Exam 2 - Chapters 17 After Birth

When assessing the episiotomy site of a postpartum client that delivered 3-hours ago, the nurse would document which findings as expected? Select all that apply. A) Edema B) Redness C) Slight bruising D) Discharge E) Bleeding

A) Edema C) Slight bruising

During the early postpartum period, a new mother is displaying dependent behaviors. What behaviors would the nurse recognize as normal for this period? Select all that apply. A) Needing assistance with changing her peripad B) Desiring to hold her infant C) Telling the nurse about her delivery experience. D) Asking the nurse to take the newborn away so she can rest. E) Changing her newborn's diaper with guidance from the nurse.

A) Needing assistance with changing her peripad C) Telling the nurse about her delivery experience. D) Asking the nurse to take the newborn away so she can rest.

During pregnancy a woman's cardiovascular system expands to care for the growing fetus. After birth, during the early postpartum period, the woman eliminates the additional fluid volume she has been carrying. What is one way she does this? A) Urinary elimination B) Elimination of solid wastes C) Being too tired to eat D) Breathing off fluid vapor

A) Urinary elimination

After the abdominal dressing is removed 24 hours following a cesarean delivery, the nurse inspects the incision and observes drainage from the incision, redness along the suture line and moderate edema. Staples are intact. What action would the nurse take? A) Record the findings in the client's chart. B) Let the RN know of your findings. C) Since everything appears normal, continue to monitor the incision every 4 hours. D) Re-apply a dressing over the incision line.

B) Let the RN know of your findings.

A client who has given birth a week ago reports discomfort when defecating and ambulating. The birth involved an episiotomy. Which suggestions should the nurse provide to the client to provide local comfort? Select all that apply. A) Maintain correct posture. B) Use of warm sitz baths. C) Use of anesthetic sprays. D) Use of witch hazel pads. E) Use good body mechanics.

B) Use of warm sitz baths. C) Use of anesthetic sprays. D) Use of witch hazel pads.

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 3 hours B) saturating 1 pad in 1 hour C) saturating 1 pad in 6 hours D) saturating 1 pad in 8 hours

B) saturating 1 pad in 1 hour

A client who gave birth 18 hours ago is experiencing a change in lochia flow from scant to moderate. Prioritize the actions the nurse would take to assess the client's fundus. All options must be used. A. Assess blood pressure. B. Assist the clients to empty her bladder in the bathroom. C. Massage the fundus if boggy. D. Palpate the fundus. E. Increase IV oxytocin or breastfeed the newborn. F. Notify the primary care provider.

B, D, C, E, A, F

The nurse is performing an assessment for a client in the immediate postpartum period. Which assessment finding should the nurse prioritize? A) Infection B) Dehydration C) Hemorrhage D) Bladder distention

C) Hemorrhage

Which client should the postpartum nurse assess first after receiving shift report? A) The 3-day postpartum client who has a pulse of 50 bpm. B) The 12-hour postpartum client who has a temperature of 100.4 ° F (38 ° C). C) The 2-day postpartum client who has a blood pressure of 138/90 mm Hg. D) The 1-day postpartum client who has a respiratory rate of 20 breaths/minute.

C) The 2-day postpartum client who has a blood pressure of 138/90 mm Hg.

A woman who had a cesarean birth of twins 6 hours ago reports shortness of breath and pain in her right calf. What complication should the nurse expect? A) infection B) hemorrhage C) pulmonary emboli D) fluid volume overload

C) pulmonary emboli

Based on the nurse's knowledge about the postpartum period and an increase in blood coagulability during the first 48 hours, the nurse closely assesses the client for which condition? A) hyperglycemia B) varicose veins C) thromboembolism D) calcium depletion

C) thromboembolism

A G1 P0101 woman delivered by cesarean is now in the recovery room. She received Duramorph via intrathecal catheter. On review of orders before transfer to the postpartum unit, the nurse notes one entry that needs clarification by the physician. Which order is the source of the nurse's concern? A) Maintain IV with 1 L LR with 20 units Pitocin over 8 hours. B) Maintain compression stockings until ambulatory. C) Monitor I & O. D) Monitor respirations every 4 hours for 24 hours.

