OB Quiz #3 NurseLabs

Following a precipitous delivery, examination of the client's vagina reveals a fourth-degree laceration. Which of the following would be contraindicated when caring for this client? A. Applying cold to limit edema during the first 12 to 24 hours. B. Instructing the client to use two or more peri pads to cushion the area. C. Instructing the client on the use of sitz baths if ordered. D. Instructing the client about the importance of perineal (Kegel) exercises.

B. Instructing the client to use two or more peri pads to cushion the area.

The uterine fundus right after delivery of placenta is palpable at A. Level of Xiphoid process B. Level of umbilicus C. Level of symphysis pubis D. Midway between umbilicus and symphysis pubis

B. Level of umbilicus

After 3 days of breastfeeding, a postpartum patient reports nipple soreness. To relieve her discomfort, the nurse should suggest that she: A. Apply warm compresses to her nipples just before feeding. B. Lubricate her nipples with expressed milk before feeding. C. Dry her nipples with a soft towel after feeding. D. Apply soap directly to her nipples, and then rinse.

B. Lubricate her nipples with expressed milk before feeding.

Which of the following are the most commonly assessed findings in cystitis? A. Frequency, urgency, dehydration, nausea, chills, and flank pain B. Nocturia, frequency, urgency dysuria, hematuria, fever, and suprapubic pain C. Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever D. High fever, chills, flank pain nausea, vomiting, dysuria, and frequency

B. Nocturia, frequency, urgency dysuria, hematuria, fever, and suprapubic pain

In vaginal delivery done in the hospital setting, the doctor routinely orders oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because: A. Oxytocin will prevent bleeding. B. Oxytocin can make the cervix close and thus trap the placenta inside. C. Oxytocin will facilitate placental delivery. D. Giving oxytocin will ensure complete delivery of the placenta.

B. Oxytocin can make the cervix close and thus trap the placenta inside.

When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period, the nurse in charge should include which of the following? A. The vaccine prevents a future fetus from developing congenital anomalies. B. Pregnancy should be avoided for 3 months after the immunization. C. The client should avoid contact with children diagnosed with rubella. D. The injection will provide immunity against the 7-day measles.

B. Pregnancy should be avoided for 3 months after the immunization.

After an Rh(-) mother has delivered her Rh (+) baby, the mother is given RhoGam. This is done in order to: A. Prevent the recurrence of Rh(+) babies in future pregnancies. B. Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby. C. Ensure those future pregnancies will not lead to maternal illness. D. To prevent the newborn from having problems of incompatibility when it breastfeeds.

B. Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby.

While the postpartum client is receiving heparin for thrombophlebitis, which of the following drugs would the nurse expect to administer if the client develops complications related to heparin therapy? A. Calcium gluconate B. Protamine sulfate C. Methylergonovine (Methergine) D. Nitrofurantoin (Macrodantin)

B. Protamine sulfate

The nursing measure to relieve fetal distress due to maternal supine hypotension is: A. Place the mother in semi-Fowler's position. B. Put the mother on the left side-lying position. C. Place mother on a knee-chest position. D. Any of the above.

B. Put the mother on the left side-lying position.

Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta? A. Excessive vaginal bleeding B. Rigid, board-like abdomen C. Tetanic uterine contractions D. Premature rupture of membranes

B. Rigid, board-like abdomen

According to Rubin's theory of maternal role adaptation, the mother will go through 3 stages during the postpartum period. These stages are: A. Going through, adjustment period, adaptation period B. Taking-in, taking hold and letting-go C. Attachment phase, adjustment phase, adaptation phase D. Taking-hold, letting-go, attachment phase

B. Taking-in, taking hold and letting-go

Which of the following best reflects the frequency of reported postpartum "blues"? A. Between 10% and 40% of all new mothers report some form of postpartum blues. B. Between 30% and 50% of all new mothers report some form of postpartum blues. C. Between 50% and 80% of all new mothers report some form of postpartum blues. D. Between 25% and 70% of all new mothers report some form of postpartum blues.

C. Between 50% and 80% of all new mothers report some form of postpartum blues.

The nurse plans to instruct the postpartum client about methods to prevent breast engorgement. Which of the following measures would the nurse include in the teaching plan? A. Feeding the neonate a maximum of 5 minutes per side on the first day. B. Wearing a supportive brassiere with nipple shields. C. Breastfeeding the neonate at frequent intervals. D. Decreasing fluid intake for the first 24 to 48 hours.

