Which reason would the nurse have for suggesting that the patient walk at frequent intervals and avoid continuous bed rest? A) To help reduce the pain B) To help promote bowel function C) To help enhance milk production D) To help reduce an elevated temperature

B) To help promote bowel function

For which reason would the nurse advise a postpartum patient to place the newborn on the right side after feeding? A) To facilitate voiding B) To prevent regurgitation C) To prevent suffocation D) To enhance blood supply

B) To prevent regurgitation

For which reason would a lactating mother lightly brush the infant's lips with the nipple? A) To break the milk suction B) To promote rooting reflex C) To reduce pain while feeding D) To prevent aspiration of the milk

B) To promote rooting reflex

For which reason would the nurse administer vitamin K intramuscularly to a new born immediately after birth? A) To reduce the risk of jaundice B) To reduce the risk of bleeding C) To reduce the risk of cold stress D) To reduce the risk of pneumonia

B) To reduce the risk of bleeding

Which behavior by a new breastfeeding mother would call for immediate corrective action? A) Burping the infant after 15 minutes of feeding B) Holding the breast away from the infant's nostrils C) Swiftly removing the breast from the infant's mouth D) Allowing the infant to feed on both breast, as needed

C) Swiftly removing the breast from the infant's mouth

The nurse is reviewing the lab reports of a postpartum pt and the newborn and expects the health care provider to prescribe RhoGAM to the patient. Which finding enabled the nurse to reach this conclusion? A) The pt and the baby are both Rh positive B) The pt and the newborn are both Rh negative C) The pt is Rh negative and the baby is Rh positive D) The pt is Rh positive and the baby is Rh negative

C) The pt is Rh negative and the baby is Rh positive

Which reason explains why the pt holds her breast away from the infant's nostrils while breastfeeding the infant? A) The pt is trying to protect the newborn's oral mucosa B) The pt is encouraging the newborn to latch on and feed C) The pt is trying to promote proper respiration in the infant D) The pt is having severe pain while holding the breast for breastfeeding

C) The pt is trying to promote proper respiration in the infant

Which statement regarding jaundice is accurate? A) The discoloration occurs in all infants and is a normal process B) The yellow color will most likely disappear within 7-10 days C) This jaundice is likely related to maternal-fetal blood incompatibility D) This is a permanent condition and the infant's skin will retain this color

C) This jaundice is likely related to maternal-fetal blood incompatibility

A labor and delivery nurse explains perineal care to a patient after delivery. Which action by the patient indicates a need for further teaching? A) Wiping the perineal area from front to back B) Spraying the perineal area with water after voiding C) Vigorously wiping the perineal area after urinating D) Changing the perineal pad after voiding and when soiled

C) Vigorously wiping the perineal area after urinating

Which symptom would the nurse monitor for in the postpartum patient to ensure safe administration of oxytocin? Select all that apply. A) Pyrosis B) Swelling C) Water intoxication D) Irregular Heartbeat E) Decreased blood pressure

C) Water intoxication D) Irregular Heartbeat E) Decreased blood pressure

A postpartum nurse is rounding on a patient 3 hours after vaginal delivery. Which statement by the patient would be of concern to the nurse? A) "This is the most beautiful baby in the world" B) "I can't wait to dress the baby in a blue outfit" C) "The baby must be hungry; he is breastfeeding well." D) "What a disappointment; I thought I was having a girl"

D) "What a disappointment; I thought I was having a girl"

Which intervention will the nurse expect to be most beneficial for an infant with severe bleeding after circumcision? A) Applying 2% phenol at the site of bleeding B) Cleaning continuously at the site of bleeding C) Applying gently pressure at the site of bleeding D) Arranging for the ligation of the bleeding blood vessel

D) Arranging for the ligation of the bleeding blood vessel

Which condition would be a contraindication to the patient taking ibuprofen for incisional pain? A) Arthritis B) Migraines C) Pancreatitis D) Kidney Failure

D) Kidney Failure

Which reflex is being demonstrated when the newborn curls the toes downward? A) Moro's B) Stepping C) Palmar Grasp D) Planter Grasp

D) Planter Grasp

The vital signs of a new born are as followed: Temp 97.9 Pulse 140 bpm Respiration 34 bpm With brief periods of apnea, and BP of 80/40 mm Hg with an increase in systolic pressure when crying. Which nursing action would be best?

