Question 1

The ICU nurse is caring for a postpartum patient who experienced complications.Which color of lochia does the nurse expect to find on the fifth day postpartum?&#10;A) Bright red&#10;B) Dark red&#10;C) Pink&#10;D) Yellow-white&#10;

Accepted Answer

By the fifth day postpartum, the lochia should have progressed to a pink color, indicating a decrease in bleeding and healing of the uterus. Bright red or dark red lochia would indicate increased bleeding and potential complications, while yellow-white lochia would indicate a lack of progression and potential retained products of conception.

Question 2

Which patient does the nurse anticipate is most likely to experience afterpains?&#10;A) The woman who had a precipitous delivery&#10;B) The woman who delivered a preterm infant&#10;C) The primipara who had a difficult pregnancy&#10;D) The multipara who delivered her fifth child&#10;

Accepted Answer

Afterpains are typically more intense in multiparas due to the increased uterine muscle tone and sensitivity from previous pregnancies. The more children a woman has had, the stronger her afterpains may be.

Question 3

Which events after delivery of the placenta cause the uterus to contract and begin shrinking to nonpregnant size?&#10;A) Reduced estrogen and progesterone levels&#10;B) Reduced estrogen and oxytocin levels&#10;C) Reduced progesterone and oxytocin levels&#10;D) Estrogen,progesterone,and oxytocin levels decline.&#10;

Accepted Answer

Reduced estrogen and progesterone levels after the delivery of the placenta signal the body to initiate uterine contractions, which help the uterus begin shrinking back to its nonpregnant size.

Question 4

The nurse is making a home-care visit when the newborn starts to cry.The new mother smiles and says,"That's his hungry cry." The nurse interprets this as indicating the mother is in which phase of maternal role attainment?

A) Taking-in phase
B) Taking-hold phase
C) Letting-go phase
D) Transitioning from taking-in to taking-hold phase

Accepted Answer

The answer of The nurse is making a home-care visit...

Question 5

Which behavior observed by the nurse indicates a new mother is beginning to bond with her newborn?&#10;A) Takes the en face position&#10;B) Tells the nurse about her labor experience&#10;C) Needs reassurance of her ability to be a good mother&#10;D) Asks to keep the baby in the nursery overnight so she can sleep&#10;

Accepted Answer

Taking the en face position (face-to-face) with the newborn indicates an instinctual attraction and connection with the baby, which is a sign of beginning to bond.

Question 6

The nurse examines a postpartum woman who is 1 day postdelivery.Which finding does the nurse consider abnormal?&#10;A) Fundus 1 cm below the umbilicus&#10;B) Bright red lochia&#10;C) Dilated cervix&#10;D) Reduced fibrinogen levels&#10;

Accepted Answer

The fundus 1 cm below the umbilicus (A), bright red lochia (B), and a dilated cervix (C) are normal findings in a woman who is 1 day postdelivery. Reduced fibrinogen levels (D) are abnormal because fibrinogen levels typically increase during pregnancy and remain elevated in the immediate postpartum period to prevent excessive bleeding.

Question 7

The nurse working in a women's clinic admits a patient who is almost 6 weeks postpartum and describes a yellow-white vaginal drainage.The nurse interprets this as indicating what?&#10;A) Bacterial infection&#10;B) Retained placenta&#10;C) Expected lochia progression&#10;D) Fungal infection&#10;

Accepted Answer

Yellow-white vaginal discharge at six weeks postpartum indicates expected lochia progression, which is a normal vaginal discharge after giving birth. It consists of blood, mucus, and uterine tissue that is discharged from the uterus as it heals after childbirth.

Question 8

Which statement by a postpartum patient indicates teaching regarding menses and contraception has been understood?&#10;A) &#34;I don't have to worry about getting pregnant until I get my first menstrual period.&#34;&#10;B) &#34;Because I am breastfeeding,I don't have to worry about getting pregnant until I quit.&#34;&#10;C) &#34;I should resume using my diaphragm as soon as I resume sexual activity.&#34;&#10;D) &#34;I should use a contraceptive when I resume sexual activity to avoid pregnancy.&#34;&#10;

Accepted Answer

Option D correctly indicates that the patient understands the need for contraception when resuming sexual activity in order to avoid pregnancy. Option A is incorrect because ovulation can occur before the first menstrual period, making it possible to become pregnant. Option B may also be incorrect as breastfeeding may not be a reliable form of contraception. Option C is incorrect because a diaphragm should not be used until after the uterus has returned to its pre-pregnancy size, and it should be refitted by a healthcare provider.

Question 9

The nurse enters a postpartum patient's room and finds the father staring at the newborn in the bassinet with a contemplative look on his face.How should the nurse interpret this behavior?&#10;A) The father may be a danger to the baby.&#10;B) The father feels resentful toward the baby.&#10;C) The father is uncertain about being a father.&#10;D) The father is bonding with the baby.&#10;

Accepted Answer

The father's contemplative look suggests that he is bonding with the newborn. New fathers often experience complex emotions and may need time to process their new roles as caregivers. It is important for the nurse to offer support and encouragement for father-infant bonding. Choices A, B, and C are not supported by the information given and may unnecessarily alarm the nurse or create an unhelpful or negative dynamic with the family.

