OB WEEK 3 chpt 15 & 16
The nurse who is working with parents and their newborn encourages which action to assist the bonding and attachment between them? a. touching b. feeding c. looking d. talking
a. touching
In a class for expectant parents, the nurse discusses the various benefits of breastfeeding. However, the nurse also describes that there are situations involving certain women who should not breastfeed. Which examples would the nurse cite? Select all that apply. a. women using street drugs b. women who had difficulties with c. breastfeeding in the past d. women on antineoplastic medications e. women on antithyroid medications f. women with more than one infant
a. women using street drugs d. women on antineoplastic medications e. women on antithyroid medications
The nurse is performing a routine assessment of the client after birth. Inspection of a woman's perineal pad reveals a 3-in (7.5-cm) lochia stain. This amount should be documented as which type? a. heavy b. light c. moderate d. scant
b. light
A nurse is providing care to a postpartum woman and is completing the assessment. Which finding would indicate to the nurse that a postpartum woman is experiencing bladder distention? a. Percussion reveals dullness. b. Uterus is firm. c. Bladder is nonpalpable. d. Lochia is less than usual.
a. Percussion reveals dullness.
A client has come to the office for her first postpartum visit. On evaluating her blood work, the nurse would be concerned if the hematocrit is noted to have: a. acutely decreased. b. slightly increased. c. slightly decreased. d. acutely increased.
a. acutely decreased.
A postpartum woman tells the home care nurse, "My hemorrhoids are really uncomfortable. Is there anything I can do?" Which suggestion(s) by the nurse would be appropriate? Select all that apply. a. "Applying ice to the area can help." b. "You should pour cold water over the area with your peribottle." c. "You might think anesthetic sprays help but they do not." d. "Witch hazel pads can have a cooling effect." e. "I will show you how to use a sitz bath."
a. "Applying ice to the area can help." d. "Witch hazel pads can have a cooling effect." e. "I will show you how to use a sitz bath."
A nurse is describing a technique developed in the 1940s by Dr. Arnold Kegel to assist postpartum women with a common issue. The nurse explains that the purpose of this technique is to: a. strengthen the pelvic floor muscles to reduce urinary incontinence. b. strengthen the uterine muscle fibers to return to their pre pregnancy condition. c. strengthen the abdominal muscles to lessen the size of stretch marks. d. strengthen the joints and return them to their normal state.
a. strengthen the pelvic floor muscles to reduce urinary incontinence.
The client is preparing to go home after a cesarean birth. The nurse giving discharge instructions stresses to the family that the client should be seen by her primary care provider within what time interval? a. 2 weeks b. 3 weeks c. 5 weeks d. 4 weeks
a. 2 weeks
It has been 2 hours since a woman gave birth vaginally to a healthy newborn. When assessing the woman's uterine 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.
a. the level of the umbilicus.
When assessing a postpartum woman, the nurse would find which factor to be most significant in identifying possible postpartum hemorrhage? a. blood pressure b. pulse rate c. hematocrit d. cardiac output
b. pulse rate
A nurse is caring for a postpartum woman who is Muslim. When developing the woman's plan of care, the nurse would make which action a priority? a. Ensure that the newborn's daily bath is performed by the nurses. b. Allow time for the numerous visitors who come to see the woman and newborn. c. Provide time for prayers to be performed at the bedside. d. Assign a female nurse to care for her.
d. Assign a female nurse to care for her.
A woman who is breastfeeding her newborn says, "He doesn't seem to want to nurse. I must be doing something wrong." After teaching the woman about breastfeeding and offering suggestions, which statement by the mother indicates the need for additional teaching? a. "Maybe a lactation specialist can help me work through this." b. "Some women just can't breastfeed. Maybe I'm one of these women." c. "Some babies latch on and catch on quickly; others take a little more time." d. "Breastfeeding takes time and practice."
b. "Some women just can't breastfeed. Maybe I'm one of these women."
Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type? a. fourth-degree laceration b. first-degree laceration c. third-degree laceration d.second-degree laceration
c. third-degree laceration
A client who is 12 hours postbirth is reporting perineal pain. After the assessment reveals no signs of an infection, which measure could the nurse offer the client? a. a heating pad applied to the perineum b. a sitz bath c. narcotic pain medication d. an ice pack applied to the perineum
d. an ice pack applied to the perineum
During a home visit with new parents, the nurse also assesses the new father's adaptation to his new role. Which statement would indicate that he is in the expectation stage? a. "I may not be a pro at helping out with the baby, but I enjoy being involved." b. "I didn't realize all that went into being a dad. I wasn't prepared for this." c. "I've learned how to diaper and bathe the baby so I can be a really involved dad." d. "It'll be fun to have a baby in the house, but things shouldn't change too much."
d. "It'll be fun to have a baby in the house, but things shouldn't change too much."
