Study Questions for Maternal Health Final Exam
D) Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia
A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization the infant is weighed, and the birth weight is 4550 g (9 pounds, 6 ounces). The nurse's most appropriate action is to: A) Leave the infant in the room with the mother. B) Take the infant immediately to the nursery. C) Perform a gestational age assessment to determine whether the infant is large for gestational age. D) Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia.
D) Include him in teaching sessions
A new father states, "I know nothing about babies," but he seems to be interested in learning. This is an ideal opportunity for the nurse to: A)Continue to observe his interaction with the newborn. B) Tell him when he does something wrong. C) Show no concern, as he will learn on his own. D) Include him in teaching sessions.
A) Acrocyanosis
A new mother states that her infant must be cold because the baby's hands and feet are blue. The nurse explains that this is a common and temporary condition called: A) Acrocyanosis. B) Erythema neonatorum. C) Harlequin color. D) Vernix caseosa.
A) Infants should be given only human milk for the first 6 months of life
According to the recommendations of the American Academy of Pediatrics on infant nutrition: A) Infants should be given only human milk for the first 6 months of life. B) Infants fed on formula should be started on solid food sooner than breastfed infants. C) If infants are weaned from breast milk before 12 months, they should receive cow's milk, not formula. D) After 6 months mothers should shift from breast milk to cow's milk.
D) I'll warm the soup in the microwave for you.
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. The nurse's most appropriate response is to ask the woman: A) "Didn't you like your lunch?" B) "Does your doctor know that you are planning to eat that?" C) "What is that anyway?" D) "I'll warm the soup in the microwave for you."
C) Fatigue may affect interest in sexual activity. D) Sexual activity can usually be safely resumed by 5 to 6 weeks after birth. E) Water-soluble lubrication may increase comfort. F) The female-on-top position may be more comfortable than other positions. Kegel exercises are usually recommended and can strengthen the pubococcygeal muscle. Breastfeeding mothers often are interested in returning to sexual activity before nonbreastfeeding mothers. The amount of psychologic energy expended by the mother in child care activities may lead to fatigue and decreased interest in sexual activity. Most women can safely resume sexual activity by 5 to 6 weeks after birth. A water-soluble gel or jelly is recommended for lubrication. A position in which the mother has control of the depth of insertion of the penis, such as the female-on-top position may be more comfortable than other positions.
A after birth woman preparing for discharge asks the nurse about resuming sexual activity. Which information is appropriate to include in the patient teaching? (Select all that apply) A) Do not perform Kegel exercises to decrease pelvic floor muscle healing time. B) If breastfeeding, sexual interest may be delayed. C) Fatigue may affect interest in sexual activity. D) Sexual activity can usually be safely resumed by 5 to 6 weeks after birth. E) Water-soluble lubrication may increase comfort. F) The female-on-top position may be more comfortable than other positions.
C) The bilirubin levels of physiologic jaundice peak between the second and fourth days of life
A first-time dad is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, what fact should be included? A) Physiologic jaundice occurs during the first 24 hours of life. B) Physiologic jaundice is caused by blood incompatibilities between the mother and infant blood types. C) The bilirubin levels of physiologic jaundice peak between the second and fourth days of life. D) This condition is also known as "breast milk jaundice."
C) Place eye shields over the newborn's closed eyes
A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method would be to: A) Apply an oil-based lotion to the newborn's skin to prevent dying and cracking. B) Limit the newborn's intake of milk to prevent nausea, vomiting, and diarrhea. C) Place eye shields over the newborn's closed eyes. D) Change the newborn's position every 4 hours.
D) Realize that this is a normal family adjusting to family change
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. The nurse should: 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 adjusting to family change.
A) Use devices that transform sound into light D) Ascertain whether the patient can read lips before teaching E) Written messages aid in communication
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) Use devices that transform sound into light. B) Assume that the patient knows sign language. C) Speak quickly and loudly. D) Ascertain whether the patient can read lips before teaching. E) Written messages aid in communication.
A) Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide
A premature infant with respiratory distress syndrome receives artificial surfactant. How would the nurse explain surfactant therapy to the parents? A) "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." B) "The drug keeps your baby from requiring too much sedation." C) "Surfactant is used to reduce episodes of periodic apnea." D) "Your baby needs this medication to fight a possible respiratory tract infection."
A) The woman leaves the infant on her bed while she takes a shower.
A primiparous woman is to be discharged from the hospital tomorrow with her infant girl. Which behavior indicates a need for further intervention by the nurse before the woman can be discharged? A) The woman leaves the infant on her bed while she takes a shower. 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 infant's diaper and then shows the nurse the contents of the diaper.
B) Applying ice to the breasts for comfort.
A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your assessment you notice that both of her breasts are swollen, warm, and tender on palpation. The woman should be advised that this condition can best be treated by: A) Running warm water on her breasts during a shower. B) Applying ice to the breasts for comfort. Expressing small amounts of milk from the breasts to relieve pressure. C) Wearing a loose-fitting bra to prevent nipple irritation.
B) Excessive uterine bleeding A urinary tract infection may result from overdistention of the bladder, but it is not the most serious consequence. Excessive bleeding can occur immediately after birth if the bladder becomes distended, because it pushes the uterus up and to the side and prevents it from contracting firmly. A ruptured bladder may result from a severely overdistended bladder. However, vaginal bleeding most likely would occur before the bladder reaches this level of overdistention. Bladder distention may result from bladder wall atony. The most serious concern associated with bladder distention is excessive uterine bleeding.
A woman gave birth to a 7-lb, 3-ounce boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is: A) UTI B) Excessive uterine bleeding C) A Ruptured bladder D) Bladder wall atony
B) First period of reactivity
A woman gave birth to a healthy 7-pound, 13-ounce infant girl. The nurse suggests that the woman place the infant to her breast within 15 minutes after birth. The nurse knows that breastfeeding is effective during the first 30 minutes after birth because this is the: A) Transition period. B) First period of reactivity. C) Organizational stage. D) Second period of reactivity.
A) One centimeter above the umbilicus
A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this woman's fundus? A) One centimeter above the umbilicus Correct B) Two centimeters below the umbilicus C) Midway between the umbilicus and the symphysis pubis D) Nonpalpable abdominally
B) Pulse 110 beats/min E) Temperature 38° C During the first 24 hours after birth, temperature may increase to 38° C (100.4° F). As the observation time is beyond that of the first 24 hours, maternal fever should be reported as this would not be considered to be a normal finding pulse, remains elevated for the first hour or so after childbirth. It then begins to decrease to a nonpregnant rate. A rapid pulse may indicate hypovolemia. Respiratory rate is normal. Blood pressure is altered slightly if at all after birth.
After completing a after birth assessment on woman who delivered 36 hours ago, the nurse should report which assessment findings to the health care provider? (Select all that apply) A) Temperature 100.0° F B) Pulse 110 beats/min C) Respiratory rate 12 breaths/min D) Blood pressure 125/78 E) Temperature 38° C
D) I can understand your need to find an answer to what caused this. What else are thinking about?
After giving birth to a stillborn infant, the woman turns to the nurse and says, "I just finished painting the baby's room. Do you think that caused my baby to die?" The nurse's best response to this woman is: A) "That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them." B) "That's not likely. Paint is associated with elevated pediatric lead levels." C) Silence. D) "I can understand your need to find an answer to what caused this. What else are you thinking about?"
D) Mongolian spots
An African-American woman noticed some bruises on her newborn girl's buttocks. She asks the nurse who spanked her daughter. The nurse explains that these marks are called: A) Lanugo. B) Vascular nevi. C) Nevus flammeus. D) Mongolian spots.