D) Monitor respirations every 4 hours for 24 hours.

A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this womans fundus? a. 1 centimeter above the umbilicus b. 2 centimeters below the umbilicus c. Midway between the umbilicus and the symphysis pubis d. Nonpalpable abdominally

a. 1 centimeter above the umbilicus

A nurse notes that an Eskimo woman does not cuddle or interact with her newborn other than to feed him, change his diapers or soiled clothes, and put him to bed. While evaluating this clients behavior with her infant, what realization does the nurse make? a. What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits. b. The woman is inexperienced in caring for a newborn. c. The woman needs a referral to a social worker for further evaluation of her parenting behaviors once she goes home with the newborn. d. Extra time needs to be planned for assisting the woman in bonding with her

a. What appears to be a lack of interest in the newborn is, in fact, the cultural way of demonstrating intense love by attempting to ward off evil spirits.

Which client is most likely to experience strong and uncomfortable afterpains? a. A woman who experienced oligohydramnios b. A woman who is a gravida 4, para 4-0-0-4 c. A woman who is bottle-feeding her infant d. A woman whose infant weighed 5 pounds, 3 ounces

b. A woman who is a gravida 4, para 4-0-0-4

When caring for a newly delivered woman, what is the best measure to prevent abdominal distention after a cesarean birth? a. Rectal suppositories b. Early and frequent ambulation c. Tightening and relaxing abdominal muscles d. Carbonated beverages

b. Early and frequent ambulation

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman? a. Estrogen b. Progesterone c. Prolactin d. Human placental lactogen

b. Progesterone

The nurse should be cognizant of which postpartum physiologic alteration? a. Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth. b. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth. c. Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. d. Hypercoagulable state protects the new mother from thromboembolism, especially after a cesarean birth.

b. Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth.

Under the Newborns and Mothers Health Protection Act, all health plans are required to allow new mothers and newborns to remain in the hospital for a minimum of hours after a normal vaginal birth and for hours after a cesarean birth. What is the correct interpretation of this legislation? a. 24; 72 b. 24; 96 c. 48; 96 d. 48; 120

c. 48; 96

A nurse hears a primiparous woman talking to her son and telling him that his chin is just like his dads. This statement is most descriptive of which process? a. Mutuality b. Synchrony c. Claiming d. Reciprocity

c. Claiming

The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, approximately 500,000 women in America experience a more severe syndrome known as PPD. Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? a. PPD symptoms are consistently severe. b. This syndrome affects only new mothers. c. PPD can easily go undetected. d. Only mental health professionals should teach new parents about this condition

c. PPD can easily go undetected.

A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client? a. Lochia rubra b. Lochia sangra c. Lochia alba d. Lochia serosa

d. Lochia serosa

A nurse visiting a postpartum client at home is reviewing the need for the woman to meet her own nutritional needs. The woman is breastfeeding her newborn. The nurse determines that the client understands her nutritional needs based on which statements? Select all that apply. A) "I need to drink about 2 to 3 quarts of fluid each day." B) "I should have about 4 servings of fruits each day." C) "I need to eat about 7 servings of vegetables daily." D) "I will have at least 4 to 5 servings of milk each day." E) "I need to cut way back on any fats and oils daily."

A) "I need to drink about 2 to 3 quarts of fluid each day." B) "I should have about 4 servings of fruits each day." D) "I will have at least 4 to 5 servings of milk each day."

The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply. A) Breasts feel slightly firm. B) Nipples have several cracks on both breasts. C) One reddened area on the left breast 3 cm in size. D) Flattened nipple on the right breast E) Breasts are non-painful

A) Breasts feel slightly firm. D) Flattened nipple on the right breast E) Breasts are non-painful

The nurse is inspecting a new mother's perineum. What actions would the nurse take for this client? Select all that apply. A) Inspect the episiotomy for sutures and to ensure that the edges are approximated. B) Palpate the episiotomy for pain. C) Note any hemorrhoids. D) Place the patient in Trendelenburg position for inspection. E) Gently palpate for any hematomas.