Realize that these vital signs are normal for a newborn, and document the data on the flow sheet

Which nursing concern for a breastfeeding mother is related to lactation issues? Select all that apply. A) Anxiety related to lactation expectations B) Decreased calorie intake because of lactation needs C) Potential for infection related to dry, cracked nipples D) Potential for dehydration because of fluid requirements E) Potential for constipation because of fluid requirements

A) Anxiety related to lactation expectations B) Decreased calorie intake because of lactation needs C) Potential for infection related to dry, cracked nipples

Which reason would the nurse give to the mother of a newborn on why not to feed the infant cow's milk? A) Causes nausea and skin rashes B) Increases glucose level to 45 mg/dL C) Impairs swallowing reflex D) Causes constipation

A) Causes nausea and skin rashes

Which action by the nursing mother will support milk production and promote infant comfort? Select all that apply. A) Drinking 8-10 glasses of fluid daily B) Avoiding spicy foods, chocolate, and onions C) Drinking 2-3 alcoholic beverages per day D) Continuing taking prenatal vitamins and minerals until they are gone E) Consuming more protein and approximately 1500 extra calories daily

A) Drinking 8-10 glasses of fluid daily B) Avoiding spicy foods, chocolate, and onions D) Continuing taking prenatal vitamins and minerals until they are gone

Which intervention would the nurse perform for a postpartum pt with an anterior rectal laceration? Select all that apply. A) Instructing the pt to drink a lot of fluids B) Administering stool softeners to the patient C) Assessing the fecal continence of the patient D) Suggesting that the patient to avoid walking for a week E) Administrating enemas or suppositories to the patient

A) Instructing the pt to drink a lot of fluids B) Administering stool softeners to the patient C) Assessing the fecal continence of the patient

The nurse would primarily monitor for symptoms of which condition in the neonate after administering 1 mg of vitamin K intramuscularly? Select all that apply. A) Kernicterus B) Constipation C) Hypothermia D) Hyperbilirubinemia E) Hemolytic anemia

A) Kernicterus D) Hyperbilirubinemia E) Hemolytic anemia

Which intervention would the nurse perform to provide effective care to a newly postpartum patient who reports feeling weak and "seeing stars?" Select all that apply. A) Monitor the pt's vital signs B) Gently massage the pt's uterus C) Ask the pt to lie flat on the back D) Notify the health care provider E) Discontinue the administration of saline solution

A) Monitor the pt's vital signs B) Gently massage the pt's uterus D) Notify the health care provider

Which data on the nursing documentation would indicate a potential complication in a patient 8 hours after a c-section delivery? A) The apical pulse is 25 bpm above predelivery baseline B) The pt's temp remains at or below 100 degrees C) Blood pressure is within 10 mm Hg of patient's normal value D) Respirations are even and unlabored at 20 bpm

A) The apical pulse is 25 bpm above predelivery baseline

Which statement indicates that a mother fully understands care of her son's penis after circumcision? Select all that apply. A) "I must apply the diaper extra snug to control the bleeding" B) "I will try not to touch the penis too much because it will be painful to the baby" C) "I should put petroleum jelly on the penis with each diaper change" D) "Some yellow discharge may be seen on the penis after a few days" E) "I will clean the penis with warm water once a day"

B) "I will try not to touch the penis too much because it will be painful to the baby" C) "I should put petroleum jelly on the penis with each diaper change" D) "Some yellow discharge may be seen on the penis after a few days"

A patient with hyperglycemia had a preterm delivery. Which intervention would the nurse plan to prevent complications in the newborn? A) Administer bovine milk to the newborn within 2 hours of birth B) Administer glucose solution to the newborn 1 hour after birth C) Administer 15 mL of sterile water before the newborn is breastfed D) Adinister insulin according to the health care provider's instructions

B) Administer glucose solution to the newborn 1 hour after birth

A patient reports pain in her right calf, and the LVN notes that the area is reddened and edematous. Which intervention would the nurse perform next? A) Report the findings to the RN B) Assess for a positive or negative Homans' Sign C) Gently massage the area to improve circulation D) Place a warm, moist compress to the area and offer an analgesic on an as needed (PRN) basis.