C) At least twice, 1 minute and 5 minutes after birth
An infant boy was born just a few minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. The Apgar assessment is performed: A) Only if the newborn is in obvious distress. B) Once by the obstetrician, just after the birth. C) At least twice, 1 minute and 5 minutes after birth. D) Every 15 minutes during the newborn's first hour after birth.
C) Hypoglycemia
An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg. The infant appears chubby with a flushed complexion and is very tremulous. The tremors are most likely the result of: A) Birth injury. B) Hypocalcemia. C) Hypoglycemia. D) Seizures.
A) little if any change. E) small amount of clear, yellow fluid expressed. Breasts are essentially unchanged for the first 24 hours after birth. Colostrum is present and may leak from the nipples. Leakage of milk occurs after the milk comes in 72 to 96 hours after birth. Engorgement occurs at day 3 or 4 after birth. A few blisters and a bruise indicate problems with the breastfeeding techniques being used.Colostrum, or early milk, a clear, yellow fluid, may be expressed from the breasts during the first 24 hours.
As part of the after birth assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day after birth. Expected findings include: (Select all that apply) A) little if any change. B) leakage of milk at let-down. C) swollen, warm, and tender on palpation. D) a few blisters and a bruise on each areola. E) small amount of clear, yellow fluid expressed.
A) 1 hour Baby-friendly hospitals mandate that the infant be put to breast within the first hour after birth (BFHI, 2010). The ideal time to initiate breastfeeding is within the first 1 to 2 hours after delivery. In many countries this is the norm; however, the Baby-Friendly Hospital Initiative (BFHI) mandates 1 hour. Ideally an infant should go no longer than 2 hours after delivery before being put to breast. This is much too long to wait to initiate breastfeeding, whether the hospital is baby-friendly or not.
Baby-friendly hospitals mandate that infants be put to breast within what time frame after birth? A) 1 hour B) 30 minutes C) 2 hours D) 4 hours
D) Inserting a sterile catheter
Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing the nurse could try is: A) Pouring water from a squeeze bottle over the woman's perineum. B) Placing oil of peppermint in a bedpan under the woman. C) Asking the physician to prescribe analgesics. D) Inserting a sterile catheter.
D) Congestion of veins and lymphatics
The nurse caring for the postpartum woman understands that breast engorgement is caused by: A) Overproduction of colostrum. B) Accumulation of milk in the lactiferous ducts. C) Hyperplasia of mammary tissue. D) Congestion of veins and lymphatics.
D) I pretend that I am trying to stop the flow of urine midstream.
Childbirth may result in injuries to the vagina and uterus. Pelvic floor exercises also known as Kegel exercises will help to strengthen the perineal muscles and encourage healing. The nurse knows that the client understands the correct process for completing these conditioning exercises when she reports: A) "I contract my thighs, buttocks, and abdomen." B) "I do 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 midstream."
A) At the time of admission to the nurse's unit
Discharge instruction, or teaching the woman what she needs to know to care for herself and her newborn, officially begins: A) At the time of admission to the nurse's 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.
C) Postpartum (PP) blues
During a phone follow-up conversation with a woman who is 4 days' postpartum, the woman tells the nurse, "I don't know what's wrong. I love my son, but I feel so let down. I seem to cry for no reason!" The nurse would recognize that the woman is experiencing: A) Taking-in. B) Postpartum depression (PPD). C) Postpartum (PP) blues. D) Attachment difficulty.
C) failure of the uterine muscle to contract firmly. Although vaginal or vulvar hematomas are a possible cause of excessive blood loss, uterine muscle failure (uterine atony) is the most common cause. Although unrepaired lacerations are a possible cause of excessive blood loss, uterine muscle failure (uterine atony) is the most common cause. Uterine atony can best be thwarted by maintaining good uterine tone and preventing bladder distention. Although retained placental fragments is a possible cause of excessive blood loss, uterine muscle failure (uterine atony) is the most common cause.
