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    Exam Review

    1. A nurse is providing education about postpartum nutritional needs for the client that is breastfeeding.What information should be included in the teaching?
      A)
      Eat a high-fat diet.
      B)
      Stop taking prenatal vitamins.
      C)
      An additional 450-500 kCal per day should be consumed.
      D)
      8-16 oz of water per day is all that is needed.
    2. A nurse is caring for a client who is 6 hours postpartum and observes a light amount of lochia rubra on the client’s perineal pad.The fundus is midline and firm at the umbilicus.Which of the following actions should the nurse take?
      A)
      Encourage the client to empty her bladder.
      B)
      Notify the client’s provider.
      C)
      Document the findings and continue to monitor the client.
      D)
      Increase the frequency of fundal massage.
    3. A nurse is caring for a client who is 18 hours postpartum.Which finding should alert the nurse to the possibility of a postpartum complication?
      A)
      Heart rate 125 bpm.
      B)
      Fundus palpable at the umbilicus.
      C)
      Urine output of 3,000 mL in 24 hr.
      D)
      Orthostatic hypotension.
    4. The nurse is reviewing the charts of several clients as she prepares to go over discharge teaching. Which of the following clients does the nurse recognize as having an increased risk for a difficult or ineffective transition to motherhood?
      A)
      A 29-year-old G3P3003 who had an uncomplicated SVD at term. Husband is at bedside. Older daughter is currently meeting her new sibling.
      B)
      A 37-year-old G3P1112 with worsening preeclampsia who was induced at 34 weeks. She is currently on Magnesium Sulfate. Baby is in the NICU.
      C)
      A 31-year-old G3P2012 who had an uncomplicated SVD. History of depression. Her husband is active-duty military and is currently deployed.
      D)
      A 16-year-old G1P1001 who delivered via cesarean section.
      E)
      A 20-year-old G1P1001 who had an unmedicated, uncomplicated spontaneous vaginal delivery (SVD) at term. Boyfriend present.
    Page 1 of 7

    Exam Review

    1. A nurse is caring for a client who experienced a vaginal birth 20 hours ago.The nurse recognizes the client is in the taking-in phase of maternal postpartum adjustment.Which finding should the nurse expect during this phase?
      A)
      Lack of appetite.
      B)
      Eagerness to learn newborn care skills.
      C)
      Discussion of birth experience.
      D)
      Reconnection with her partner.
    2. A nurse is caring for a client who is breastfeeding and states that her nipples are sore and cracking.Which of the following actions should the nurse take?
      A)
      Assess and ensure the newborn has a successful latch.
      B)
      Recommend increasing the length of time between feedings.
      C)
      Educate the client to apply mineral oil to the nipples between feedings.
      D)
      Educate the client to keep the nipples covered between breastfeeding sessions.
    3. A nurse is caring for a client who is 3 days postpartum and is attempting to breastfeed.Which of the following findings indicate mastitis?
      A)
      Swelling in both breasts.
      B)
      A white patch on a nipple.
      C)
      Cracked and bleeding nipples.
      D)
      Red and painful area in one breast.
    4. A nurse is caring for a client who is postpartum and received a bolus of Oxytocin 30 units in 500 mL of NS over 1 hour following delivery of the placenta.Which of the following findings indicates that the medication was effective?
      A)
      Increase in lochia.
      B)
      Report of absent breast pain.
      C)
      Increase in blood pressure.
      D)
      Fundus firm to palpation.
    Page 2 of 7

    Exam Review

    1. A nurse is providing discharge teaching to a postpartum client.The nurse emphasizes indications of potential complications and what to report to their provider.Which of the following findings should the nurse teach the client as a sign of a complication and requires further evaluation by a healthcare provider?
      (SATA)
      A)
      Headache that is not relieved by hydration, rest or OTC medication.
      B)
      Brownish red or pink lochia at 7 days postpartum.
      C)
      Chills and fever greater than 100.4 F (38.0 C).
      D)
      Feelings or thoughts of harming self or infant.
      E)
      Increased urinary output.
      F)
      Redness, pain or tenderness in calf.
    2. A nurse is assessing a client who is 3 days postpartum and is breastfeeding.The nurse notes that the fundus is three fingerbreadths below the umbilicus, lochia rubra is light, and the breasts are full and warm to palpation, without evidence of redness or pain.Which of the following interpretations of these findings should the nurse make?
      A)
      The client is exhibiting expected assessment findings.
      B)
      The client is exhibiting indications of mastitis.
      C)
      The client should be advised to remove her nursing bra.
      D)
      The client should be advised to stop breastfeeding.
    3. A nurse is providing education to a client about the Rubella vaccine.Which of the following statements made by the client indicated they understood the teaching?
      A)
      The rubella vaccine would be better to take during my next pregnancy.
      B)
      A rubella vaccine is recommended during each pregnancy.
      C)
      I need the vaccine because my baby is Rh positive.
      D)
      I should avoid pregnancy for 28 days.
    4. The nurse is caring for a patient that delivered 6 hours ago.She had a spontaneous vaginal delivery (SVD) with a second degree laceration that was repaired.She pushed for three hours and has swollen perineum and inflamed hemorrhoids.The patient complains of overall perineal discomfort and rates it a 6/10 on the pain scale.Which of the following interventions would the nurse include in the client’s plan of care for pain management? Select all that apply.
      A)
      Warm compress.
      B)
      Tucks pads.
      C)
      Dermaplast spray.
      D)
      Ibuprofen 600 mg PO.
      E)
      Encourage the patient to sit in a high Fowler’s position.
    Page 3 of 7

