Deck 36: The Postpartum Family: Needs and Care

Question 1

A patient is preparing to take a sitz bath for the first time. The nurse will:

A) Allow the patient privacy during the sitz bath.
B) Place a call bell well within reach and check on the patient frequently.
C) Discourage the patient from taking a sitz bath.
D) Check on the patient after the sitz bath.

Answer 1

Place a call bell well within reach and check on the patient frequently.

Question 2

The hospital is developing a new maternity unit. What aspects should be included in the planning of the new unit to best promote family wellness?

A) Normal newborn nursery centrally located to all patient rooms
B) A kitchen with a refrigerator stocked with juice and sandwiches
C) Small, cozy rooms with a patient bed and rocking chair
D) A nursing care model based on providing couplet care

Answer 2

A nursing care model based on providing couplet care

Question 3

A new grandmother comments that when her children were born, they stayed in the nursery. The grandmother asks the nurse why her daughter's baby stays mostly in the room instead of the nursery. How should the nurse respond?

A) "Babies like to be with their mothers more than they like to be in the nursery."
B) "Contact between parents and babies increases attachment."
C) "Budget cuts have decreased the number of nurses in the nursery."
D) "Why do you ask? Do you have concerns about your daughter's parenting?"

Answer 3

"Contact between parents and babies increases attachment."

Question 4

RhoGAM is given to the postpartum patient for the purpose of:

A) Preventing congenital birth defects through vaccination.
B) Preventing or avoiding the chronic state of infection of hepatitis B.
C) Preventing sensitization from the fetomaternal transfusion of Rh-positive fetal red blood cells.
D) Preventing the spread of Group B streptococcal infection in the neonate.

Question 5

The postpartum patient delivered 4 hours ago. She has a mediolateral episiotomy and large hemorrhoids. She is rating her pain at 7 on a scale of 1- 10. She has a history of anaphylactic reaction to Tylenol (acetaminophen). Which nursing action would be best?

A) Offer the patient 800 mg Advil (ibuprofen) orally with food.
B) Provide two Percocet (oxycodone with acetaminophen) by mouth.
C) Encourage the use of Dermoplast topical anesthetic spray.
D) Run very warm water into the tub and assist her into the bath.

Question 6

A patient who delivered 2 hours ago tells the nurse that she is exhausted and feels guilty because her friends told her how euphoric they felt after giving birth. How should the nurse respond?

A) "Everyone is different, and both responses are normal."
B) "Most mothers do feel euphoria; I don't know why you don't."
C) "It's good for me to know that because it might indicate a problem."
D) "Let me bring your baby to the nursery so that you can rest."

Question 7

The patient having her second child is scheduled for a cesarean birth because the baby is in a breech presentation. The patient states, "I'm wondering what will be different this time compared with my first birth, which was vaginal." What response is best?

A) "We'll take good care of you and your baby. You'll be home before you know it."
B) "You'll be wearing a sequential compression device until you start walking."
C) "You will have a lot of pain, but there are medications that we give when it gets really bad."
D) "You won't be able to nurse until the baby is 12 hours old, because of your epidural."

Question 8

Which statement by a nursing student preparing to care for a postpartum lesbian mother would indicate the need for further teaching?

A) "I can't let the patient know I've never worked with lesbian mothers."
B) "I will have to adjust some of my discharge instruction for this mother."
C) "I don't need to include the partner when I provide care and instruction."
D) "Discharge teaching is exactly the same for lesbian mothers as for all others."

Question 9

The nurse assesses the postpartum patient to have moderate lochia rubra with clots. Which nursing intervention would be appropriate?

A) Assess fundus and bladder status.
B) Catheterize the patient.
C) Administer Methergine IM per order.
D) Contact the physician immediately.

Question 10

The nurse is providing education to the new family. Which is best?

A) "Do you know how to give the baby a bath?"
B) "You have diapers and supplies at home, right?"
C) "How have your breastfeedings been going?"
D) "How much formal education do you have?"

Question 11

The postpartum nurse provides anticipatory guidance for the new mother as well as teaching on self-care and infant care before discharge. Which topics should be included?

A) Role changes brought on by the addition to the family unit
B) The realities of having a new baby, and how it affects previous lifestyle
C) Potential complications such as infant colic, postpartum fatigue, and postpartum depression
D) Sexuality and contraception
E) Toilet-training and preschool options

Question 12

The nurse is teaching a new mother about ways to manage fatigue after she returns home. Which instructions should the nurse include?

