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?

Accepted Answer

A decrease in pulse rate postpartum is a normal physiological response as the body adjusts after delivery. The cardiovascular system is returning to its pre-pregnancy state, and a lower pulse rate can be a normal finding during this adjustment period.

Question 2

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

Accepted Answer

Applying an ice pack to the site is the most appropriate action to decrease pain associated with an episiotomy immediately after birth because it helps reduce swelling and provides numbing of the area, which can alleviate pain.

Question 3

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

Accepted Answer

Docusate (Colace) is a stool softener, which is often prescribed to postpartum clients with a fourth-degree perineal laceration to prevent straining during bowel movements and to promote healing.

Question 4

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

Accepted Answer

Statement B ("He looks like a frog to me.") could indicate a negative perception of the newborn's appearance by the mother, which might alert a nurse to the potential for impaired bonding. Positive or neutral comments about the baby's features typically do not raise concerns about bonding.

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?

Accepted Answer

Frequent scant voidings could indicate inadequate fluid intake or urinary retention, both of which require further assessment and possible intervention. The other options are normal postpartum findings.

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?

Accepted Answer

Applying ice packs to the breasts can help reduce inflammation and slow the production of milk, which is beneficial for someone who is not breastfeeding and wishes to decrease milk supply and relieve engorgement discomfort.

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:

Accepted Answer

RhoGAM is administered to prevent the Rh-negative mother from developing Rh antibodies (sensitization) after exposure to Rh-positive fetal blood, which could affect future pregnancies with Rh-positive fetuses.

Question 8

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

Accepted Answer

Uterine atony, placenta previa, and operative procedures are known risk factors for postpartum hemorrhage. Uterine atony is the inability of the uterus to contract effectively after delivery, placenta previa involves the placenta covering the cervical opening, and operative procedures can include interventions like cesarean sections, which can increase the risk of bleeding.

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?

Accepted Answer

Offering round-the-clock nursery care for all infants would be least effective in promoting bonding and attachment. This practice can limit the opportunities for parents to spend time with their newborns, which is crucial for establishing early bonding and attachment. Practices that encourage close and frequent parent-infant interaction, such as rooming-in, immediate post-birth contact, and flexible visiting hours, are more supportive of bonding.

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?

Accepted Answer

Early parent-infant contact following birth is crucial for promoting bonding and attachment between parents and their newborn. This immediate contact helps establish a strong emotional connection that is foundational for the child's development and the parent-child relationship.

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?

Accepted Answer

Placing her hand in a basin of cool water is least effective in stimulating voiding postpartum. The other options (A, B, D) utilize warmth and the sound of water, which can help relax the pelvic floor muscles and stimulate the micturition reflex, aiding in voiding.

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?

Accepted Answer

Placing the call light within reach is a priority to ensure the safety of the postpartum woman, allowing her to call for assistance if needed.

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.)

Accepted Answer

The answer of A nurse is reviewing the medical record...

Question 14

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

Accepted Answer

A temperature of 101° F (38.3° C) postpartum could indicate an infection, such as endometritis, which is a potential problem requiring further assessment and possibly treatment.

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?

Accepted Answer

A 4-inch stain on the perineal pad is considered light lochia. Scant would be a very small amount, moderate would be more than light but not soaking the pad, and large would be heavy bleeding or a pad soaked within an hour.

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?

Accepted Answer

A third-degree laceration extends through the anal sphincter muscle. This type of laceration is more severe than first or second-degree lacerations, which involve only the skin and perineal muscles, respectively, but does not extend through the anterior rectal wall as a fourth-degree laceration would.

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?

Accepted Answer

The en face position refers to a face-to-face interaction where the mother and newborn are making eye-to-eye contact, which is crucial for bonding and emotional connection.

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.)

Accepted Answer

The answer of After teaching a group of students about...

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?

Accepted Answer

The answer of A postpartum woman who is breast-feeding tells...

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.)

Accepted Answer

Breastfeeding can lead to fluctuations in sexual interest due to hormonal changes, vaginal dryness which can be alleviated with water-based lubricants, and increased breast sensitivity. Resuming sexual intercourse is generally recommended after the postpartum checkup, usually 4-6 weeks post-delivery, not two weeks. Combined hormonal contraceptives are not recommended immediately postpartum for breastfeeding women due to the potential impact on milk supply and the risk of thrombosis.

Quiz 16: Nursing Management During the Postpartum Period