OB Postpart
A nurse is instructing a patient who is breastfeeding for the first time that before her milk comes in she should expect to see colostrum, which is best described as which of the following? a) creamy yellow b) gray liquid c) bluish white d) milky white
creamy yellow
Which of the following would the nurse include when teaching the parents of a newborn who have a 2-year-old boy at home? a) "Expect to see your 2-year-old become more independent when the baby gets home." b) "Have your 2-year-old stay at home while you're here in the hospital." c) "Talk to your 2-year-old about the baby when you're driving him to day care." d) "Ask your 2-year-old to pick out a special toy for his sister."
"Ask your 2-year-old to pick out a special toy for his sister."
A mother just delivered 3 hours ago. The nurse enters the room to continue hourly assessments and finds the patient on the phone telling the listener about her fear while driving to the hospital and not making it in time. The mother finishes the call, and the nurse begins her assessment with which phrase? a) "I need to assess your fundus now." b) "If you plan to breastfeed, you need to calm down." c) "You have a beautiful baby, why worry about that now?" d) "It sounded like you had quite a time getting here. Would you like to continue your story?"
"It sounded like you had quite a time getting here. Would you like to continue your story?"
A client who gave birth vaginally 16 hours ago states she doesn't need to void at this time. The nurse reviews the documentation and finds that the client hasn't voided for 7 hours. Which response by the nurse is indicated? a) "I'll contact your physician." b) "It's not uncommon after delivery for you to have a full bladder even though you can't sense the fullness." c) "If you don't attempt to void, I'll need to catheterize you." d) "I'll check on you in a few hours."
"It's not uncommon after delivery for you to have a full bladder even though you can't sense the fullness."
A nursing instructor teaching students how to check the patient's uterus postpartum realizes that further instruction is needed when one of the students says: a) "Six to twelve hours after birth the fundus is typically at the level of the umbilicus." b) "One to two hours after birth the fundus is typically between the umbilicus and symphysis pubis." c) "Normally the fundus progresses downward at a rate of 1 fingerbreadth per day after birth." d) "One to two hours after birth the fundus is typically at the level of the umbilicus."
"One to two hours after birth the fundus is typically at the level of the umbilicus."
Two days after giving birth, a client is to receive RhoGAM. The client asks the nurse why this is necessary. The most appropriate response from the nurse is: a) "RhoGAM suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-negative blood." b) "RhoGAM suppresses antibody formation in a woman with Rh-positive blood who gave birth to a baby with Rh-negative blood." c) "RhoGAM suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-positive blood." d) "RhoGAM suppresses antibody formation in a woman with Rh-positive blood who gave birth to a baby with Rh-positive blood."
"RhoGAM suppresses antibody formation in a woman with Rh-negative blood who gave birth to a baby with Rh-positive blood."
A woman who is breast-feeding her newborn says, "He doesn't seem to want to nurse. I must be doing something wrong." Which response by the nurse would be least helpful? a) "Let me contact our lactation specialist and together maybe we can work through this." b) "Some babies latch on and catch on quickly; others take a little more time." c) "Breast-feeding takes time. Let's see what's happening." d) "Some women just can't breast-feed. Maybe you're one of these women."
"Some women just can't breast-feed. Maybe you're one of these women."
Which finding would the nurse describe as "light" or "small" lochia? a) 4- to 6-inch stain with an estimated loss of 25 to 50 ml b) 4-inch stain or a 1 to 25 ml loss c) 1- to 2-inch lochia stain on the perineal pad or a 10 ml loss d) pad is saturated within 1 hour after changing it
4-inch stain or a 1 to 25 ml loss Explanation: Scant: a 1- to 2-inch lochia stain on the pad or a 10 ml loss; Light or small: 4-inch stain or a 10 to 25 ml loss; Moderate: 4- to 6-inch stain with an estimated loss of 25 to 50 ml; Large or heavy: a pad is saturated within 1 hour after changing it.
