Take The NCLEX Quiz On Obstetrical Nursing
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A postpartum nurse is preparing to care for a woman who has just delivered a healthy newborn infant. In the immediate postpartum period the nurse plans to take the woman’s vital signs:
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Every 30 minutes during the first hour and then every hour for the next two hours.
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Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
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Every hour for the first 2 hours and then every 4 hours
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Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours
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Obstetrical nursing is one of the toughest exams in NCLEX. If you are someone who is preparing for it, then take this quiz that contains questions on obstetrical nursing. The quiz contains various questions ranging from easy medium to hard level that covers all exam-related aspects and prepares you well for the final day. The quiz also provides valuable feedback that would help clarify concepts and revise core exam areas. All the best!
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- 2.
The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia is red and has a foul-smelling odor. The nurse determines that this assessment finding is:
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Normal
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Indicates the presence of infection
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Indicates the need for increasing oral fluids
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Indicates the need for increasing ambulation
Correct Answer
A. Indicates the presence of infectionExplanation
Lochia. the discharge present after birth. is red for the first 1 to 3 days and gradually decreases in amount. Foul smelling or purulent lochia usually indicates infection. and these findings are not normal.Option A: Normal lochia has a fleshy odor.Options C and D: Encouraging the woman to drink fluids or increase ambulation is not an accurate nursing intervention.Rate this question:
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- 3.
A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing action in performing this assessment is which of the following?
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Ask the client to turn on her side
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Ask the client to lie flat on her back with the knees and legs flat and straight.
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Ask the mother to urinate and empty her bladder
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Massage the fundus gently before determining the level of the fundus
Correct Answer
A. Ask the mother to urinate and empty her bladderExplanation
Before starting the fundal assessment. the nurse should ask the mother to empty her bladder so that an accurate assessment can be done.Options A and B: When the nurse is performing a fundal assessment. the nurse asks the woman to lie flat on her back with the knees flexed.Option D: Massaging the fundus is not appropriate unless the fundus is boggy and soft. and then it should be massaged gently until firm.Rate this question:
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- 4.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn infant. The nurse instructs the mother that she should expect normal bowel elimination to return:
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One the day of the delivery
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3 days PP
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7 days PP
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Within 2 weeks PP
Correct Answer
A. 3 days PPExplanation
After birth. the nurse should auscultate the woman’s abdomen in all four quadrants to determine the return of bowel sounds. Normal bowel elimination usually returns 2 to 3 days PP. Surgery. anesthesia. and the use of narcotics and pain control agents also contribute to the longer period of altered bowel function.Rate this question:
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- 5.
When performing a PP assessment on a client. the nurse notes the presence of clots in the lochia. The nurse examines the clots and notes that they are larger than 1 cm. Which of the following nursing actions is most appropriate?
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Document the findings
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Notify the physician
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Reassess the client in 2 hours
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Encourage increased intake of fluids
Correct Answer
A. Notify the physicianExplanation
Normally. one may find a few small clots in the first 1 to 2 days after birth from pooling of blood in the vagina. Clots larger than 1 cm are considered abnormal. The cause of these clots. such as uterine atony or retained placental fragments. needs to be determined and treated to prevent further blood loss. Although the findings would be documented. the most appropriate action is to notify the physician.Rate this question:
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- 6.
Upon completion of a vaginal examination on a laboring woman. the nurse records 50%. 6 cm. -1. Which of the following is a correct interpretation of the data?
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Fetal presenting part is 1 cm above the ischial spines
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Effacement is 4 cm from completion
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Dilation is 50% completed
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Fetus has achieved passage through the ischial spines
Correct Answer
A. Fetal presenting part is 1 cm above the ischial spinesExplanation
Station of – 1 indicates that the fetal presenting part is above the ischial spines and has not yet passed through the pelvic inlet. A station of zero would indicate that the presenting part has passed through the inlet and is at the level of the ischial spines or is engaged.Options B and C: Progress of effacement is referred to by percentages with 100% indicating full effacement and dilation by centimeters (cm) with 10 cm indicating full dilation.Option D: Passage through the ischial spines with internal rotation would be indicated by a plus station. such as + 1.Rate this question:
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- 7.
