Deck 57: Postpartum Care

Question 1

A postpartum client who is breastfeeding asks the nurse when her menstrual period will return.Which of these responses should the nurse make?

A)"It will largely depend on your breastfeeding pattern."
B)"It will occur within 3 months after the birth."
C)"It usually returns by 120 days postpartum."
D)"It usually takes place between 27 days and 2 months after birth."

Answer 1

"It will largely depend on your breastfeeding pattern."

Question 2

A postpartum client has a midline episiotomy and states there is a great deal of discomfort whenever she moves.To decrease the discomfort,the nurse should instruct the client to:

A)ask for medication as needed
B)sit on a large pillow at all times
C)walk around frequently to restore circulation
D)tighten the buttocks and perineum before sitting and relax the area once seated

Answer 2

tighten the buttocks and perineum before sitting and relax the area once seated

Question 3

A client who is breastfeeding experiences engorgement on the 4th postpartum day.The nurse should explain to the client that engorgement is the result of:

A)a blocked milk duct
B)milk stasis that has resulted in inflammation of the breast
C)the breasts beginning to fill with colostrum
D)vasocongestion of breast tissues as milk production begins

Answer 3

vasocongestion of breast tissues as milk production begins

Question 4

While palpating a client's uterus postpartum,the nurse notes the fundus position to be 2 centimeters higher than on previous assessments and off to the left side.Which of these actions should the nurse take?

A)Ask the client to urinate,and then reassess the fundus position.
B)Initiate a Pitocin IV drip according to the health care provider's routine orders.
C)Note the position of the uterus on the nurse's notes because these findings are normal.
D)Notify the health care provider immediately.

Question 5

During the first 30 to 60 minutes after birth,which attachment takes place between parent and child?

A)bonding
B)claiming
C)engrossment
D)entrainment

Question 6

When a client is 12 hours postpartum,the nurse would expect the client's fundus to be in which of these positions?

A)at the level of the umbilicus
B)below the symphysis pubis and no longer palpable
C)1 centimeter above the umbilicus
D)1 centimeter below the umbilicus

Question 7

A client delivered her baby vaginally 1 week ago today.The nurse would expect to palpate the client's uterine fundus at which of these levels?

A)1 centimeter below the level documented on the day of delivery
B)7 centimeters below the level documented on the day of delivery
C)7 centimeters below the umbilicus
D)The uterus should not be palpable 1 week after a vaginal delivery.

Question 8

A client with blood type B negative has given birth to an infant with blood type O positive.When should the client receive Rh immune globulin?

A)only if she plans any future pregnancies
B)only if she has had an Rh-negative infant
C)right after the delivery of her infant
D)within 72 hours after delivery

Question 9

When conducting a telephone follow-up of all clients who are 2 weeks postpartum,the nurse would expect clients to describe their uterine and vaginal discharge as:

A)bright red
B)nonexistent
C)pinkish brown
D)yellowish white

Question 10

Which of these descriptions of lochia is expected of a mother who had a cesarean delivery?

A)contains more clots than that of a mother who has had a vaginal birth
B)has rubra for a longer period of time than that of a mother who has had a vaginal birth
C)is greater in amount than that of a mother who has had a vaginal birth
D)is smaller in amount than that of a mother who has had a vaginal birth

Question 11

A client is exhibiting signs of postpartum depression.Which of the following symptoms would indicate the client's condition has advanced to that of postpartum psychosis?

A)decreased concentration
B)insomnia
C)obsessive concerns about the infant's health
D)spontaneous crying

Question 12

What are the usual causes of maternal afterpains?

A)cesarean delivery and prolonged labor
B)multiparity and breastfeeding
C)postpartal hemorrhage and puerperal infection
D)uterine involution and breast engorgement

Question 13

During the first 24 hours postpartum,a client states her vaginal discharge is bright red with small pieces of mucus.Which of these actions should the nurse take?