A client is Rh-negative and has given birth to a newborn who is Rh-positive. Within how many hours should Rh immunoglobulin be injected in the mother? a) 80 b) 72 c) 78 d) 75
72
Which of the following findings would lead you to suspect that a woman is developing a postpartum complication? a) Red-colored lochia for the first 24 hours b) An absence of lochia c) Lochia that is the color of menstrual blood d) Lochia appearing pinkish-brown on the fourth day
An absence of lochia
When completing the morning postpartum data collection, the nurse notices the client's perineal pad is completely saturated. Which action should be the nurse's first response? a) Ask the client when she last changed her perineal pad. b) Have the charge nurse review the assessment. c) Vigorously massage the fundus. d) Immediately call the primary care provider.
Ask the client when she last changed her perineal pad.
Seven hours ago, a G5 P4014 woman delivered a 4133-g male infant. She has voided once and calls for a nurse to check because she states that she feels "really wet" now. Upon examination, her perineal pad is saturated. The immediate nursing action is to a) Inspect the perineum for lacerations b) Assess and massage the fundus c) Increase the flow of an IV d) Call the physician or the nurse-midwife
Assess and massage the fundus
A postpartal woman has a history of thrombophlebitis. Which of the following would help you to determine if she is developing this postpartally? a) Ask her if she feels any warmth in her legs. b) Assess for calf redness and edema. c) Take her temperature every 4 hours. d) Palpate her feet for tingling or numbness.
Assess for calf redness and edema.
When caring for a postpartum woman who is Muslim, which of the following would be a priority? a) Assigning a female nurse to care for her b) Ensuring that the newborn's daily bath is performed by the nurses c) Allowing time for the numerous visitors who come to see the woman and newborn d) Providing time for prayers to be performed at the bedside
Assigning a female nurse to care for her
A G1 P1001 mother is just home after delivering her first child 5 days ago. Her delivery was complicated by an emergency cesarean delivery resulting from incomplete cervical dilation and hemorrhage. The nurse determines that the mother has not slept longer than 3 hours at one time. The appropriate nursing diagnosis for this patient care issue is a) At risk for interruption of tissue integrity b) At risk for inadequate healing due to decreased nutrition c) At risk for safety due to low hemoglobin d) At risk for postpartum depression due to inadequate rest
At risk for postpartum depression due to inadequate rest
Which of the following suggestions would be most appropriate to include in the teaching plan for a postpartum woman who needs to lose weight? a. Increase fluid intake and acid-producing foods in her diet. b. Avoid empty-calorie foods and increase exercise. c. Start a high-protein diet and restrict fluids. d. Eat no snacks or carbohydrates.
Avoid empty-calorie foods and increase exercise.
During assessment of the mother during the postpartum period, what would alert the nurse that the client is likely experiencing uterine atony? a) Boggy or relaxed uterus b) Fundus feels firm c) Foul-smelling urine d) Purulent vaginal drainage
Boggy or relaxed uterus
A nurse is to care for a client during the postpartum period. The client complains of pain and discomfort in her breasts. What signs should a nurse look for to find out if the client has engorged breasts? Select all that apply. a) Breasts are hard. b) Breasts are tender. c) Nipples are cracke d) Breasts are soft. e) Nipples are fissured.
Breasts are hard. Breasts are tender.
A new mother has been reluctant to hold her newborn. A nurse can promote this mother's attachment to her newborn by a) Bringing the newborn into the room b) Talking about how the nurse held her own newborn while on the delivery table c) Showing a video of parents feeding their babies d) Allowing the mother to pick the best time to hold her newborn
Bringing the newborn into the room
After teaching a group of breast-feeding women about nutritional needs, the nurse determines that the teaching was successful when the women state that they need to increase their intake of which nutrients? a. Carbohydrates and fiber b. Fats and vitamins c. Calories and protein d. Iron-rich foods and minerals
Calories and protein
A pregnant woman's pulse fluctuates throughout pregnancy and the early postpartum period. When assessing a 1-day postpartum woman's pulse, what is the first action a nurse should take in response to a rate of 56 bpm? a) Ask the woman what she has had to eat today. b) Compare the pulse rate of 56 bpm with her pulse rate on the first prenatal care visit. c) Do nothing, this is normal. d) Advise that the woman not get out of bed until the nurse returns with assistance.