Excessive blood loss after childbirth can have several causes; however, the most common is: A) vaginal or vulvar hematomas. B) unrepaired lacerations of the vagina or cervix. C) failure of the uterine muscle to contract firmly. D) retained placental fragments.
C) the expected weight loss immediately after birth averages about 11 to 13 lbs. Prepregnant weight is usually achieved by 2 to 3 months after birth, not within the 6-week after birth period. Weight loss from diuresis, diaphoresis, and bleeding is about 9 lbs. The expected weight loss immediately following delivery is 11 to 13 lbs, followed by a gradual decrease and a return to prepregnancy weight in 2 to 3 months. Weight loss continues during breastfeeding since fat stores developed during pregnancy and extra calories consumed are used as part of the lactation process.
Following the birth of her baby, a woman expresses concern about the weight she gained during pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the expected pattern of weight loss, should begin by telling this woman that: A) return to prepregnant weight is usually achieved by the end of the after birth period. B) fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3-lb weight loss. C) the expected weight loss immediately after birth averages about 11 to 13 lbs. D) lactation will inhibit weight loss since caloric intake must increase to support milk production.
C) preterm before 37 weeks, and post-term beyond 42 weeks, no matter the size for gestational age at birth
For clinical purposes, preterm and post-term infants are defined as: A) Preterm before 34 weeks if appropriate for gestational age (AGA) and before 37 weeks if small for gestational age (SGA). B) Post-term after 40 weeks if large for gestational age (LGA) and beyond 42 weeks if AGA. C) Preterm before 37 weeks, and post-term beyond 42 weeks, no matter the size for gestational age at birth. D) Preterm, SGA before 38 to 40 weeks, and post-term, LGA beyond 40 to 42 weeks.
A) Breast tenderness is likely to persist for about a week after the start of lactation.
Knowing that the condition of the new mother's breasts will be affected by whether she is breastfeeding, nurses should be able to tell their clients all the following statements except: A) Breast tenderness is likely to persist for about a week after the start of lactation. B) As lactation is established, a mass may form that can be distinguished from cancer by its position shift from day to day. C) In nonlactating mothers colostrum is present for the first few days after childbirth. D) If suckling is never begun (or is discontinued), lactation ceases within a few days to a week.
B) Grandparents can help you w/parenting skills and also help preserve family traditions.
Many first-time parents do not plan on their parents' help immediately after the newborn arrives. What statement by the nurse is the most appropriate when counseling new parents about the involvement of grandparents? A) "You should tell your parents to leave you alone." B) "Grandparents can help you with parenting skills and also help preserve family traditions." C) "Grandparent involvement can be very disruptive to the family." D) "They are getting old. You should let them be involved while they can."
A) The mother should check the photo ID of any person who comes to her room. D) Parents should use caution when posting photos of their infants on the internet. E) The mom should request that a second staff member verify the identity of any questionable person
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 ID of any person who comes to her room. B) The baby should be carried in the parent's arms from the room to the nursery. C) Because of infant security systems, the baby can be left unattended in the patient's room. D) Parents should use caution when posting photos of their infant on the Internet. E) The mom should request that a second staff member verify the identity of any questionable person.
D) An environment that fosters as much privacy as possible should be created.
Nursing activities that promote parent-infant attachment are many and varied. One activity that should not be overlooked is management of the environment. While providing routine mother-baby care, the nurse should ensure that: 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 mother-baby discharge. D) An environment that fosters as much privacy as possible should be created.
D) Massage the woman's fundus.
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. The nurse's first action is to: A) Begin an intravenous (IV) infusion of Ringer's lactate solution. B) Assess the woman's vital signs. C) Call the woman's primary health care provider. D) Massage the woman's fundus.