B) Assess for a positive or negative Homans' Sign

Which physiologic adaptation will the nurse expect to occur in the newly postpartum patient? Select all that apply. A) Increase in appetite B) Bruising of the perineum C) Sloughing of the uterine lining D) Rapid decline of cardiac output E) Immediate descent of the uterus

B) Bruising of the perineum C) Sloughing of the uterine lining D) Rapid decline of cardiac output

When providing discharge instructions to the family of a newborn infant, which symptom would the parents be instructed to report to the health care provider? Select all that apply. A) Gas B) Fever C) Diarrhea D) Vomiting E) Spitting Up

B) Fever C) Diarrhea D) Vomiting

Which intervention would the nurse perform first when assessing the new mother's uterus and noting it to be boggy? A) Instruct the pt to void B) Gently massage the fundus to increase contractility C) Contact the heath care provider for an oxytocin medication D) Direct the pt to assume a lateral position w/ her upper leg drawn toward the chest

B) Gently massage the fundus to increase contractility

During palpation, the nurse finds that a 10-week postpartum patient's uterus is involved. Which finding regarding the uterine fundus enabled the nurse to reach this conclusion? A) Distended B) No longer palpable C) At the level of the umbilicus midline D) Between the umbilicus and the symphysis pubis

B) No longer palpable

Which intervention would the nurse provide to the non-breastfeeding postpartum patient to provide relief from swollen, firm, and painful breasts? Select all that apply. A) Instruct the pt to restrict fluids B) Suggest that the pt take lukewarm showers C) Instruct the pt to avoid consuming dairy D) Suggest that the pt wear a good supportive bra E) Apply ice bags on the pt's breasts four times daily

B) Suggest that the pt take lukewarm showers D) Suggest that the pt wear a good supportive bra E) Apply ice bags on the pt's breasts four times daily

Which essential intervention would the nurse perform for the Rh-negative patient that gives birth to an Rh-positive baby? A) Administer the rubella vaccine B) Prepare for a blood transfusion C) Administer RhoGAM as prescribed D) Give the infant a vitamin K injection

C) Administer RhoGAM as prescribed

A patient who has had a routine vaginal delivery has a urinary output of 100 mL , 150 mL, and a 275 mL recorded for three voidings in 6 hours after delivery. Which nursing action would be best? A) Collect a urine specimen B) Massage the uterine fundus C) Catheterize the patient, if ordered D) Perform perineal care to promote bladder emptying

C) Catheterize the patient, if ordered

Which instructions would the nurse give the patient regarding taking simethicone (Mylicon)? A) Swallow the capsule whole B) Crush the tablet into powder form C) Chew the pill thoroughly before swallowing D) Allow the tablet to dissolve under the tongue

C) Chew the pill thoroughly before swallowing

Which complication will the nurse expect to find in the newborn who has asymmetric gluteal folds? A) Syndactyly B) Down syndrome C) Congenital hip dysplasia D) Sudden infant death syndrome

C) Congenital hip dysplasia

The father's behavior when introduced to his new baby is typically an intense fascination. Which term describes this behavior? A) Bonding B) Taking-in C)Engrossment D) Enforcement

C) Engrossment

Which medication would the nurse anticipate administering to all newborns admitted to the nursery? Select all that apply. A) Oxytocin B) Witch Hazel C) Erythromycin Drops D) Vitamin K E) Benzocaine