Compare the pulse rate of 56 bpm with her pulse rate on the first prenatal care visit.
A woman gave birth vaginally approximately 12 hours ago and her temperature is now 100°F (37.8°C). Which action would be most appropriate? a) Notify the health care provider about this elevation; this finding reflects infection. b) Obtain a urine culture; the woman most likely has a urinary tract infection. c) Inspect the perineum for hematoma formation. d) Continue to monitor the woman's temperature every 4 hours; this finding is normal.
Continue to monitor the woman's temperature every 4 hours; this finding is normal.
Elevation of a patient's temperature is a crucial first sign of infection. However, when is elevated temperature not a warning sign of impending infection? a) During the first 24 hours after delivery owing to dehydration from exertion b) When the elevated temperature exceeds 100.4° F c) When the white blood cell count is less than 10,000/mm³ d) After any period of decreased intake
During the first 24 hours after delivery owing to dehydration from exertion
Which of the following would the nurse assess as indicating positive bonding between the parents and their newborn? a. Holding the infant close to the body b. Having visitors hold the infant c. Buying expensive infant clothes d. Requesting that the nurses care for the infant
Holding the infant close to the body
Which of these activities would best help the postpartum nurse to provide culturally sensitive care for the childbearing family? a. Taking a transcultural course b. Caring for only families of his or her cultural origin c. Teaching Western beliefs to culturally diverse families d. Educating himself or herself about diverse cultural practices
Educating himself or herself about diverse cultural practices
A client who gave birth by cesarean delivery 3 days ago is bottle-feeding her neonate. While collecting data the nurse notes that vital signs are stable, the fundus is four fingerbreadths below the umbilicus, lochia are small and red, and the client reports discomfort in her breasts, which are hard and warm to touch. The best nursing intervention based on this data would be: a) Encouraging the client to wear a supportive bra. b) Informing the physician that the client is showing early signs of breast infection. c) Using a breast pump to facilitate removal of stagnant breast milk. d) Having the client stand facing in a warm shower.
Encouraging the client to wear a supportive bra.
Which of the following is an appropriate nursing intervention for prevention of a urinary tract infection (UTI) in the postpartum woman? a) Increasing oral fluid intake. b) Encouraging the woman to empty her bladder completely every 2 to 4 hours. c) Increasing intravenous fluids. d) Screening for bacteriuria in the urine.
Encouraging the woman to empty her bladder completely every 2 to 4 hours.
A nurse is applying ice packs to the perineal area of a client who has had a vaginal delivery. Which of the following interventions should the nurse perform to ensure that the client gets the optimum benefits of the procedure? a) Apply ice packs for 40 minutes continuously. b) Apply ice packs directly to the perineal are c) Ensure ice pack is changed frequently. d) Use ice packs for a week after delivery.
Ensure ice pack is changed frequently.
