Study Book - Ch. 7 - Normal PP

A nurse is counseling a woman about PP blues. Which of the following should be included in the discussion? 1. The father may become sad and weepy 2. PP blues last about a week or two 3. Medications are available to relive symptoms 4. Very few women experience PP blues

2. PP blues last about a week or two

The nurse is caring for a breastfeeding mother who asks advice on foods that will provide both vitamin A and iron. Which of the following should the nurse recommend? 1. 1/2 cup raw celery dipped in 1 oz cream cheese 2. 8 oz yogurt mixed with 1 medium banana 3. 12 oz strawberry milkshake 4. 1 1/2 cup raw broccoli

4. 1 1/2 cup raw broccoli

The nurse is caring for a Seventh Day Adventist woman who delivered a baby boy by c-section. Which of the following questions should be asked regarding this woman's care? 1. "Would you like me to order a vegetarian diet for you?" 2. "Is there anything special you will need for your Sabbath on Sunday?" 3. "Would you like to telephone your clergy to set up a date for the baptism?" 4. "Will a rabbi be performing the circumcision on your baby?"

1. "Would you like me to order a vegetarian diet for you?"

The nurse must initiate discharge teaching with the couple regarding the need for an infant car seat for the day of discharge. Which of the following responses indicates that the nurse acted appropriately? The nurse discussed the need with the couple: 1. On admission to the labor room 2. In the client room after delivery 3. When the client put the baby to the breast for the first time 4. The day before the client and baby are to leave the hospital

1. On admission to the labor room (Discharge teaching should begin upon entry to the hospital)

During a PP assessment, it is noted a G1 P1 woman who delivered vaginally over an intact perineum has a cluster of hemorrhoids. Which of the following would be appropriate for the nurse to include in the woman's health teaching? (Select all that apply) 1. The client should use a sitz bath daily as a relief measure 2. The client should digitally replace external hemorrhoid into her rectum 3. The client should breastfeed frequently to stimulate oxytocin to reduce the size of the hemorrhoids 4. The client should be advised that the hemorrhoids will increase in size and quantity with subsequent pregnancies 5. The client should apply topical anesthetic as relief measure

1. The client should use a sitz bath daily as a relief measure 2. The client should digitally replace external hemorrhoid into her rectum 5. The client should apply topical anesthetic as relief measure

A 3-day-PP client questions why she is to receive the rubella vaccine before leaving the hospital. Which of the following rationales should guide the nurse's response? 1. The client's OB status is optimal for receiving the vaccine 2. The client's immune system is highly responsive during the PP period 3. The client's baby will be high risk for acquiring rubella if the woman does not receive the vaccine 4. The client's insurance company will pay for the shot if it is given during the immediate PP period

1. The client's OB status is optimal for receiving the vaccine

A 3-day-breastfeeding client who is not immune to rubella is to receive the rubella vaccine at discharge. Which of the following must the nurse include in her discharge teaching regarding the vaccine? 1. The woman should not become pregnant for at least 4 weeks 2. The woman should pump/dump her milk for 1 week 3. Surgical masks must be worn by the mother when she holds the baby 4. Antibodies transported through the breast milk will protect the baby

1. The woman should not become pregnant for at least 4 weeks

The nurse palpates a distended bladder on a woman who delivered vaginally 2 ours earlier. The woman refuses to go to the bathroom, "I really don't need to go." Which of the following responses by the nurse is appropriate? 1. "Okay. I must be palpating your uterus" 2. "I understand but I still would like you to try to urinate" 3. You still must be numb from the local anesthesia 4."That is a problem I will have to catheterize you"

2. "I understand but I still would like you to try to urinate"

A mother who delivered a 2,800 g baby vaginally 30 minutes earlier, is transferred to the PP unit. She pushed for 45 minutes and the placenta was delivered 10 minutes later. She is relieving an IV with 20 unites oxytocin added. The PP nurse questions why the oxytocin was added to the IV bag. Which of the following responses by the transferring nurse is most likely? 1. "The medication was added 10 minutes ago to prevent excess bleeding during transfer" 2. "The medication was added immediately after the baby's birth to promote placental delivery" 3. "The medication was added after the placenta was delivered because of rapid separation" 4. "The medication was added while she was pushing to speed up the baby's birth"

2. "The medication was added immediately after the baby's birth to promote placental delivery"

