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1/75 Questions

After delivering a full-term infant, a breastfeeding mother, who is preparing for discharge, asks a nurse if there is any type of contraceptive method that should be avoided while she is breastfeeding. Which contraceptive should the nurse advise the client to avoid?
- An intrauterine device (IUD).
- Diaphragm
- The progesterone-only mini pill
- The combined oral contraceptive (COC) pill

About This Quiz

Nursing of a woman who is about to or has already given birth requires special care and attention. A nurse can give some information to the Mother that will help them through the process. The quiz below is best suited to test a nurse’s ability to do so. Give it a try!

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2.

A postpartum client, who is 24 hours post-vaginal birth and breastfeeding, asks a nurse when she can begin exercising to regain her prepregnancy body shape. Which response by the nurse is correct?
- “You should not exercise while you are breastfeeding.”
- “You will need to wait until after your 6-week postpartum checkup.”
- “Once your lochia has stopped you can begin exercising.”
- “Simple abdominal and pelvic exercises can begin right now.”
Correct Answer

A. “Simple abdominal and pelvic exercises can begin right now.”

Explanation

The correct answer is "Simple abdominal and pelvic exercises can begin right now." This response is correct because it is safe for the postpartum client to start gentle abdominal and pelvic exercises immediately after a vaginal birth. These exercises can help strengthen the core muscles and promote a faster recovery. It is important to note that the client should listen to her body and start with low-impact exercises, gradually increasing the intensity as she feels comfortable.

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3.

A nurse walks into the room of a postpartum client and observes her looking in the mirror at her abdomen. The client says, “My stomach still looks like I’m pregnant!” The nurse explains that the abdominal muscles, which separate during pregnancy, will do which of the following?
- Regain tone within the first week after birth.
- Regain tone as the client loses the weight gained.
- Remain permanently separated giving the abdomen a slight bulge.
- Regain pre-pregnancy tone with exercise.
Correct Answer

A. Regain pre-pregnancy tone with exercise.

Explanation

The nurse explains that the abdominal muscles, which separate during pregnancy, will regain their pre-pregnancy tone with exercise. This means that with regular exercise and strengthening of the abdominal muscles, the client's stomach will become flatter and more toned, resembling her pre-pregnancy appearance. This is a common and expected process after childbirth.

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4.

A nurse has been given a report on a postpartum client that includes the information that the client suffered a fourth-degree perineal laceration during her vaginal birth. In response to this information, which intervention should the nurse add to the client’s plan of care?
- Decrease fluid intake to 1,000 mL every 24 hours.
- Limit ambulation to bathroom privileges only.
- Instruct the client on a high-fiber diet and administer stool softeners.
- Monitor the uterus for firmness every 2 hours.
Correct Answer

A. Instruct the client on a high-fiber diet and administer stool softeners.

Explanation

A fourth-degree perineal laceration is a severe tear that extends through the vaginal wall, perineal muscles, and anal sphincter. This type of injury can cause significant pain and discomfort, especially during bowel movements. Instructing the client on a high-fiber diet and administering stool softeners can help prevent constipation and straining, which can worsen the pain and delay healing. This intervention promotes regular bowel movements and reduces the risk of complications such as infection and dehiscence.

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5.

Twenty-four hours post–vaginal delivery, a postpartum client tells a nurse that she is concerned because she has not had a bowel movement since before delivery. In response to this information, the nurse should intervene by doing which of the following?
- Documenting the information in the client’s healthcare records.
- Assessing the client’s bowel sounds
- Administering a laxative that has been ordered on an as needed basis
- Notifying the health-care practitioner immediately
Correct Answer

A. Documenting the information in the client’s healthcare records.

Explanation

The nurse should intervene by documenting the information in the client's healthcare records. This is important for maintaining accurate and up-to-date records of the client's condition and any concerns or symptoms they may be experiencing. It allows for continuity of care and provides a reference for future healthcare providers. Assessing the client's bowel sounds may be necessary to gather more information, but it is not the initial intervention. Administering a laxative should only be done if ordered by the healthcare practitioner. Notifying the healthcare practitioner immediately may not be necessary unless there are further complications or concerns.

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6.

Although the nurse has massaged the uterus every 15 minutes, the uterus remains flaccid and the patient continues to pass large clots. The nurse recognizes these signs as indicating:
- Uterine hypoplasia
- Uterine dysfunction
- Uterine atony
- Uterine dystocia.
Correct Answer

A. Uterine atony

Explanation

Uterine atony is a loss of tone in the uterine musculature. Normally, contraction of the uterine muscle compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. Thus, lack of uterine muscle contraction can cause an acute hemorrhage.

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7.

A newly postpartum client is going into hypovolemic shock as a result of uterine inversion. Which initial order should the nurse expect to implement to restore fluid volume?
- Increase the IV infusion rate
- Administer oxygen at 3 to 4L/min via nasal cannula
- Monitor heart rate every five minutes
- Administer an oxytoxic drug via IV
Correct Answer

A. Increase the IV infusion rate

Explanation

Increasing the rate of IV fluids is an effective initial measure necessary to replace lost fluid volume that occus in uterine inversion caused by hemorrhage. Blood products might also be necessary, but generally take some time to obtain from the blood bank. Oxygen would be given to increase perfussion to tissues, but does not restore circulating volume. An oxytocic drug will help to limit further bleeding, but will not limit the condition because it is an assessment rather than an intervention.