A nurse is providing care to a woman who is 6 hours postpartum. The nurse suspects urinary retention based on which finding? a. 50 to 70 mL urine per void every hour b. Urine clear yellow in color c. Fundus at the level of the umbilicus d. Moderate amount of lochia rubra
a. 50 to 70 mL urine per void every hour
A nurse is providing care to a postpartum woman who is breastfeeding her 1-day old neonate. While observing the interaction, the woman says to the nurse, "I have noticed some tingling in both of my breasts just before my baby starts to feed and then for a bit during the feeding. What is happening?" Which response by the nurse would be appropriate? a. "I need to call your provider because it sounds like you might be developing an infection." b. "What you are feeling is the normal let-down reflex when milk is released." c. "There must be something causing a blockage in your milk ducts." d. "Tingling in your breasts is most likely a sign that your breast tissue is swollen."
b. "What you are feeling is the normal let-down reflex when milk is released."
A woman gave birth vaginally approximately 12 hours ago, and her temperature is now 100.8° F (38.2° C). Which action would be most appropriate for the nurse to take? a. Obtain a urine culture; the woman most likely has a urinary tract infection. b. Notify the health care provider about this elevation; this finding reflects possible infection. c. Inspect the perineum for hematoma formation. d. Continue monitoring the woman's temperature every 4 hours; this finding is normal.
b. Notify the health care provider about this elevation; this finding reflects possible infection.
A woman comes to the clinic for her first postpartum visit. She gave birth to a healthy term neonate 2 weeks ago. As part of this visit, the woman has a complete blood count drawn. Which result would the nurse identify as a potential problem? a. Hematocrit 42% (0.42) b. Platelets 350,000/μL (350 ×109/L) c. White blood cell count d. 14,000/mm3 (14 × 109/L) e. Hemoglobin 12.5 g/dL (125 g/L)
c. White blood cell count d. 14,000/mm3 (14 × 109/L)
A nurse is conducting a in-service education program for a group of nurses working in the postpartum unit about postpartal infection. The nurse determines that the teaching was successful when the group identifies which factor as contributing to the risk for infection postpartally? a. multiparity b. hemoglobin of 11.5 mg/dL c. placenta removed via manual extraction d. labor of 12 hours
c. placenta removed via manual extraction
A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn. During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet resumed. Which suggestion by the nurse would be most appropriate? a. "This is entirely normal, and many women go through it. It just takes time." b. "It takes a while to get your body back to its normal function after having a baby." c. "Try doing Kegel exercises to get your pelvic muscles back in shape." d. "You might try using a water-soluble lubricant to ease the discomfort."
d. "You might try using a water-soluble lubricant to ease the discomfort."
A nurse is developing a plan of care for a postpartum woman, newborn, and partner to facilitate the attachment process. Which intervention would be appropriate for the nurse to include in the plan? a. Urge parents to talk to each other when holding the baby. b. Encourage contact between the newborn's skin and parental clothing. c. Have the parents participate in newborn care once a day. d. Ensure early and frequent parent-newborn interactions.
d. Ensure early and frequent parent-newborn interactions.
During a routine assessment the nurse notes the postpartum client is tachycardic. What is a possible cause of tachycardia? a. bladder distention b. extreme diaphoresis c. uterine atony d. delayed hemorrhage
d. delayed hemorrhage
A nurse is working with the parents of a newborn girl. The parents have a 2-year-old boy at home. Which statement would the nurse include when teaching these parents? a. "Ask your 2-year-old to pick out a special toy for his sister." b. "Expect to see your 2-year-old become more independent when the baby gets home." c. "Talk to your 2-year-old about the baby when you're driving him to day care." d. "Have your 2-year-old stay at home while you're here in the hospital."
a. "Ask your 2-year-old to pick out a special toy for his sister."
A postpartum client has decided to bottle feed her newborn. After teaching the woman about it, the nurse determines that the teaching was successful based on which client statement(s)? Select all that apply. a. "I will be sure not to use the microwave to warm the formula." b. "I will use warm water to mix the powdered formula." c. "I will store any formula left over from a feeding in the refrigerator." d. "I will get my newborn to suck by touching the nipple to the lips." e. "I will make sure the nipple and neck of the bottle are filled with formula during a feeding."
a. "I will be sure not to use the microwave to warm the formula." d. "I will get my newborn to suck by touching the nipple to the lips." e. "I will make sure the nipple and neck of the bottle are filled with formula during a feeding."
