Deck 28: The Woman With a Postpartum Complication

Question 1

Which statement by a postpartum woman indicates that further teaching is not needed regarding thrombus formation?

A) "I'll stay in bed for the first 3 days after my baby is born."
B) "I'll keep my legs elevated with pillows."
C) "I'll sit in my rocking chair most of the time."
D) "I'll put my support stockings on every morning before rising."

Answer 1

"I'll put my support stockings on every morning before rising."

Question 2

The nurse knows that a measure for preventing late postpartum hemorrhage is to

A) Administer broad-spectrum antibiotics.
B) Inspect the placenta after delivery.
C) Manually remove the placenta.
D) Pull on the umbilical cord to hasten the delivery of the placenta.

Answer 2

Inspect the placenta after delivery.

Question 3

When caring for a postpartum woman experiencing hypovolemic shock,the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is

A) Absence of cyanosis in the buccal mucosa
B) Cool, dry skin
C) Diminished restlessness
D) Decreased urinary output

Answer 3

Decreased urinary output

Question 4

The patient who is being treated for endometritis is placed in Fowler's position because it

A) Promotes comfort and rest
B) Facilitates drainage of lochia
C) Prevents spread of infection to the urinary tract
D) Decreases tension on the reproductive organs

Question 5

Which nursing measure is appropriate to prevent thrombophlebitis in the recovery period after a cesarean birth?

A) Roll a bath blanket and place it firmly behind the knees.
B) Limit oral intake of fluids for the first 24 hours.
C) Assist the patient in performing gentle leg exercises.
D) Ambulate the patient as soon as her vital signs are stable.

Question 6

A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000 g infant.Her fundus is boggy,lochia is heavy,and vital signs are unchanged.The nurse has the woman void and massages her fundus,but her fundus remains difficult to find,and the rubra lochia remains heavy.The nurse should

A) Continue to massage the fundus.
B) Notify the physician.
C) Recheck vital signs.
D) Insert a Foley catheter.

Question 7

The mother-baby nurse must be able to recognize what sign of thrombophlebitis?

A) Visible varicose veins
B) Positive Homans' sign
C) Local tenderness, heat, and swelling
D) Pedal edema in the affected leg

Question 8

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

Question 9

Which measure may prevent mastitis in the breastfeeding mother?

A) Initiating early and frequent feedings
B) Nursing the infant for 5 minutes on each breast
C) Wearing a tight-fitting bra
D) Applying ice packs before feeding

Question 10

The nurse should expect medical intervention for subinvolution to include

A) Oral methylergonovine maleate (Methergine) for 48 hours
B) Oxytocin intravenous infusion for 8 hours
C) Oral fluids to 3000 mL/day
D) Intravenous fluid and blood replacement

Question 11

One of the first symptoms of puerperal infection to assess for in the postpartum woman is

A) Fatigue continuing for longer than 1 week
B) Pain with voiding
C) Profuse vaginal bleeding with ambulation
D) Temperature of 38° C (100.4° F) or higher on 2 successive days starting 24 hours after birth

Question 12

A postpartum patient is at increased risk for postpartum hemorrhage if she delivers a(n)

A) 5-lb, 2-oz infant with outlet forceps
B) 6.5-lb infant after a 2-hour labor
C) 7-lb infant after an 8-hour labor
D) 8-lb infant after a 12-hour labor

Question 13

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests

A) Uterine atony
B) Lacerations of the genital tract
C) Perineal hematoma
D) Infection of the uterus

Question 14

The perinatal nurse caring for the postpartum woman understands that late postpartum hemorrhage is most likely caused by

A) Subinvolution of the uterus
B) Defective vascularity of the decidua
C) Cervical lacerations
D) Coagulation disorders

Question 15

Early postpartum hemorrhage is defined as a blood loss greater than

A) 500 mL in the first 24 hours after vaginal delivery
B) 750 mL in the first 24 hours after vaginal delivery
C) 1000 mL in the first 48 hours after cesarean delivery
D) 1500 mL in the first 48 hours after cesarean delivery

Question 16

A woman delivered a 9-lb,10-oz baby 1 hour ago.When you arrive to perform her 15-minute assessment,she tells you that she "feels all wet underneath." You discover that both pads are completely saturated and that she is lying in a 6-inch-diameter puddle of blood.What is your first action?

A) Call for help.
B) Assess the fundus for firmness.
C) Take her blood pressure.
D) Check the perineum for lacerations.

Question 17

If nonsurgical treatment for late postpartum hemorrhage is ineffective,which surgical procedure is appropriate to correct the cause of this condition?