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8.

A type 1 diabetic gravida has developed polyhydramnios. The client should be taught to report which of the following?
- Marked fatigue.
- Reduced urinary output.
- Uterine contractions.
- Puerperal rash.
Correct Answer

A. Uterine contractions.

Explanation

Polyhydramnios is the excessive accumulation of amniotic fluid — the fluid that surrounds the baby in the uterus during pregnancy.

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9.

While assisting with the vaginal delivery of a fullterm newborn, a nurse observes that, in spite of the fact that the client did not have an episiotomy or a perineal laceration, her perineum and labia are edematous. To promote comfort and decrease the edema, which intervention is most appropriate?
- Applying an ice pack to the perineum
- Applying a warm pack
- Providing the client with a plastic donut cushion to be used when sitting
- Teaching the client to relax her buttocks before sitting in a chair
Correct Answer

A. Applying an ice pack to the perineum

Explanation

Applying an ice pack to the perineum is the most appropriate intervention to promote comfort and decrease the edema in this situation. Ice helps to reduce swelling and inflammation by constricting blood vessels and numbing the area. By applying an ice pack to the perineum, the nurse can help alleviate discomfort and reduce the edema in the client's perineum and labia. This intervention is commonly used after vaginal delivery to provide relief and promote healing.

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10.

Which assessment finding would lead a nurse to suspect that a client with a puerperal infection has developed peritonitis?
- Burning on urination
- Edema of the area.
- Rigid abdomen.
- Site tenderness.
Correct Answer

A. Rigid abdomen.

Explanation

Inflammation of the membrane lining the abdominal wall and covering the abdominal organs.

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11.

A postpartum client is being discharged to home with a streptococcal puerperal infection. The client is taking antibiotics but asks a nurse what precautions she should take at home to prevent spreading the infection to her husband, newborn, and toddler. Which is the best response by the nurse?
- “You need to perform hand hygiene before caring for your children and after toileting and perineal care.”
- “Your husband should provide all of the care for both children until your infection is gone.”
- “No precautions are necessary since you are taking antibiotics.”
- “You should wear a mask when caring for your newborn and toddler.”
Correct Answer

A. “You need to perform hand hygiene before caring for your children and after toileting and perineal care.”

Explanation

The best response by the nurse is to advise the client to perform hand hygiene before caring for her children and after toileting and perineal care. This is because hand hygiene is crucial in preventing the spread of infection. While taking antibiotics will help treat the infection, it does not eliminate the need for proper hand hygiene. Wearing a mask is not necessary unless the client is experiencing respiratory symptoms. Having the husband provide all the care for the children may not be practical or necessary if proper hand hygiene is practiced.

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12.

While assessing a postpartum client who is 10 hours post-vaginal delivery, a nurse notes a perineal pad that is totally saturated with lochia. To determine the significance of this finding, which question should the nurse ask the client first?
- “Have you passed any clots?”
- “When was the last time you changed your peri pad?”
- “Are you having uterine cramping?”
- “Are you having any difficulty emptying your bladder?”
Correct Answer

A. “When was the last time you changed your peri pad?”

Explanation

The nurse should ask the client when the last time they changed their perineal pad because this will provide information about the rate of bleeding. If the pad is saturated quickly after being changed, it could indicate excessive bleeding and may require further assessment and intervention. This question helps the nurse determine the significance of the finding and assess the client's postpartum bleeding.

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13.

What is the correct way to elicit Babinski's reflex on a newborn?
- Stroke the lateral sole on the side of the small toe toward and across the ball of the foot.
- Place a finger in each hand.
- Place a nipple in the neonate's mouth.
- Run a finger down the neonate's back.
Correct Answer

A. Stroke the lateral sole on the side of the small toe toward and across the ball of the foot.

Explanation

Babinski reflex is one of the normal reflexes in infants. Reflexes are responses that occur when the body receives a certain stimulus. The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

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14.

When palpating a neonate's anterior fontanel, which finding should the nurse consider normal?
- Bulging.
- Complete closure.
- Softness.
- Depression.
Correct Answer

A. Softness.

Explanation

The nurse should consider softness as a normal finding when palpating a neonate's anterior fontanel. The anterior fontanel is a soft spot on the baby's head where the skull bones have not yet fully fused. It is expected to feel soft and slightly sunken. Bulging, complete closure, and depression are not normal findings and may indicate abnormalities or health concerns.

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15.

A Caucasian postpartum client asks a nurse if the stretch marks (striae gravidarum) on her abdomen will ever go away. Which response by the nurse is most accurate?
- “Your stretch marks may become lighter in color if you keep that area of your skin hydrated.”
- “Your stretch marks should totally disappear over the next month.”
- “Your stretch marks will fade to pale white over the next 3 to 6 months.”
- “Your stretch marks will always appear raised and reddened.”
Correct Answer

A. “Your stretch marks will fade to pale white over the next 3 to 6 months.”

Explanation

The correct answer is "Your stretch marks will fade to pale white over the next 3 to 6 months." This is the most accurate response because stretch marks typically fade over time, becoming less noticeable and often turning pale white. It is important to note that while they may become less visible, they may not completely disappear. Keeping the skin hydrated can help lighten the color of the stretch marks, but it is not a guarantee that they will go away entirely.

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16.