A nurse has been assigned to the care of a client who has just given birth. How frequently should the nurse perform the assessments during the first hour after delivery? a) After 45 minutes b) After 60 minutes c) Every 30 minutes d) Every 15 minutes
Every 15 minutes
A nurse, assigned to check the pulse, discerns tachycardia in a postpartum client. Which of the following does it suggest? a) Pulmonary embolism b) Excessive blood loss c) Atelectasis d) Pulmonary edema
Excessive blood loss
A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. Which of the following classifications will the nurse use to describe the laceration? a) First-degree laceration b) Third-degree laceration c) Fourth-degree laceration d) Second-degree laceration
Fourth-degree laceration
Given that the first 24 hours after delivery is a time for return to homeostasis, which postpartum findings are considered acceptable during this time? Select all that apply. a) Fundus one fingerbreadth above umbilicus b) Moderate saturation of peripad every 3 hours c) Inverted nipples following breastfeeding d) Urination of 50 mL every hour e) Hypotonic bowel sounds
Fundus one fingerbreadth above umbilicus Moderate saturation of peripad every 3 hours
A woman yesterday delivered a child with a cleft palate. The newborn is in the special care nursery, and the mother has seen the newborn only at delivery. The nurse's priority is to assist the mother to a) Review causes of a cleft palate b) Care for herself c) Visit the child in the nursery d) Grieve for the loss of the perfect baby
Grieve for the loss of the perfect baby
The major purpose of the first postpartum homecare visit is to: a. Identify complications that require interventions b. Obtain a blood specimen for PKU testing c. Complete the official birth certificate d. Support the new parents in their parenting roles
Identify complications that require interventions
A nurse working on the postpartum floor is mentoring a new graduate and instructs the new nurse to make sure that patients empty their bladders. A full bladder can lead to which of the following complications? a) Ruptured bladder b) Fluid volume overload c) Increased lochia drainage d) Permanent urinary incontinence
Increased lochia drainage
A nurse is assessing a postpartum client. Which of the following measures is appropriate? a) Place the client in a supine position with her arms overhead for the examination of her breasts and fundus. b) Perform the examination as quickly as possible. c) Instruct the client to empty her bladder before the examination. d) Wear sterile gloves when assessing the pad and perineum.
Instruct the client to empty her bladder before the examination.
Which of the following exercises should a nurse suggest to the client during the first day of postpartum? a) Thigh-toning exercises b) Abdominal exercises c) Kegel exercises d) Buttock exercises
Kegel exercises
Two days ago, a woman delivered her third infant; she is now preparing for discharge home. After the delivery of her second child, she developed an endometrial infection. Nursing goals for this discharge include all of the following EXCEPT a) List signs of infection that she will report to her health care provider b) The patient will show no signs of infection c) Maintain previous household routines to prevent infection d) Discuss methods that the woman will use to prevent infection
Maintain previous household routines to prevent infection
A nurse assessing a postpartum patient notices excessive bleeding. What should be the nurse's first action? a) Call the physician. b) Massage the boggy fundus until it is firm. c) Document the findings. d) Nothing--excessive postpartum blood loss is normal.
Massage the boggy fundus until it is firm.
Inspection of a woman's perineal pad reveals a 5-inch stain. The nurse documents this amount as which of the following? a) Light b) Heavy c) Scant d) Moderate
Moderate
A client who has a breastfeeding newborn complains of sore nipples. Which of the following interventions can the nurse suggest to alleviate the client's condition? a) Encourage use of breast pads with plastic liners. b) Fasten nursing bra flaps immediately after feeding. c) Recommend a moisturizing soap to clean the nipples. d) Offer suggestions based on observation to correct positioning or latching.
Offer suggestions based on observation to correct positioning or latching.
