OB Exam 2 Practice Questions

A client is concerned because it is 24 hours after giving birth and their breasts have still not become engorged with breast milk. How should the nurse respond to this concern?

"It takes about 3 days after birth for milk to begin forming."

A postpartum client tells the home care nurse, "My hemorrhoids are really uncomfortable. Is there anything I can do?" Which suggestion(s) by the nurse is appropriate? Select all that apply.

"Witch hazel pads can have a cooling effect." "I will show you how to use a sitz bath." "Applying ice to the area can help."

A client gave birth 2 months ago to a healthy term newborn. During today's visit, the client tells the nurse, "I have noticed that I am a bit uncomfortable now when I have sexual intercourse. Is there anything that I can do?" The client's menstrual period has not yet resumed. Which suggestion by the nurse is appropriate?

"You might try using a water-soluble lubricant to ease the discomfort."

A client who gave birth 36 hours ago informs the nurse that they have been passing unusually large volumes of urine very often. How should the nurse explain this to the client?

"Your body usually retains extra fluids during pregnancy, so this is one way it rids itself of the excess fluid."

After the birth of the newborn, the client is ready to be discharged home. The client's parent is present and states they will remain with the client for 1 month. The client's parent tells the nurse that the client will not be allowed to leave the house for the first month after the birth, based on the family's cultural customs. How should the nurse respond to this statement?

Accept the client parent's statement and perform discharge teaching accordingly.

A nurse is performing an assessment on a female client who gave birth 24 hours ago. On assessment, the nurse finds that the fundus is 2 cm above the umbilicus and boggy. Which intervention is a priority?

Have the client void, and then massage the fundus until it is firm.

A concerned client tells the nurse that their spouse, who was very excited about the infant before the birth, appears happy but seems to be afraid of caring for the infant. What suggestion should the nurse give to the spouse to help resolve the issue?

Hold the infant frequently.

The nurse is inspecting a postpartum client's perineum. What action(s) will the nurse take for this client? Select all that apply.

Inspect the episiotomy for sutures and ensure that the edges are approximated. Note any hemorrhoids. Gently palpate for any hematomas.

The nurse is conducting a postpartum examination on a client who reports pain and is unable to sit comfortably. The perineal examination reveals an episiotomy without signs of a hematoma. Which action should the nurse prioritize?

Place an ice pack.

When assessing the uterus of a client who is 2 days postpartum, which finding does the nurse evaluate as normal?

a moderate amount of lochia rubra

The nurse is caring for several postpartum clients on the unit. Which client's reaction should the nurse prioritize for possible intervention?

client who neglects to engage or provide care or show interest in newborn

A postpartum client is in the second developmental stage of becoming a parent and is becoming independent in their actions. Which action by the nurse best fosters this stage?

demonstrating how to do cord care on the newborn

The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of tissue. Which observation did the nurse make?

difficult to separate clots

The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the client's history reveals a prepartum hemoglobin of 14 g/dl (140 g/l) and hematocrit of 42% (0.42). Which result should the nurse prioritize?

hemoglobin 9 g/dl (90 g/l) and hematocrit 32% (0.32) in a client who has given birth by cesarean

The nurse is assessing a postpartum client and is concerned the client may be hemorrhaging. Which assessment finding is the nurse finding most concerning?

increased heart rate

A nurse is caring for a client on the second day postpartum. The client informs the nurse that they are voiding a large volume of urine frequently. Which factor should the nurse identify as a potential cause for urinary frequency?

postpartum diuresis

The nurse is preparing a nursing care plan for an immediate postpartum client. Which nursing concern should the nurse prioritize?

postpartum hemorrhage risk associated with uterine atony

The primigravida client is surprised by the continued uterine contractions while holding their newborn. Which explanation by the nurse explains the primary reason the contractions occur?

seals off the blood vessels at the site of the placenta

Based on the nurse's knowledge about the postpartum period and an increase in blood coagulability during the first 48 hours, the nurse closely assesses the client for which condition?

thromboembolism

A nurse provides care to pregnant clients and their families. As the nurse communicates with the families, the nurse integrates understanding of communication as being more than just speaking and listening. Which aspect must the nurse also consider?

touching

A client comes to the clinic for their first postpartum visit. The client gave birth to a healthy term neonate 2 weeks ago. As part of this visit, the client has a complete blood count drawn. Which result will the nurse identify as a potential problem?

white blood cell count 14,000/mm3 (14 ×109/L)