A nurse is reviewing the record of a 15-hour-old newborn before beginning a physical assessment. The nurse notes the following labor history: “Mother positive for group B streptococcal (GBS) infection at 37 weeks gestation. Membranes ruptured at home 14 hours before mother presented to the hospital at 40 weeks gestation. Precipitous labor, no antibiotic given.” Considering this information, the nurse should observe the infant closely for:
- Pink stains in the diaper.
- Temperature instability.
- Meconium stools.
- Development of erythema toxicum.
Correct Answer

A. Temperature instability.

Explanation

Based on the labor history provided, the mother was positive for group B streptococcal (GBS) infection and did not receive antibiotics during labor. GBS infection can be transmitted to the newborn during delivery, and without antibiotic treatment, the newborn is at risk of developing an infection. One of the signs of infection in a newborn is temperature instability, which can manifest as either hypothermia or hyperthermia. Therefore, the nurse should closely observe the infant for temperature instability as a potential indicator of infection.

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17.

A patient G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2F. Which of the following is the appropriate nursing intervention at this time?
- Encourage intake of water and other fluids.
- Request an infectious disease consult from the doctor.
- Notify the doctor to get an order for acetaminophen.
- Provide the woman with cool compresses.
Correct Answer

A. Encourage intake of water and other fluids.

Explanation

A temperature of 100.2F is considered a low-grade fever and is a common occurrence after childbirth. Encouraging the intake of water and other fluids helps to prevent dehydration, which is important for the postpartum recovery process. It also helps to regulate body temperature. Therefore, encouraging fluid intake is an appropriate nursing intervention in this situation. Requesting an infectious disease consult or notifying the doctor for medication like acetaminophen is not necessary for a low-grade fever after childbirth. Providing cool compresses may provide temporary relief, but it does not address the underlying issue of dehydration.

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18.

A primiparous client, who is bottle feeding her infant, asks a nurse when she can expect to start having her menstrual cycle again. Which response by the nurse is most accurate?
- “Most women who bottle feed their infants can expect their periods to return within 6 to 10 weeks after birth.”
- “You will notice a change in your vaginal discharge from pink to white; once that happens your period should return within a week.”
- “Your period should return a few days after your lochial discharge stops.”
- “Bottle feeding will delay the return of a normal menstrual cycle until 6 months post-birth.”
Correct Answer

A. “Most women who bottle feed their infants can expect their periods to return within 6 to 10 weeks after birth.”

Explanation

The correct answer is "Most women who bottle feed their infants can expect their periods to return within 6 to 10 weeks after birth." This response is the most accurate because it provides a general timeframe for when the client can expect her menstrual cycle to return. It acknowledges that there may be some variation among individuals, but provides a reasonable estimate based on common experiences.

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19.

When assessing a client's lochia on the fifth postpartum day, what would a nurse expect to find?
- Lochia alba.
- Lochia rubra.
- Lochia serosa.
- Absence of lochia.
Correct Answer

A. Lochia serosa.

Explanation

On the fifth postpartum day, a nurse would expect to find lochia serosa when assessing a client's lochia. Lochia serosa is the third stage of lochia, which occurs around days 4-10 after childbirth. It is characterized by a pinkish-brown color and a thinner consistency compared to lochia rubra. This stage indicates the healing process of the uterus after childbirth. Lochia alba is the final stage, which occurs around days 10-14, and is characterized by a yellowish-white color. Absence of lochia would not be expected on the fifth postpartum day as it is a normal occurrence after childbirth.

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20.

Which observation of a client should lead a nurse to be concerned about the client’s attachment to her male infant?
- Repeatedly telling her husband that she wanted a girl
- Calling the baby by name
- Asking the licensed practical nurse (LPN) about how to change her infant’s diaper
- Comparing her baby’s nose to her brother’s nose
Correct Answer

A. Repeatedly telling her husband that she wanted a girl

Explanation

The client repeatedly telling her husband that she wanted a girl suggests that she may have a preference for a female child and may not be fully attached or accepting of her male infant. This could indicate a potential issue with the client's attachment to her baby and may warrant further assessment and support from the nurse.

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21.

Two hours after delivery, a mother, who is bottle feeding, tells a nurse that she experienced “terrible pain when my milk came in with my last baby.” The client asks if there is a way this can be prevented from happening after this birthing experience. Which response by the nurse is most appropriate?
- “Engorgement usually occurs immediately after birth, so if you don’t have it yet you probably won’t develop it.”
- “Development of engorgement is familial; if you had it with your last pregnancy there probably is no way to avoid it with this birth.”
- “Once you have recovered from the birth I will help you bind your breasts.”
- “You should put on a supportive bra as soon as possible and wear it continuously for the next 1 to 2 weeks.”
Correct Answer

A. “You should put on a supportive bra as soon as possible and wear it continuously for the next 1 to 2 weeks.”

Explanation

Engorgement is a common occurrence when a mother's milk comes in after delivery. Wearing a supportive bra can help alleviate the discomfort and prevent further engorgement. This response by the nurse is appropriate because it provides a practical solution to prevent or minimize the occurrence of engorgement.

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22.

