Obstetrical Nursing – Postpartum – NCLEX Quiz 4

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Obstetrical Nursing  Postpartum  NCLEX Quiz 4 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.


Questions and Answers
  • 1. 

    Which of the following behaviors characterizes the PP mother in the taking in phase?

    • A.

      Passive and dependant

    • B.

      Striving for independence and autonomy

    • C.

      Curious and interested in care of the baby

    • D.

      Exhibiting maximum readiness for new learning

    Correct Answer
    A. Passive and dependant
    Explanation
    During the taking in phase. which usually lasts 1-3 days. the mother is passive and dependent and expresses her own needs rather than the neonate’s needs.Options B. C. and D: The taking hold phase usually lasts from days 3-10 PP. During this stage. the mother strives for independence and autonomy; she also becomes curious and interested in the care of the baby and is most ready to learn.

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  • 2. 

    Which of the following complications may be indicated by continuous seepage of blood from the vagina of a PP client. when palpation of the uterus reveals a firm uterus 1 cm below the umbilicus?

    • A.

      Retained placental fragments

    • B.

      Urinary tract infection

    • C.

      Cervical laceration

    • D.

      Uterine atony

    Correct Answer
    C. Cervical laceration
    Explanation
    Continuous seepage of blood may be due to cervical or vaginal lacerations if the uterus is firm and contracting.Options A and D: Retained placental fragments and uterine atony may cause subinvolution of the uterus. making it soft. boggy. and larger than expected.Option B: UTI won’t cause vaginal bleeding. although hematuria may be present.

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  • 3. 

    What type of milk is present in the breasts 7 to 10 days PP?

    • A.

      Colostrum

    • B.

      Hind milk

    • C.

      Mature milk

    • D.

      Transitional milk

    Correct Answer
    D. Transitional milk
    Explanation
    Transitional milk comes after colostrum and usually lasts until 2 weeks PP.

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  • 4. 

    Which of the following complications is most likely responsible for a delayed postpartum hemorrhage?

    • A.

      Cervical laceration

    • B.

      Clotting deficiency

    • C.

      Perineal laceration

    • D.

      Uterine subinvolution

    Correct Answer
    D. Uterine subinvolution
    Explanation
    Late postpartum bleeding is often the result of subinvolution of the uterus. Retained products of conception or infection often cause subinvolution.Options A and C: Cervical or perineal lacerations can cause an immediate postpartum hemorrhage.Option B: A client with a clotting deficiency may also have an immediate PP hemorrhage if the deficiency isn’t corrected at the time of delivery.

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  • 5. 

    Before giving a PP client the rubella vaccine. which of the following facts should the nurse include in client teaching?

    • A.

      The vaccine is safe in clients with egg allergies

    • B.

      Breastfeeding isn’t compatible with the vaccine

    • C.

      Transient arthralgia and rash are common adverse effects

    • D.

      The client should avoid getting pregnant for 3 months after the vaccine because the vaccine has teratogenic effects

    Correct Answer
    D. The client should avoid getting pregnant for 3 months after the vaccine because the vaccine has teratogenic effects
    Explanation
    The client must understand that she must not become pregnant for 3 months after the vaccination because of its potential teratogenic effects.Option A: The rubella vaccine is made from duck eggs so an allergic reaction may occur in clients with egg allergies.Option B: The virus is not transmitted into the breast milk. so clients may continue to breastfeed after the vaccination.Option C: Transient arthralgia and rash are common adverse effects of the vaccine.

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  • 6. 

    Which of the following changes best described the insulin needs of a client with type 1 diabetes who has just delivered an infant vaginally without complications?

    • A.

      Increase

    • B.

      Decrease

    • C.

      Remain the same as before pregnancy

    • D.

      Remain the same as during pregnancy

    Correct Answer
    B. Decrease
    Explanation
    The placenta produces the hormone human placental lactogen. an insulin antagonist. After birth. the placenta. the major source of insulin resistance. is gone. Insulin needs decrease and women with type 1 diabetes may only need one-half to two-thirds of the prenatal insulin during the first few PP days.

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  • 7. 

    Which of the following responses is most appropriate for a mother with diabetes who wants to breastfeed her infant but is concerned about the effects of breastfeeding on her health?

    • A.

      Mothers with diabetes who breastfeed have a hard time controlling their insulin needs

    • B.

      Mothers with diabetes shouldn’t breastfeed because of potential complications

    • C.

      Mothers with diabetes shouldn’t breastfeed; insulin requirements are doubled.

    • D.

      Mothers with diabetes may breastfeed; insulin requirements may decrease from breastfeeding.

    Correct Answer
    D. Mothers with diabetes may breastfeed; insulin requirements may decrease from breastfeeding.
    Explanation
    Breastfeeding has an antidiabetogenic effect. Insulin needs are decreased because carbohydrates are used in milk production. Breastfeeding mothers are at a higher risk of hypoglycemia in the first PP days after birth because the glucose levels are lower. Mothers with diabetes should be encouraged to breastfeed.

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  • 8. 

    On the first PP night. a client requests that her baby be sent back to the nursery so she can get some sleep. The client is most likely in which of the following phases?

    • A.

      Depression phase

    • B.

      Letting-go phase

    • C.

      Taking-hold phase

    • D.

      Taking-in phase

    Correct Answer
    D. Taking-in phase
    Explanation
    The taking-in phase occurs in the first 24 hours after birth. The mother is concerned with her own needs and requires support from staff and relatives.Option B: The letting-go phase begins several weeks later when the mother incorporates the new infant into the family unit.Option C: The taking-hold phase occurs when the mother is ready to take responsibility for her care as well as the infant’s care.

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  • 9. 

    Which of the following physiological responses is considered normal in the early postpartum period?

    • A.

      Urinary urgency and dysuria

    • B.

      Rapid diuresis

    • C.

      Decrease in blood pressure

    • D.

      Increase motility of the GI system

    Correct Answer
    B. Rapid diuresis
    Explanation
    In the early PP period. there’s an increase in the glomerular filtration rate and a drop in the progesterone levels. which result in rapid diuresis.Options A: There should be no urinary urgency. though a woman may feel anxious about voiding.Options C and D: There’s a minimal change in blood pressure following childbirth. and a residual decrease in GI motility.

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  • 10. 

    During the 3rd PP day. which of the following observations about the client would the nurse be most likely to make?

    • A.

      The client appears interested in learning about neonatal care

    • B.

      The client talks a lot about her birth experience

    • C.

      The client sleeps whenever the neonate isn’t present

    • D.

      The client requests help in choosing a name for the neonate.

    Correct Answer
    A. The client appears interested in learning about neonatal care
    Explanation
    The third to tenth days of PP care are the “taking-hold” phase. in which the new mother strives for independence and is eager for her neonate. The other options describe the phase in which the mother relives her birth experience.

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