Question 1

A postpartum patient is experiencing early postpartum hemorrhage.Which is the nurse's priority intervention?&#10;A) Notifying the provider&#10;B) Performing fundal massage&#10;C) Expressing clots from the boggy uterus&#10;D) Weighing peripads and linens to determine blood loss&#10;

Accepted Answer

Performing fundal massage is the priority intervention in early postpartum hemorrhage as it helps to contract the uterus and stop bleeding. Notifying the provider and weighing peripads/linens to determine blood loss are important interventions as well, but they can wait until after the bleeding has been stabilized with fundal massage. Expressing clots from the boggy uterus is inappropriate as it can cause further bleeding and should be avoided.

Question 2

When the nurse reviews a patient's past history,which finding is identified as placing the patient at greater risk for postpartum psychosis?&#10;A) Depression&#10;B) Bipolar disorder&#10;C) Obsessive-compulsive disorder&#10;D) Previous postpartum depression&#10;

Accepted Answer

Bipolar disorder is a major risk factor for postpartum psychosis, with up to 25% of women with bipolar disorder experiencing postpartum psychosis. While depression and previous postpartum depression are also risk factors, they are not as significant as bipolar disorder. Obsessive-compulsive disorder may increase the risk for postpartum anxiety, but not necessarily postpartum psychosis.

Question 3

The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic.Which assessment finding is incorrect to document as part of this examination?&#10;A) Breasts firm and tender; patient reports sore nipples&#10;B) Fundus 2 cm below umbilicus,firm&#10;C) Lochia pink,small amount of drainage&#10;D) Pulse strong and regular at rate of 84 beats per minute&#10;

Accepted Answer

Pulse rate is not documented under BUBBLE LE mnemonic. The mnemonic stands for breasts, uterus, bladder, bowel, lochia, episiotomy/laceration, legs, and emotional status.

Question 4

A new adolescent mother asks the nurse how to bathe her baby.Which is the nurse's best approach to teach her this procedure?&#10;A) Have the new mother bathe the baby while the nurse talks her through the process&#10;B) Explain the procedure using pictures and diagrams&#10;C) Give the new mother a brochure and tell her to ask if she has any questions&#10;D) Let the new mother watch the nurse bathe the baby and then give a return demonstration tomorrow&#10;

Accepted Answer

The answer of A new adolescent mother asks the nurse...

Question 5

Which new mother is not at increased risk for postpartum depression?&#10;A) The mother who relinquishes her baby&#10;B) The adolescent mother&#10;C) The mother with a history of previous postpartum depression&#10;D) The mother who delivered by scheduled Cesarean section&#10;

Accepted Answer

The mother who delivered by scheduled Cesarean section is not at increased risk for postpartum depression compared to other mothers.

Question 6

The nurse assesses a postpartum patient's perineum and notes a discoloration and bulging of the vagina that is very tender to the touch.Which symptom reported by the patient is the result of this assessment finding?

A) "When I urinate,it burns until after I finish cleansing with the water bottle."
B) "I am bleeding much less today than I did yesterday,and it's pink rather than red now."
C) "I have the constant feeling of needing to have a bowel movement,but I can't do anything."
D) "I am so tired.I just want to sleep whenever I don't have visitors or the baby with me."

Accepted Answer

The symptoms described in the assessment findings suggest a hematoma, which can cause pressure and a feeling of needing to have a bowel movement due to its location and swelling, but without the ability to do so.

Question 7

A new mother is having difficulty getting the baby to latch on properly,resulting in cracked,sore nipples.The nurse recognizes this as a risk factor for what? (Select all that apply.)&#10;A) Mastitis&#10;B) Blocked milk ducts&#10;C) Milk stasis&#10;D) Inability to breastfeed&#10;E) Breast abscess&#10;

Accepted Answer

The answer of A new mother is having difficulty getting...

Question 8

What does the nurse do to reduce the size of a newly discovered 3-cm hematoma and encourage reabsorption of the clot?&#10;A) Administer analgesics&#10;B) Apply ice&#10;C) Encourage warm sitz baths&#10;D) Prepare the patient for the OR&#10;

Accepted Answer

Applying ice to the area can help reduce inflammation and encourage reabsorption of the clot.

Question 9

The nurse is caring for a postpartum patient experiencing hemorrhage that has not responded to massage,compression,or medications.Which should the nurse prepare for?&#10;A) Moving the patient to the operating room (OR)&#10;B) Bimanual compression of the uterus&#10;C) Pelvic examination with visualization&#10;D) Administration of whole blood&#10;

Accepted Answer

If hemorrhage does not respond to initial interventions, the patient may need surgical intervention, which requires moving to the operating room.