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected lochia drainage. The nurse instructs the mother that the normal amount of lochia may vary but should never exceed the need for:
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One peripad per day
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Two peripads per day
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Three peripads per day
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Eight peripads per day
Correct Answer
A. Eight peripads per dayExplanation
The normal amount of lochia may vary with the individual but should never exceed 4 to 8 peripads per day. The average number of peripads is 6 per day.Rate this question:
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- 8.
The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia would be:
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Severe postpartum headache
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Limited perception of bladder fullness
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Increase in respiratory rate
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Hypotension
Correct Answer
A. HypotensionExplanation
Epidural anesthesia can lead to vasodilation and a drop in blood pressure that could interfere with adequate placental perfusion. The woman must be well hydrated before and during epidural anesthesia to prevent this problem and maintain an adequate blood pressure.Option A: Headache is not a side effect since the spinal fluid is not disturbed by this anesthetic as it would be with a low spinal (saddle block) anesthesia.Option B is an effect of epidural anesthesia but is not the most harmful.Option C: Respiratory depression is a potentially serious complication.Rate this question:
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- 9.
Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position. and her vital signs are stable and fall within a normal range. Contractions are intense. last 90 seconds. and occur every 1 1/2 to 2 minutes. The nurse’s immediate action would be to:
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Change the woman’s position
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Stop the Pitocin
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Elevate the woman’s legs
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Administer oxygen via a tight mask at 8 to 10 liters/minute
Correct Answer
A. Stop the PitocinExplanation
Late deceleration patterns noted are most likely related to alteration in uteroplacental perfusion associated with the strong contractions described. The immediate action would be to stop the Pitocin infusion since Pitocin is an oxytocin which stimulates the uterus to contract.Option A: The woman is already in an appropriate position for uteroplacental perfusion.Option C: Elevation of her legs would be appropriate if hypotension were present.Option D: Oxygen is appropriate but not the immediate action.Rate this question:
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- 10.
A client is admitted to the L & D suite at 36 weeks’ gestation. She has a history of C-section and complains of severe abdominal pain that started less than 1 hour earlier. When the nurse palpates tetanic contractions. the client again complains of severe pain. After the client vomits. she states that the pain is better and then passes out. Which is the probable cause of her signs and symptoms?
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Hysteria compounded by the flu
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Placental abruption
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Uterine rupture
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Dysfunctional labor
Correct Answer
A. Uterine ruptureExplanation
Uterine rupture is a medical emergency that may occur before or during labor. Signs and symptoms typically include abdominal pain that may ease after uterine rupture. vomiting. vaginal bleeding. hypovolemic shock. and fetal distress. With placental abruption. the client typically complains of vaginal bleeding and constant abdominal pain.Rate this question:
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- 11.
Perineal care is an important infection control measure. When evaluating a postpartum woman’s perineal care technique. the nurse would recognize the need for further instruction if the woman:
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Uses soap and warm water to wash the vulva and perineum
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Washes from symphysis pubis back to episiotomy
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Changes her perineal pad every 2 – 3 hours
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Uses the peri bottle to rinse upward into her vagina
Correct Answer
A. Uses the peri bottle to rinse upward into her vaginaExplanation
The peri bottle should be used in a backward direction over the perineum. The flow should never be directed upward into the vagina since debris would be forced upward into the uterus through the still-open cervix.Rate this question:
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- 12.
The nurse is assessing a client who is 6 hours PP after delivering a full-term healthy infant. The client complains to the nurse of feelings of faintness and dizziness. Which of the following nursing actions would be most appropriate?