Question 10

A woman reports she has not urinated since delivering 8 hours ago and says she has no urge to void despite drinking adequate fluids postpartum.The nurse attributes this to what?&#10;A) The woman was dehydrated and has not fully hydrated yet to produce urine.&#10;B) The woman's bladder tone is reduced,and she does not feel the urge to urinate.&#10;C) The bladder has more room to expand and can hold more urine because of a smaller uterus.&#10;D) The woman is experiencing a release of epinephrine,causing absence of bladder sensation.&#10;

Accepted Answer

The woman's lack of urge to void and not urinating since delivery may indicate a reduced bladder tone, which is a common postpartum condition. The uterus is still enlarged postpartum, which can cause pressure on the bladder and decrease its tone. It is not necessary that the woman is dehydrated or experiencing epinephrine release. While the bladder may have more room to expand due to the smaller uterus, this is not the primary reason for the woman's lack of urge to void.

Question 11

While reviewing laboratory values,the nurse sees a postpartum patient's white blood cell count is 26,699 mg/dL,and her neutrophil count is also elevated.Which is the nurse's priority action?&#10;A) Assessing the episiotomy for signs of infection&#10;B) Notifying the RN and/or provider&#10;C) Continuing to monitor laboratory findings&#10;D) Obtaining STAT vital signs&#10;

Accepted Answer

The answer of While reviewing laboratory values,the nurse sees a...

Question 12

Which observed behavior arouses the nurse's concern as an indication the mother is not bonding with her baby?&#10;A) The mother expresses fear she will hurt the baby because she doesn't know what to do.&#10;B) The mother stares at the baby's face and touches it only with her fingertips.&#10;C) The mother does not want to hold the infant and asks to keep the baby in the nursery.&#10;D) The mother asks many questions about self-care and newborn care.&#10;

Accepted Answer

The answer of Which observed behavior arouses the nurse's concern...

Question 13

Which is the best intervention for the nurse to use to promote eye contact between the mother and newborn?&#10;A) Pointing out characteristics of the newborn such as eye color,milia,and other facial features&#10;B) Encouraging the mother to change the baby's diaper&#10;C) Encouraging the mother to hold the baby&#10;D) Taking the baby to the nursery and allowing the mother to rest&#10;

Accepted Answer

The answer of Which is the best intervention for the...

Question 14

It is time for a newborn to have blood collected for the newborn screening.How does the nurse turn this into a bonding opportunity for the mother?&#10;A) Perform the test in the mother's room and encourage her to comfort the newborn afterward&#10;B) Take the baby to the nursery for the test to avoid upsetting the mother&#10;C) Explain the bandage on the baby's foot when returning the baby to the mother's room&#10;D) Perform the test without mentioning it to the mother to reduce anxiety&#10;

Accepted Answer

The answer of It is time for a newborn to...

Question 15

A breastfeeding mother says,&#34;One good thing about breastfeeding is that I won't have to worry about getting pregnant till I stop.&#34; Which information will the nurse provide to this patient?&#10;A) Ovulation and menstruation may be delayed by breastfeeding,but not always.&#10;B) Ovulation will resume as early as 27 days after delivery.&#10;C) Ovulation will resume within 30 days of stopping breastfeeding.&#10;D) By breastfeeding even once a day,she can delay ovulation.&#10;

Accepted Answer

The answer of A breastfeeding mother says,&#34;One good thing about...

Question 16

The nurse is caring for a woman who delivered her third child 2 days ago and who says,"I am having pain; it feels like labor pain.I never experienced this with my other children,and it is worse when I breastfeed." Which is the nurse's priority response?

A) Further assess the pain's location,intensity,and frequency
B) Explain the purpose of afterpains and reassure the patient
C) Immediately obtain vital signs and monitor vital signs every 15 minutes
D) Administer a narcotic analgesic to control pain

Accepted Answer

The answer of The nurse is caring for a woman...

Question 17

When does the nurse expect to be unable to palpate the uterus in a postpartum patient?&#10;A) Immediately after delivery&#10;B) 5 days postdelivery&#10;C) 1 week postdelivery&#10;D) 2 weeks postdelivery&#10;

Accepted Answer

The answer of When does the nurse expect to be...

Question 18

The nurse examines a woman's lochia and notices excessive bleeding.Which is the nurse's priority action?&#10;A) Assessing for a full bladder&#10;B) Placing the patient in the Trendelenburg position&#10;C) Massaging the uterus&#10;D) Encouraging the woman to breastfeed&#10;

Accepted Answer

The answer of The nurse examines a woman's lochia and...

Deck 13: Physiological and Behavioral Adaptations During the Postpartum Period