During postpartum care, the nurse should:
- Take the client's temperature rectally after delivery.
- Be aware that the client's temperature may be lower than normal.
- Monitor vital signs every 4 hours after delivery.
- Suspect postpartum infection with any elevation in temperature above 100.4F after the first 24 hours.
Correct Answer

A. Suspect postpartum infection with any elevation in temperature above 100.4F after the first 24 hours.

Explanation

After delivery, it is important for the nurse to monitor the client's temperature and be aware that it may be lower than normal. However, the key point in this question is that any elevation in temperature above 100.4F after the first 24 hours should be a cause for suspicion of postpartum infection. This is because an elevated temperature can be a sign of infection, and postpartum women are at a higher risk for developing infections due to the changes that occur in their bodies during pregnancy and childbirth. Therefore, it is crucial for the nurse to be vigilant and monitor for any signs of infection in the postpartum client.

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23.

An abnormal direct Coombs test on a neonate indicates:
- Hypoxia.
- Jaundice.
- Anemia.
- Red blood cell destruction.
Correct Answer

A. Jaundice.

Explanation

The direct Coombs test is used to detect these antibodies or complement proteins that are bound to the surface of red blood cells; a blood sample is taken and the RBCs are washed (removing the patient's own plasma) and then incubated with anti-human globulin (also known as "Coombs reagent").

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24.

A common complication of fundal palpation and massage is:
- Soft, boggy uterus.
- A postpartum hemorrhage.
- Pain.
- Premature uterine contractions.
Correct Answer

A. Pain.

Explanation

Fundal palpation and massage are common techniques used to assess the uterus after childbirth. These techniques involve gently feeling and massaging the top part of the uterus to check for firmness and position. While pain may be experienced during these procedures, it is considered a common complication rather than a desired outcome. This pain can be caused by various factors such as uterine tenderness or sensitivity. It is important for healthcare providers to be gentle and considerate during fundal palpation and massage to minimize discomfort for the patient.

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25.

Which placental anomaly is the placenta deeply attached to the uterus?
- Battledore placenta
- Placenta circumvallata
- Placenta accreta
- Placenta succenturiata
Correct Answer

A. Placenta accreta

Explanation

Placenta accreta is a placental anomaly where the placenta is deeply attached to the uterus. In this condition, the placenta's villi attach too firmly to the uterine wall, making it difficult to separate during childbirth. This can lead to complications such as heavy bleeding after delivery. Placenta accreta is usually diagnosed during pregnancy and may require medical intervention or a planned cesarean delivery to minimize the risks associated with detachment.

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26.

A student nurse is assisting a registered nurse (RN) in the care of a postpartum client who is 48 hours post–vaginal delivery. The student reports finding a warm, red, tender area on the client’s left calf. The nurse assesses the client and explains to the student that postpartum clients are at increased risk for thrombophlebitis because of which of the following?
- The fibrinogen levels in the blood are decreased.
- Constriction of the veins in the lower extremities is present.
- Dilation of the common iliac vein occurs during pregnancy.
- The legs are elevated in stirrups at the time of delivery.
Correct Answer

A. The legs are elevated in stirrups at the time of delivery.

Explanation

The correct answer is "The legs are elevated in stirrups at the time of delivery." Elevating the legs in stirrups during delivery can cause venous stasis, which increases the risk of thrombophlebitis. Venous stasis occurs when blood flow slows down or stops, allowing blood to pool in the veins. This can lead to the formation of blood clots. Thrombophlebitis is the inflammation of a vein due to a blood clot, and postpartum clients are at increased risk due to factors such as hormonal changes, immobility, and trauma during delivery.

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27.

A nurse receives orders from a health-care provider for insertion of dinoprostone (Prepidil® ) for cervical ripening for four inpatient clients. For which client should the nurse question this order?
- Client A, who is G1P0000 and 41 weeks gestation
- Client C, who is a G1P0000, type 1 diabetic at 38 weeks gestation, with evidence of fetal macrosomia
- Client B, who is a G5P4004 at 40 and 42 weeks gestation
- Client D, who is a G2P1001 at 40 weeks gestation attempting a vaginal birth after cesarean section with the client’s other pregnancy
Correct Answer

A. Client D, who is a G2P1001 at 40 weeks gestation attempting a vaginal birth after cesarean section with the client’s other pregnancy

Explanation

Prepidil gel is a prostaglandin used for inducing labor in pregnant women at term or near term.
Contraindications include allergy to Prepidil ingredients, history of cessarean section, cephalopelvic disproportion present, fetal distress where delivery not imminent, history of difficult labor, nonvertex presentation, overactive uterus, if the client has had 6 or more previous term pregnancies, genital herpes, unexplained vaginal bleeding.

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28.

While working in a perinatal clinic, a nurse receives a phone call from a client who is 20 days postpartum. The client tells the nurse she has been having heavy, bright red bleeding since leaving the hospital 18 days ago. She is concerned and wonders what she should do. Which instruction to the client is correct?
- Call again next week if the bleeding has not stopped by then
- Stop being concerned because this is expected after birth
- Come to the clinic immediately
- Decrease physical activity until the bleeding stops
Correct Answer

A. Come to the clinic immediately

Explanation

The nurse should instruct the client to come to the clinic immediately because heavy, bright red bleeding 18 days postpartum is not normal and could indicate a postpartum complication. It is important for the nurse to assess the client's condition and provide appropriate care and treatment.

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29.