C. Breastfeeding the neonate at frequent intervals.

A new mother is having trouble breastfeeding her newborn. The child is making frantic rooting motions and will not grasp the nipple. Which intervention should the nurse implement? A. Encourage frequent use of a pacifier so that the infant becomes accustomed to sucking. B. Hold the infant's head firmly against the breast until he latches onto the nipple. C. Encourage the mother to stop feeding for a few minutes and comfort the infant. D. Provide a formula for the infant until he becomes calm, and then offer the breast again.

C. Encourage the mother to stop feeding for a few minutes and comfort the infant.

To enhance milk production, a lactating mother must do the following interventions, except: A. Increase fluid intake including milk. B. Eat foods that increase lactation which is called galactagogues. C. Exercise adequately like aerobics. D. Have adequate nutrition and rest.

C. Exercise adequately like aerobics.

Which of the following is the priority focus of nursing practice with the current early postpartum discharge? A. Promoting comfort and restoration of health. B. Exploring the emotional status of the family. C. Facilitating safe and effective self and newborn care. D. Teaching about the importance of family planning.

C. Facilitating safe and effective self and newborn care.

A nurse is monitoring the amount of lochia drainage in a client who is 2 hours postpartum and notes that the client has a saturated perineal pad in 1 hour. The nurse reports the amount of lochial flow as: A. Scanty B. Light C. Heavy D. Excessive

C. Heavy

A client who delivered by cesarean section 24 hours ago is using a patient-controlled analgesia (PCA) pump for pain control. Her oral intake has been ice chips only since surgery. She is now complaining of nausea and bloating, and states that because she had nothing to eat, she is too weak to breastfeed her infant. Which nursing diagnosis has the highest priority? A. Altered nutrition, less than body requirements for lactation. B. Alteration in comfort related to nausea and abdominal distention. C. Impaired bowel motility related to pain medication and immobility. D. Fatigue related to cesarean delivery and physical care demands of infant.

C. Impaired bowel motility related to pain medication and immobility.

A client in her third trimester tells the nurse, "I'm constipated all the time!" Which of the following should the nurse recommend? A. Daily enemas B. Laxatives C. Increased fiber intake D. Decreased fluid intake

C. Increased fiber intake

When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is: A. Allow the woman to exercise. B. Let the woman walk for a while. C. Let the woman lie down and dorsiflex the foot towards the knees. D. Ask the woman to raise her legs.

C. Let the woman lie down and dorsiflex the foot towards the knees.

The following are interventions to make the fundus contract postpartally, except: A. Make the baby suck the breast regularly. B. Apply ice cap on fundus. C. Massage the fundus vigorously for 15 minutes until contracted. D. Give oxytocin as ordered.

C. Massage the fundus vigorously for 15 minutes until contracted.

Which of the following assessment findings would the nurse expect if the client develops DVT? A. Mid Calf pain, tenderness, and redness along the vein. B. Chills, fever, malaise, occurring 2 weeks after delivery. C. Muscle pain, the presence of Homans sign, and swelling in the affected limb. D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery.

C. Muscle pain, the presence of Homans sign, and swelling in the affected limb.

The lochia on the first few days after delivery is characterized as A. Pinkish with some blood clots B. Whitish with some mucus C. Reddish with some mucus D. Serous with some brown tinged mucus

C. Reddish with some mucus

Breast self-examination is best done by the woman on herself every month during A. The middle of her cycle to ensure that she is ovulating. B. During the menstrual period. C. Right after the menstrual period so that the breast is not being affected by the increase in hormones particularly estrogen. D. Just before the menstrual period to determine if ovulation has occurred.

C. Right after the menstrual period so that the breast is not being affected by the increase in hormones particularly estrogen.

Which of the following would be a disadvantage of breastfeeding? A. Involution occurs more rapidly. B. The incidence of allergies increases due to maternal antibodies. C. The father may resent the infant's demands on the mother's body. D. There is a greater chance for error during preparation.

C. The father may resent the infant's demands on the mother's body.

While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: A. Express a strong need to review the events and her behavior during the process of labor and birth. B. Exhibit a reduced attention span, limiting readiness to learn. C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D. Have reestablished her role as a spouse or partner.

C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn.