A)Hold her NPO,and immediately notify her health care provider.
B)Observe the sanitary pad,and document your findings.
C)Verify that the amount and appearance are normal at this time.
D)Compress her fundus vigorously to express clots.

Question 14

A postpartum client who is a primipara and her husband prepared for their baby's birth by taking Lamaze classes,but the client had to have an emergency cesarean delivery.According to Reva Rubin's restorative/adaptive phases,the nurse would expect this couple to experience the MOST difficulty during which phase?

A)letting go
B)taking hold
C)taking in
D)postpartum blues

Question 15

A postpartum client reports calf discomfort when the nurse supports her left knee and dorsiflexes her foot.Which of these actions should the nurse take?

A)Allow the client to rest,and reassess her later in the shift.
B)Chart this finding as a negative Homans' sign.
C)Massage the affected calf,and apply moist heat.
D)Report this finding to the health care provider at once.

Question 16

Which of these actions is essential when a nurse is caring for a postpartum client who is getting out of bed for the first time?

A)Stay with the client during ambulation.
B)Ask a family member to walk with the client.
C)Administer pain medication before getting the client up.
D)Have a walker or cane readily available.

Question 17

A nurse would expect a postpartum client's uterine and vaginal discharge on the 4th postpartum day to be lochia:

A)absent
B)alba
C)rubra
D)serosa

Question 18

The normal postpartum uterus has which of these characteristics?

A)firm and in the midline
B)firm and slightly to the left of the umbilicus
C)firm when breastfeeding in varied positions,and within abdominal cavity
D)soft and within the pelvic inlet

Question 19

The Newborns' and Mothers' Health Protection Act of 1995 mandates that all health care plans require a minimal postpartum hospital stay of how many hours for vaginal and cesarean births?

A)vaginal,24;Cesarean,48
B)vaginal,48;Cesarean,96
C)vaginal,72;Cesarean,72
D)vaginal,72;Cesarean,96

Question 20

During the immediate postpartum period,a client's fundus is firmly contracted,midline,and at the appropriate level,but she is exhibiting an excessive amount of bleeding.The nurse should suspect the cause of bleeding to be:

A)a full bladder
B)ambulation
C)breastfeeding
D)cervical or vaginal tears

Question 21

If a nurse observes an increased pulse rate and decreased blood pressure in a new postpartum client,the nurse should suspect the client has developed which of these conditions?

A)positive Homans' sign
B)postpartum hemorrhage
C)dehydration
D)uterine distention

Question 22

To decrease the incidence of thromboembolic conditions in a postpartum client,the nurse would encourage the client to:

A)ambulate early and frequently after delivery
B)cross legs when sitting
C)rest in bed as much as possible
D)massage extremities and apply heat if discomfort or pain occurs

Question 23

The nurse caring for an expectant mother would monitor for which of the following that predisposes the mother for a risk of bleeding? (Select all that apply. )

A)decreased platelet level
B)history of alcohol abuse
C)a mother who is obese
D)increased hematocrit level
E)taking NSAIDs
F)taking herbal medications

Question 24

A breastfeeding client who is 2 weeks' postpartum tells the nurse her nipples are very sore and she is able to breastfeed for only short periods.The nurse should recognize the client is at risk for developing:

A)metritis
B)mastitis
C)thrombophlebitis
D)vaginitis

Question 25

What is the main goal of medical management of the postpartum client with disseminated intravascular coagulation (DIC)?

A)administration of heparin therapy
B)administration of platelets
C)correction of the underlying cause
D)symptomatic treatment only

Question 26

A client who has a puerperal infection is receiving intravenous (IV)antibiotic treatment.The nurse should recognize that the infant will:

A)receive prophylactic antibiotics
B)be kept separate from the mother until her fever is gone for 24 hours
C)remain with the mother
D)be discharged home before the mother

Question 27

When the nurse is caring for a postpartum client,assessment would be focused on which priority areas? (Select all that apply. )

A)cervical enlargement
B)episiotomy or incision
C)bladder distention
D)depression
E)lochia
F)breasts