Which of the following factors in a postpartum woman's history would lead the nurse to watch the woman closely for an infection? a) Hemoglobin of 11.5 mg/dL b) Placenta removed via manual extraction c) Labor of 12 hours d) Multiparity
Placenta removed via manual extraction
The nurse is observing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus? a) At the level of the umbilicus b) Below the symphysis pubis c) One fingerbreadth above the umbilicus d) One fingerbreadth below the umbilicus
One fingerbreadth below the umbilicus
The nurse is observing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus? a) One fingerbreadth above the umbilicus b) One fingerbreadth below the umbilicus c) Below the symphysis pubis d) At the level of the umbilicus
One fingerbreadth below the umbilicus
Question: Postpartum bleeding must be assessed carefully during the first 24 hours after delivery. Prioritize the actions taken upon detection of increased vaginal bleeding in a patient who delivered within the last 24 hours. 1 Palpate the fundus 2 Massage the fundus if boggy 3 Notify the physician or the nurse-midwife of excessive bleeding 4 Increase IV pitocin or breastfeed the newborn 5 Assess blood pressure 6 Assist the patient to empty her bladder in the bathroom
Palpate the fundus Massage the fundus if boggy Notify the physician or the nurse-midwife of excessive bleeding Increase IV pitocin or breastfeed the newborn Assess blood pressure Assist the patient to empty her bladder in the bathroom
Which finding would indicate to the nurse that a postpartum woman is experiencing bladder distention? a) Bladder is nonpalpable b) Lochia is less than usual c) Percussion reveals dullness d) Uterus is firm
Percussion reveals dullness
When assessing a postpartum woman, which of the following would lead the nurse to suspect postpartum blues? a. Panic attacks and suicidal thoughts b. Anger toward self and infant c. Periodic crying and insomnia d. Obsessive thoughts and hallucinations
Periodic crying and insomnia
Which of the following factors in a postpartum woman's history would lead the nurse to watch the woman closely for an infection? a) Labor of 12 hours b) Multiparity c) Placenta removed via manual extraction d) Hemoglobin of 11.5 mg/dL
Placenta removed via manual extraction
Which activity would the nurse include in the teaching plan for parents with a newborn and an older child to reduce sibling rivalry when the newborn is brought home? a. Punishing the older child for bedwetting behavior b. Sending the sibling to the grandparents' house c. Planning a daily "special time" for the older sibling d. Allowing the sibling to share a room with the infant
Planning a daily "special time" for the older sibling
A patient delivered 2 days ago and is preparing for discharge. The nurse assesses respirations to be 26 rpm and labored, and the patient was short of breath ambulating from the bathroom this morning. Lung sounds are clear. The nurse alerts the physician and the nurse-midwife to her concern that the patient may be experiencing a) Mitral valve collapse b) Upper respiratory infection c) Pulmonary embolism d) Thrombophlebitis
Pulmonary embolism
Not all mothers express joy at seeing their newborn upon delivery and during their hospitalization. A behavior that indicates impaired attachment of the mother to the newborn is a) Giving the child an uncommon name b) Referring to a facial feature as "ugly" c) Bottle feeding d) Dressing the child in old clothes
Referring to a facial feature as "ugly"
A client who has given birth is being discharged from the health care facility. She wants to know how safe it would be for her to have intercourse. Which of the following instructions should the nurse provide to the client regarding intercourse after childbirth? a) Use oral contraceptives for contraception. b) Avoid performing pelvic floor exercises. c) Avoid use of water-based gel lubricants. d) Resume intercourse if bright-red bleeding stops.
Resume intercourse if bright-red bleeding stops.
When giving a postpartum client self-care instructions in preparation for discharge, the nurse instructs her to report heavy or excessive bleeding. How should the nurse describe "heavy bleeding?" a) Saturating 1 pad in 1 hour b) Saturating 1 pad in 8 hours c) Saturating 1 pad in 3 hours d) Saturating 1 pad in 6 hours
Saturating 1 pad in 1 hour
The nurse observes a 2-in lochia stain on the perineal pad of a postpartum client. Which of the following terms should the nurse use to describe the amount of lochia present? a) Moderate b) Light c) Large d) Scant
Scant
Which of the following would you emphasize in the teaching plan for a postpartal woman who is reluctant to begin taking warm sitz baths? a) Sitz baths cause perineal vasoconstriction and decreased bleeding. b) The longer a sitz bath is continued, the more therapeutic it becomes. c) Sitz baths increase the blood supply to the perineal area. d) Sitz baths may lead to increased postpartal infection.
Sitz baths increase the blood supply to the perineal area.