A nurse is caring for a PP client who has stated that she is putting her newborn up for adoption. The client asks the nurse to help her breastfeed her baby. Which of the following responses by the nurse is appropriate? 1. "Are you sure you want to try breastfeeding? You won't be able to do it once you give your baby away" 2. "You want to place your baby on a lap pillow and have your baby face you. Then wait for the baby to open its mouth before moving the baby toward your breast" 3. "If you stimulate your breasts to produce milk by having the baby breastfeed, you may become engorged when your baby leaves you" 4. "You should be forewarned that breastfeeding is such an intimate experience that if you start feeding your baby that way, you won't want to give them up"

2. "You want to place your baby on a lap pillow and have your baby face you. Then wait for the baby to open its mouth before moving the baby toward your breast"

The nurse is developing a plan of care for a PP client during the "taking in" phase. Which of the following should the nurse include in the plan? 1. Teach baby-care skills such as diapering 2. Discuss the labor and birth with the mother 3. Discuss contraceptive choices with the mother 4. Teach breastfeeding skills such as pumping

2. Discuss the labor and birth with the mother

Which of the following statements is true about breastfeeding mothers as compared to bottle-feeding mothers? 1. Breastfeeding mothers usually involute completely by 3 weeks PP 2. Breastfeeding mothers have decreased incidence of DM later in life 3. Breastfeeding mothers show higher levels of bone density after menopause 4. Breastfeeding mothers are prone to fewer bouts of infection immediately PP

2. Breastfeeding mothers have decreased incidence of DM later in life

To prevent infection, the nurse teaches the PP client to perform which of the following tasks? 1. Apply antibiotic ointment to the perineum daily 2. Change the peripad at each voiding 3. Void at least every 2 hours 4. Spray the perineum with povidone-iodine after toileting

2. Change the peripad at each voiding

A breastfeeding client, G10 P6, delivered 10 mins ago. Which of the following assessments is most important for the nurse to perform at this time? 1. Pulse 2. Fundus 3. Bladder 4. Breast

2. Fundus

During a home visit, the nurses asses a client 2 weeks after delivery. Which of the following s/s should the nurse expect to see? 1. Diaphoresis 2. Lochia alba 3. Cracked nippels 4. Hypertension

2. Lochia alba

A client, G1 P0, PP 1 day is assessed. The nurse notes that the clien'ts lochia rubra is moderate and her fundus is boggy 2 cm above the umbilicus and deviated to the right. Which of the following actions should the nurse take first? 1. Notify the woman's primary healthcare provider 2. Massage the woman's fundus 3. Escort the woman to the bathroom to urinate 4. Check the quantity of lochia on the peripad

2. Massage the woman's fundus

The nurse is assessing the lab report on a 2-day PP G1 P1. The woman had a normal PP assessment this morning. Which of the following results should the nurse report to the PCP? 1. WBC, 12,500 2. RBC, 4,500,000 3. Hematocrit, 26% 4. Hemoglobin, 11 grams

3. Hematocrit, 26%

The nurse has taught a new admission to the PP unit about pericare. Which of the following indicates that the client understands the procedure? (Select all that apply) 1. The woman performs the procedure twice a day 2. The woman washes her hands before and after the procedure 3. The woman sits in warm tap water for 10 minutes 3x a day 4. The woman sprays her perineum from front to back 5. The woman mixes warm tap water with hydrogen peroxide

2. The woman washes her hands before and after the procedure 4. The woman sprays her perineum from front to back

The nurse is caring for a client who had a c-section under spinal anesthesia less than 2 hrs ago. Which of the following nursing actions is appropriate at this time? 1. Elevate the head of the bed 60 degrees 2. Report absence of bowel sounds to the physician 3. Have her turn and deep breath every 2 hrs 4. Assess for patellar hyperreflexia bilaterally

3. Have her turn and deep breath every 2 hrs

A client is 30 minutes PP from a low forceps vaginal delivery over a right mediolateral episiotomy. Her physician has just finished repairing the incision. The client's legs are in stirrups and she is breastfeeding her baby. Which of the following actions should the nurse perform? 1. Assess her feet and ankles for pitting edema 2. Advise the client to stop feeding her baby while her BP is assessed 3. Lower both of her legs at the same time 4. Measure the length of the episiotomy and document the findings in the chart

3. Lower both of her legs at the same time

A physician has ordered an iron supplement for a PP woman. The nurse strongly suggests that the woman take the medicine with which of the following drinks? 1. Skim milk 2. Ginger ale 3. Orange juice 4. Chamomile tea

3. Orange juice

A woman, 24 hours PP, is complaining of profuse diaphoresis. She has no other complaints. Which of the following actions by the nurse is appropriate? 1. Take the woman's temp 2. Advise the woman to decrease her fluid intake 3. Reassure the woman that this is normal 4. Notify the neonate's pediatrician