During a postpartum home visit, a woman tells the nurse that her hip joints are sore, just like they were when she was pregnant. Which information would the nurse likely include when teaching the woman about this condition? Select all that apply. a. "Let me show you how to use good body mechanics to lessen the problem." b. "It is important to lie down on your back at least 3 times a day." c. "It is important to get this checked out with an x-ray just to make sure." d. "You will probably need to take an opioid pain medicine for a few weeks." e. "This soreness should go away in about 6 to 8 weeks."
a. "Let me show you how to use good body mechanics to lessen the problem." e. "This soreness should go away in about 6 to 8 weeks."
A nurse is conducting a class on various issues that might develop after going home with a new infant. After discussing how to care for hemorrhoids, the nurse understands that which statement by the class would indicate the need for more information? a. "Sitz baths worked the last time." b. "I only eat a low-fiber diet." c. "My mom always used dibucaine." d. "I already have some pads with witch hazel at home."
a. "Sitz baths worked the last time." b. "I only eat a low-fiber diet."
A postpartum woman has been unable to urinate since giving birth. When the nurse is assessing the woman, which finding would indicate that this client is experiencing bladder distention? a. Uterus is boggy. b. Percussion reveals tympani. c. Lochia is less than usual. d. Bladder is nonpalpable.
a. Uterus is boggy.
The nurse has been asked to conduct a class to teach new mothers how to avoid developing stress incontinence. Which action would the nurse include in the discussion as possible strategies for the new mothers to do? Select all that apply. a. avoiding smoking b. performing Kegel exercises c. starting jogging d. losing weight if obese e. increasing fluid intake
a. avoiding smoking b. performing Kegel exercises d. losing weight if obese
The nurse is providing care to a postpartum woman who has given birth vaginally to a healthy term neonate about 4 hours ago. While assessing the client, the client tells the nurse, "I've really been urinating a lot in the past hour." The nurse interprets this finding as suggestive of a decrease in which hormone? a. estrogen b. prolactin c. progesterone d. hCG
a. estrogen
A young mother is at the office for her 6-week visit. She is still experiencing mild loch alba and is concerned that she has an infection. Which finding would the nurse interpret as supporting this suspicion? a. light brown discharge b. fleshy smell c. creamy discharge d. foul odor
d. foul odor
A nurse is preparing a class for a group of new parents on the psychological adaptations that occur after the birth. The nurse should include which signs and symptoms that might suggest postpartum depression? Select all that apply. a. feelings of worthlessness b. hunger c. sleeping well d. restlessness e. feeling overwhelmed
a. feelings of worthlessness d. restlessness e. feeling overwhelmed
During a routine home visit, the couple asks the nurse when it will be safe to resume full sexual relations. Which answer would be the best? a. generally within 3 to 6 weeks b. whenever the couple wishes c. usually within a couple weeks d. generally after 12 weeks
a. generally within 3 to 6 weeks
Prior to discharge is an appropriate time to evaluate the client's status for preventative measures such as immunizations and Rh status. Which test would the nurse ensure has been conducted to evaluate the Rh negative mother? a. indirect Coombs' test b. ANA c. CBC with differential d. titer screen
a. indirect Coombs' test
A nurse is reviewing a postpartum woman's history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor? a. placenta removed via manual extraction b. hemoglobin of 11.5 mg/dL c. multiparity d. labor less than 3 hours
a. placenta removed via manual extraction
The birth center recognizes that attachment is very important in the early stages after birth. Which policy would be inappropriate for the birth center to implement when assisting new parents in this process? a. policies that discourage unwrapping and exploring the infant b. policies that allow flexibility for cultural differences c. policies that allow rooming the infant and mother together d. policies that allow visitors
a. policies that discourage unwrapping and exploring the infant
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. 1 cm below the umbilicus. c. between the umbilicus and symphysis pubis. d. 2 cm below the umbilicus.
a. the level of the umbilicus.
A new mother comes in for her first visit and reports pain and tenderness in her breast just before feeding. Based on her description, the nurse determines she is experiencing breast engorgement. Which instruction should the nurse provide to her? a. "Wear a supportive tight bra all day long." b. "Take a warm shower just before feeding your infant." c. "Use ice for about 15 minutes every other hour to promote comfort." d. "Try not to touch your breasts or nipples until the swelling subsides."
b. "Take a warm shower just before feeding your infant."