A) Inspect the episiotomy for sutures and to ensure that the edges are approximated. C) Note any hemorrhoids. E) Gently palpate for any hematomas.

A nurse is caring for a client who has had a vaginal birth. The nurse understands that pelvic relaxation can occur in any woman experiencing a vaginal birth. Which should the nurse recommend to the client to improve pelvic floor tone? A) Kegel exercises B) urinating immediately when the urge is felt C) abdominal crunches D) sitz baths

A) Kegel exercises

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) Wear tight supportive bra 24 hours each day. B) Apply ice to the breast for approximately 15 to 20 minutes every other hour. C) Avoid sexual stimulation D) Pump her breasts once a day only. E) Take a hot shower.

A) Wear tight supportive bra 24 hours each day. B) Apply ice to the breast for approximately 15 to 20 minutes every other hour. C) Avoid sexual stimulation

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 joints and return them to their normal state. D) strengthen the abdominal muscles to lessen the size of stretch marks.

A) strengthen the pelvic floor muscles to reduce urinary incontinence.

Which finding would the nurse describe as "light" or "small" lochia? A) 1- to 2-inch lochia stain on the perineal pad or a 10 ml loss B) 4-inch stain or a 10 to 25 ml loss C) 4- to 6-inch stain with an estimated loss of 25 to 50 ml D) pad is saturated within 1 hour after changing it

B) 4-inch stain or a 10 to 25 ml loss

A nurse is assessing a woman during the first 24 hours after birth. Which assessment finding would the nurse determine as acceptable during this time? Select all that apply. A) Inverted nipples following breastfeeding B) Fundus one fingerbreadth below the umbilicus C) Hypotonic bowel sounds D) Urination of 100 mL every 4 hours E) Moderate saturation of peripad every 3 hours

B) Fundus one fingerbreadth below the umbilicus E) Moderate saturation of peripad every 3 hours

Which societal factors have a strong influence on parental response to their infant? (Select all that apply.) a. An adolescent mothers egocentricity and unmet developmental needs interfere with her ability to parent effectively. b. An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers. c. Adolescent mothers have a higher documented incidence of child abuse. d. Mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido. e. Relationships between adolescent mothers and fathers are more stable than older adults.

a. An adolescent mothers egocentricity and unmet developmental needs interfere with her ability to parent effectively. b. An adolescent mother is likely to use less verbal instruction, be less responsive, and interact less positively than other mothers. d. Mothers older than 35 years of age often deal with more stress related to work and career issues, as well as decreasing libido.

When should discharge instruction, or the teaching plan that tells the woman what she needs to know to care for herself and her newborn, officially begin? a. At the time of admission to the nurses unit b. When the infant is presented to the mother at birth c. During the first visit with the physician in the unit d. When the take-home information packet is given to the couple

a. At the time of admission to the nurses unit

New parents express concern that because of the mothers emergency cesarean birth under general anesthesia, they did not have the opportunity to hold and bond with their daughter immediately after her birth. Which information should the nurses response convey? a. Attachment, or bonding, is a process that occurs over time and does not require early contact. b. Time immediately after birth is a critical period for humans. c. Early contact is essential for optimal parent-infant relationships. d. These new parents should just be happy that the infant is healthy.

a. Attachment, or bonding, is a process that occurs over time and does not require early contact.

After delivery, excess hypertrophied tissue in the uterus undergoes a period of selfdestruction. What is the correct term for this process? a. Autolysis b. Subinvolution c. Afterpains d. Diastasis

a. Autolysis

In many hospitals, new mothers are routinely presented with gift bags containing samples of infant formula. This practice is inconsistent with what? a. Baby Friendly Hospital Initiative b. Promotion of longer periods of breastfeeding c. Perception of being supportive to both bottle feeding and

a. Baby Friendly Hospital Initiative

Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding. Should this pain be severe or persistent, it may discourage or inhibit breastfeeding altogether. Which factors might contribute to this pain? (Select all that apply.) a. Improper feeding position b. Large-for-gestational age infant c. Fair skin d. Progesterone deficiency e. Flat or retracted nipples

a. Improper feeding position c. Fair skin e. Flat or retracted nipples

Which concerns regarding parenthood are often expressed by visually impaired mothers? (Select all that apply.) a. Infant safety b. Transportation c. Ability to care for the infant d. Visually missing out e. Needing extra time for parenting activities to accommodate the visual limitations

a. Infant safety b. Transportation d. Visually missing out e. Needing extra time for parenting activities to accommodate the visual limitations

