Exam Review
- 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 might try is:A)Placing oil of peppermint in a bedpan under the woman.B)Inserting a sterile catheter.C)Asking the physician to prescribe analgesics.D)Pouring water from a squeeze bottle over the woman's perineum.
- A woman gave birth to an infant boy 6 hours ago. Where would the nurse expect to locate this woman's fundus?A)Just above the umbilicus by about 1 centimeter.B)Non-palpable abdominally.C)Two centimeters (finger breadths) below the umbilicus.D)Midway between the umbilicus and the symphysis pubis.
- 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. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is:A)Increased venous pressure in the lower extremities.B)Loss of increased blood and fluid volume associated with pregnancy.C)Increased basal metabolic rate after giving birth.D)Elevated temperature caused by postpartum infection.
- The nurse is teaching the postpartum mother who is ready for discharge.A)The nurse reminds her to take the extra peripads home with her.B)The client states, "Oh, I don't use those.C)I always use tampons.”. Which of the following actions by the nurse is appropriate at this time?D)Advise the client that for the next several days she will be bleeding too heavily for a tampon.E)Get her a supply of tampons to take home.
Exam Review
- One of the first symptoms of puerperal infection to assess for in the postpartum woman is:A)Temperature of 38° C (100.4° F) or higher on postpartum day 2-3.B)Profuse vaginal bleeding with ambulation.C)Pain when passing stool.D)Fatigue continuing for longer than 1 week.
- The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:A)Wearing a nipple shield for the first few days of breastfeeding.B)Wearing a tight sports bra 24 hours a day.C)Frequent breastfeeding or pumping.D)Avoiding feeding if the nipple is cracked.
- The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to:A)Palpate the uterus and massage it if it is boggy.B)Assess maternal blood pressure and pulse for signs of hypovolemic shock.C)Administer the standing order for an oxytocic medication.D)Call the woman's primary health care provider.
- Medications used to manage postpartum hemorrhage (PPH) include (Choose all that apply):(SATA)A)Terbutaline/Brethine.B)Magnesium sulfate.C)Carboprost Tromethamine/Hemabate.D)Oxytocin/Pitocin.E)Methylergonovine/Methergine.
Exam Review
- If a woman is at risk for thrombus and is not ready to ambulate, nurses might intervene by doing all of these interventions except:A)Notifying the physician immediately if a positive Homan's sign occurs or if warmth, redness, and tenderness of the calf are present.B)Having her sit in a chair.C)Having her flex, extend, and rotate her feet, ankles, and legs.D)Putting her in antiembolic stockings (TED hose) and/or sequential compression device (SCD) boots.
- Which of the following could increase a woman's risk for postpartum hemorrhage?(SATA)A)Labor that lasted 2 1/2 hours.B)Induction with oxytocin/Pitocin.C)Oligohydramnios.D)SGA (small for gestational age) baby.E)Triplet pregnancy.
- A new mother calls the nurse into the room to tell her she gets abdominal cramps every time the baby breastfeeds. Which of the following is the correct explanation for this?A)Breastfeeding causes the ovaries to release prolactin and that will cause you to have increased abdominal pain.B)Milk production can be painful.C)When you breastfeed, the brain releases oxytocin that triggers the milk ejection reflex and makes your uterus contract causing cramps.D)That is probably because the baby is laying on your belly as you feed.
- The nurse enters the patient's room and notices the new mother quietly weeping as she packs up to take her newborn home. After talking with the patient, the nurse notes that the following factors increase this patient's risk for postpartum depression:A)She has a history of anxiety and depression.B)This is her third baby.C)She and her husband just moved far from family for his new job; he works 12-hour days.D)This is her first baby.
Exam Review
- The nurse notes a hemorrhoid when performing a postpartum physical exam. She instructs the patient to do all of the following to encourage healing, except:A)Gently wipe the area with witch hazel pads (Tucks pads).B)Apply hemorrhoid cream to the area after taking a sitz bath.C)Consume a high-fiber diet.D)Attempt to delay the first bowel movement at least 48 hours to allow adequate time for healing.
- The nurse is reviewing care of an episiotomy repair in preparation for her patient's discharge home. The nurse instructs the patient to call her physician if she notices:A)Discomfort while sitting during the first three weeks postpartum.B)Slight pain with urination and bowel movements during the first three weeks postpartum.C)Slight pain with walking and climbing stairs during the first three weeks postpartum.D)Fluid draining from the repair site during the first three weeks postpartum.
- Which of the following statements about "baby blues" does the nurse understand to be correct?A)Baby blues are often related to a phase of adjustment to new parenthood and can last several days to a couple of weeks.B)Baby blues is a term used to describe postpartum depression.C)Baby blues are often related to a phase of adjustment to new parenthood and can last several months.D)Baby blues should be treated with antidepressants.
- The nurse is caring for 4 patients on the postpartum unit. Which of her patients is at greatest risk for the development of thromboembolic disease?A)A 28-year-old G2P2 recovering from her second vaginal birth.B)A 28-year-old G1P1 recovering from her first cesarean section birth.C)A 37-year-old G3P3 recovering from her first cesarean section birth.D)A 37-year-old G1P1 recovering from her second vaginal birth.
Exam Review
- At 3 weeks postpartum, a patient calls the nurse on the triage line at the OB clinic. The patient states that she is now experiencing a whitish vaginal discharge. The nurse correctly explains to the patient:A)This is normal.B)A whitish vaginal discharge called lochia alba typically occurs during weeks 2-6 in the postpartum period.C)This is normal.D)A whitish vaginal discharge called lochia serosa typically occurs during weeks 2-6 in the postpartum period.
- Which of the following postpartum patients would the nurse expect to resume her menses first?A)A G1P1 who is bottle-feeding with infant formula.B)A G1P1 who is exclusively pumping and providing her infant with bottled, expressed breastmilk.C)A G3P3 who is breastfeeding and supplementing with formula.D)A G2P2 who is breastfeeding exclusively and on-demand.
- The nurse recognizes that the best time to discuss potential contraception options with the postpartum patient is:A)At the 2-week postpartum visit.B)When the patient experiences her first menses postpartum.C)Prior to discharge from the postpartum unit.D)At the 6-week postpartum visit.
- A patient with a history of chronic hypertension begins to hemorrhage following a precipitous vaginal delivery. The nurse knows that all of the following medications can be administered to this patient, EXCEPT:A)methylergonovine or Methergine.B)misoprostol or Cytotec.C)carboprost or Hemabate.D)oxytocin or Pitocin.
Exam Review
- The nurse expects which of the following to be included in the active management of the third stage of labor? SELECT ALL THAT APPLY.A)Delayed cord clamping.B)Controlled traction on the umbilical cord.C)Administration of oxytocin or Pitocin before placental delivery.D)Fundal massage before placental delivery.
- To reduce swelling and discomfort in the perineal area following a vaginal delivery, the nurse applies which of the following to the patient’s perineum in the first 24 hours postpartum?A)a topical anesthetic cream.B)nothing; it is best not to touch the area.C)ice packs.D)warm packs.
- The nurse notices that her postpartum patient has soaked through a large pad in 30 minutes. The nurse assesses the client’s fundus and finds it firm, midline, and at the appropriate height. The nurse should next:A)Assess for lacerations or hematomas.B)Change the pad and reassess in 15 minutes.C)Alert the provider.D)Assist the client in emptying her bladder.
- A client who has experienced a significant postpartum hemorrhage following a vaginal delivery should be instructed to rest and increase her intake of:A)Folic acid and protein.B)Omega 3 and calcium.C)Calcium and folic acid.D)Iron and protein.