C) Erythromycin Drops D) Vitamin K

Which nursing intervention would best enable the nurse to assess a postpartum patient for Homan's sign? A) Have the pt lie on the left side and extend the legs B) Have the patient lie supine, cross the legs, and point the toes C) Have the pt lie flat and point the toes toward the ankles D) Raise the head of the bed and have the patient point the toes toward the ceiling

C) Have the pt lie flat and point the toes toward the ankles

A new mother reports feeling weak, lightheaded, and sick to her stomach. The LVN also notes that the pt's perineal pad is soaked since she last checked it 15 minutes ago. The pt's skin is cool and clammy and her pulse is 110 bpm and blood pressure is 80/60. Which complication do these symptoms indicate? A) Preeclampsia B) Puerperal Infection C) Hypovolemic Shock D) Pregnancy-induced Hypertension

C) Hypovolemic Shock

Which intervention would the nurse perform when observing a new mother turning way from her infant and sighing deeply? A) Ignore this because it is common after childbirth B) Assess the new mother for pain and offer analgesics as prescribed C) Inform the chaplain that the patient may require spiritual counseling because she is rejecting her infant D) Encourage the new mother to discuss her feelings by sitting next to her and stating, "Having a baby can be overwhelming."

D) Encourage the new mother to discuss her feelings by sitting next to her and stating, "Having a baby can be overwhelming."

The nurse palpates the uterus of a postpartum patient for involution and observes that the uterine fundus is soft and distended. Which medication will the nurse expect the health care provider to prescribe to the patient? A) Nystatin (Mycostatin) B) Simethicone (Mylicon) C) Benzocaine (Dermoplast Ointment) D) Methylergonovine Maleate (Methergine)

D) Methylergonovine Maleate (Methergine)

Which occurrence would be prevented by folding the baby's diaper down such that the plastic side is facing outside for proper umbilical cord care? A) Severance of the umbilicus B) Redness near the umbilicus C) Foul odor from the umbilicus D) Moisture retention in the umbilicus

D) Moisture retention in the umbilicus

Which medication will the nurse expect the health care provider to prescribe for the newborn with a white patchy coating on the oral mucous membrane that cannot be wiped off? A) Ibuprofen B) Oxytocin C) Simethicone D) Nystatin

D) Nystatin

A patient who had a c-section is due to be discharged home. Which data obtained during an assessment would be of concern to the nurse? A) Scant bloody non-odorous discharge is noted B) The patient is awake, alert, and oriented to person, place and time C) The abdomen is soft and slightly protruding, with active bowel sounds in four quadrants D) The abdominal incision is red and warm, and edges are non-approximated, with moderate exudate

D) The abdominal incision is red and warm, and edges are non-approximated, with moderate exudate

Which inference will the nurse conclude when the infant is passing very watery and green stools after the transition stools? A) The infant lacks intestinal flora B) The infant is given formula milk C) The mother drinks excessive fluids D) The infant has gastrointestinal irritation

D) The infant has gastrointestinal irritation

Which inference would the nurse make when observing a Vietnamese mother changing her newborn's diaper and providing basic care but failing to cuddle, kiss, or talk to the infant? A) There is a lack of bonding B) The mother is adapting to the new role C) The mother is exhausted from the delivery D) This behavior is normal for a mother of this culture

D) This behavior is normal for a mother of this culture

Why would the nurse place an ice pack on the patient's perineum 4 hours after delivery? A) To retain moisture B) To prevent infection C) To decrease swelling D) To provide pain relief

D) To provide pain relief

Which reason explains why a postpartum patient with significant bleeding would be prescribed an intravenous (IV) infusion of lactated Ringer's solution? A) Pale yellow skin B) Decreased pulse rate C) Increased blood pressure D) Weakness and frequent vomiting

D) Weakness and frequent vomiting

Which actions by the mother indicate that the teaching of nipple care after breast-feeding was not effective? A) Rubbing lanolin cream on both nipples after feeding B) Using warm water to wash the nipples after each feeding C) Allowing nipples to air-dry without removing the milk residue D) Wiping each nipple thoroughly with an alcohol pad after feeding

D) Wiping each nipple thoroughly with an alcohol pad after feeding