3. Reassure the woman that this is normal

A client has just been transferred to the PP unit from labor/delivery. Which of the following nursing care goals is of highest priority? 1. The client will breastfeed her baby every 2 hours 2. The client will consume a normal diet 3. The client will have a moderate lochia flow 4. The client will ambulate to the bathroom every 2 hours

3. The client will have a moderate lochia flow

A client, 2 days post op from a c-section, complains to the nurse that she has yet to have a bowel movement since the surgery. Which of the following responses by the nurse would be appropriate at this time? 1. "That is very concerning. I will request that your physician order an enema for you." 2. "Two days is not that bad. Some patients go four days or longer without a BM" 3. "You have been taking antibiotics through your IV. That is probably why you are constipated" 4. "Fluids and exercise often help to combat constipation. Take a stroll around the unit and drink lots of fluid"

4. "Fluids and exercise often help to combat constipation. Take a stroll around the unit and drink lots of fluid"

A bottle-feeding woman, 1 1/2 weeks PP from a vaginal delivery, calls the OB office to state that she has saturated two pads in the past 1 hour. Which of the following responses by the nurse is appropriate? 1. "You must be doing too much. Lie down for a few hours and call back if the bleeding has not subsided" 2. "You are probably getting your period back. You will bleed like that for a day or two and then it will lighten up" 3. "It is not unusual to bleed heavily every once in a while after a baby is born. It should subside shortly" 4. "It is important for you to be examined by the doctor today. Let me check to see when you can come in"

4. "It is important for you to be examined by the doctor today. Let me check to see when you can come in"

A 2-day-PP breastfeeding woman states "I am sick of being fat. When can I go on a diet?" Which of the following responses is appropriate? 1. "It is fine for you to start dieting right now as long as you drink plenty of milk" 2. "Your breast milk will be low in vitamins if you start to diet while breastfeeding" 3. "You must eat at least 3,000 calories/day in order to produce enough milk" 4. "Many mothers lose weight when they breastfeed because the baby consumes about 600 calories/day"

4. "Many mothers lose weight when they breastfeed because the baby consumes about 600 calories/day."

A client, G1 P1, who had an epidural just delivered a daughter, apgar 9/9, over a mediolateral episiotomy. The physician used low forceps. While recovering, the client states, "I'm a failure. I couldn't stand the pain and couldn't even push my baby cut by myself!". Which of the following is the best response for the nurse to make? 1. "You'll feel better later after you have had a chance to rest and eat: 2. "Don't say that. There are many women who would be ecstatic to have a baby: 3. "I am sure that you will have another baby. I bet that it will be a natural delivery" 4. "To have things work out differently than you had planned in disappointing"

4. "To have things work out differently than you had planned in disappointing"

The nurse is develping a plan of care for the PP client during the "taking hold" phase. Which of the following should the nurse include in the plan? 1. Provide the client with a nutritious meal 2. Encourage the client to take a nap 3. Assist the client with activities of daily living 4. Assure the client that she is an excellent mother

4. Assure the client that she is an excellent mother

A multigravid, postpartum woman reports severe abdominal cramping whenever she nurses her infant. Which of the following responses by the nurse is appropriate? 1. Suggest that the woman bottlefeed for a few days. 2. Instruct the patient on how to massage her fundus. 3. Instruct the patient to feed using an alternate position. 4. Discuss the action of breastfeeding hormones.

4. Discuss the action of breastfeeding hormones.

The nurse is evaluating the involution of the woman who is 3 days PP. Which of the following findings would the nurse evaluate as normal? 1. Fundus 1 cm above the umbilicus, lochia rosa 2. Fundus 2 cm above the umbilicus, lochia alba 3. Fundus 2 cm blow the umbilicus, lochia rubra 4. Fundus 3 cm below the umbilicus, locia serosa

4. Fundus 3 cm below the umbilicus, locia serosa

A client informs the nurse that she intents to bottle feed her baby. Which of the following actions should the nurse encourage the client to perform? Select all that apply. 1. Increase her fluid intake for a few days 2. Massage her breasts every 4 hours 3. Apply heat packs to her axillae 4. Wear a supportive bra 24 hours/day 5. Stand with her back toward the shower water

4. Wear a supportive bra 24 hours/day 5. Stand with her back toward the shower water

A pt, G2 P1 , who delivered her baby 8 hours ago, now has a temp of 100.2F. Which of the following is appropriate nursing intervention at this time? 1. Notify the dr. to get an order for acetaminophen 2. Request an infectious disease consult from the dr. 3. Provide the woman with cool compresses 4. Encourage intake of water and other fluids