During which phase of maternal adjustment will the mother relinquish the baby of her fantasies and accept the real baby? a. Letting go b. Taking hold c. Taking in d. Taking on

a. Letting go

Rho immune globulin will be ordered postpartum if which situation occurs? a. Mother Rh, baby Rh+ b. Mother Rh, baby Rh c. Mother Rh+, baby Rh+ d. Mother Rh+, baby Rh

a. Mother Rh, baby Rh+

When the infants behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics, what is the correct term for this behavior? a. Mutuality b. Bonding c. Claiming d. Acquaintance

a. Mutuality

Several delivery changes in the integumentary system that appear during pregnancy disappear after birth, although not always completely. What change is almost certain to be completely reversed? a. Nail brittleness b. Darker pigmentation of the areolae and linea nigra c. Striae gravidarum on the breasts, abdomen, and thighs d. Spider nevi

a. Nail brittleness

Which practices contribute to the prevention of postpartum infection? (Select all that apply.) a. Not allowing the mother to walk barefoot at the hospital b. Educating the client to wipe from back to front after voiding c. Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home d. Instructing the mother to change her perineal pad from front to back each time she voids or defecates e. Not permitting visitors with cough or colds to enter the postpartum unit

a. Not allowing the mother to walk barefoot at the hospital c. Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home d. Instructing the mother to change her perineal pad from front to back each time she voids or defecates

Which statement by the nurse can assist a new father in his transition to parenthood? a. Pointing out that the infant turned at the sound of his voice b. Encouraging him to go home to get some sleep c. Telling him to tape the infants diaper a different way d. Suggesting that he let the infant sleep in the bassinet

a. Pointing out that the infant turned at the sound of his voice

If a woman is at risk for thrombus and is not ready to ambulate, which nursing intervention would the nurse use? (Select all that apply.) a. Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots b. Having her flex, extend, and rotate her feet, ankles, and legs c. Having her sit in a chair d. Immediately notifying the physician if a positive Homans sign occurs e. Promoting bed rest

a. Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) b. Having her flex, extend, and rotate her feet, ankles, and legs d. Immediately notifying the physician if a positive Homans sign occurs

Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage? (Select all that apply.) a. Respirations b. Skin condition c. Blood pressure d. Level of consciousness e. Urinary output

a. Respirations b. Skin condition d. Level of consciousness e. Urinary output

The laboratory results for a postpartum woman are as follows: blood type, A; Rh status, positive; rubella titer, 1:8 (enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the nurse best interpret these data? a. Rubella vaccine should be administered. b. Blood transfusion is necessary. c. Rh immune globulin is necessary within 72 hours of childbirth. d. Kleihauer-Betke test should be performed.

a. Rubella vaccine should be administered.

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the womans vital signs, which finding would be of greatest concern to the nurse? a. Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg b. Temperature 37.4 C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg c. Temperature 38 C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg d. Temperature 36.8 C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg

a. Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg An EBL of 1500 ml with tachycardia and hypotension suggests hypovolemia caused by excessive blood loss.

Nurses play a critical role in educating parents regarding measures to prevent infant abduction. Which instructions contribute to infant safety and security? (Select all that apply.) a. The mother should check the photo identification (ID) of any person who comes to her room. b. The baby should be carried in the parents arms from the room to the nursery. c. Because of infant security systems, the baby can be left unattended in the clients room. d. Parents should use caution when posting photographs of their infant on the Internet. e. The mom should request that a second staff member verify the identity of any questionable person.

a. The mother should check the photo identification (ID) of any person who comes to her room. d. Parents should use caution when posting photographs of their infant on the Internet. e. The mom should request that a second staff member verify the identity of any questionable person.

