Question 1

What would prevent early discharge of a postpartum woman?&#10;A) Afterpains when breastfeeding&#10;B) Birth at 38 weeks of gestation&#10;C) Has voided 130 mL since delivery&#10;D) Episiotomy that shows slight redness and edema,is dry and approximated

Accepted Answer

A volume of at least 150 mL is expected for each voiding.Some women experience difficulty in emptying the bladder,possibly as a result of diminished bladder tone,edema from trauma,use of epidural or spinal anaesthetic,or fear of discomfort,so only voiding 130 mL since delivery indicates that the woman should not be discharged early.Afterpains when breastfeeding is not a reason to delay early discharge.The birth of an infant at term is not a criterion that would prevent early discharge.A normal episiotomy would show slight redness and edema and would be dry and approximated and would not prevent a woman from being discharged early.

Question 2

Which finding could prevent early discharge of a newborn at 12 hours of age?&#10;A) Birth weight of 3000 g&#10;B) One meconium stool since birth&#10;C) Voided,clear,pale urine three times since birth&#10;D) Infant breastfed once with some difficulty latching on and sucking and once with some success for about 5 minutes on each breast

Accepted Answer

The infant breastfeeding once with some difficulty latching on and sucking and once with some success for about 5 minutes on each breast indicates that the infant is having some difficulty with breastfeeding.The infant needs to complete at least two successful feedings (normal sucking and swallowing)before an early discharge can occur.Birth weight of 3000 g;one meconium stool since birth;and voided,clear,pale urine three times since birth are normal infant findings and would not prevent early discharge.

Question 3

Because a full bladder prevents the uterus from contracting normally,nurses intervene to help the woman empty her bladder spontaneously as soon as possible.Which would be the last intervention that the nurse would implement?

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

Inserting a sterile catheter

Accepted Answer

Invasive procedures usually are the last to be tried,especially with so many other simple and easy methods available (e.g. ,water,analgesics).Pouring water over the perineum may stimulate voiding.If the woman is anticipating pain from voiding,pain medications may be helpful.Other nonmedical means could be tried first,but medications still come before insertion of a catheter.

Question 4

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 nurse's initial response?&#10;A) Begin an intravenous (IV)infusion of Ringer's lactate solution.&#10;B) Assess the woman's vital signs.&#10;C) Call the woman's primary health care provider.&#10;D) Massage the woman's fundus.

Accepted Answer

The nurse should assess the uterus for atony.When the uterus is atonic,the fundus should be massaged gently and clots expelled.Uterine tone must be established to prevent excessive blood loss.The nurse may begin an 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 impending hemorrhage;assessing vital signs should not be the nurse's first action.The physician would be notified after the nurse completes the assessment of the woman.

Question 5

A primiparous woman is to be discharged from the hospital tomorrow with her infant girl.Which behaviour indicates a need for further intervention by the nurse before the woman can be discharged?&#10;A) The woman leaves the infant on her bed while she takes a shower.&#10;B) The woman continues to hold and cuddle her infant after she has fed her.&#10;C) The woman reads a magazine while her infant sleeps.&#10;D) The woman changes her infant's diaper and shows the nurse the contents of the diaper.

Accepted Answer

Leaving an infant on a bed unattended is never acceptable,for various safety reasons.Holding and cuddling the infant after feeding and reading a magazine while the infant sleeps are appropriate parent-infant interactions.Changing the diaper and then showing the nurse the contents of the diaper is appropriate because the mother is seeking approval from the nurse and notifying the nurse of the infant's elimination patterns.

Question 6

Nursing care in the fourth trimester includes an important intervention sometimes referred to as taking the time to &#34;mother the mother.&#34; What does this expression refer to?&#10;A) Formally initializing individualized care by confirming the woman's and infant's identification (ID)numbers on their respective wrist bands&#10;B) Teaching the mother to check the identity of any person who comes to remove the baby from the room&#10;C) Including other family members in the teaching of self-care and child care&#10;D) Nurturing the woman by providing encouragement and support as she takes on the many tasks of motherhood

Accepted Answer

Many professionals believe that the nurse's nurturing and support function is more important than providing physical care and teaching.Matching ID wrist bands is more of a formality,but it is also a get-acquainted procedure."Mothering the mother" is more a process of encouraging and supporting the woman in her new role.Having the mother check IDs is a security measure for protecting the baby from abduction.Teaching the whole family is just good nursing practice.

Question 7

Which is true with regard to rubella and Rh issues?&#10;A) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus.&#10;B) Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for 1 month after vaccination.&#10;C) Rh immune globulin is safely administered intravenously because it cannot harm a nursing infant.&#10;D) Rh immune globulin boosts the immune system and thereby enhances the effectiveness of vaccinations.

Accepted Answer

Women should understand that they must practice contraception for 1 month after being vaccinated.Because the live attenuated rubella virus is not communicable in breast milk,breastfeeding mothers can be vaccinated.Rh immune globulin is administered intramuscularly;it should never be given to an infant.Rh immune globulin suppresses the immune system and therefore might thwart the rubella vaccination.

Question 8

A woman gave birth vaginally to a 4400 g girl yesterday.Her primary health care provider has written orders for perineal ice packs,use of a sitz bath TID,and a stool softener.What information is most closely correlated with these orders?

A) The woman is a gravida 2,para 2.
B) The woman had a vacuum-assisted birth.
C) The woman received epidural anaesthesia.
D) The woman has had an episiotomy.

Accepted Answer

These orders are typical interventions for a woman who has had an episiotomy,lacerations,and hemorrhoids.A multiparous classification is not an indication for these orders.A vacuum-assisted birth may be used in conjunction with an episiotomy,which would indicate these interventions.Use of epidural anaesthesia has no correlation with these orders.