A) Take frequent rest periods.
B) Nap when the newborn is sleeping.
C) Avoid overdoing housework and unnecessary chores. Do not clean when infant is sleeping.
D) Avoid having others come to the house to do housework and interfere with rest.
E) Utilize friends and family to provide help and support, such as cooking a meal.

Question 13

The postpartum patient expresses concern about getting back to her prepregnant shape, and asks the nurse when she will be able to run again. Which statement by the patient indicates that teaching was effective?

A) "I can start running in 2 weeks, and can breastfeed as soon as I am done."
B) "I should see how my energy level is at home, and increase my activity slowly."
C) "Running is not recommended for breastfeeding women."
D) "If I am getting 8 hours of sleep per day, I can start running."

Question 14

The nurse is caring for a patient who had a cesarean birth 4 hours ago. Which interventions would the nurse implement at this time?

A) Administer analgesics as needed.
B) Encourage the patient to ambulate to the bathroom to void.
C) Encourage leg exercises every 2 hours.
D) Encourage the patient to cough and deep-breathe every 2-4 hours.
E) Encourage the use of breathing, relaxation, and distraction.

Question 15

The breastfeeding patient asks the nurse about appropriate contraception. The nurse's best response is:

A) "Breastfeeding has many effects on sexual intercourse."
B) "IUDs are easy to use and easy to insert prior to sexual intercourse."
C) "It's possible to get pregnant before your menstrual period returns. Let's talk about some different options for contraception."
D) "Breastfeeding hampers ovulation, so no contraception is needed."

Question 16

A postpartum patient has just received a rubella vaccination. The patient demonstrates understanding of the teaching associated with administration of this vaccine when she states:

A) "I will need another vaccination in 3 months."
B) "I must avoid getting pregnant for 1 month."
C) "This will prevent me from getting chickenpox."
D) "This will protect my newborn from getting the measles."

Question 17

What information should the nurse include when teaching the postpartal patient and partner about resumption of sexual activity?

A) Couples should be encouraged to abstain from intercourse until the episiotomy is healed and the lochial flow has stopped.
B) Postpartum women often experience vaginal dryness, and should be encouraged to use some kind of lubrication initially during intercourse.
C) Breastfeeding the newborn after intercourse can reduce the chance of milk spouting from the nipples.
D) Maternal changes in libido are usually indicative of psychological depression.
E) Maternal fatigue is often a significant factor limiting the resumption of sexual intercourse.

Question 18

On the 3rd day postpartum, a patient who is not breastfeeding experiences engorgement. To relieve her discomfort, the nurse should encourage the patient to:

A) Remove her bra.
B) Apply heat to the breasts.
C) Apply cold packs to the breasts.
D) Use a breast pump to release the milk.

Question 19

The advantage of using patient-controlled analgesia (PCA) following a cesarean birth is that the patient:

A) Receives a bolus of the analgesia when pressing the button.
B) Experiences pain relief within 30 minutes.
C) Feels a greater sense of control, and is less dependent on the nursing staff.
D) Can deliver as many doses of the medication as needed.

Question 20

What maternity unit policies promote postpartal family wellness and shared parenting?

A) Mother-baby care or couplet care on the postpartum unit
B) Skin-to-skin contact between the mother and baby and the father and baby
C) Newborn kept in the nursery to allow mother to rest between feedings
D) Self-demand feeding schedule for both breastfed and bottle-fed infants
E) Limited visiting hours for the father so that the mother can sleep as needed

Question 21

The nurse is performing discharge teaching for a newly delivered first-time mother and her infant on the 2nd postpartum day. Which statement by the mother indicates that teaching has been successful?

A) "Taking baths will help my perineum feel less sore each day."
B) "If I develop heavy bleeding, I should take my temperature."
C) "My bowel movements should resume in a week."
D) "I will go back to the doctor in 4 days for my RhoGAM shot."

Question 22

When caring for a new mother after cesarean birth, what complications would the nurse anticipate?

A) Back pain
B) Blood clots
C) Deep vein thrombosis
D) Pulmonary embolism
E) Perineal edema

Question 23

The nurse is preparing to receive a newly delivered patient. The patient is a young single mother who is relinquishing custody of her newborn through an open adoption. What action is most important?

A) Assign the patient a room on the GYN surgical floor instead of on the postpartum floor.
B) Prepare to complete teaching in time for discharge at 24 hours post-delivery.
C) Make an effort not to bring up the topic of the baby, and discuss the mother's health instead.
D) Ask the patient how much contact she would like with the baby, and whether she wants to feed it.