A primiparous woman is to be discharged from the hospital the following day with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged? a. The woman is disinterested in learning about infant care. b. The woman continues to hold and cuddle her infant after she has fed her. c. The woman reads a magazine while her infant sleeps. d. The woman changes her infants diaper and then shows the nurse the contents of the diaper.

a. The woman is disinterested in learning about infant care.

A hospital has a number of different perineal pads available for use. A nurse is observed soaking several of them and writing down what she sees. What goal is the nurse attempting to achieve by performing this practice? a. To improve the accuracy of blood loss estimation, which usually is a subjective assessment b. To determine which pad is best c. To demonstrate that other nurses usually underestimate blood loss d. To reveal to the nurse supervisor that one of them needs some time off

a. To improve the accuracy of blood loss estimation, which usually is a subjective assessment

The transition to parenting for same-sex couples can present unique challenges. How can the nurse foster adjustment to parenting for these clients? (Select all that apply.) a. Use a supplemental feeding device to simulate breastfeeding. b. Allow the partner to cut the cord. c. Gay fathers should meet their new infant soon after the birth mother has recovered. d. Understand that strong social sanctions remain. e. Provide information regarding support groups.

a. Use a supplemental feeding device to simulate breastfeeding. b. Allow the partner to cut the cord. d. Understand that strong social sanctions remain. e. Provide information regarding support groups.

A parent who has a hearing impairment is presented with a number of challenges in parenting. Which nursing approaches are appropriate for working with hearing-impaired new parents? (Select all that apply.) a. Using devices that transform sound into light b. Assuming that the client knows sign language c. Speaking quickly and loudly d. Ascertaining whether the client can read lips before teaching e. Writing messages that aid in communication

a. Using devices that transform sound into light d. Ascertaining whether the client can read lips before teaching e. Writing messages that aid in communication

Which statement regarding the postpartum uterus is correct? a. At the end of the third stage of labor, the postpartum uterus weighs approximately 500 g. b. After 2 weeks postpartum, it should be abdominally nonpalpable. c. After 2 weeks postpartum, it weighs 100 g. d. Postpartum uterus returns to its original (prepregnancy) size by 6 weeks postpartum.

b. After 2 weeks postpartum, it should be abdominally nonpalpable.

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time? a. Run warm water on her breasts during a shower. b. Apply ice to the breasts for comfort. c. Express small amounts of milk from the breasts to relieve the pressure. d. Wearing a loose-fitting bra to prevent nipple irritation.

b. Apply ice to the breasts for comfort.

Many first-time parents do not plan on having their parents help immediately after the newborn arrives. Which statement by the nurse is the most appropriate when counseling new parents regarding the involvement of grandparents? a. You should tell your parents to leave you alone. b. Grandparents can help you with parenting skills. c. Grandparent involvement can be very disruptive to the family. d. They are getting old. You should let them be involved while they can.

b. Grandparents can help you with parenting skills.

Postpartum fatigue (PPF) is more than just feeling tired. It is a complex phenomenon affected by physiologic, psychologic, and situational variables. Which factors contribute to this phenomenon? (Select all that apply.) a. Precipitous labor b. Hospital routines c. Bottle feeding d. Anemia e. Excitement

b. Hospital routines d. Anemia e. Excitement

In addition to eye contact, other early sensual contacts between the infant and mother involve sound and smell. What other statement regarding the senses is correct? a. High-pitched voices irritate newborns. b. Infants can learn to distinguish their mothers voice from others soon after birth. c. All babies in the hospital smell alike. d. Mothers breast milk has no distinctive odor.

b. Infants can learn to distinguish their mothers voice from others soon after birth.

The postpartum woman continually repeats the story of her labor, delivery, and recovery experience. What is this new mother attempting to achieve with this behavior? a. Providing others with her knowledge of events b. Making the birth experience real c. Taking hold of the events leading up to her labor and delivery d. Accepting her response to labor and delivery

b. Making the birth experience real

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth? a. My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter. b. My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles. c. I will not have a menstrual cycle for 6 months after childbirth. d. My first menstrual cycle will be heavier than normal and then will be light for several months after.

b. My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles.