The nurse should warn a client who is about to receive Methergine (ergonovine) of which of the following side effects?
- Headache.
- Cramping.
- Fatigue.
- Nausea.
Correct Answer

A. Cramping.

Explanation

This medication is used after childbirth to help stop bleeding from the uterus. Methylergonovine belongs to a class of drugs known as ergot alkaloids. It works by increasing the rate and strength of contractions and the stiffness of the uterus muscles. These effects help to decrease bleeding.

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30.

Which statement about pulse and blood pressure in the postpartum period is true?
- Tachycardia is common during the first 6 to 10 days after delivery.
- Gestational hypertension does not occcur in the postpartum period.
- Rapid , thready pulse could indicate hemorrhage.
- Blood pressure is usually normotensive within 72 hours after delivery.
Correct Answer

A. Rapid , thready pulse could indicate hemorrhage.

Explanation

A rapid, thready pulse could indicate hemorrhage in the postpartum period. Hemorrhage is a potential complication after delivery, and a rapid, thready pulse may be a sign of excessive bleeding. It is important to monitor the pulse and other vital signs closely in the postpartum period to detect any signs of hemorrhage and take appropriate interventions.

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31.

Treatment for uterine inversion should include:
- Removal of the placenta if it is attached.
- Oxytocin (Pitocin) administration prior to manual replacement of the uterus.
- Preparation for hysterectomy.
- Postpartum antibiotic therapy.
Correct Answer

A. Postpartum antibiotic therapy.

Explanation

Postpartum antibiotic therapy is recommended as part of the treatment for uterine inversion. Uterine inversion is a rare but serious complication where the uterus turns inside out after childbirth. It can lead to severe bleeding and infection. Antibiotics are given to prevent or treat infection that may occur as a result of the inversion. The other options mentioned in the question, such as removal of the placenta, oxytocin administration, and preparation for hysterectomy, are also important components of the treatment for uterine inversion, but the specific answer requested is postpartum antibiotic therapy.

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32.

A nurse is assisting in the delivery of a term newborn. Immediately after delivery of the placenta, the nurse palpates the uterine fundus and finds that it is firm and located halfway between the client’s umbilicus and symphysis pubis. Which action should the nurse take based on the assessment findings?
- Assess for bladder distension.
- Document the findings.
- Immediately begin to massage the uterus.
- Monitor the client closely for increased vaginal bleeding.
Correct Answer

A. Document the findings.

Explanation

Based on the assessment findings, the nurse should document the findings. The firm and located halfway between the client's umbilicus and symphysis pubis indicates that the uterus is in a normal position and is adequately contracting. There is no indication of bladder distension or increased vaginal bleeding, so there is no immediate action required. Therefore, the nurse should document the findings for future reference and monitoring.

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33.

A neonate has an elevated bilirubin and is slightly jaundiced on day 3 of life. What is the probable reason for these changes?
- Hemolysis of neonatal red blood cells by the maternal antibodies.
- Pathological liver function resulting from hypoxemia during the birthing process.
- Delayed meconium excretion resulting in the production of direct bilirubin.
- Physiological destruction of fetal red blood cells during the extrauterine period.
Correct Answer

A. Physiological destruction of fetal red blood cells during the extrauterine period.

Explanation

The elevated bilirubin and slight jaundice in a neonate on day 3 of life is likely due to the physiological destruction of fetal red blood cells during the extrauterine period. This is a normal process that occurs as the neonate transitions from the intrauterine environment to the outside world. As fetal red blood cells break down, bilirubin is released, leading to jaundice. This is a common occurrence in newborns and usually resolves on its own without treatment. Hemolysis of neonatal red blood cells by maternal antibodies, pathological liver function, and delayed meconium excretion are not typically associated with jaundice in the neonatal period.

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34.

Which finding is most characteristic of a perineal hematoma?
- Lethargy.
- Positive Homan's sign.
- Fever.
- Severe vulvar pain.
Correct Answer

A. Severe vulvar pain.

Explanation

A perineal hematoma refers to the accumulation of blood in the perineal area, which is the region between the vagina and the anus. Severe vulvar pain is the most characteristic finding of a perineal hematoma because the hematoma causes pressure and swelling in the area, leading to intense discomfort and pain. Lethargy, positive Homan's sign, and fever are not specifically associated with a perineal hematoma and may indicate other medical conditions.

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35.

The clinic nurse receives a telephone call from a 7-day postpartum client who states she is having increased vaginal bleeding and asks if it is serious and what could be the cause. The nurse suspects which most common etiology of late-postpartum hemorrhage?
- Retained placental fragments
- Laceration
- Uterine atonyn
- Disseminated intravascular coagulopathy (DIC)
Correct Answer

A. Retained placental fragments

Explanation

Retained placental fragments are a cause of late-postpartum hemorrhage (which occurs anytime ater the first 24 hours post delivery). The retained fragments undergo necrosis, forming fibrin deposits. These deposits form polyps, which eventually detach from the myometrium, causing hemorrhage.
Uterine atony, DIC, and lacerations are causes of early postpartum hemorrhage.

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36.