Which of the following would lead the nurse to suspect that a postpartum woman was developing a complication? a. Fatigue and irritability b. Perineal discomfort and pink discharge c. Pulse rate of 60 bpm d. Swollen, tender, hot area on breast
Swollen, tender, hot area on breast
A patient who has just delivered a baby girl demonstrates behavior not indicative of bonding when she does which of the following? a) Talks to company and ignores the baby lying next to her b) Strokes the infants' head c) Holds and smiles at the infant d) Kisses the infant on her cheek
Talks to company and ignores the baby lying next to her
An episiotomy or a cesarean incision requires assessment. Which assessment criterion for skin integrity is not initially noted? a) Temperature b) Drainage c) Redness d) Edema
Temperature
You help a postpartum woman out of bed for the first time postpartally and notice that she has a very heavy lochia flow. Which of the following assessment findings would best help you decide that the flow is within normal limits? a) Her uterus is soft to your touch. b) The flow contains large clots. c) The flow is over 500 mL. d) The color of the flow is red.
The color of the flow is red.
It has been 8 hours since a woman gave birth vaginally to a healthy newborn. When assessing the woman's fundus, the nurse would expect to find it at: a) The level of the umbilicus b) 2 cm below the umbilicus c) Between the umbilicus and symphysis pubis d) 1 cm below the umbilicus
The level of the umbilicus
Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this as which of the following? a) Third-degree laceration b) Second-degree laceration c) First-degree laceration d) Fourth-degree laceration
Third-degree laceration
The nurse can expect a patient who had a cesarean birth to have less lochia discharge than the patient who had a vaginal birth. a) True b) False
True
Which factor puts a client on her first postpartum day at risk for hemorrhage? a) Thrombophlebitis b) Uterine atony c) Moderate amount of lochia rubra d) Hemoglobin level of 12 g/dl
Uterine atony
A postpartum client who had a cesarean birth reports right calf pain to the nurse. The nurse observes that the client has nonpitting edema from her right knee to her foot. The nurse knows to prepare the client for which test first? a) Venogram of the right leg b) Noninvasive arterial studies of the right leg c) Transthoracic echocardiogram d) Venous duplex ultrasound of the right leg
Venous duplex ultrasound of the right leg
A woman states that she still feels exhausted on her second postpartal day. Your best advice for her would be to do which of the following? a) Walk the length of the hallway to regain her strength. b) Avoid elevating her feet when she rests in a chair. c) Avoid getting out of bed for another 2 days. d) Walk with you the length of her room.
Walk with you the length of her room.
A postpartal woman asks you about perineal care. Which of the following recommendations would you give? a) Refrain from washing lochia from the suture line. b) Use an alcohol wipe to wash her suture line. c) Wash her perineum with her daily shower. d) Avoid using soap in her perineal care.
Wash her perineum with her daily shower.