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Obtain hemoglobin and hematocrit levels
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Instruct the mother to request help when getting out of bed
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Elevate the mother’s legs
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Inform the nursery room nurse to avoid bringing the newborn infant to the mother until the feelings of lightheadedness and dizziness have subsided
Correct Answer
A. Instruct the mother to request help when getting out of bedExplanation
Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings of faintness or dizziness are signs that should caution the nurse to be aware of the client’s safety. The nurse should advise the mother to get help the first few times the mother gets out of bed.Option A: Obtaining an H/H requires a physician’s order.Rate this question:
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- 13.
A postpartum nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4 hours ago. The nurse notes that the mother’s temperature is 100.2*F. Which of the following actions would be most appropriate?
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Retake the temperature in 15 minutes
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Notify the physician
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Document the findings
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Increase hydration by encouraging oral fluids
Correct Answer
A. Increase hydration by encouraging oral fluidsExplanation
The mother’s temperature may be taken every 4 hours while she is awake. Temperatures up to 100.4 F (38 C) in the first 24 hours after birth are often related to the dehydrating effects of labor. The most appropriate action is to increase hydration by encouraging oral fluids. which should bring the temperature to a normal reading.Option C: Although the nurse would document the findings. the most appropriate action would be to increase the hydration.Rate this question:
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- 14.
Parents can facilitate the adjustment of their other children to a new baby by:
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Having the children choose or make a gift to give to the new baby upon its arrival home
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Emphasizing activities that keep the new baby and other children together
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Having the mother carry the new baby into the home so she can show the other children the new baby
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Reducing stress on other the by limiting their involvement in the care of the new baby
Correct Answer
A. Having the children choose or make a gift to give to the new baby upon its arrival homeExplanation
Special time should be set aside just for the other children without interruption from the newborn. Someone other than the mother should carry the baby into the home so she can give full attention to greeting her other children. Children should be actively involved in the care of the baby according to their ability without overwhelming them.Rate this question:
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- 15.
A nurse is caring for a PP woman who has received epidural anesthesia and is monitoring the woman for the presence of a vulva hematoma. Which of the following assessment findings would best indicate the presence of a hematoma?
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Complaints of a tearing sensation
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Complaints of intense pain
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Changes in vital signs
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Signs of heavy bruising
Correct Answer
A. Changes in vital signsExplanation
Changes in vitals indicate hypovolemia in the anesthetized PP woman with vulvar hematoma.Options A and B: Because the woman has had epidural anesthesia and is anesthetized. she cannot feel pain. pressure. or a tearing sensation.Option D: Heavy bruising may be visualized. but vital sign changes indicate hematoma caused by blood collection in the perineal tissues.Rate this question:
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- 16.
Select all of the physiological maternal changes that occur during the PP period.
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Cervical involution occurs
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Vaginal distention decreases slowly
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Fundus begins to descend into the pelvis after 24 hours
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Cardiac output decreases with resultant tachycardia in the first 24 hours
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Digestive processes slow immediately
Correct Answer(s)
A. Cervical involution occurs
A. Fundus begins to descend into the pelvis after 24 hoursExplanation
After 1 week the muscle begins to regenerate and the cervix feels firm and the external os. is the width of a pencil. The fundus begins to descent into the pelvic cavity after 24 hours. a process known as involution.Option B: Although the vaginal mucosa heals and vaginal distention decreases. it takes the entire PP period for complete involution to occur and muscle tone is never restored to the pregravid state.Option D: Despite blood loss that occurs during delivery of the baby. a transient increase in cardiac output occurs. The increase in cardiac output. which persists about 48 hours after childbirth. is probably caused by an increase in stroke volume because Bradycardia is often noted during the PP period.Option E: Soon after childbirth. digestion begins to begin to be active. and the new mother is usually hungry because of the energy expended during labor.Rate this question:
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Current Version
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Nov 22, 2023Quiz Edited by
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Sep 09, 2017Quiz Created by
Santepro