A postpartum client, who delivered a full-term infant 2 days previously, calls a nurse to her room and states that she is concerned because her breasts “seem to be growing.” She reports that the bra she wore during pregnancy is too small. She asks the nurse what is wrong with her. The nurse’s response should be based on which of the following statements?
- Increasing breast tissue may be a sign of postpartum fluid retention.
- Breast tissue increases in the early postpartum period as milk forms.
- Enlarging breasts are a symptom of infection.
- Thrombi may form in veins of the breast and cause increased breast size.
Correct Answer

A. Breast tissue increases in the early postpartum period as milk forms.

Explanation

Breast tissue increases in the early postpartum period as milk forms. During pregnancy, the breasts undergo changes in preparation for breastfeeding. After delivery, the hormone prolactin stimulates milk production, causing the breast tissue to increase in size. This is a normal physiological process and not a cause for concern. It is important for the nurse to reassure the client that her breast growth is a normal part of postpartum recovery.

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37.

In which condition should a nursing priority be to administer oxygen, anticipate the need for an endotracheal tube intubation, and prepare for cardiopulmonary resuscitation?
- Amniotic fluid embolism
- Placental anomalies
- Uterine rupture
- Umbilical cord prolapse
Correct Answer

A. Amniotic fluid embolism

Explanation

Amniotic fluid embolism is a life-threatening condition where amniotic fluid enters the maternal bloodstream, causing a severe allergic reaction. This can lead to respiratory distress, cardiac arrest, and ultimately, death. Administering oxygen is crucial to support the patient's oxygenation. Anticipating the need for endotracheal tube intubation is important because the patient may develop respiratory failure and require mechanical ventilation. Preparing for cardiopulmonary resuscitation is necessary as the patient's condition can rapidly deteriorate, leading to cardiac arrest. Therefore, in the case of amniotic fluid embolism, these interventions are nursing priorities to ensure the patient's survival.

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38.

The husband of a postpartum client, who has been diagnosed with postpartum depression (PPD), is concerned and asks a nurse what kind of treatment his wife will require. The nurse’s response should be based on the knowledge that the collaborative plan of care for PPD includes which of the following?
- Hypnotic agents and psychotherapy
- Psychotherapy alone
- Antidepressant medications and psychotherapy
- Removal of the infant from the home
Correct Answer

A. Antidepressant medications and psychotherapy

Explanation

The collaborative plan of care for postpartum depression (PPD) includes the use of antidepressant medications and psychotherapy. Antidepressant medications help to alleviate the symptoms of depression, while psychotherapy provides emotional support and helps the client develop coping strategies. This combination approach has been found to be effective in treating PPD. Hypnotic agents may not be appropriate for treating PPD, as they are typically used for sleep disorders and not specifically for depression. Removing the infant from the home is not a recommended treatment for PPD.

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39.

Which action is appropriate for a client who is breast-feeding?
- Establishing a feeding schedule of every 2 hours initially and then every 3 to 4 hours.
- Washing the breasts after each feeding with warm soapy water and then patting them dry.
- Having the neonate begin the breast feeding on the breast last used for the previous feeding.
- Wearing a loose-fitting bra tha can be closed in the front instead of the back.
Correct Answer

A. Having the neonate begin the breast feeding on the breast last used for the previous feeding.

Explanation

It is appropriate for a breastfeeding client to have the neonate begin breastfeeding on the breast last used for the previous feeding. This helps to ensure that both breasts are emptied and that the baby receives a balanced amount of milk from each breast. It also helps to stimulate milk production and prevent engorgement.

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40.

A nurse is caring for a 26-week-pregnant client who has been admitted twice in the past week for preterm labor. A physician orders corticosteroid therapy as a means to assist with fetal lung maturation. The nurse should anticipate that the medication and dosage to be ordered should be:
- Methylprednisolone (Medrol® ) 40 mg IM weekly until 34 weeks.
- Prednisone (Deltasone® ) 12 mg IM every 24 hours for 2 doses.
- Dexamethasone (Decadron® ) 6 mg IM every 12 hours for 4 doses.
- Betamethasone (Celestone® ) 12 mg IM every 24 hours for 2 doses.
Correct Answer

A. Betamethasone (Celestone® ) 12 mg IM every 24 hours for 2 doses.

Explanation

The correct answer is betamethasone (Celestone®) 12 mg IM every 24 hours for 2 doses. This medication and dosage are commonly used for antenatal corticosteroid therapy to promote fetal lung maturation in preterm labor. The administration of betamethasone helps to accelerate the production of surfactant in the fetal lungs, reducing the risk of respiratory distress syndrome and other complications associated with premature birth. The timing and dosage of the medication are important to ensure its effectiveness in improving neonatal outcomes.

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41.

Which medication is administered to a neonate prophylactically to prevent a transient deficiency of coagulation factors?
- Vitamin E
- Erythromycin
- Tetracycline
- Vitamin K
Correct Answer

A. Vitamin K

Explanation

Vitamin K is administered to a neonate prophylactically to prevent a transient deficiency of coagulation factors. This is because newborns have low levels of vitamin K, which is necessary for blood clotting. Administering vitamin K helps prevent bleeding disorders in neonates.

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42.

A Muslim woman requets something to eat after the delivery of her baby. Which of the following meals would be most appropriate for the nurse to give her?
- Spaghetti and sausage.
- Chicken and dumplings
- Bacon and eggs
- Ham sandwich
Correct Answer

A. Chicken and dumplings

Explanation

Chicken and dumplings would be the most appropriate meal for the nurse to give the Muslim woman after the delivery of her baby. This is because chicken and dumplings is a dish that does not contain any pork, which is forbidden in Islam. Since the woman is Muslim, it is important to consider her dietary restrictions and provide her with a meal that aligns with her religious beliefs.