A client has been discharged from the hospital after a cesarean birth. Which of the following is the most appropriate time for scheduling a follow-up appointment for the client? a) Within 2 weeks of hospital discharge b) Within 1 week of hospital discharge c) Between 4 and 6 weeks after hospital discharge d) Within 3 weeks of hospital discharge
Within 2 weeks of hospital discharge
A nurse finds the uterus of a postpartum woman to be boggy and somewhat relaxed. This a sign of which of the following? a) atony b) normal involution c) hemorrhage d) infection
atony
A new mother tells the nurse at the baby's 3 month check-up, "When she cries, it seems like I am the only one who can calm her down." This is an example of which of the following? a) bonding b) attachment c) being spoiled d) none of the above
attachment
Many patients experience a slight fever after delivery especially during the first 24 hours. To what should the nurse attribute this elevated temperature? a) change in the temperature from the delivery room b) dehydration c) fluid volume overload d) infection
dehydration
A nurse is instructing students on how to check an episiotomy and perineum of a woman after Which of the following are normal in the early postpartum period? (Select all that apply.) a) discharge b) edema c) slight bruising d) redness
edema slight bruising
A patient who delivered twins 6 hours ago becomes restless and nervous. Her blood pressure falls from 130/80 to 96/50. Her pulse drops from 80 to 56. She was induced earlier in the day and experienced abruptio placentae. Based on this information, what postpartum complication would the nurse expect is happening? a) infection b) pulmonary emboli c) fluid volume overload d) hemorrhage
hemorrhage
Thirty minutes after receiving pain medication, a postpartum woman states that she sill has severe pain in the perineal region. Upon assessing and palpating the site, what can the nurse expect to find that might be causing this severe pain? a) nothing--it is normal b) hematoma c) DVT d) infection
hematoma
A patient appears to be resting comfortably 12 hours after delivering her first child. In contrast, she labored for more than 24 hours, the physician had to use forceps to deliver the baby, and she had multiple vaginal examinations during labor. Based on this information what postpartum complication is the patient at risk for developing? a) depression b) pulmonary emboli c) infection d) hemorrhage
infection
A nurse is instructing a woman that it is important to lose pregnancy weight gain within 6 months of delivery, because studies show that keeping extra weight longer is a predictor of which of the following? a) feelings of increased self-esteem b) long-term obesity c) diabetes d) increased sex drive
long-term obesity
A new mother who is breastfeeding reports that her right breast is very hard, tender, and painful. Upon examination the nurse notices several nodules and the breast feels very warm to the touch. What do these findings indicate to the nurse? a) mastitis b) too much milk being retained c) an improperly positioned baby during feedings d) normal findings in breastfeeding mothers
mastitis
A new mother talking to a friend states, "I wish my baby was more like yours. You are so lucky. My baby has not slept straight through the night even once. It seems like all she wants to do is breastfeed. I am so tired of her." This is an example of which of the following? a) negative attachment b) positive bonding c) positive attachment d) negative bonding
negative attachment
The nurse working on a postpartum must check lochia in terms of amount, color, change with activity and time, and: a) pH b) specific gravity c) consistency d) odor
odor
A nurse is auscultating the lungs of a postpartum patient and notices crackles and some dyspnea. The patient's respiratory rate is 12 breaths/min; she appears in some distress. What complication should the nurse suspect based on these data? a) pulmonary edema b) infection c) hemorrhage d) fluid volume deficit
pulmonary edema
A nursing student learns that a certain condition in 1 in every 2,000 pregnancies is a major cause of death. What is this condition? a) pulmonary embolism b) infection c) hypertension d) hemorrhage
pulmonary embolism
A woman who had a cesarean delivery of twins 6 hours ago reports shortness of breath and pain in her right calf. What complication should the nurse expect? a) fluid volume overload b) pulmonay emboli c) infection d) hemorrhage
pulmonay emboli
When an infant smiles at the mother and the mother in turn smiles and kisses her baby, this would be which phase of attachment? a) proximity b) reciprocity c) commitment d) all of the above
reciprocity
A nurse is assessing a client during the postpartum period. Which of the following indicate normal postpartum adjustment? Select all that apply. a) Active bowel sounds b) Nondistended abdomen c) Abdominal pain d) Passing gas e) Tender abdomen
• Active bowel sounds • Passing gas • Nondistended abdomen
Patient teaching is conducted throughout a patient's hospitalization and is reinforced before discharge. Which self-care items are to be reinforced before discharge? a) Infant formula selection b) Activity c) Resumption of prepregnancy diet d) Resumption of intercourse e) Signs and symptoms of infection
• Activity • Resumption of intercourse • Signs and symptoms of infection
Given that the first 24 hours after delivery is a time for return to homeostasis, which postpartum findings are considered acceptable during this time? Select all that apply. a) Inverted nipples following breastfeeding b) Fundus one fingerbreadth above umbilicus c) Urination of 50 mL every hour d) Hypotonic bowel sounds e) Moderate saturation of peripad every 3 hours
• Fundus one fingerbreadth above umbilicus • Moderate saturation of peripad every 3 hours
When teaching the new mother about breastfeeding, the nurse is correct when providing what instructions? Select all that apply. a) Show mothers how to initiate breastfeeding within 30 minutes of birth. b) Encourage breastfeeding of the newborn infant on demand. c) Give newborns water and other foods to balance nutritional needs. d) Provide breastfeeding newborns with pacifiers. e) Place baby in uninterrupted skin-to-skin contact with the mother.
