OB Chapter 14

11. The nurse is caring for a postpartum patient experiencing hemorrhage that has not responded to massage, compression, or medications. Which should the nurse prepare for? 1) Moving the patient to the operating room (OR) 2) Bimanual compression of the uterus 3) Pelvic examination with visualization 4) Administration of whole blood

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9. After a patient has been taught postpartum self-care, which statement by the mother indicates the need for further teaching? 1) "I will make an appointment with my provider to have my episiotomy stitches removed next week." 2) "I can take acetaminophen and use warm sitz baths to control discomfort at my episiotomy site." 3) "I'll keep a squirt bottle filled with warm water in the bathroom to cleanse with each time I urinate." 4) "I will wear my nursing bra at all times, even when I go to bed, as long as I continue to nurse the baby."

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18. A new mother is having difficulty getting the baby to latch on properly, resulting in cracked, sore nipples. The nurse recognizes this as a risk factor for what? (Select all that apply.) 1) Mastitis 2) Blocked milk ducts 3) Milk stasis 4) Inability to breastfeed 5) Breast abscess

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19. What does the nurse assess as part of the BUBBLE LE mnemonic? (Select all that apply.) 1) Episiotomy or abdominal incision 2) Bonding and attachment 3) Pain 4) Circulation in the legs 5) Gait

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1. After the nurse assesses a woman's uterus and finds it soft and boggy with no improvement after massage, which is the priority intervention? 1) Notifying the provider 2) Assessing the bladder 3) Inserting a catheter 4) Having the woman breastfeed

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10. A postpartum patient is experiencing early postpartum hemorrhage. Which is the nurse's priority intervention? 1) Notifying the provider 2) Performing fundal massage 3) Expressing clots from the boggy uterus 4) Weighing peripads and linens to determine blood loss

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13. What does the nurse do to reduce the size of a newly discovered 3-cm hematoma and encourage reabsorption of the clot? 1) Administer analgesics 2) Apply ice 3) Encourage warm sitz baths 4) Prepare the patient for the OR

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16. When the nurse reviews a patient's past history, which finding is identified as placing the patient at greater risk for postpartum psychosis? 1) Depression 2) Bipolar disorder 3) Obsessive-compulsive disorder 4) Previous postpartum depression

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5. The nursing instructor observes a student providing care to an adolescent postpartum patient. Which statement made by the student indicates the need for further teaching? 1) "Let me show you a way to hold the baby when you're giving him a bath." 2) "Do you want your little friend to stay while you breastfeed?" 3) "You're going to be a great mother because you really want to learn." 4) "Do you have any questions or need help with anything?"

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20. Which actions performed by the nurse demonstrate appropriate uterine massage for the postpartum patient? (Select all that apply.) 1) Positioning one hand at the fundus of the uterus 2) Pressing down until the fundus is palpated as a firm, hard, globular mass 3) Noting the position of the fundus 4) Placing one hand at the base of the uterus 5) Calling and informing the provider of the uterine location

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12. The nurse assesses a postpartum patient's perineum and notes a discoloration and bulging of the vagina that is very tender to the touch. Which symptom reported by the patient is the result of this assessment finding? 1) "When I urinate, it burns until after I finish cleansing with the water bottle." 2) "I am bleeding much less today than I did yesterday, and it's pink rather than red now." 3) "I have the constant feeling of needing to have a bowel movement, but I can't do anything." 4) "I am so tired. I just want to sleep whenever I don't have visitors or the baby with me."

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14. The nursing assessment of a postpartum patient indicates a temperature of 39.4°C, lower left abdominal tenderness, and foul-smelling lochia. Which independent nursing intervention does the nurse begin before notifying the provider? 1) Administering IV fluids 2) Administering antipyretics 3) Encouraging fluid intake 4) Administering analgesics

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2. The nurse caring for a patient during the first hour after delivery needs to notify the provider when which condition is assessed? 1) Several small blood clots on the peripad 2) Saturation of two peripads over the hour 3) Passing a large clot the size of a fist 4) Yellow-white drainage from the nipples

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4. While performing a BUBBLE LE postpartum assessment, the nurse notes a raised area just above the symphysis pubis. Which is the nurse's priority action? 1) Completing the assessment and documenting the findings 2) Notifying the provider and obtaining orders 3) Assisting the patient to the bathroom 4) Massaging the uterus until it becomes firm

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17. Which new mother is not at increased risk for postpartum depression? 1) The mother who relinquishes her baby 2) The adolescent mother 3) The mother with a history of previous postpartum depression 4) The mother who delivered by scheduled Cesarean section

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3. The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic. Which assessment finding is incorrect to document as part of this examination? 1) Breasts firm and tender, patient reports sore nipples 2) Fundus 2 cm below umbilicus, firm 3) Lochia pink, small amount of drainage 4) Pulse strong and regular at rate of 84 beats per minute

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6. A new adolescent mother asks the nurse how to bathe her baby. Which is the nurse's best approach to teach her this procedure? 1) Have the new mother bathe the baby while the nurse talks her through the process 2) Explain the procedure using pictures and diagrams 3) Give the new mother a brochure and tell her to ask if she has any questions 4) Let the new mother watch the nurse bathe the baby and then give a return demonstration tomorrow

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7. What is the nurse's role when caring for a mother who is relinquishing her infant for adoption? 1) Discouraging her from holding or seeing her infant 2) Encouraging her to see the infant and take pictures 3) Avoiding discussion about the baby or her labor unless she brings it up 4) Respecting the mother's choices regarding the baby

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8. A postpartum patient who plans to relinquish her baby for adoption says, "I'm having second thoughts. Maybe I should keep the baby." Which is the nurse's best response? 1) "If you aren't sure, you should keep the baby until you make up your mind." 2) "You've made a promise to the adopting parents, and it's too late to change your mind." 3) "It is such a difficult decision to make. You must feel pulled in two directions." 4) "I can hear the indecision in your voice. Would you like to talk about it?"

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15. Which statement made by a patient at high risk for venous thrombosis indicates the need for further teaching? 1) "I have to continue wearing compression stockings for only the first 2 weeks after delivery." 2) "I will not start smoking again because that will increase the risk of a blood clot developing." 3) "I will try to remain active and avoid prolonged periods of sitting or resting in bed." 4) "I will report any pain, swelling, or redness in my legs to my provider."

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