Question 24

The nurse is supervising a student nurse who is working with a 14-year-old patient who delivered her first child yesterday. Which statement indicates that the nursing student understands the particular needs of an adolescent patient?

A) "This patient will need less teaching, because she will have gotten the right information in school."
B) "Because of her age, this patient will require less frequent fundal checks to assess for postpartal hemorrhage."
C) "Because of her age, this patient will probably need extra teaching about the terminology for her anatomy."
D) "This patient will need to have her grandmother provide day care and help raise the baby."

Question 25

To actively involve the postpartal patient during discharge teaching, the postpartum nurse applies which adult learning principle?

A) Reprints of magazine articles
B) Classroom lectures
C) Audiotapes
D) Sensory involvement and active participation

Question 26

The postpartum nurse is planning discharge teaching for the postpartum mother, who has two other children at home. What is the best way to provide instruction to this patient?

A) Provide all information while discharging the patient.
B) Provide written discharge material only.
C) No teaching is required, as this is not the patient's first postpartum experience.
D) Deliver information a little at a time and repeat it until discharge.

Question 27

The nurse is caring for a 15-year-old patient who gave birth to her first child yesterday. What action is the best indicator that the nurse understands the parenting adolescent?

A) The patient's mother is included in all discussions and demonstrations.
B) The father of the baby is encouraged to change a diaper and give a bottle.
C) The nurse explains the characteristics and cues of the baby when assessing him.
D) A discussion on contraceptive methods is the first topic of teaching.

Question 28

The nurse is caring for a patient who plans to relinquish her baby for adoption. The nurse would implement which approach to care?

A) Encourage the patient to see and hold her infant.
B) Encourage the patient to express her emotions.
C) Respect any special requests for the birth.
D) Acknowledge the grieving process in the patient.
E) Allow access to the infant, if the patient requests it.

Question 29

The nurse is caring for a patient who delivered by cesarean birth. The patient received a general anesthetic. To prevent or minimize abdominal distention, the nurse would encourage: Note: Credit will be given if all correct choices and no incorrect choices are selected. Standard Text:

A) Increased intake of cold beverages.
B) Leg exercises every 2 hours.
C) Abdominal tightening.
D) Ambulation.
E) Eating a high-protein general diet.

Question 30

What possible approaches should the nurse use to provide sensitive, holistic nursing care for the mother who is relinquishing her newborn?

A) Allow the mother minimal control over the infant.
B) Use active listening strategies to determine the patient's needs.
C) Provide only physical care in the early postpartum period.
D) Demonstrate empathy, concern, and compassion.
E) Provide nonjudgmental support and personalized care.

Question 31

The nurse is assessing patients after delivery. For which patient is early discharge at 24 hours after delivery appropriate?

A) Multipara, has had two successful breastfeedings.
B) Primipara, bottle-feeding, has not voided since delivery.
C) Multipara, twins delivered at 35 weeks, bottle-feeding
D) Primipara, cesarean birth performed for fetal distress

Question 32

The nurse is preparing a teaching brochure for Spanish-speaking postpartum patients. Which topics are critical for this population?

A) Baby baths and birth certificates
B) Pregnancy fitness and avoiding cesarean delivery
C) When and how to contact the provider
D) Pain-relief options in labor and after birth

Question 33

The nurse is providing postpartum care to an obese patient. As part of care for this patient, the nurse should:

A) Apply sequential compression devices.
B) Have the mother ambulate as early as possible.
C) Encourage bottle-feeding over breastfeeding.
D) Supervise breastfeeding.
E) Instruct the patient on signs of infection.

Question 34

A multiparous patient delivered her first child vaginally 2 years ago, and delivered an infant by cesarean yesterday due to breech presentation. Which statement would the nurse expect the patient to make?

A) "I can't believe how much more tired I was with the first baby."
B) "I'm having significantly more pain this time than with my last birth."
C) "It is disappointing that I can't breastfeed because of the cesarean."
D) "Getting in and out of bed feels more comfortable than last time."

Question 35

The nurse is planning care for three newly delivered adolescents and their babies. What should the nurse keep in mind when planning their care?

A) The baby's father should be encouraged to participate when the nurse is providing instruction.
B) A class for all the adolescents would decrease teaching effectiveness.
C) The schools that the adolescents attend will provide teaching on bathing.
D) Adolescents understand the danger signals in newborns.