On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily? a. 1,000 additional calories per day b. 500 additional calories per day c. 250 additional calories per day d. 750 additional calories per day
b. 500 additional calories per day
The new mother has decided to feed her infant formula. When teaching her about the different types of formula, the nurse should stress the infant should receive how many calories each day? a. 500 calories b. 650 calories c. 950 calories d. 800 calories
b. 650 calories
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. Inspect the perineum for hematoma formation. b. Continue to monitor the woman's temperature every 4 hours; this finding is normal. c. Notify the health care provider about this elevation; this finding reflects infection. d. Obtain a urine culture; the woman most likely has a urinary tract infection.
b. Continue to monitor the woman's temperature every 4 hours; this finding is normal.
While providing care to a postpartum client on her first day at home, the nurse observes which behavior that would indicate the new mother is in the taking-hold phase? a. Pointing out specific features in the newborn b. Showing increased confidence when caring for the newborn c. Having feelings of grief or guilt d. Talking about her labor experience to others around her
b. Showing increased confidence when caring for the newborn
A nurse works at a facility that provides care to clients holding various cultural beliefs. The nurse integrates understanding of the areas recognized by other cultures that are not necessarily acknowledged by the Western culture. Which area would the nurse need to incorporate into the plans of care? a. expectations of what the new mother should be doing b. balance of hot and cold c. introducing the infant to the rest of the family d. allowing family members at the birth
b. balance of hot and cold
A nurse is describing the many changes that will occur during the early postpartum period with a group of young parents. The nurse reviews common reports experienced as the woman's body returns to her prepregnancy state. The nurse determines that the teaching was successful when the participants identify which report as being most common during the first week that will indicate their fluid volume is returning to normal? a. urinary urgency b. diaphoresis c. nocturia d. urinary frequency
b. diaphoresis
The nurse is concerned that the parents are having difficulties relating to their newborn. In an effort to assist with and encourage attachment, which activity should the nurse suggest? a. playing a recording of their voices at all times b. promoting skin-to-skin contact on the chest c. keeping the baby in the same room at all times d. sleeping with the infant
b. promoting skin-to-skin contact on the chest
During an assessment, the nurse notes that the client has been unable to urinate properly since giving birth and is bleeding more than expected. The nurse suspects which condition? a. pain when voiding b. uterine atony c. postpartum diaphoresis d. urinary tract infection
b. uterine atony
A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. a. breastfeeding b. uterine infection c. early ambulation d. empty bladder e. prolonged labor f. hydramnios
b. uterine infection e. prolonged labor f. hydramnios
The nurse is making a home visit to a woman who is 4 days postpartum. Which finding would indicate to the nurse that the woman is experiencing a problem? a. diaphoresis b. uterus 1 cm below umbilicus c. lochia serosa d. edematous vagina
b. uterus 1 cm below umbilicus
After a class for expectant parents on the various forms of birth control after the birth of their infant, the nurse realizes more training is needed when a participant makes which comment? a. "We will be discussing birth control with our primary care provider to find the best method for us." b. "We're going to use a barrier for the first few months and then decide what we want to do." c. "I'm going to be breastfeeding occasionally, so we won't need to use any other birth control for at least six months." d. "I'm going back on the pill as soon as the doctor okays it."
c. "I'm going to be breastfeeding occasionally, so we won't need to use any other birth control for at least six months."
The nurse is teaching a postpartum woman and her spouse about postpartum blues. The nurse would instruct the couple to seek further care if the client's symptoms persist beyond which time frame? a. 1 week b. 4 weeks. c. 2 weeks d. 3 weeks
c. 2 weeks
A nurse is making a postpartum home visit to a woman who gave birth vaginally about 12 days ago. The woman's partner is present during the visit. When assessing the woman and the family, which finding related to the partner would lead the nurse to suspect that the partner may be experiencing postpartum depression? Select all that apply. a. Use of encouraging statements about the infant b. Feelings of being unprepared for the role c. Reports of feeling highly stressed d. Statements that woman is getting all the attention e. Reports of frequent headaches
c. Reports of feeling highly stressed d. Statements that woman is getting all the attention e. Reports of frequent headaches
The nurse is assisting a young mother who has decided not to breastfeed her infant. The nurse should make which suggestions to the client to ease discomfort and prevent breast engorgement? Select all that apply. a. Take a hot shower. b. Pump her breasts once a day only. c. Wear tight supportive bra 24 hours each day. d. Avoid sexual stimulation. e. Apply ice to the breast for approximately 15 to 20 minutes every other hour.
c. Wear tight supportive bra 24 hours each day. d. Avoid sexual stimulation. e. Apply ice to the breast for approximately 15 to 20 minutes every other hour.