Question 10

Which statement made by a patient at high risk for venous thrombosis indicates the need for further teaching?&#10;A) &#34;I have to continue wearing compression stockings for only the first 2 weeks after delivery.&#34;&#10;B) &#34;I will not start smoking again because that will increase the risk of a blood clot developing.&#34;&#10;C) &#34;I will try to remain active and avoid prolonged periods of sitting or resting in bed.&#34;&#10;D) &#34;I will report any pain,swelling,or redness in my legs to my provider.&#34;&#10;

Accepted Answer

Compression stockings should be worn continuously for at least 6 weeks after delivery to prevent venous thrombosis. So, the statement made by the patient that they need to wear compression stockings for only 2 weeks after delivery indicates the need for further teaching.

Question 11

After the nurse assesses a woman's uterus and finds it soft and boggy with no improvement after massage,which is the priority intervention?&#10;A) Notifying the provider&#10;B) Assessing the bladder&#10;C) Inserting a catheter&#10;D) Having the woman breastfeed&#10;

Accepted Answer

The answer of After the nurse assesses a woman's uterus...

Question 12

A postpartum patient who plans to relinquish her baby for adoption says,&#34;I'm having second thoughts.Maybe I should keep the baby.&#34; Which is the nurse's best response?&#10;A) &#34;If you aren't sure,you should keep the baby until you make up your mind.&#34;&#10;B) &#34;You've made a promise to the adopting parents,and it's too late to change your mind.&#34;&#10;C) &#34;It is such a difficult decision to make.You must feel pulled in two directions.&#34;&#10;D) &#34;I can hear the indecision in your voice.Would you like to talk about it?&#34;&#10;

Accepted Answer

The answer of A postpartum patient who plans to relinquish...

Question 13

The nursing assessment of a postpartum patient indicates a temperature of 39.4°C,lower left abdominal tenderness,and foul-smelling lochia.Which independent nursing intervention does the nurse begin before notifying the provider?

A) Administering IV fluids
B) Administering antipyretics
C) Encouraging fluid intake
D) Administering analgesics

Accepted Answer

The answer of The nursing assessment of a postpartum patient...

Question 14

While performing a BUBBLE LE postpartum assessment,the nurse notes a raised area just above the symphysis pubis.Which is the nurse's priority action?&#10;A) Completing the assessment and documenting the findings&#10;B) Notifying the provider and obtaining orders&#10;C) Assisting the patient to the bathroom&#10;D) Massaging the uterus until it becomes firm&#10;

Accepted Answer

The answer of While performing a BUBBLE LE postpartum assessment,the...

Question 15

After a patient has been taught postpartum self-care,which statement by the mother indicates the need for further teaching?&#10;A) &#34;I will make an appointment with my provider to have my episiotomy stitches removed next week.&#34;&#10;B) &#34;I can take acetaminophen and use warm sitz baths to control discomfort at my episiotomy site.&#34;&#10;C) &#34;I'll keep a squirt bottle filled with warm water in the bathroom to cleanse with each time I urinate.&#34;&#10;D) &#34;I will wear my nursing bra at all times,even when I go to bed,as long as I continue to nurse the baby.&#34;&#10;

Accepted Answer

The answer of After a patient has been taught postpartum...

Question 16

What is the nurse's role when caring for a mother who is relinquishing her infant for adoption?&#10;A) Discouraging her from holding or seeing her infant&#10;B) Encouraging her to see the infant and take pictures&#10;C) Avoiding discussion about the baby or her labor unless she brings it up&#10;D) Respecting the mother's choices regarding the baby&#10;

Accepted Answer

The answer of What is the nurse's role when caring...

Question 17

The nursing instructor observes a student providing care to an adolescent postpartum patient.Which statement made by the student indicates the need for further teaching?&#10;A) &#34;Let me show you a way to hold the baby when you're giving him a bath.&#34;&#10;B) &#34;Do you want your little friend to stay while you breastfeed?&#34;&#10;C) &#34;You're going to be a great mother because you really want to learn.&#34;&#10;D) &#34;Do you have any questions or need help with anything?&#34;&#10;

Accepted Answer

The answer of The nursing instructor observes a student providing...

Question 18

The nurse caring for a patient during the first hour after delivery needs to notify the provider when which condition is assessed?&#10;A) Several small blood clots on the peripad&#10;B) Saturation of two peripads over the hour&#10;C) Passing a large clot the size of a fist&#10;D) Yellow-white drainage from the nipples&#10;

Accepted Answer

The answer of The nurse caring for a patient during...

Deck 14: Assessment and Care of the Family After Birth