D) massage the woman's fundus. The nurse may begin an intravenous (IV) infusion to restore circulatory volume, but this would not be the first action. Blood pressure is not a reliable indicator of impending shock from an impending hemorrhage; assessing vital signs should not be the nurse's first action. The physician should be notified after the nurse completes assessment of the woman. The nurse should assess the uterus for atony. Uterine tone must be established to prevent excessive blood loss.
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. The nurse's first action is to: A) begin an intravenous (IV) infusion of Ringer's lactate solution. B) assess the woman's vital signs. C) call the woman's primary health care provider. D) massage the woman's fundus.
B) Infants can learn to distinguish their mother's voice from others soon after birth
Other early sensual contacts between infant and mother involve sound and smell. Nurses should be aware that, despite what folk wisdom may say: A) High-pitched voices irritate newborns. B) Infants can learn to distinguish their mother's voice from others soon after birth. C) All babies in the hospital smell alike. D) A mother's breast milk has no distinctive odor.
D) uses the peribottle to rinse upward into her vagina. These are all appropriate measures. The peribottle should be used in a backward direction over the perineum. The flow should never be directed upward into the vagina since debris would be forced upward into the uterus through the still-open cervix.
Perineal care is an important infection control measure. When evaluating a after birth woman's perineal care technique, the nurse would recognize the need for further instruction if the woman: A) uses soap and warm water to wash the vulva and perineum. B) washes from the symphysis pubis back to the episiotomy. C) changes her perineal pad every 2 to 3 hours. D) uses the peribottle to rinse upward into her vagina.
D) if a smell is detected then an infection is present. Lochia flow should approximate a heavy menstrual period for the first 2 hours and then steadily decrease. Less lochia usually is seen after cesarean births. Lochia usually increases with ambulation and breastfeeding. An odor indicates an infection.
Postbirth uterine/vaginal discharge, called lochia: A) is similar to a light menstrual period for the first 6 to 12 hours. B) is usually greater after cesarean births. C) will usually decrease with ambulation and breastfeeding. D) if a smell is detected then an infection is present.
A) wear a snug, supportive bra. A snug, supportive bra limits milk production and reduces discomfort by supporting the tender breasts and limiting their movement. Cold packs reduce tenderness, whereas warmth would increase circulation, thereby increasing discomfort. Expressing milk results in continued milk production. Plastic liners keep the nipples and areola moist, leading to excoriation and cracking.
The breasts of a bottle-feeding woman are engorged. The nurse should tell her to: A) wear a snug, supportive bra. B) allow warm water to soothe the breasts during a shower. C) express milk from breasts occasionally to relieve discomfort. D) place absorbent pads with plastic liners into her bra to absorb leakage.
C) PPD can easily go undetected
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, about one-half million women in America experience a more severe syndrome known as postpartum depression (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) Palpate the uterus and massage it if it is boggy
The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to: A)Call the woman's primary health care provider. B) Administer the standing order for an oxytocic. C) Palpate the uterus and massage it if it is boggy. D) Assess maternal blood pressure and pulse for signs of hypovolemic shock.
B) massage her fundus. There is no indication of a distended bladder; thus having the woman urinate will not alleviate the problem. A boggy or soft fundus indicates that uterine atony is present. This is confirmed by the profuse lochia and passage of clots. The first action would be to massage the fundus until firm. The physician can be called after massaging the fundus, especially if the fundus does not become or remain firm with massage. Methergine can be administered after massaging the fundus, especially if the fundus does not become or remain firm with massage.
The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action would be to: A) place her on a bedpan to empty her bladder. B) massage her fundus. C) call the physician. D) administer Methergine, 0.2 mg IM, which has been ordered prn.
A) I can store my breast milk in the refrigerator for 3 months
The nurse is discussing storage of breast milk with a mother whose infant is preterm and in the special care unit. What statement would indicate that the mother needs additional teaching? A) "I can store my breast milk in the refrigerator for 3 months." B) "I can store my breast milk in the freezer for 3 months." C) "I can store my breast milk at room temperature for 8 hours." D) "I can store my breast milk in the refrigerator for 3 to 5 days."