4. encourage intake of water and other fluids

A PP nurse is caring for a client who received epidural anesthesia during her labor and delivery. The nurse should advise the woman that she may experience which of the following side effects of the medication during the PP period? 1. Backache 2. Light-headedness 3. Hypertension 4. Footdrop

1. Backache

The OB has ordered a postop c-section client's PCA be discontinued. Which of the following actions by the nurse is appropriate. 1. Discard the remaining meds in the presence of another nurse 2. Recomment waiting until her pain level is zero to discontinue the medicine 3. Discontinue the meds only after the analgesia is completely absorbed 4. Return the unused portion of medication to the narcotics cabinet

1. Discard the remaining meds in the presence of another nurse

A 3-day-PP breastfeeding woman is being assessed. Her breasts are firm and warm to the touch. When asked when she last fed the baby her reply is "I fed the baby last evening. I let the nurses feed him last night. I needed to rest." Which of the following actions should the nurse take at this time? 1. Encourage the woman exclusively to breastfeed her baby 2. Have the woman massage her breasts hourly 3. Obtain an order to culture her expressed milk 4. Take the temp and pule rate of the woman

1. Encourage the woman exclusively to breastfeed her baby

The nurse is the OB clinic received a telephone call from the bottle feeding mother of a 3 day old. The client states that her breasts are firm, red, and warm to the touch. Which of the following is the best action for the nurse to advise the client to perform? 1. Intermittently apply ice packs to her axillae and breasts 2. Apply lanolin to her breasts and nipples every 3 hours 3. Express milk from the breasts every 3 hours 4. Ask PCP to order a milk suppressant

1. Intermittently apply ice packs to her axillae and breasts

Which of the following complementary therapies can a nurse suggest to a multiparous woman who is complaining of severe afterbirth pains? 1. Lie prone with a small pillow cushioning her abdomen 2. Contract her abdominal muscles for a count of ten 3. Slowly ambulate in the hallways 4. Drink ice tea with lemon or lime

1. Lie prone with a small pillow cushioning her abdomen

During a PP assessment, the nurse assesses the calves of a client's legs. The nurse is checking for which of the following s/s? (Select all that apply) 1. Pain 2. Warmth 3. Discharge 4. Ecchymosis 5. Redness

1. Pain 2. Warmth 5. Redness

An Asian client's temp 10 hrs after delivery is 100.2F but, when encouraged, she refuses to drink her ice water. Which of the following nursing actions is most appropriate? 1. Replace the ice water with hot water 2. Notify the client's healthcare provider 3. Reassess the temperature in one-half hour 4. Remind the client that drinking is very important

1. Replace the ice water with hot water

A client is receiving an epidural infusion of a narcotic for pain relief after a c-section. The nurse would report to the anesthesiologist if which of the following were assessed? 1. Respiratory rate 8 rpm 2. Complaint of thirst 3. Urinary output of 250 mL/hr 4. Numbness of feet and ankles

1. Respiratory rate 8 rpm

A client who is 3 days PP asks the nurse "When may my husband and I begin having sex again?" The nurse should encourage the couple to wait until after which of the following has occurred? 1. The client has had her six-week PP checkup 2. The episiotomy has healed and the lochia has stopped 3. The lochia has turned to pink and the vagina is no longer tender 4. The client has had her first PP menstrual period

1. The client has had her six-week PP checkup

The nurse informs a PP woman that which of the following is the reason ibuprofen is especially effective for afterbirth pains? 1. Ibuprofen is taken every 2 hours 2. Ibuprofen has an anti-prostaglandin effect 3. Ibuprofen is given via the parenteral route 4. Ibuprofen can be administered in high doses

2. Ibuprofen has an anti-prostaglandin effect

The surgeon has removed the surgical c-section dressing from a postop day 1 client. Which of the following actions by the nurse is appropriate? 1. Irrigate the incision twice daily 2. Monitor the incision for drainage 3. Apply steristrips to the incision line 4. Palpate the incision and assess pain

2. Monitor the incision for drainage

The third stage of labor has just ended for a client who has decided to bottle feed her baby. Which of the following maternal hormones will increase sharply at this time? 1. Estrogen 2. Prolactin 3. Human placental lactogen 4. Human chorionic gonadotropin

2. Prolactin

A breastfeeding woman has been counseled on how to prevent engorgement. Which of the following actions by the mother shows that the teaching was effective? 1. She pumps her breasts after each feeding 2. She feeds her baby every 2 to 3 hours 3. She feeds her baby 10 minutes on each side 4. She supplements each feeding with formula

