Deck 16: Nursing Management During the Postpartum Period

Question 1

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per minute. Which of these actions should the nurse take?

A) Document the finding, as it is a normal finding at this time.
B) Contact the physician, as it indicates early DIC.
C) Contact the physician, as it is a first sign of postpartum eclampsia.
D) Obtain an order for a CBC, as it suggests postpartum anemia.

Answer 1

Document the finding, as it is a normal finding at this time.

Question 2

To decrease the pain associated with an episiotomy immediately after birth, which action by the nurse would be most appropriate?

A) Offer warm blankets.
B) Encourage the woman to void.
C) Apply an ice pack to the site.
D) Offer a warm sitz bath.

Answer 2

Apply an ice pack to the site.

Question 3

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered?

A) Ferrous sulfate (Feosol)
B) Methylergonovine (Methergine)
C) Docusate (Colace)
D) Bromocriptine (Parlodel)

Answer 3

Docusate (Colace)

Question 4

Which statement would alert the nurse to the potential for impaired bonding between mother and newborn?

A) "You have your daddy's eyes."
B) "He looks like a frog to me."
C) "Where did you get all that hair?"
D) "He seems to sleep a lot."

Question 5

After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?

A) Presence of lochia serosa
B) Frequent scant voidings
C) Fundus firm, below umbilicus
D) Milk filling in both breasts

Question 6

A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction would be most appropriate to aid in relieving her discomfort?

A) "Express some milk from your breasts every so often to relieve the distention."
B) "Remove your bra to relieve the pressure on your sensitive nipples and breasts."
C) "Apply ice packs to your breasts to reduce the amount of milk being produced."
D) "Take several warm showers daily to stimulate the milk let-down reflex."

Question 7

The nurse administers RhoGAM to an Rh-negative client after delivery of an Rh-positive newborn based on the understanding that this drug will prevent her from:

A) Becoming Rh positive
B) Developing Rh sensitivity
C) Developing AB antigens in her blood
D) Becoming pregnant with an Rh-positive fetus

Question 8

Which of the following factors in a client's history would alert the nurse to an increased risk for postpartum hemorrhage?

A) Multiparity, age of mother, operative delivery
B) Size of placenta, small baby, operative delivery
C) Uterine atony, placenta previa, operative procedures
D) Prematurity, infection, length of labor

Question 9

A nurse is working as part of a committee to establish policies to promote bonding and attachment. Which practice would be least effective in achieving this goal?

A) Allowing unlimited visiting hours on maternity units
B) Offering round-the-clock nursery care for all infants
C) Promoting rooming-in
D) Encouraging infant contact immediately after birth

Question 10

When developing the plan of care for the parents of a newborn, the nurse identifies interventions to promote bonding and attachment based on the rationale that bonding and attachment are most supported by which measure?

A) Early parent-infant contact following birth
B) Expert medical care for the labor and birth
C) Good nutrition and prenatal care during pregnancy
D) Grandparent involvement in infant care after birth

Question 11

A postpartum woman is having difficulty voiding for the first time after giving birth. Which of the following would be least effective in helping to stimulate voiding?

A) Pouring warm water over her perineal area
B) Having her hear the sound of water running nearby
C) Placing her hand in a basin of cool water
D) Standing her in the shower with the warm water on

Question 12

The nurse is assisting a postpartum woman out of bed to the bathroom for a sitz bath. Which of the following would be a priority?

A) Placing the call light within her reach
B) Teaching her how the sitz bath works
C) Telling her to use the sitz bath for 30 minutes
D) Cleaning the perineum with the peri-bottle

Question 13

A nurse is reviewing the medical record of a postpartum client. The nurse identifies that the woman is at risk for a postpartum infection based on which of the following? (Select all that apply.)

A) History of diabetes
B) Labor of 12 hours
C) Rupture of membranes for 16 hours
D) Hemoglobin level 10 mg/dL
E) Placenta requiring manual extraction

Question 14

A nurse is completing a postpartum assessment. Which finding would alert the nurse to a potential problem?

A) Lochia rubra with a fleshy odor
B) Respiratory rate of 16 breaths per minute
C) Temperature of 101° F
D) Pain rating of 2 on a scale from 0 to 10

Question 15

The nurse is assessing a postpartum client's lochia and finds that there is about a 4-inch stain on the perineal pad. The nurse documents this finding as which of the following?

A) Scant
B) Light
C) Moderate
D) Large

Question 16

When reviewing the medical record of a postpartum client, the nurse notes that the client has experienced a third-degree laceration. The nurse understands that the laceration extends to which of the following?

A) Superficial structures above the muscle
B) Through the perineal muscles
C) Through the anal sphincter muscle
D) Through the anterior rectal wall

Question 17

A nurse is observing a postpartum client interacting with her newborn and notes that the mother is engaging with the newborn in the en face position. Which of the following would the nurse be observing?

A) Mother placing the newborn next to bare breast.
B) Mother making eye-to-eye contact with the newborn
C) Mother gently stroking the newborn's face
D) Mother holding the newborn upright at the shoulder

Question 18

After teaching a group of students about risk factors associated with postpartum hemorrhage, the instructor determines that the teaching was successful when the students identify which of the following as a risk factor? (Select all that apply.)

A) Prolonged labor
B) Placenta previa
C) Null parity
D) Hydramnios
E) Labor augmentation

Question 19

A postpartum woman who is breast-feeding tells the nurse that she is experiencing nipple pain. Which of the following would be least appropriate for the nurse to suggest?

A) Use of a mild analgesic about 1 hour before breast-feeding
B) Application of expressed breast milk to the nipples
C) Application of glycerin-based gel to the nipples
D) Reinstruction about proper latching-on technique

Question 20

A nurse is developing a teaching plan for a postpartum woman who is breast-feeding about sexuality and contraception. Which of the following would the nurse most likely include? (Select all that apply.)

A) Resumption of sexual intercourse about two weeks after delivery
B) Possible experience of fluctuations in sexual interest
C) Use of a water-based lubricant to ease vaginal discomfort
D) Use of combined hormonal contraceptives for the first three weeks
E) Possibility of increased breast sensitivity during sexual activity

Question 21

After teaching a postpartum woman about breast-feeding, the nurse determines that the teaching was successful when the woman states which of the following?

A) "I should notice a decrease in abdominal cramping during breast-feeding."
B) "I should wash my hands before starting to breast-feed."
C) "The baby can be awake or sleepy when I start to feed him."
D) "The baby's mouth will open up once I put him to my breast."

Question 22

A postpartum woman who is bottle-feeding her newborn asks the nurse, "About how much should my newborn drink at each feeding?" The nurse responds by saying that to feel satisfied, the newborn needs which amount at each feeding?

A) 1 to 2 ounces
B) 2 to 4 ounces
C) 4 to 6 ounces
D) 6 to 8 ounces

Question 23

A nurse is observing a postpartum woman and her partner interact with the their newborn. The nurse determines that the parents are developing parental attachment with their newborn when they demonstrate which of the following? (Select all that apply.)

A) Frequently ask for the newborn to be taken from the room
B) Identify common features between themselves and the newborn
C) Refer to the newborn as having a monkey-face
D) Make direct eye contact with the newborn
E) Refrain from checking out the newborn's features

Question 24

After reviewing information about postpartum blues, a group of students demonstrate understanding when they state which of the following about this condition?

A) "Postpartum blues is a long-term emotional disturbance."
B) "Sleep usually helps to resolve the blues."
C) "The mother loses contact with reality."
D) "Extended psychotherapy is needed for treatment."