A nurse is reviewing the history of a postpartum woman. The nurse determines that the woman is at low risk for uterine subinvolution based on which findings? Select all that apply. a. prolonged labor b. uterine infection c. breastfeeding d. hydramnios e. early ambulation
c. breastfeeding e. early ambulation
A nurse provides care to pregnant women and their families from a wide range of cultural backgrounds and considers their culture and traditions when providing care. 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? a. pictures b. writing c. touching d. recognizing the meaning of words
c. touching
After teaching a group of pregnant women about the skin changes that will occur after the birth of their newborn, the nurse understands there is a need for additional teaching when one of the women makes which statement? a. "This line on my belly will go away over time." b. "My nipples won't be so dark after I give birth." c. "I might lose some hair, but it will grow back." d. "I can't wait for these stretch marks to disappear after I give birth."
d. "I can't wait for these stretch marks to disappear after I give birth."
When assessing a new father's adaptation to his new role, which statement would indicate that he is in the reality stage? a. "I may not be a pro at helping out with the baby, but I enjoy being involved." b. "It'll be fun to have a baby in the house, but things shouldn't change too much." c. "I've learned how to diaper and bathe the baby so I can be a really involved dad." d. "I didn't realize all that went into being a dad. I wasn't prepared for this."
d. "I didn't realize all that went into being a dad. I wasn't prepared for this."
After teaching a postpartum client about postpartum blues, the nurse determines that the teaching was effective when the client makes which statement? a. "I'll need to take medication to treat the anxiety and sadness." b. "I should call this support line only if I hear voices." c. "If the symptoms last more than a few days, I need to call my doctor." d. "I might feel like laughing one minute and crying the next."
d. "I might feel like laughing one minute and crying the next."
During a home visit, the client mentions she is still having significant of joint pain. The nurse explains that the changes that softened the pelvic joints to allow for the birth were due to the hormone relaxin. The nurse informs the client that it takes approximately how long for the joints to return to prepregnancy status? a. 2 to 4 weeks after pregnancy b. 4 to 6 weeks after pregnancy c. 8 to 10 weeks after pregnancy d. 6 to 8 weeks after pregnancy
d. 6 to 8 weeks after pregnancy
During the discharge planning for new parents, what would the case manager do to help provide the positive reinforcement and ensure multiple assessments are conducted? a. Provide phone numbers for call centers for questions. b. Ask family members to monitor the parents' progress. c. Encourage frequent clinic visits for high-risk families. d. Schedule home visits for high-risk families.
d. Schedule home visits for high-risk families.
The nurse realizes that accommodating for the various cultural differences in her clients is an important aspect in providing their care. When caring for a Japanese-American postpartum woman, which action would be a priority? a. providing time for prayers to be performed at the bedside b. assigning a female nurse to care for her c. allowing time for the numerous visitors who come to see the woman and newborn d. ensuring that the newborn receives a daily bath
d. ensuring that the newborn receives a daily bath
When describing the hormonal changes that occur after birth of a newborn, the nurse would identify a decrease in which hormone as being associated with breast engorgement? a. progesterone b. prolactin c. human chorionic gonadotropin (hCG) d. estrogen
d. estrogen
During the birth, the primary care provider performed an episiotomy. The client is now reporting discomfort. To reduce this discomfort and increase hygiene to the perineum, the nurse would encourage the client to use which intervention? a. alcohol wipes b. moist cloths c. baby wipes d. peribottle and warm water
d. peribottle and warm water
A nurse is teaching a postpartum woman about breastfeeding. When explaining the influence of hormones on breast-feeding, the nurse would identify which hormone that is responsible for milk production? a. oxytocin b. progesterone c. estrogen d. prolactin
d. prolactin
A nurse is providing care to a postpartum woman during the immediate postpartum period. The nurse recognizes that the mother will need assistance with meeting her basic needs based on the understanding that the mother is most likely in which phase? a. taking-hold phase b. letting-go phase c. attachment phase d. taking-in phase
d. taking-in phase
The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause? a. hormonal shifting of relaxin and estrogen b. infection c. normal response to the body converting back to prepregnancy state d. thromboembolic disorder of the lower extremities
d. thromboembolic disorder of the lower extremities