    Exam Review

    1. A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?
      A)
      Change the dressing on a cesarean incision for a patient who is 1 day post-op.
      B)
      Document the lochia amount on the perineal pad of a client who just transferred from labor and delivery.
      C)
      Assess an area of redness on the breast of a client who is 4 days postpartum.
      D)
      Provide a sitz bath to a client who has a third-degree laceration and is 2 days postpartum.
    2. The nurse is providing education to a client that is 3 hours postpartum after a vaginal delivery with a second-degree laceration.Which of the following actions should the nurse include in the perineal care teaching? (Select all that apply.)
      A)
      Wash your hands before and after perineal care or voiding.
      B)
      Leave your current pad on until it is fully saturated.
      C)
      Wipe the perineum thoroughly with a back-and-forth motion.
      D)
      Use a perineal squeeze bottle to cleanse the perineum.
      E)
      Apply ice or cold packs to the perineum.
    3. A nurse is caring for a client who is postpartum and finds the fundus firm and deviated to the left, lochia is rubra and scant.Based on these findings, which of the following actions should the nurse take?
      A)
      Ask the client to rate her pain.
      B)
      Encourage the client to perform Kegel exercises.
      C)
      Assist the client to the bathroom to void.
      D)
      Encourage the client to move to the left lateral position.
    4. A nurse in a clinic is caring for a client who is 4 weeks postpartum following the birth of a healthy newborn.The client reports feeling “down and sad,” having no energy, and wanting to cry.Which of the following is a priority action by the nurse?
      A)
      Ask the client if she has thoughts of or considered harming herself or her newborn.
      B)
      Anticipate a prescription by the provider for an antidepressant.
      C)
      Assist the family to identify prior use of positive coping skills in family crises.
      D)
      Reinforce postpartum and newborn care discharge teaching.
    Page 4 of 7

    Exam Review

    1. A nurse is providing education on preventing pregnancy to a postpartum client.Which of the following statements made by the client indicates additional education is needed?
      A)
      “Long-acting reversible contraceptives, like an intrauterine device (IUD), are highly effective in preventing pregnancy.”.
      B)
      “Breastfeeding is not a form of contraception.”.
      C)
      “I will begin to use a barrier method after I start my first menstrual cycle.”.
      D)
      “Withdrawal method is not very effective at avoiding pregnancy.”.
    2. A student nurse is reviewing the process of milk production in pregnancy and postpartum.Which of the following is the process of lactation maintenance and is reliant on breast stimulation and milk removal?
      A)
      Galactopoiesis.
      B)
      Lactogenesis II.
      C)
      Mammogenesis.
      D)
      Lactogenesis
      E)
      . .
    3. A nurse is caring for a client who is considering several methods of contraception.Which of the following methods of contraception should the nurse identify as being most reliable?
      A)
      An intrauterine device (IUD).
      B)
      An oral contraceptive.
      C)
      A male condom.
      D)
      A diaphragm with spermicide.
    4. A nurse is caring for a client who is 5 hours postpartum following a successful vaginal birth of twins.The nurse should recognize that this client is at increased risk for which of the following postpartum complications?
      A)
      Mastitis.
      B)
      Uterine infection.
      C)
      Uterine atony.
      D)
      Retained placental fragments.
    Page 5 of 7

    Exam Review

    1. A nurse is providing teaching about comfort measures for breast engorgement to a client who is postpartum and is not planning on breastfeeding.Which of the following statements by the client indicates she understood the teaching?
      A)
      “I should pump out the milk when my breasts become engorged.”.
      B)
      “I will not wear a bra throughout the day.”.
      C)
      “I should apply hot packs to my breasts.”.
      D)
      “I will avoid stimulation to my nipples.”.
    2. A nurse is caring for a postpartum client, who delivered yesterday and complains of constipation.She had a vaginal delivery complicated by a fourth degree laceration, which was repaired.Based upon this information, which of the following is contraindicated?
      A)
      Increase fluid intake to 2-3 L/day.
      B)
      Stool softeners as needed.
      C)
      Increase fiber intake.
      D)
      Rectal suppository as needed.
    3. A postpartum client is prescribed 800 mg of ibuprofen every 6 hours for pain management. The nurse has 200 mg tablets of ibuprofen available. How many tablets should the nurse administer for each dose?
      A)
      4 tablets.
      B)
      1 tablet.
      C)
      2 tablets.
      D)
      3 tablets.
    4. A nurse is caring for a postpartum client with a distended bladder.The client is assisted to the bathroom, but is unable to void.Which of the following interventions would be contraindicated?
      A)
      Use the bladder scanner to assess for urinary retention.
      B)
      Catheterize to empty the bladder.
      C)
      Place peppermint oil on a cotton ball and place it in the urinary “hat” while the client is on the toilet.
      D)
      Assist the client back to bed and tell her to try to void again in 2 hours.
    Page 6 of 7