A) Hysterectomy
B) Laparoscopy
C) Laparotomy
D) D&C

Question 18

Nursing measures that help prevent postpartum urinary tract infection include

A) Promoting bed rest for 12 hours after delivery
B) Discouraging voiding until the sensation of a full bladder is present
C) Forcing fluids to at least 3000 mL/day
D) Encouraging the intake of orange, grapefruit, or apple juice

Question 19

Which woman is at greatest risk for early postpartum hemorrhage?

A) A primiparous woman (G 2 P 1 0 0 1) being prepared for an emergency cesarean birth for fetal distress
B) A woman with severe preeclampsia on magnesium sulfate whose labor is being induced
C) A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor
D) A primigravida in spontaneous labor with preterm twins

Question 20

What instructions should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?

A) Palpate the fundus daily to ensure that it is soft.
B) Notify the physician of any increase in the amount of lochia or a return to bright red bleeding.
C) Report any decrease in the amount of brownish red lochia.
D) The passage of clots as large as an orange can be expected.

Question 21

The nurse is in the process of assessing the comfort level of her postpartum patient.Excess bleeding is not obvious; however,the new mother complains of deep,severe pelvic pain.The registered nurse (RN)has noted both skin and vital sign changes.This patient may have formed a(n)________.

Question 22

Which condition is a transient,self-limiting mood disorder that affects new mothers after childbirth?

A) Postpartum depression
B) Postpartum psychosis
C) Postpartum bipolar disorder
D) Postpartum blues

Question 23

_______________ is the most common postpartum infection.

Question 24

If the nurse suspects a uterine infection in the postpartum patient,she should assess the

A) Pulse and blood pressure
B) Odor of the lochia
C) Episiotomy site
D) Abdomen for distention

Question 25

Pulmonary embolism (PE)is a serious complication of deep vein thrombosis (DVT)and the leading cause of maternal mortality.As many as 15% to 25% of all DVTs lead to PEs if not recognized and treated.Is this statement true or false?

Question 26

Of all pregnant women being treated for depression,approximately one-third have a first occurrence during pregnancy.All pregnant and postpartum women should be screened for perinatal mood disorders by using the _________ Postnatal Depression Scale.

Question 27

Should a postpartum complication such as hemorrhage occur,the nursing staff will spring into action to ensure that patient safety needs are met.This level of activity is very reassuring to both the new mother and her family members as they can see that the patient is receiving the best care.Is this statement true or false?

Question 28

Anxiety disorders are the most common mental disorders that affect women.While providing care to the maternity patient,the nurse should be aware that one of these disorders is likely to be triggered by the process of labor and birth.This disorder is

A) A phobia
B) Panic disorder
C) Posttraumatic stress disorder (PTSD)
D) Obsessive-compulsive disorder (OCD)

Question 29

A mother with mastitis is concerned about breastfeeding while she has an active infection.The nurse should explain that

A) The infant is protected from infection by immunoglobulins in the breast milk.
B) The infant is not susceptible to the organisms that cause mastitis.
C) The organisms that cause mastitis are not passed to the milk.
D) The organisms will be inactivated by gastric acid.

Question 30

To provide adequate postpartum care,the nurse should be aware that postpartum depression (PPD)

A) Is the "baby blues" plus the woman has a visit with a counselor or psychologist
B) Is more common among older, Caucasian women because they have higher expectations
C) Is distinguished by pervasive sadness that lasts at least 2 weeks
D) Will disappear on its own without outside help

Question 31

With shortened hospital stays,new mothers are often discharged before they begin to experience symptoms of the baby blues or postpartum depression.As part of the discharge teaching,the nurse can prepare the mother for this adjustment to her new role by instructing her regarding self-care activities to help prevent postpartum depression.The most accurate statement as related to these activities is to

A) Stay home and avoid outside activities to ensure adequate rest.
B) Be certain that you are the only caregiver for your baby in order to facilitate infant attachment.
C) Keep feelings of sadness and adjustment to your new role to yourself.
D) Realize that this is a common occurrence that affects many women.

Question 32

According to Beck's studies,what risk factor for postpartum depression (PPD)is likely to have the greatest effect on the woman's condition?

A) Prenatal depression
B) Single-mother status
C) Low socioeconomic status
D) Unplanned or unwanted pregnancy

Question 33

Medications used to manage postpartum hemorrhage include (select all that apply)

A) Pitocin
B) Methergine
C) Terbutaline
D) Hemabate
E) Magnesium sulfate

Question 34

When a woman is diagnosed with postpartum psychosis,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