• Show mothers how to initiate breastfeeding within 30 minutes of birth. • Encourage breastfeeding of the newborn infant on demand. • Place baby in uninterrupted skin-to-skin contact with the mother.
A newly delivered mother has difficulty sleeping despite her exhaustion from labor. This inability to rest is due to Select all that apply. a) The baby's crying b) Frequent trips to the bathroom due to diuresis c) Inability to get adequate pain relief d) Bottle feeding e) Excess fatigue and overstimulation by visitors
• The baby's crying • Frequent trips to the bathroom due to diuresis • Inability to get adequate pain relief • Excess fatigue and overstimulation by visitors
Postpartum infection is one event that is known to impede the recovery process of a new mother. Which characteristics after delivery make a woman more susceptible to infection? Select all that apply. a) Episiotomy b) White blood cell count 25,000/mm³ c) Urinary stasis d) Denuded endometrial arteries
• Urinary stasis • Denuded endometrial arteries • Episiotomy
A nursing student is studying postpartal complications. Thromboembolic conditions have which of the following risk factors? (Select all that apply.) a) obesity b) anemia c) multiparity d) cigarette smoking e) irritable bowel f) diabetes
• anemia • diabetes • cigarette smoking • obesity • multiparity
Hypercoagulability during pregnancy protects the mother against excessive blood loss during childbirth. It also can increase a woman's risk of developing a blood clot. It does this by which of the following ways? (Select all that apply.) a) localized vascular damage b) decline in WBCs c) altered coagulation d) stasis e) decline in HGB
• stasis • altered coagulation • localized vascular damage
The nurse who works on a post-partum floor is mentoring a new graduate. She informs the new nurse that a post-partum assessment of the mother includes which of the following? (check all that apply) a) vital signs of mother b) head-to-toe assessment of newborn c) pain level d) head-to-toe assessment e) newborn's vital signs
• vital signs of mother • pain level • head-to-toe assessment
After teaching a postpartum woman about postpartum blues, which statement indicates effective teaching? a) "If the symptoms last more than a few days, I need to call my doctor." b) "I'll need to take medication to treat the anxiety and sadness." c) "I should call this support line only if I hear voices." d) "I might feel like laughing one minute and crying the next."
"I might feel like laughing one minute and crying the next."
When doing a health assessment, at which of the following locations would you expect to palpate the fundus in a woman on the second postpartal day and how should it feel? a) Fundus height 4 cm below umbilicus and midline b) Fundus two fingerbreadths below umbilicus and firm c) Fundus two fingerbreadths above symphysis pubis and hard d) Fundus 4 cm above symphysis pubis and firm
Fundus two fingerbreadths below umbilicus and firm
A woman who delivered 10 hours ago is ambulating to the bathroom and calls for assistance with perineal care. When the nurse touches her skin, he notices that she is excessively warm. After reinforcing the woman's self-care, the nurse encourages increased oral intake. Why was this the appropriate instruction to give to this patient? a) The patient needs to walk to the bathroom more often. b) Increased intake will increase the patient's output and therefore will provide an opportunity for more frequent perineal self-care. c) Increased intake will rehydrate the patient and decrease her skin temperature. d) The patient will have to call for the nurse's help more often.
Increased intake will rehydrate the patient and decrease her skin temperature.