C) May indicate that the infant has a tracheoesophageal fistula or esophageal atresia
The nurse is performing a gestational age and physical assessment on the newborn. The infant appears to have an excessive amount of saliva. The nurse recognizes that this finding: A) Is normal. B) Indicates that the infant is hungry. C) May indicate that the infant has a tracheoesophageal fistula or esophageal atresia. D) May indicate that the infant has a diaphragmatic hernia.
B) Seldom makes eye contact w/her son
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) Talks and coos to her son B) Seldom makes eye contact with her son C) Cuddles her son close to her D) Tells visitors how well her son is feeding
A) Uterine atony
The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is: A) Uterine atony. B) Uterine inversion. C) Vaginal hematoma. D) Vaginal laceration.
B) Bladder training and pelvic muscle exercises
The prevalence of urinary incontinence (UI) increases as women age, with more than one third of women in the United States suffering from some form of this disorder. The symptoms of mild to moderate UI can be successfully decreased by a number of strategies. Which of these should the nurse instruct the client to use first? A) Pelvic floor support devices B) Bladder training and pelvic muscle exercises C) Surgery D) Medications
C) Place the infant to the breast
To initiate the milk ejection reflex (MER), the mother should be advised to: A) Wear a firm-fitting bra. B) Drink plenty of fluids. C)Place the infant to the breast. D) Apply cool packs to her breast.
D) hematoma formation. Bladder distention results in an elevation of the fundus above the umbilicus and deviation to the right or left of midline. Uterine atony results in a boggy fundus. Constipation is unlikely at this time. Increasing perineal pressure along with a firm fundus and moderate lochial flow are characteristic of hematoma formation.
Two hours after giving birth a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm at the umbilicus and midline. Her lochia is moderate rubra with no clots. The nurse suspects: A) bladder distention. B) uterine atony. C) constipation. D) hematoma formation.
C) Mastitis
What infection is contracted mostly by first-time mothers who are breastfeeding? A) Endometritis B) Wound infections C) Mastitis D) Urinary tract infections
C) Harm her infant
When a woman is diagnosed with postpartum depression (PPD) with psychotic features, one of the main concerns is that she may: A) Have outbursts of anger. B) Neglect her hygiene. C) Harm her infant. D) Lose interest in her husband.
C) assist the woman to empty her bladder. A firm fundus should not be massaged since massage could overstimulate the fundus and cause it to relax. Methergine is not indicated in this case since it is an oxytocic and the fundus is already firm. The findings indicate a full bladder, which pushes the uterus up and to the right or left of midline. The recommended action would be to empty the bladder. If the bladder remains distended, uterine atony could occur, resulting in a profuse flow. This is not a normal finding, and an action is required.
When palpating the fundus of a woman 18 hours after birth, the nurse notes that it is firm, two fingerbreadths above the umbilicus, and deviated to the left of midline. The nurse should: A) massage the fundus. B) administer Methergine, 0.2 mg PO, that has been ordered prn. C) assist the woman to empty her bladder. D) recognize this as an expected finding during the first 24 hours following birth.
B) Rugae reappear within 3 to 4 weeks The cervix regains its form within days; the cervical os may take longer. Rugae are never again as prominent as in a nulliparous woman. Localized dryness may occur until ovarian function resumes. Most episiotomies take 2 to 3 weeks to heal. Hemorrhoids can take 6 weeks to decrease in size.
Which description of after birth restoration or healing times is accurate? A) The cervix shortens, becomes firm, and returns to form within a month after birth. B) Rugae reappear within 3 to 4 weeks 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
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.
A) The fundus is palpable two fingerbreadths above the umbilicus
Which finding 12 hours after birth requires further assessment? A) The fundus is palpable two fingerbreadths above the umbilicus. B) The fundus is palpable at the level of the umbilicus. C) The fundus is palpable one fingerbreadth below the umbilicus. D) The fundus is palpable two fingerbreadths below the umbilicus.
