Deck 10: Nursing Care of Women with Complications After Birth

Question 1

After a prolonged labor,a woman vaginally delivered a 10 pound,3 ounce infant boy.In the immediate postpartum period,the nurse would be alert for the development of:

A) cervical laceration.
B) hematoma.
C) endometritis.
D) retained placental fragments.

Answer 1

hematoma.

Question 2

The nurse is caring for a woman who had a cesarean birth yesterday.Varicose veins are visible on both legs.To prevent thrombus formation the nurse would:

A) have the woman sit in a chair for meals.
B) monitor vital signs every 4 hours and report any changes.
C) tell the woman to remain in bed with her legs elevated.
D) assist the woman with ambulation for short periods of time.

Answer 2

assist the woman with ambulation for short periods of time.

Question 3

When the 4-week postpartum patient with mastitis asks the nurse if she can continue to breastfeed,the nurse's most helpful response is:

A) "Stop breastfeeding until the infection clears. "
B) "Pump the breasts to continue milk production, but do not give breast milk to the infant. "
C) "Begin all feedings with the affected breast until the mastitis is resolved. "
D) "Breastfeeding can continue unless there is any abscess formation. "

Answer 3

"Breastfeeding can continue unless there is any abscess formation. "

Question 4

A woman had a vaginal delivery two days ago and is preparing for discharge.To help prevent postpartum complications,the nurse plans to teach the woman to report any:

A) fever.
B) change in lochia from red to white.
C) contractions.
D) fatigue and irritability.

Question 5

The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side.The nurse should next assess:

A) fullness of the bladder.
B) amount of lochia.
C) blood pressure.
D) level of pain.

Question 6

The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

A) cold, clammy skin.
B) tachycardia.
C) hypotension.
D) decreased urinary output.

Question 7

The best response to a postpartum woman who tells the nurse that she feels "tired and sick all of the time since I had the baby 3 months ago" is:

A) "This is a normal response for the body after pregnancy. Try to get more rest. "
B) "I'll bet you will snap out of this funk real soon. "
C) "Why don't you arrange for a babysitter so you and your husband can have a night out?"
D) "Let's talk about this further. I am concerned about how you are feeling. "

Question 8

During a postpartum assessment,a woman reports that her right calf is painful.The nurse observes edema and redness along the saphenous vein in the right lower leg.Based on this finding,the nurse explains that the probable treatment will involve:

A) anticoagulants for 6 weeks.
B) application of ice to the affected leg.
C) gentle massage of the affected leg.
D) passive leg exercises twice a day.

Question 9

While caring for a postpartum patient who had a vaginal delivery yesterday,the nurse assesses both a firm uterine fundus and a trickle of bright blood.The nurse is:

A) concerned and reports a probable cervical laceration.
B) attentive and massages the uterus to expel retained clots.
C) distressed and reports a possible clotting disorder.
D) satisfied with the normal early postpartum finding.

Question 10

A woman has had persistent lochia rubra for two weeks after her delivery and is experiencing pelvic discomfort.When subinvolution is diagnosed,the nurse explains that the usual treatment for this disorder is:

A) uterine massage.
B) oxytocin infusion.
C) dilation and curettage.
D) hysterectomy.

Question 11

Five days after a spontaneous vaginal delivery,a woman comes to the emergency room because she has a fever and persistent cramping.The nurse recognizes that the cause of these signs and symptoms may be:

A) dehydration.
B) hypovolemic shock.
C) endometritis.
D) cystitis.

Question 12

At her 6-week postpartum checkup,a woman mentions to the nurse that she cannot sleep and is not eating.She feels guilty because sometimes she believes her infant is dead.The nurse recognizes this woman's symptoms as:

A) bipolar disorder.
B) major depression.
C) postpartum blues.
D) postpartum depression.

Question 13

The statement that would indicate to the nurse on a postpartum home visit that the patient understands the signs of late postpartum hemorrhage is:

A) "My discharge would change to red after it has been pink or white. "
B) "If I have a postpartum hemorrhage, I will have severe abdominal pain. "
C) "I should be alert for an increase in bright red blood. "
D) "I would pass a large clot that was retained from the placenta. "

Question 14

The nurse's first action when postpartum hemorrhage from uterine atony is suspected is to:

A) teach the patient how to massage the abdomen and then get help.
B) start IV fluids to prevent hypovolemia, then notify the registered nurse.
C) begin massaging the fundus while another person notifies the physician.
D) ask the patient to void and reassess fundal tone and location.