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43.

A nurse enters the room of a postpartum client who delivered a healthy newborn 36 hours previously. The nurse finds the client crying. When asked what is wrong, the client replies, “Nothing really. I’m not in pain or anything but I just seem to cry a lot for no reason.” Based on this information, what should be the nurse’s first intervention?
- Ask the client to discuss her birth experience.
- Remind the client that she has a healthy baby and there is nothing to cry about.
- Call the health-care provider (HCP) immediately and report the incidence.
- Call the client’s support person to come and sit with her.
Correct Answer

A. Ask the client to discuss her birth experience.

Explanation

The nurse should ask the client to discuss her birth experience because the client's crying for no reason may indicate postpartum blues or postpartum depression. By allowing the client to talk about her birth experience, the nurse can assess her emotional well-being and determine if further intervention or support is needed. It is important for the nurse to provide a safe and supportive environment for the client to express her feelings and concerns.

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44.

Which finding would a nurse expect in a client with endometritis?
- Tachycardia.
- Burning on urination.
- Heavy, foul smelling lochia.
- Abdominal pain and tenderness.
Correct Answer

A. Heavy, foul smelling lochia.

Explanation

A nurse would expect heavy, foul smelling lochia in a client with endometritis. Endometritis is an infection of the lining of the uterus, which can cause an increase in the amount of lochia (postpartum vaginal discharge) and a foul odor. Other symptoms of endometritis may include abdominal pain and tenderness, but heavy, foul smelling lochia is a characteristic finding. Tachycardia (rapid heart rate) and burning on urination are not specific to endometritis and may indicate other conditions.

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45.

A pregnant client is concerned because she is now 14 days over her due date. A nurse should monitor the client for which most concerning problem for a post-term fetus?
- Macrosomia
- Birth trauma
- Meconium-stained amniotic fluid
- Fetal demise
Correct Answer

A. Fetal demise

Explanation

The most concerning problem for a post-term fetus is fetal demise, which refers to the death of the fetus before or during delivery. When a pregnancy goes beyond the due date, the placenta may not function as effectively, leading to decreased oxygen and nutrient supply to the fetus. This can result in fetal distress and ultimately fetal demise. It is important for the nurse to closely monitor the client in order to identify any signs of fetal distress and take appropriate actions to ensure the well-being of the fetus.

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46.

A breastfeeding client is being seen in the emergency department with a hard, red, warm nodule in the upper outer quadrant of her left breast. Her vital signs are: T:104.6F, P 100, R 20, and BP 110/60. She has a recent history of mastitis and is crying in pain. Which of the following nursing diagnoses is highest priority?
- Infection
- Pain
- Ineffective breastfeeding
- Ineffective individual coping
Correct Answer

A. Infection

Explanation

The nursing diagnosis of "Infection" is the highest priority because the client's symptoms, including a hard, red, warm nodule in the breast, a high temperature of 104.6F, and a recent history of mastitis, indicate a possible infection. Infections can quickly worsen and lead to serious complications if not treated promptly. Therefore, addressing the infection should be the priority to prevent further harm to the client and promote healing.

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47.

While assisting with the delivery of a term newborn, which intervention should a nurse anticipate to prevent postpartum hemorrhage during the third stage of labor?
- Application of fundal pressure
- Administration of subcutaneous terbutaline sulfate (Brethine® )
- Clamping the umbilical cord before pulsations stop
- Administration of intravenous oxytocin (Pitocin® )
Correct Answer

A. Administration of intravenous oxytocin (Pitocin® )

Explanation

During the third stage of labor, the nurse should anticipate administering intravenous oxytocin (Pitocin®) to prevent postpartum hemorrhage. Oxytocin is a hormone that stimulates uterine contractions, which helps the uterus to contract and control bleeding after delivery. By administering oxytocin, the nurse can help ensure that the uterus contracts effectively, reducing the risk of excessive bleeding. The other interventions listed, such as fundal pressure, subcutaneous terbutaline sulfate, and clamping the umbilical cord before pulsations stop, are not appropriate interventions for preventing postpartum hemorrhage during the third stage of labor.

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48.

When inspecting the umbilical cord, a nurse should identify the presence of:
- One artery and two veins.
- One artery and one vein.
- One artery and one ligament.
- Two arteries and one vein.
Correct Answer

A. Two arteries and one vein.

Explanation

When inspecting the umbilical cord, a nurse should identify the presence of two arteries and one vein. This is because the umbilical cord contains blood vessels that connect the fetus to the placenta. The two arteries carry deoxygenated blood from the fetus to the placenta, while the one vein carries oxygenated blood from the placenta to the fetus. It is important for the nurse to identify these blood vessels correctly to ensure the proper functioning and health of the newborn.

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49.

While caring for a small for gestational age newborn (SGA), a nurse notes slight tremors of the extremities, a high-pitched cry, and an exaggerated Moro reflex. In response to these assessment findings, what should be the nurse’s first action?
- Document the findings in the infant’s medical record
- Assess the infant’s blood sugar level
- Assess the infant’s temperature
- Immediately inform the health-care provider of the symptoms
Correct Answer

A. Assess the infant’s blood sugar level

Explanation

The correct answer is to assess the infant's blood sugar level. Slight tremors of the extremities, a high-pitched cry, and an exaggerated Moro reflex are signs of hypoglycemia in a newborn. Assessing the infant's blood sugar level is important to determine if the baby is experiencing low blood sugar levels, which can be life-threatening if not treated promptly.