In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which is a facilitating behavior? a. Parents have difficulty naming the infant. b. Parents hover around the infant, directing attention to and pointing at the infant. c. Parents make no effort to interpret the actions or needs of the infant. d. Parents do not move from fingertip touch to palmar contact and holding.

b. Parents hover around the infant, directing attention to and pointing at the infant.

The postpartum nurse should be cognizant of what with regard to the adaptation of other family members (primarily siblings and grandparents) to the newborn? a. Sibling rivalry cannot be dismissed as overblown psychobabble; negative feelings and behaviors can take a long time to blow over. b. Participation in preparation classes helps both siblings and grandparents. c. In the United States, paternal and maternal grandparents consider themselves of equal importance and status. d. Since 1990, the number of grandparents providing permanent care to their grandchildren has been declining.

b. Participation in preparation classes helps both siblings and grandparents.

In the United States, the en face position is preferred immediately after birth. Which actions by the nurse can facilitate this process? (Select all that apply.) a. Washing both the infants face and the mothers face b. Placing the infant on the mothers abdomen or breast with their heads on the same plane c. Dimming the lights d. Delaying the instillation of prophylactic antibiotic ointment in the infants eyes e. Placing the infant in the grandmothers arms

b. Placing the infant on the mothers abdomen or breast with their heads on the same plane c. Dimming the lights d. Delaying the instillation of prophylactic antibiotic ointment in the infants eyes

A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth. Recognizing the needs of women during this stage, how should the nurse respond? a. Foster an active role in the babys care. b. Provide time for the mother to reflect on the events of her labor and delivery. c. Recognize the womans limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital. d. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.

b. Provide time for the mother to reflect on the events of her labor and delivery.

The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, would the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? a. The postpartum woman talks and coos to her son. b. She seldom makes eye contact with her son. c. The mother cuddles her son close to her. d. She tells visitors how well her son is feeding.

b. She seldom makes eye contact with her son.

The nurse observes that a first-time mother appears to ignore her newborn. Which strategy should the nurse use to facilitate mother-infant attachment? a. Tell the mother she must pay attention to her infant. b. Show the mother how the infant initiates interaction and attends to her. c. Demonstrate for the mother different positions for holding her infant while feeding. d. Arrange for the mother to watch a video on parent-infant interaction.

b. Show the mother how the infant initiates interaction and attends to her.

Which description of postpartum restoration or healing times is accurate? a. The cervix shortens, becomes firm, and returns to form within a month postpartum. b. Vaginal rugae reappear by 3 weeks postpartum. c. Most episiotomies heal within a week. d. Hemorrhoids usually decrease in size within 2 weeks of childbirth.

b. Vaginal rugae reappear by 3 weeks postpartum.

What information should the nurse understand fully regarding rubella and Rh status? a. Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus. b. Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination. c. Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant. d. Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations.

b. Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination.

Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand? a. Kidney function returns to normal a few days after birth. b. Diastasis recti abdominis is a common condition that alters the voiding reflex. c. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. d. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth.

c. Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium.

Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing? a. Elevated temperature caused by postpartum infection b. Increased basal metabolic rate after giving birth c. Loss of increased blood volume associated with pregnancy d. Increased venous pressure in the lower extremities

c. Loss of increased blood volume associated with pregnancy

During a telephone follow-up conversation with a woman who is 4 days postpartum, the woman tells the nurse, I dont know whats wrong. I love my son, but I feel so let down. I seem to cry for no reason! Which condition might this new mother be experiencing? a. Letting-go b. Postpartum depression (PPD) c. Postpartum blues d. Attachment difficulty

c. Postpartum blues

Postpartum overdistention of the bladder and urinary retention can lead to which complications? a. Postpartum hemorrhage and eclampsia b. Fever and increased blood pressure c. Postpartum hemorrhage and urinary tract infection d. Urinary tract infection and uterine rupture

c. Postpartum hemorrhage and urinary tract infection

What should the nurses next action be if the clients white blood cell (WBC) count is 25,000/mm3 on her second postpartum day? a. Immediately inform the physician. b. Have the laboratory draw blood for reanalysis. c. Recognize that this count is an acceptable range at this point postpartum. d. Immediately begin antibiotic therapy.

c. Recognize that this count is an acceptable range at this point postpartum.