Question 15

The one-day postpartum patient shows a temperature elevation,cough,and slight shortness of breath on exertion.Based on these symptoms the nurse should:

A) notify the charge nurse of a possible upper respiratory infection.
B) notify the physician of a possible pulmonary embolism.
C) document expected postpartum mucous membrane congestion.
D) medicate with antipyretic remedy for elevated temperature.

Question 16

The nurse determines that a woman with mastitis understands treatment instructions when she says she will:

A) "Apply cold compresses to the painful areas. "
B) "Take a warm shower before nursing the baby. "
C) "Nurse first on the affected side. "
D) "Empty the affected breast every 8 hours. "

Question 17

If massage and putting the infant to breast is not effective in controlling a boggy uterus,the nurse explains that the physician may order:

A) ritodrine.
B) magnesium sulfate.
C) oxytocin.
D) bromocriptine.

Question 18

Although the nurse has massaged the uterus every 15 minutes it remains flaccid,and the patient continues to pass large clots.The nurse recognizes that these signs indicate uterine:

A) atony.
B) dystocia.
C) hypoplasia.
D) dysfunction.

Question 19

Three weeks after delivering her first child,a woman tells the nurse,"I waited so long for this baby and now that she is here,I can't believe how different my life is from what I expected." The best nursing response to the woman's statement is:

A) "How is your partner adjusting to the change?"
B) "I hear this from a lot of first-time mothers. "
C) "Have you told anyone else about your feelings?"
D) "Tell me how things are different. "

Question 20

One day after discharge,the postpartum patient calls the clinic complaining of a reddened area on her lower leg,temperature elevation of 37 ° C (99.8° F),rust-colored lochia,and sore breasts.From these symptoms,the nurse suspects:

A) phlebitis.
B) puerperal infection.
C) late postpartum hemorrhage.
D) mastitis.

Question 21

The nurse explains that the process of the body returning to the nonpregnant state is called _______________.

Question 22

By flexing the patient's leg and dorsiflexing the foot,the nurse is:

A) assessing for edema in the lower limb.
B) performing range-of-motion exercises.
C) stimulating circulation to limbs.
D) assessing for deep vein thrombus.

Question 23

The nurse weighs a saturated perineal pad and finds it to weigh 15 grams.The nurse is aware that this indicates a blood loss of _____ mL.

Question 24

The nurse assesses the perineal pad placed on a 3-hour postdelivery patient and finds that there is no lochia on it.What would the nurse expect to find on further assessment? Select all that apply.

A) A firm fundus the size of a grapefruit
B) A full bladder
C) Retained placental fragments
D) Vital signs indicative of shock
E) A soft, boggy fundus

Question 25

In order to reduce the risk of mastitis,what will the nurse teach a nursing mother to do? Select all that apply.

A) Limit fluid intake to 1 liter per day.
B) Empty both breasts with each feeding.
C) Take warm showers.
D) Wear a supportive bra.
E) Pump breasts to ensure emptying.

Question 26

The new mother who had a vaginal delivery yesterday has a white blood cell count of 30,000 cells/dL.The nurse should:

A) notify charge nurse of a possible infection.
B) prepare to put the patient in isolation.
C) have the infant removed from the room and returned to the nursery.
D) assess the patient further.

Question 27

The nurse assesses a positive Homans sign if the patient complains of pain in the _______ when the patient's leg is flexed and the foot is sharply dorsiflexed.

A) groin
B) Achilles tendon
C) top of the foot
D) calf of the leg

Question 28

The nurse conducting a childbirth preparation class warns the patients that shock,a real threat after delivery,is caused by what factor(s)? Select all that apply.

A) Hypertension
B) Blood clotting disorders
C) Anemia
D) Infection
E) Postpartum hemorrhage

Question 29

The nurse instructs the postpartum patient that her nutritional intake should include which food(s)particularly supportive to healing? Select all that apply.

A) Legumes
B) Potatoes and pasta
C) Citrus fruits
D) Rice
E) Cantaloupe