Question 9

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.Which information should the nurse offer the woman?

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 pressure.
D) Wear a loose-fitting bra to prevent nipple irritation.

Accepted Answer

This woman is experiencing engorgement,which can be treated by using ice packs (since she is not breastfeeding)and cabbage leaves.A bottle-feeding mother should avoid any breast stimulation,including pumping or expressing milk.A bottle-feeding mother should wear a well-fitted support bra or breast binder continuously for at least the first 72 hours after giving birth.A loose-fitting bra will not aid lactation suppression.Furthermore,the shifting of the bra against the breasts may stimulate the nipples and thereby stimulate lactation.

Question 10

If a woman is at risk for thrombus and is not ready to ambulate,which intervention should the nurse perform?&#10;A) Put on antiembolic stockings (TED hose).&#10;B) Have her avoid leg exercises.&#10;C) Have her sit in a chair.&#10;D) Keep her legs flat;do not elevate.

Accepted Answer

Putting on antiembolic stockings (TED hose)is a preventative measure for women who are at risk.Sitting immobile in a chair will not help.Leg exercises are to be encouraged.Elevation of the legs would be encouraged.

Question 11

In combined maternity care,who shares the care of the infant with the mother?&#10;A) The father of the infant&#10;B) Her mother (the infant's grandmother)&#10;C) Her eldest daughter (the infant's sister)&#10;D) The nurse

Accepted Answer

The answer of In combined maternity care,who shares the care...

Question 12

How long should the nurse teach the woman who is not breastfeeding to wear a well-fitted support bra or breast binder to suppress lactation in the postpartum period?&#10;A) 24 hours&#10;B) 48 hours&#10;C) 72 hours&#10;D) 7 days

Accepted Answer

The answer of How long should the nurse teach the...

Question 13

What is the correct time frame for an early discharge after a Caesarean birth?&#10;A) 24 to 36 hours&#10;B) 1 to 2 days&#10;C) 2 to 4 days&#10;D) 3 to 5 days

Accepted Answer

The answer of What is the correct time frame for...

Question 14

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 does this activity indicate that the nurse is doing?

A) Improving the accuracy of blood loss estimation,which usually is a subjective assessment
B) Determining which pad is best
C) Demonstrating that other nurses usually underestimate blood loss
D) Indicating to the nurse supervisor that one of them needs some time off

Accepted Answer

The answer of A hospital has a number of different...

Question 15

What is the most likely cause of postpartum hemorrhage in a 25-year-old multiparous woman (G3T2P0A0L2)who gave birth 4 hours ago to a 4300 g boy after augmentation of labour with oxytocin?&#10;A) Retained placental fragments&#10;B) Unrepaired vaginal lacerations&#10;C) Uterine atony&#10;D) Puerperal infection

Accepted Answer

The answer of What is the most likely cause of...

Question 16

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 basis of the nurse's most appropriate response?

A) Asking the patient if she did not like the lunch that was served to her.
B) Checking with the patient that she has obtained permission from her health care provider to consume seaweed soup.
C) Asking the husband what the soup contains.
D) Offering to warm the soup up in the microwave for the woman.

Accepted Answer

The answer of A 25-year-old multiparous woman gave birth to...

Question 17

The laboratory results for a postpartum woman are as follows: blood type,A;Rh status,positive;rubella titre,1:8 (EIA 0.6);hematocrit,30%.How would the nurse best interpret these data?&#10;A) Rubella vaccine should be given.&#10;B) A blood transfusion is necessary.&#10;C) Rh immune globulin is necessary within 72 hours of birth.&#10;D) A Kleihauer-Betke test should be performed.

Accepted Answer

The answer of The laboratory results for a postpartum woman...

Question 18

Which is the primary influence for shorter postpartum hospital stays?&#10;A) Desire for a family-centred experience&#10;B) Budget-driven decision&#10;C) Hospitals&#10;D) The federal government

Accepted Answer

The answer of Which is the primary influence for shorter...

Question 19

What is the most common cause of excessive blood loss after childbirth?&#10;A) Vaginal or vulvar hematomas&#10;B) Unrepaired lacerations of the vagina or cervix&#10;C) Failure of the uterine muscle to contract firmly&#10;D) Retained placental fragments

Accepted Answer

The answer of What is the most common cause of...

Question 20

Which woman should receive Rh immune globulin?&#10;A) Rh+,sensitized&#10;B) Rh+,not sensitized&#10;C) Rh-,sensitized&#10;D) Rh-,not sensitized

Accepted Answer

The answer of Which woman should receive Rh immune globulin?&#10;A)...

Question 21

When does planning for discharge officially begin?&#10;A) At the time of admission to the nurse's unit&#10;B) When the infant is presented to the mother at birth&#10;C) During the first visit with the physician in the unit&#10;D) When the take-home information packet is given to the couple

Accepted Answer

The answer of When does planning for discharge officially begin?&#10;A)...

Question 22

Which should the nurse be concerned about with regard to potential psychosocial complications during a 6-week postpartum mother and baby checkup? Select all that apply.Express answer in small letters,followed by a comma and a space-e.g. ,a,b,

A) The mother discusses her labour and birth experience excessively.
B) The mother views herself as ugly and is not able to look at herself in a mirror.
C) The mother has not given the baby a name.
D) The mother has a partner who reacts very positively about the baby.
E) The mother expresses disappointment over the baby's gender.
F) The mother believes that her baby is more attractive and clever than any others.

Accepted Answer

The answer of Which should the nurse be concerned about...

Deck 22: Nursing Care of the Family During the Postpartum Period