Which statement made by the client indicates that the mother understands the limitations of breastfeeding her newborn? A. "Breastfeeding my infant consistently every 3 to 4 hours stops ovulation and my period." B. "Breastfeeding my baby immediately after drinking alcohol is safer than waiting for the alcohol to clear my breast milk." C. "I can start smoking cigarettes while breastfeeding because it will not affect my breast milk." D. "When I take a warm shower after I breastfeed, it relieves the pain from being engorged between breastfeedings."

A. "Breastfeeding my infant consistently every 3 to 4 hours stops ovulation and my period."

During the postpartum period, the fundus of the uterus is expected to go down normally about how many centimeters per day? A. 1.0 cm B. 2.0 cm C. 2.5 cm D. 3.0 cm

A. 1.0 cm

To ensure adequate lactation the nurse should teach the mother to: A. Breastfeed the baby on self-demand day and night. B. Feed primarily during the day and allow the baby to sleep through the night. C. Feed the baby every 3-4 hours following a strict schedule. D. Breastfeed when the breasts are engorged to ensure adequate supply.

A. Breastfeed the baby on self-demand day and night.

Normal lochial findings in the first 24 hours post-delivery include: A. Bright red blood B. Large clots or tissue fragments C. A foul odor D. The complete absence of lochia

A. Bright red blood

What are the important considerations that the nurse must remember after the placenta is delivered? Select all that apply. A. Check if the placenta is complete including the membranes B. Check if the cord is long enough for the baby C. Check if the umbilical cord has 3 blood vessels D. Check if the cord has a meaty portion and a shiny portion

A. Check if the placenta is complete including the membranes C. Check if the umbilical cord has 3 blood vessels

When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be avoided? A. Diaphragm B. Female condom C. Oral contraceptives D. Rhythm method

A. Diaphragm

A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which of the following would the nurse be alert? A. Endometritis B. Endometriosis C. Salpingitis D. Pelvic thrombophlebitis

A. Endometritis

The nurse should anticipate that hemorrhage related to uterine atony may occur postnatally if this condition was present during the delivery: A. Excessive analgesia was given to the mother. B. Placental delivery occurred within thirty minutes after the baby was born. C. An episiotomy had to be done to facilitate delivery of the head. D. The labor and delivery lasted for 12 hours.

A. Excessive analgesia was given to the mother.

If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur. Select all that apply. A. Laceration of cervix B. Laceration of perineum C. Cranial hematoma in the fetus D. Fetal anoxia

A. Laceration of cervix B. Laceration of perineum C. Cranial hematoma in the fetus D. Fetal anoxia

Which change would the nurse identify as a progressive physiological change in the postpartum period? A. Lactation B. Lochia C. Uterine involution D. Diuresis

A. Lactation

A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated, remains unusually large, and not descending as normally expected. Which of the following should the nurse assess next? A. Lochia B. Breasts C. Incision D. Urine

A. Lochia

While assessing a primipara during the immediate postpartum period, the nurse in charge plans to use both hands to assess the client's fundus to: A. Prevent uterine inversion. B. Promote uterine involution. C. Hasten the puerperium period. D. Determine the size of the fundus.

A. Prevent uterine inversion.

The nurse in charge is caring for a postpartum client who had a vaginal delivery with a midline episiotomy. Which nursing diagnosis takes priority for this client? A. Risk for deficient fluid volume related to hemorrhage. B. Risk for infection related to the type of delivery. C. Pain related to the type of incision. D. Urinary retention related to periurethral edema.

A. Risk for deficient fluid volume related to hemorrhage.

Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples? A. Tell her to breastfeed more frequently. B. Administer a narcotic before breastfeeding. C. Encourage her to wear a nursing brassiere. D. Use soap and water to clean the nipples.

A. Tell her to breastfeed more frequently.

In a woman who is not breastfeeding, menstruation usually occurs after how many weeks? A. 2-4 weeks B. 6-8 weeks C. 6 months D. 12 months

B. 6-8 weeks

Lochia normally disappears after how many days postpartum? A. 5 days B. 7-10 days C. 18-21 days D. 28-30 days

B. 7-10 days

The nursing intervention to relieve pain in breast engorgement while the mother continues to breastfeed is A. Apply cold compress on the engorged breast. B. Apply warm compress on the engorged breast. C. Massage the breast. D. Apply analgesic ointment.