2. She feeds her baby every 2 to 3 hours

A nurse is assessing the fundus of a client during the immediate PP period. Which of the following actions indicates that the nurse is performing the skill correctly? 1. The nurse measures the fundal height using a paper cm tape 2. The nurse stabilizes the base of the uterus with her dependent hand 3. The nurse palpates the fundus with the tips of his fingers 4. The nurse precedes the assessment with a sterile vaginal exam

2. The nurse stabilizes the base of the uterus with her dependent hand

A breastfeeding woman, 1 1/2 moths postdelivery, cals the nurse in the OB's office and states "I am very embarrassed but I need help. Last night I had an orgasm when my husband and I were making love. You should have seen the milk. We were both soaking wet. What is wrong with me?" The nurse should base the response to the client on which of the following? 1. The woman is exhibiting signs of pathological galactorrhea 2. The same hormone stimulates orgasms and the milk ejection reflex 3. The woman should have a serum galactosemia assessment done 4. The baby is stimulating the woman to produce too much milk

2. The same hormone stimulates orgasms and the milk ejection reflex

A post c-section, breastfeeding client whose subjective pain level is 2/5 requests her as-needed narcotic analgesics every 3 hours. She states "I have decided to make sure that I feel as little pain from this experience as possible." Which of the following should the nurse conclude in relation to this woman's behavior? 1. The woman needs a stronger narcotic order 2. The woman is high risk for severe constipation 3. The woman's breast milk volume may drop while taking the medicine 4. The woman's newborn may become addicted to the medication

2. The woman is high risk for severe constipation

Which of the following lab values would the nurse expect to see in a normal PP woman? 1. Hematocrit, 39% 2. WBC, 16,000 3. RBC, 5 million 4. Hemoglobin, 15 grams

2. WBC, 16,000

The nurse is assessing the midline episiotomy on a PP client. Which of the following findings should the nurse expect to see? 1. Moderate serosangunous drainage 2. Well-approximated edges 3. Ecchymotic are distal to the episiotomy 3. An area of redness adjacent to the incision

2. Well-approximated edges

A medication order reads: Methergine 0.2 mg PO q 6 h x 4 doses. Which of the following assessments should be made before administering each dose of this medication? 1. Apical pulse 2. Lochia flow 3. Blood pressure 4. Episiotomy

3. Blood pressure

The nurse monitors her PP client carefully because which of the following physiological changes occurs during the early PP period? 1. Decreased urinary output 2. Increased BP 3. Decreased blood volume 4. Increased estrogen level

3. Decreased blood volume

The nurse is examining a 2-day-PP client whose fundus is 2 cm below the umbilicus and whose bright red lochia saturates about 4 inches of a pad in 1 hour. What should the nurse document in the nursing record? 1. Abormal involution, lochia rubra heavy 2. Abnormal involution, lochia serosa scant 3. Normal involution, lochia rubra moderate 4. Normal involution, lochia serosa heavy

3. Normal involution, lochia rubra moderate

A breastfeeding mother states that she has sore nipples. In response to the complaint, the nurse assists with "latch on" and recommends that the mother do which of the following? 1. Use a nipple shield at each breastfeeding 2. Cleanse the nipples with soap 3x a day 3. Rotate the baby's position at each feed 4. Bottle feed for 2 days then resume breastfeeding

3. Rotate the baby's position at each feed

The nurse is developing a care plan for a PP client who have had midline episiotomies. Which of the following interventions should be included in the plan? 1. Assist with stitch removal on the third PP day 2. Administer analgesics every four hours per drs. orders 3. Teach the client to contract her buttocks before sitting 4. Irrigate the incision twice daily with antibiotic solution

3. Teach the client to contract her buttocks before sitting

A G2 P2 who is PP 6 hours from a spontaneous vaginal delivery is assessed. The nurse notes that the fundus is firm at the umbilicus, there is heavy lochia rubra, and perineal sutures are intact. Which of the following actions should the nurse take at this time? 1. Do nothing. This is a normal finding 2. Massage the woman's fundus 3. Take the woman to the bathroom to void 4. Notify the woman's primary healthcare provider

4. Notify the woman's primary healthcare provider

A nurse is assessing a 1-day-PP woman who had her baby by c-section. Which of the following should the nurse report to the surgeon? 1. Fundus at the umbilicus 2. Nodular breasts 3. Pulse rate 60 bpm 4. Pad saturation every 30 minutes

4. Pad saturation every 30 minutes