Deck 21: Nursing Care of the Family During the Postpartum Period

Question 1

A primiparous woman is to be discharged from the hospital the following day with her infant girl.Which behavior indicates a need for further intervention by the nurse before the woman can be discharged?

A) The woman is disinterested in learning about infant care.
B) The woman continues to hold and cuddle her infant after she has fed her.
C) The woman reads a magazine while her infant sleeps.
D) The woman changes her infant's diaper and then shows the nurse the contents of the diaper.

Answer 1

The woman is disinterested in learning about infant care.

Question 2

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup.Which response by the client alerts the nurse that psychosocial outcomes have not been met?

A) The woman excessively discusses her labor and birth experience.
B) The woman feels that her baby is more attractive and clever than any others.
C) The woman has not given the baby a name.
D) The woman has a partner or family members who react very positively about the baby.

Answer 2

The woman has not given the baby a name.

Question 3

Under the Newborns' and Mothers' Health Protection Act,all health plans are required to allow new mothers and newborns to remain in the hospital for a minimum of _____ hours after a normal vaginal birth and for _____ hours after a cesarean birth.What is the correct interpretation of this legislation?

A) 24; 72
B) 24; 96
C) 48; 96
D) 48; 120

Answer 3

48; 96

Question 4

The laboratory results for a postpartum woman are as follows: blood type,A; Rh status,positive; rubella titer,1:8 (enzyme immunoassay [EIA] 0.8); hematocrit,30%.How should the nurse best interpret these data?

A) Rubella vaccine should be administered.
B) Blood transfusion is necessary.
C) Rh immune globulin is necessary within 72 hours of childbirth.
D) Kleihauer-Betke test should be performed.

Question 5

When should discharge instruction,or the teaching plan that tells the woman what she needs to know to care for herself and her newborn,officially begin?

A) At the time of admission to the nurse's unit
B) When the infant is presented to the mother at birth
C) During the first visit with the physician in the unit
D) When the take-home information packet is given to the couple

Question 6

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?

A) Notify the physician of an impending hemorrhage.
B) Assess the blood pressure and pulse.
C) Evaluate the lochia.
D) Assist the client in emptying her bladder.

Question 7

Because a full bladder prevents the uterus from contracting normally,nurses intervene to help the woman spontaneously empty her bladder as soon as possible.If all else fails,what tactic might the nurse use?

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 analgesic agents
D) Inserting a sterile catheter

Question 8

A woman gave birth 48 hours ago to a healthy infant girl.She has decided to bottle feed.During the assessment,the nurse notices that both breasts are swollen,warm,and tender on palpation.Which guidance should the nurse provide to the client at this time?

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

Question 9

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 nurse's most appropriate response?

A) "Didn't you like your lunch?"
B) "Does your physician know that you are planning to eat that?"
C) "What is that anyway?"
D) "I'll warm the soup in the microwave for you."

Question 10

Parents who have not already done so need to make time for newborn follow-up of the discharge.According to the American Academy of Pediatrics (AAP),when should a breastfeeding infant first need to be seen for a follow-up examination?

A) 2 weeks of age
B) 7 to 10 days after childbirth
C) 4 to 5 days after hospital discharge
D) 48 to 72 hours after hospital discharge

Question 11

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 highest priority at this time?

A) Beginning an intravenous (IV) infusion of Ringer's lactate solution
B) Assessing the woman's vital signs
C) Calling the woman's primary health care provider
D) Massaging the woman's fundus

Question 12

Postpartum overdistention of the bladder and urinary retention can lead to which complications?

A) Postpartum hemorrhage and eclampsia
B) Fever and increased blood pressure
C) Postpartum hemorrhage and urinary tract infection
D) Urinary tract infection and uterine rupture

Question 13

In many hospitals,new mothers are routinely presented with gift bags containing samples of infant formula.This practice is inconsistent with what?

A) Baby Friendly Hospital Initiative
B) Promotion of longer periods of breastfeeding
C) Perception of being supportive to both bottle feeding and breastfeeding mothers
D) Association with earlier cessation of breastfeeding

Question 14

The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth.Which scenario is not a contributor to this model of care?

A) Wellness orientation model of care rather than a sick-care model
B) Desire to reduce health care costs
C) Consumer demand for fewer medical interventions and more family-focused experiences
D) Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information

Question 15

Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding.Should this pain be severe or persistent,it may discourage or inhibit breastfeeding altogether.Which factors might contribute to this pain?

A) Improper feeding position
B) Large-for-gestational age infant
C) Fair skin
D) Progesterone deficiency
E) Flat or retracted nipples

Question 16

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 goal is the nurse attempting to achieve by performing this practice?

A) To improve the accuracy of blood loss estimation, which usually is a subjective assessment
B) To determine which pad is best
C) To demonstrate that other nurses usually underestimate blood loss
D) To reveal to the nurse supervisor that one of them needs some time off

Question 17

When caring for a newly delivered woman,what is the best measure to prevent abdominal distention after a cesarean birth?

A) Rectal suppositories
B) Early and frequent ambulation
C) Tightening and relaxing abdominal muscles
D) Carbonated beverages

Question 18

What information should the nurse understand fully regarding rubella and Rh status?

A) Breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus.
B) Women should be warned that the rubella vaccination is teratogenic and that they must avoid pregnancy for at least 1 month after vaccination.
C) Rh immunoglobulin is safely administered intravenously because it cannot harm a nursing infant.
D) Rh immunoglobulin boosts the immune system and thereby enhances the effectiveness of vaccinations.

Question 19

Rhₒ immune globulin will be ordered postpartum if which situation occurs?

A) Mother Rh-, baby Rh+
B) Mother Rh-, baby Rh-
C) Mother Rh+, baby Rh+
D) Mother Rh+, baby Rh-

Question 20

A woman gave birth vaginally to a 9-pound,12-ounce girl yesterday.Her primary health care provider has written orders for perineal ice packs,use of a sitz bath three times daily,and a stool softener.Which information regarding the client's condition is most closely correlated with these orders?

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

Question 21

Postpartum fatigue (PPF)is more than just feeling tired.It is a complex phenomenon affected by physiologic,psychologic,and situational variables.Which factors contribute to this phenomenon?

A) Precipitous labor
B) Hospital routines
C) Bottle feeding
D) Anemia
E) Excitement

Question 22

Much of a woman's behavior during the postpartum period is strongly influenced by her cultural background. Nurses are likely to come into contact with women from many different countries and cultures. All cultures have developed safe and satisfying methods of caring for new mothers and their babies. Match the cultural norm with the nationality of origin.

Korean or other South East Asian countries

A)Prefer not to give babies colostrum.
B)Eat only warm foods and hot drinks.
C)Take the placenta home to bury.
D)Will not eat pork or pork products.
E)Have an intrauterine device (IUD) inserted after the first child.

Question 23

Much of a woman's behavior during the postpartum period is strongly influenced by her cultural background. Nurses are likely to come into contact with women from many different countries and cultures. All cultures have developed safe and satisfying methods of caring for new mothers and their babies. Match the cultural norm with the nationality of origin.

Chinese

A)Prefer not to give babies colostrum.
B)Eat only warm foods and hot drinks.
C)Take the placenta home to bury.
D)Will not eat pork or pork products.
E)Have an intrauterine device (IUD) inserted after the first child.

Question 24

If a woman is at risk for thrombus and is not ready to ambulate,which nursing intervention would the nurse use?

A) Putting her in antiembolic stockings (thromboembolic deterrent [TED] hose) and/or sequential compression device (SCD) boots
B) Having her flex, extend, and rotate her feet, ankles, and legs
C) Having her sit in a chair
D) Immediately notifying the physician if a positive Homans sign occurs
E) Promoting bed rest

Question 25

Which practices contribute to the prevention of postpartum infection?

A) Not allowing the mother to walk barefoot at the hospital
B) Educating the client to wipe from back to front after voiding
C) Having staff members with conditions such as strep throat, conjunctivitis, and diarrhea stay home
D) Instructing the mother to change her perineal pad from front to back each time she voids or defecates
E) Not permitting visitors with cough or colds to enter the postpartum unit

Question 26

Much of a woman's behavior during the postpartum period is strongly influenced by her cultural background. Nurses are likely to come into contact with women from many different countries and cultures. All cultures have developed safe and satisfying methods of caring for new mothers and their babies. Match the cultural norm with the nationality of origin.

Haitian

A)Prefer not to give babies colostrum.
B)Eat only warm foods and hot drinks.
C)Take the placenta home to bury.
D)Will not eat pork or pork products.
E)Have an intrauterine device (IUD) inserted after the first child.

Question 27

Much of a woman's behavior during the postpartum period is strongly influenced by her cultural background. Nurses are likely to come into contact with women from many different countries and cultures. All cultures have developed safe and satisfying methods of caring for new mothers and their babies. Match the cultural norm with the nationality of origin.

Muslim countries

A)Prefer not to give babies colostrum.
B)Eat only warm foods and hot drinks.
C)Take the placenta home to bury.
D)Will not eat pork or pork products.
E)Have an intrauterine device (IUD) inserted after the first child.

Question 28

Which physiologic factors are reliable indicators of impending shock from postpartum hemorrhage?

A) Respirations
B) Skin condition
C) Blood pressure
D) Level of consciousness
E) Urinary output

Question 29

Nurses play a critical role in educating parents regarding measures to prevent infant abduction.Which instructions contribute to infant safety and security?

A) The mother should check the photo identification (ID) of any person who comes to her room.
B) The baby should be carried in the parent's arms from the room to the nursery.
C) Because of infant security systems, the baby can be left unattended in the client's room.
D) Parents should use caution when posting photographs of their infant on the Internet.
E) The mom should request that a second staff member verify the identity of any questionable person.

Question 30

Much of a woman's behavior during the postpartum period is strongly influenced by her cultural background. Nurses are likely to come into contact with women from many different countries and cultures. All cultures have developed safe and satisfying methods of caring for new mothers and their babies. Match the cultural norm with the nationality of origin.

Mexican

A)Prefer not to give babies colostrum.
B)Eat only warm foods and hot drinks.
C)Take the placenta home to bury.
D)Will not eat pork or pork products.
E)Have an intrauterine device (IUD) inserted after the first child.