D) Pain in left calf with dorsiflexion of left foot E) Lochia rubra with foul odor Postural hypotension is an expected finding related to circulatory changes after birth. A temperature of 100.4° F in the first 24 hours most likely indicates dehydration, which is easily corrected by increasing oral fluid intake. A heart rate of 55 beats/min is an expected finding in the initial after birth period. These findings indicate a positive Homans' sign and are suggestive of thrombophlebitis and should be investigated. Lochia with odor may indicate infection.
Which findings would be a source of concern if noted during the assessment of a woman who is 12 hours' after birth? (Select all that apply) A) Postural hypotension B) Temperature of 100.4° F C) Bradycardia—pulse rate of 55 beats/min D) Pain in left calf with dorsiflexion of left foot E) Lochia rubra with foul odor
C) Massage the fundus every hour for the first 24 hours following birth Administration of Methergine can help prevent after birth hemorrhage. Voiding frequently can help the uterus contract, thus preventing after birth hemorrhage. The fundus should be massaged only when boggy or soft. Massaging a firm fundus could cause it to relax. Rest and nutrition are helpful for enhancing healing and preventing hemorrhage.
Which measure would be least effective in preventing after birth hemorrhage? A) Administer Methergine, 0.2 mg every 6 hours for four doses, as ordered B) Encourage the woman to void every 2 hours C) Massage the fundus every hour for the first 24 hours following birth D) Teach the woman the importance of rest and nutrition to enhance healing
B) "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." A newly delivered woman following childbirth can expect her first menstrual cycle to be heavier than normal, and the volume of her subsequent cycles to return to prepregnant levels within three or four cycles. This is an accurate statement and indicates her understanding of her expected menstrual activity. Most women experience a heavier than normal flow during the first menstrual cycle, which occurs by 3 months after childbirth. She can expect her first menstrual cycle to be heavier than normal, and the volume of her subsequent cycles to return to prepregnant levels within three or four cycles.
Which statement by a newly delivered woman indicates that she knows what to expect about 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."
C) Document the finding as erythema toxicum
While assessing the integument of a 24-hour-old newborn, the nurse notes a pink, papular rash with vesicles superimposed on the thorax, back, and abdomen. The nurse should: A) Notify the physician immediately. B) Move the newborn to an isolation nursery. C) Document the finding as erythema toxicum. D) Take the newborn's temperature and obtain a culture of one of the vesicles.
C) 120 to 160 bpm
While assessing the newborn, the nurse should be aware that the average expected apical pulse range of a full-term, quiet, alert newborn is: A) 80 to 100 beats/min. B) 100 to 120 beats/min. C) 120 to 160 beats/min. D) 150 to 180 beats/min.
C) more noticeable in births in which the uterus was overdistended. The cramping that causes afterbirth pains arises from periodic, vigorous contractions and relaxations that persist through the first part of the after birth period. After birth pains are more common in multiparous women because first-time mothers have better uterine tone. A large baby or multiple babies overdistend the uterus. Breastfeeding intensifies afterbirth pain because it stimulates contractions.
With regard to afterbirth pains, nurses should be aware that these pains are: A) caused by mild, continual contractions for the duration of the after birth period. B) more common in first-time mothers. C) more noticeable in births in which the uterus was overdistended. D) alleviated somewhat when the mother breastfeeds.
C) fluid loss through perspiration and increased urinary output account for a weight loss of more than 2 kg during the puerperium. Kidney function usually returns to normal in about a month. Diastasis recti abdominis is the separation of muscles in the abdominal wall; it has no effect on the voiding reflex. Excess fluid loss through other means occurs as well. Bladder tone usually is restored 5 to 7 days after childbirth.
With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that: 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 account for a weight loss of more than 2 kg during the puerperium. D) with adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth.
