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

Question 1

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.This activity indicates that the nurse is trying to:

A)Improve the accuracy of blood loss estimation,which usually is a subjective assessment
B)Determine which pad is best
C)Demonstrate that other nurses usually underestimate blood loss
D)Reveal to the nurse supervisor that one of them needs some time off

Answer 1

Improve the accuracy of blood loss estimation,which usually is a subjective assessment

Question 2

The _________________________ test is used to detect the amount of fetal blood in the maternal circulation.

Answer 2

Kleihauer-Betke
This test is ordered if a large fetomaternal transfusion is suspected.If more than 15 ml of fetal blood is present in maternal circulation,a higher dose of Rh immune globulin must be given.

Question 3

Nursing care in the fourth trimester includes an important intervention sometimes referred to as taking the time to mother the mother.Specifically,this expression refers to:

A)Formally initializing individualized care by confirming the woman's and infant's ID numbers on their respective wrist bands ("This is your baby")
B)Teaching the mother to check the identity of any person who comes to remove the baby from the room ("It's a dangerous world out there")
C)Including other family members in the teaching of self-care and child care ("We're all in this together")
D)Nurturing the woman by providing encouragement and support as she takes on the many tasks of motherhood

Answer 3

Nurturing the woman by providing encouragement and support as she takes on the many tasks of motherhood

Question 4

A woman gave birth vaginally to a 9-lb,12-oz girl yesterday.Her primary health care provider has written orders for perineal ice packs,use of a sitz bath tid,and a stool softener.What information is most closely correlated with these orders?

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

Question 5

Because a full bladder prevents the uterus from contracting normally,nurses intervene to help the woman empty her bladder spontaneously as soon as possible.If all else fails,the last thing the nurse might try is:

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 analgesics
D)Inserting a sterile catheter

Question 6

Which finding could prevent early discharge of a newborn who is now 12 hours old?

A)Birth weight of 3000 g
B)One meconium stool since birth
C)Voided,clear,pale urine three times since birth
D)Infant breastfed once with some difficulty with latch and sucking and once with some success for about 5 minutes on each breast

Question 7

If a woman is at risk for thrombus and is not ready to ambulate,nurses might intervene by doing all of these interventions except:

A)Putting her in antiembolic stockings (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)Notifying the physician immediately if a positive Homans' sign occurs

Question 8

What is not a postpartum practice for preventing infections?

A)Not letting the mother 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

Question 9

Infant abduction from hospitals in the United States has increased over the past few years.As a result many maternity units have put practices into place to protect infants from possible abduction.These practices include:

A)Limited-entry systems
B)Photo identification badges
C)Fingerprint identification of all newborns
D)Infant should always be transported in a bassinet
E)Staff wear special scrubs or unique ID badges

Question 10

A woman gave birth 48 hours ago to a healthy infant girl.She has decided to bottle-feed.During your assessment you notice that both her breasts are swollen,warm,and tender on palpation.The woman should be advised that this condition can best be treated by:

A)Running warm water on her breasts during a shower
B)Applying ice to the breasts for comfort
C)Expressing small amounts of milk from the breasts to relieve pressure
D)Wearing a loose-fitting bra to prevent nipple irritation

Question 11

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.The nurse should be aware of a variety of factors that may contribute to nipple pain.These include:

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

Question 12

What will prevent early discharge of a postpartum woman?

A)Hgb <10 g
B)Birth at 38 weeks of gestation
C)Voids about 200 to 300 ml per void
D)Episiotomy that shows slight redness and edema and is dry and approximated

Question 13

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.The nurse's most appropriate response is to ask the woman:

A)"Didn't you like your lunch?"
B)"Does your doctor 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 14

What is not a reliable indicator of impending shock from early hemorrhage?

A)Respirations
B)Blood pressure
C)Skin condition
D)Urinary output

Question 15

A recently delivered mother and her baby are at the clinic for a 6-week postpartum checkup.The nurse should be concerned that psychosocial outcomes are not being met if the woman:

A)Discusses her labor and birth experience excessively
B)Feels that her baby is more attractive and clever than any others
C)Has not given the baby a name
D)Has a partner or family members who react very positively about the baby

Question 16

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

A)Rubella vaccine should be given
B)A blood transfusion is necessary
C)Rh immune globulin is necessary within 72 hours of birth
D)A Kleihauer-Betke test should be performed

Question 17

The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth for all of the following reasons except:

A)A wellness orientation rather than a sick-care model
B)A 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 18

With regard to rubella and Rh issues,nurses should be aware that:

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

Question 19

A primiparous woman is to be discharged from the hospital tomorrow 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.

Question 20

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.

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

Question 21

If a mother and her family have freely chosen early discharge from the hospital,the nurse and the health care provider are not legally responsible if complications occur and her condition had not been stabilized within normal limits.Is this statement true or false?

Question 22

Regardless of her obstetric status,no woman should be discharged from the recovery area until she has completely recovered from the effects of anesthesia and has been cleared by a member of the anesthesia care team.Is this statement true or false?

Question 23

During the immediate postpartum period,saturation of one pad within 1 hour or less is considered ____________________ blood loss.