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Mar 22, 2023

Quiz Edited by
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Dec 03, 2015

Quiz Created by
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Its About Women Health Quiz

After delivering a full-term infant, a breastfeeding mother, who is preparing for discharge, asks a nurse if there is any type of contraceptive method that should be avoided while she is breastfeeding. Which contraceptive should the nurse advise the client to avoid?

Quiz Preview

A postpartum client, who is 24 hours post-vaginal birth and breastfeeding, asks a nurse when she can begin exercising to regain her prepregnancy body shape. Which response by the nurse is correct?

A nurse walks into the room of a postpartum client and observes her looking in the mirror at her abdomen. The client says, “My stomach still looks like I’m pregnant!” The nurse explains that the abdominal muscles, which separate during pregnancy, will do which of the following?

A nurse has been given a report on a postpartum client that includes the information that the client suffered a fourth-degree perineal laceration during her vaginal birth. In response to this information, which intervention should the nurse add to the client’s plan of care?

Twenty-four hours post–vaginal delivery, a postpartum client tells a nurse that she is concerned because she has not had a bowel movement since before delivery. In response to this information, the nurse should intervene by doing which of the following?

Although the nurse has massaged the uterus every 15 minutes, the uterus remains flaccid and the patient continues to pass large clots. The nurse recognizes these signs as indicating:

A newly postpartum client is going into hypovolemic shock as a result of uterine inversion. Which initial order should the nurse expect to implement to restore fluid volume?

A type 1 diabetic gravida has developed polyhydramnios. The client should be taught to report which of the following?

While assisting with the vaginal delivery of a fullterm newborn, a nurse observes that, in spite of the fact that the client did not have an episiotomy or a perineal laceration, her perineum and labia are edematous. To promote comfort and decrease the edema, which intervention is most appropriate?

Which assessment finding would lead a nurse to suspect that a client with a puerperal infection has developed peritonitis?

A postpartum client is being discharged to home with a streptococcal puerperal infection. The client is taking antibiotics but asks a nurse what precautions she should take at home to prevent spreading the infection to her husband, newborn, and toddler. Which is the best response by the nurse?

While assessing a postpartum client who is 10 hours post-vaginal delivery, a nurse notes a perineal pad that is totally saturated with lochia. To determine the significance of this finding, which question should the nurse ask the client first?

What is the correct way to elicit Babinski's reflex on a newborn?

When palpating a neonate's anterior fontanel, which finding should the nurse consider normal?

A Caucasian postpartum client asks a nurse if the stretch marks (striae gravidarum) on her abdomen will ever go away. Which response by the nurse is most accurate?

A patient G2 P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2F. Which of the following is the appropriate nursing intervention at this time?

A primiparous client, who is bottle feeding her infant, asks a nurse when she can expect to start having her menstrual cycle again. Which response by the nurse is most accurate?

When assessing a client's lochia on the fifth postpartum day, what would a nurse expect to find?

Which observation of a client should lead a nurse to be concerned about the client’s attachment to her male infant?

During postpartum care, the nurse should:

An abnormal direct Coombs test on a neonate indicates:

A common complication of fundal palpation and massage is:

Which placental anomaly is the placenta deeply attached to the uterus?

A nurse receives orders from a health-care provider for insertion of dinoprostone (Prepidil® ) for cervical ripening for four inpatient clients. For which client should the nurse question this order?

The nurse should warn a client who is about to receive Methergine (ergonovine) of which of the following side effects?

Which statement about pulse and blood pressure in the postpartum period is true?

Treatment for uterine inversion should include:

A neonate has an elevated bilirubin and is slightly jaundiced on day 3 of life. What is the probable reason for these changes?

Which finding is most characteristic of a perineal hematoma?

The clinic nurse receives a telephone call from a 7-day postpartum client who states she is having increased vaginal bleeding and asks if it is serious and what could be the cause. The nurse suspects which most common etiology of late-postpartum hemorrhage?

In which condition should a nursing priority be to administer oxygen, anticipate the need for an endotracheal tube intubation, and prepare for cardiopulmonary resuscitation?

Which action is appropriate for a client who is breast-feeding?

A nurse is caring for a 26-week-pregnant client who has been admitted twice in the past week for preterm labor. A physician orders corticosteroid therapy as a means to assist with fetal lung maturation. The nurse should anticipate that the medication and dosage to be ordered should be:

Which medication is administered to a neonate prophylactically to prevent a transient deficiency of coagulation factors?

A Muslim woman requets something to eat after the delivery of her baby. Which of the following meals would be most appropriate for the nurse to give her?

Which finding would a nurse expect in a client with endometritis?

A pregnant client is concerned because she is now 14 days over her due date. A nurse should monitor the client for which most concerning problem for a post-term fetus?

While assisting with the delivery of a term newborn, which intervention should a nurse anticipate to prevent postpartum hemorrhage during the third stage of labor?

When inspecting the umbilical cord, a nurse should identify the presence of:

While caring for a small for gestational age newborn (SGA), a nurse notes slight tremors of the extremities, a high-pitched cry, and an exaggerated Moro reflex. In response to these assessment findings, what should be the nurse’s first action?