B. Apply warm compress on the engorged breast.

Which of the following is an abnormal vital sign in postpartum? A. Pulse rate between 50-60/min B. BP diastolic increase from 80 to 95mm Hg C. BP systolic between 100-120mm Hg D. Respiratory rate of 16-20/min

B. BP diastolic increase from 80 to 95mm Hg increase of 15mm Hg in the diastolic which is a possible sign of hypertension in pregnancy.

The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following assessments would warrant notification of the physician? A. A dark red discharge on a 2-day postpartum client. B. A pink to brownish discharge on a client who is 5 days postpartum. C. Almost colorless to creamy discharge on a client 2 weeks after delivery. D. A bright red discharge 5 days after delivery.

D. A bright red discharge 5 days after delivery.

Postpartum blues is said to be normal provided that the following characteristics are present. These are A. Within 3-10 days only B. Woman exhibits the following symptoms- episodic tearfulness, fatigue, oversensitivity, poor appetite C. Maybe more severe symptoms in primipara D. All of the above

D. All of the above

The following are nursing measures to stimulate lactation, except: A. Frequent regular breastfeeding B. Breast pumping C. Breast massage D. Application of cold compress on the breast

D. Application of cold compress on the breast

Before assessing the postpartum client's uterus for firmness and position in relation to the umbilicus and midline, which of the following should the nurse do first? A. Assess the vital signs. B. Administer analgesia. C. Ambulate her in the hall. D. Assist her to urinate.

D. Assist her to urinate.

Which of the following is the primary predisposing factor related to mastitis? A. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts. B. Endemic infection occurring randomly and localizing in the peri glandular connective tissue. C. Temporary urinary retention due to decreased perception of the urge to avoid. D. Breast injury caused by overdistention, stasis, and cracking of the nipples.

D. Breast injury caused by overdistention, stasis, and cracking of the nipples.

The nurse assesses the vital signs of a client, 4 hours' postpartum that are as follows: BP 90/60; temperature 100.4ºF; pulse 100 weak, thready; R 20 per minute. Which of the following should the nurse do first? A. Report the temperature to the physician. B. Recheck the blood pressure with another cuff. C. Assess the uterus for firmness and position. D. Determine the amount of lochia.

D. Determine the amount of lochia.

An appropriate nursing intervention when caring for a postpartum mother with thrombophlebitis is: A. Encourage the mother to ambulate to relieve the pain in the leg. B. Instruct the mother to apply elastic bondage from the foot going towards the knee to improve venous return flow. C. Apply warm compress on the affected leg to relieve the pain. D. Elevate the affected leg and keep the patient on bedrest.

D. Elevate the affected leg and keep the patient on bedrest.

Upon assessment, the nurse got the following findings: two (2) perineal pads highly saturated with blood within 2 hours postpartum, PR= 80 bpm, fundus soft, and boundaries not well defined. The appropriate nursing diagnosis is: A. Normal blood loss B. Blood volume deficiency C. Inadequate tissue perfusion related to hemorrhage D. Hemorrhage secondary to uterine atony

D. Hemorrhage secondary to uterine atony

Which of the following best describes thrombophlebitis? A. Inflammation and clot formation that result when blood components combine to form an aggregate body. B. Inflammation and blood clots that eventually become lodged within the pulmonary blood vessels. C. Inflammation and blood clots that eventually become lodged within the femoral vein. D. Inflammation of the vascular endothelium with clot formation on the vessel wall.

D. Inflammation of the vascular endothelium with clot formation on the vessel wall.

When the uterus is firm and contracted after delivery but there is vaginal bleeding, the nurse should suspect which of the following? A. Uterine hypercontractility B. Uterine atony C. Uterine inversion D. Laceration of soft tissues of the cervix and vagina

D. Laceration of soft tissues of the cervix and vagina

Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage? A. More than 200 ml B. More than 300 ml C. More than 400 ml D. More than 500 ml

D. More than 500 ml

After administering bethanechol to a patient with urine retention, the nurse in charge monitors the patient for adverse effects. Which is most likely to occur? A. Decreased peristalsis B. Increase heart rate C. Dry mucous membranes D. Nausea and Vomiting

D. Nausea and Vomiting

The following are nursing interventions to relieve episiotomy wound pain, except: A. Giving analgesic as ordered B. Sitz bath C. Perineal heat D. Perineal care

D. Perineal care

Which of the following would be inappropriate to assess in a mother who's breastfeeding? A. The attachment of the baby to the breast. B. The mother's comfort level with positioning the baby. C. Audible swallowing. D. The baby's lips smacking.

D. The baby's lips smacking.