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup. Which response by the client alerts the nurse that psychosocial outcomes have not been met? a. The woman excessively discusses her labor and birth experience. b. The woman feels that her baby is more attractive and clever than any others. c. The woman has not given the baby a name. d. The woman has a partner or family members who react very positively about the baby.

c. The woman has not given the baby a name.

Parents who have not already done so need to make time for newborn follow-up of the discharge. According to the American Academy of Pediatrics (AAP), when should a breastfeeding infant first need to be seen for a follow-up examination? a. 2 weeks of age b. 7 to 10 days after childbirth c. 4 to 5 days after hospital discharge d. 48 to 72 hours after hospital discharge

d. 48 to 72 hours after hospital discharge

25-year-old gravida 1 para 1 who had an emergency cesarean birth 3 days ago is scheduled for discharge. As the nurse prepares her for discharge, she begins to cry. The nurses next action should be what? a. Assess her for pain. b. Point out how lucky she is to have a healthy baby. c. Explain that she is experiencing postpartum blues. d. Allow her time to express her feelings.

d. Allow her time to express her feelings

While providing routine mother-baby care, which activities should the nurse encourage to facilitate the parent-infant attachment? a. The baby is able to return to the nursery at night so that the new mother can sleep. b. Routine times for care are established to reassure the parents. c. The father should be encouraged to go home at night to prepare for discharge of the mother and baby. d. An environment that fosters as much privacy as possible should be created.

d. An environment that fosters as much privacy as possible should be created.

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus? a. Notify the physician of an impending hemorrhage. b. Assess the blood pressure and pulse. c. Evaluate the lochia. d. Assist the client in emptying her bladder.

d. Assist the client in emptying her bladder.

After birth, a crying infant may be soothed by being held in a position in which the newborn can hear the mothers heartbeat. This phenomenon is known as what? a. Entrainment b. Reciprocity c. Synchrony d. Biorhythmicity

d. Biorhythmicity

A client is concerned that her breasts are engorged and uncomfortable. What is the nurses explanation for this physiologic change? a. Overproduction of colostrum b. Accumulation of milk in the lactiferous ducts and glands c. Hyperplasia of mammary tissue d. Congestion of veins and lymphatic vessels

d. Congestion of veins and lymphatic vessels

Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium? a. Varicosities of the legs b. Carpal tunnel syndrome c. Periodic numbness and tingling of the fingers d. Headaches

d. Headaches

Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing after childbirth. The nurse requests the client to repeat back instructions for this exercise. Which response by the client indicates successful learning? a. I contract my thighs, buttocks, and abdomen. b. I perform 10 of these exercises every day. c. I stand while practicing this new exercise routine. d. I pretend that I am trying to stop the flow of urine in midstream

d. I pretend that I am trying to stop the flow of urine in midstream

A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband brings a large container of brown seaweed soup to the hospital. When the nurse enters the room, the husband asks for help with warming the soup so that his wife can eat it. What is the nurses most appropriate response? a. Didnt you like your lunch? b. Does your physician know that you are planning to eat that? c. What is that anyway? d. Ill warm the soup in the microwave for you.

d. Ill warm the soup in the microwave for you.

A new father states, I know nothing about babies; however, he seems to be interested in learning. How would the nurse best respond to this father? a. Continue to observe his interaction with the newborn. b. Tell him when he does something wrong. c. Show no concern; he will learn on his own. d. Include him in teaching sessions.

d. Include him in teaching sessions.

Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman spontaneously empty her bladder as soon as possible. If all else fails, what tactic might the nurse use? a. Pouring water from a squeeze bottle over the womans perineum b. Placing oil of peppermint in a bedpan under the woman c. Asking the physician to prescribe analgesic agents d. Inserting a sterile catheter

d. Inserting a sterile catheter

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochia. Which statement is the most appropriate? a. Lochia is similar to a light menstrual period for the first 6 to 12 hours. b. It is usually greater after cesarean births. c. Lochia will usually decrease with ambulation and breastfeeding. d. It should smell like normal menstrual flow unless an infection is present.

d. It should smell like normal menstrual flow unless an infection is present.

The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth. Which scenario is not accurate to this model of care? a. Wellness orientation model of care rather than a sick-care model b. Desire to reduce health care costs c. Consumer demand for fewer medical interventions and more family-focused experiences d. Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information

d. Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the nurses highest priority at this time? a. Beginning an intravenous (IV) infusion of Ringers lactate solution b. Assessing the womans vital signs c. Calling the womans primary health care provider d. Massaging the womans fundus

d. Massaging the womans fundus

After giving birth to a healthy infant boy, a primiparous client, 16 years of age, is admitted to the postpartum unit. An appropriate nursing diagnosis for her at this time is Deficient knowledge of infant care. What should the nurse be certain to include in the plan of care as he or she prepares the client for discharge? a. Teach the client how to feed and bathe her infant. b. Give the client written information on bathing her infant. c. Advise the client that all mothers instinctively know how to care for their infants. d. Provide time for the client to bathe her infant after she views a demonstration of infant bathing.

d. Provide time for the client to bathe her infant after she views a demonstration of infant bathing.

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state? a. Involutionary period because of what happens to the uterus b. Lochia period because of the nature of the vaginal discharge c. Mini-tri period because it lasts only 3 to 6 weeks d. Puerperium, or fourth trimester of pregnancy

d. Puerperium, or fourth trimester of pregnancy

A 30-year-old multiparous woman has a boy who is years old and has recently delivered an infant girl. She tells the nurse, I dont know how Ill ever manage both children when I get home. Which suggestion would assist this new mother in alleviating sibling rivalry? a. Tell the older child that he is a big boy now and should love his new sister. b. Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the newborn. c. Ask friends and relatives not to bring gifts to the older sibling because you do not want to spoil him. d. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.

d. Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.

A nurse is observing a family. The mother is holding the baby she delivered less than 24 hours ago. Her husband is watching his wife and asking questions about newborn care. The 4-year-old brother is punching his mother on the back. How should the nurse react to this situation? a. Report the incident to the social services department. b. Advise the parents that the toddler needs to be reprimanded. c. Report to oncoming staff that the mother is probably not a good disciplinarian. d. Realize that this is a normal family unit adjusting to a major family change.

d. Realize that this is a normal family unit adjusting to a major family change.

What are the most common causes for subinvolution of the uterus? a. Postpartum hemorrhage and infection b. Multiple gestation and postpartum hemorrhage c. Uterine tetany and overproduction of oxytocin d. Retained placental fragments and infection

d. Retained placental fragments and infection

A client asks the nurse when her ovaries will begin working again. Which explanation by the nurse is most accurate? a. Almost 75% of women who do not breastfeed resume menstruating within 1 month after birth. b. Ovulation occurs slightly earlier for breastfeeding women. c. Because of menstruation and ovulation schedules, contraception considerations can be postponed until after the puerperium. d. The first menstrual flow after childbirth usually is heavier than normal.

d. The first menstrual flow after childbirth usually is heavier than normal.

In follow-up appointments or visits with parents and their new baby, it is useful if the nurse can identify infant behaviors that can either facilitate or inhibit attachment. What is an inhibiting behavior? a. The infant cries only when hungry or wet. b. The infants activity is somewhat predictable. c. The infant clings to the parents. d. The infant seeks attention from any adult in the room

d. The infant seeks attention from any adult in the room

A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a stool softener. Which information regarding the clients condition is most closely correlated with these orders? a. Woman is a gravida 2, para 2. b. Woman had a vacuum-assisted birth. c. Woman received epidural anesthesia. d. Woman has an episiotomy.

d. Woman has an episiotomy.