Its About Women Health Quiz

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  • 1/75 Questions

    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.
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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. 

    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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  • 3. 

    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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  • 4. 

    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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  • 5. 

    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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  • 6. 

    What term is used to describe the white, cheesy protective coating composed of desquamated epithelial cells and sebum?

    • Vernix caseosa.

    • Telangiectasia.

    • Mongolian spots.

    • Nevus vasculosis.

    Correct Answer
    A. Vernix caseosa.
    Explanation
    Vernix caseosa is the correct answer because it is the term used to describe the white, cheesy protective coating that covers the skin of newborn babies. It is composed of desquamated epithelial cells and sebum, and it helps to protect the baby's skin from the amniotic fluid while in the womb.

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  • 7. 

    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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  • 8. 

    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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  • 9. 

    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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  • 10. 

    The postpartum nurse would use which therapeutic measure to help prevent a urinary tract infection (UTI) in an assigned client who has just delivered an infant?

    • Encourage fluids to 3000 mL per day

    • Discourage voiding until the bladder regains the sensation of being full

    • Encourage the intake of orange, grapefruit, or apple juice

    • Promote bedrest for 12 hours postdelivery

    Correct Answer
    A. Encourage fluids to 3000 mL per day
    Explanation
    Adequate fluid intake (up to 3000 ml per day) prevents urinary stasis, dilutes urine, and flushes out waste products, all of which help to prevent UTI. Bedrest is of no value in preventing UTI.

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  • 11. 

    Four pregnant women advise the nurse that they wish to breastfeed their babies.  Which of the mothers should be advised to bottle feed her child.

    • The woman with a neoplasm requiring chemotherapy.

    • The woman with thrombosis.

    • The woman with a concussion.

    • The woman with cholecystitis requiring surgery.

    Correct Answer
    A. The woman with a neoplasm requiring chemotherapy.
    Explanation
    The woman with a neoplasm requiring chemotherapy should be advised to bottle feed her child because chemotherapy drugs can be passed through breast milk and may harm the baby. It is safer for the baby to be bottle fed in this situation to avoid any potential risks.

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  • 12. 

    When caring for a postpartum family, a nurse determines that paternal engrossment is occurring when the newborn’s father is observed:

    • Talking to his newborn from across the room.

    • Discussing the similarity between his ears and the newborn’s ears.

    • Being hesitant to touch his newborn.

    • Expressing feelings of frustration when the infant cries.

    Correct Answer
    A. Discussing the similarity between his ears and the newborn’s ears.
    Explanation
    Paternal engrossment refers to the process in which a father develops a strong emotional bond and attachment to his newborn. Discussing the similarity between his ears and the newborn's ears indicates that the father is actively engaging with the baby and showing an interest in their physical features. This behavior demonstrates a level of emotional connection and involvement, which is a characteristic of paternal engrossment.

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  • 13. 

    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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  • 14. 

    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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  • 15. 

    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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  • 16. 

    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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  • 17. 

    The postpartum nurse who is reviewing the client assignment determines that which client is at greatest risk for early postpartum hemorrhage?

    • A client with endometritis

    • A client who is 17 years old

    • A client with an infant weighing 5 pounds, 7 ounces

    • A client with uterine atony

    Correct Answer
    A. A client with uterine atony
    Explanation
    Uterine atony accounts for 80 to 90% of all early (within first 24 hours) hemorrhage. The client's age does not increase the incidence of postpartum hemorrhage. Endometritis could cause late postpartm hemorrhage, not early postpartum hemorrhage.

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  • 18. 

    Which point should be included when teaching a mother who is HIV positive?

    • Breast feeding is contraindicated.

    • Contraceptive use is discouraged.

    • Intrauterine devices are the best method for an HIV-positive mother.

    • Direct mother-neonate contact should be avoided.

    Correct Answer
    A. Breast feeding is contraindicated.
    Explanation
    When teaching a mother who is HIV positive, it is important to include the information that breastfeeding is contraindicated. This means that the mother should not breastfeed her baby because HIV can be transmitted through breast milk. Instead, she should be advised to use formula feeding as a safe alternative to ensure that the baby does not become infected with HIV.

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  • 19. 

    A nurse is caring for a postpartum client who is 15 years old. The nurse has concerns about this client’s ability to parent a newborn because the nurse recognizes that developmentally the client is:

    • Developing autonomy.

    • Egocentric.

    • Career oriented.

    • Motivated to follow rules established by outside sources.

    Correct Answer
    A. Egocentric.
    Explanation
    The nurse recognizes that the client is egocentric because egocentrism is a characteristic of adolescence where individuals tend to be self-centered and focused on their own thoughts and feelings. This may pose a challenge when it comes to parenting a newborn as the client may struggle to prioritize the needs and well-being of the baby over their own.

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  • 20. 

    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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  • 21. 

    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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  • 22. 

    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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  • 23. 

    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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  • 24. 

    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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  • 25. 

    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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  • 26. 

    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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  • 27. 

    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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  • 28. 

    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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  • 29. 

    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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  • 30. 

    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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  • 31. 

    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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  • 32. 

    Which statement about nutrition in the postpartum period is true? 

    • The client should eat low-fiber foods.

    • The client shoud maintainn a high-carbohydrate diet.

    • The client should increase protein and caloric intake.

    • The client should expect a decrease in thirst.

    Correct Answer
    A. The client should increase protein and caloric intake.
    Explanation
    In the postpartum period, it is important for the client to increase their protein and caloric intake. This is because the body requires additional energy and nutrients for recovery and breastfeeding. Protein is essential for tissue repair and growth, while an increase in calories helps to meet the increased energy demands. Therefore, increasing protein and caloric intake is crucial for the client's overall health and well-being during this period.

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  • 33. 

    Which statement describes immunoglobulin G?

    • It is found in colostrum and breast milk.

    • It is not detectable at birth and does not cross the placenta.

    • It is synthesized by the 20th week of gestation.

    • It is placentally transferred and provides the neonate with anti-bodies to bacterial and viral agents.

    Correct Answer
    A. It is placentally transferred and provides the neonate with anti-bodies to bacterial and viral agents.
    Explanation
    Immunoglobulin G (IgG) is a type of antibody that is placentally transferred from the mother to the fetus during pregnancy. This transfer allows the neonate to acquire antibodies against bacterial and viral agents, providing passive immunity in the early stages of life. Unlike the other options, IgG is detectable at birth and crosses the placenta. It is synthesized by the mother and transferred to the fetus, offering protection against various pathogens.

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  • 34. 

    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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  • 35. 

    A postpartum client, who had a forceps-assisted vaginal birth 4 hours ago, calls a nurse to her room to report continuing perineal pain rated at 7 out of 10 on a numeric scale and rectal pressure, even though an oral analgesic was given and ice applied to the perineum. Considering this information, what should be the nurse’s next  intervention?

    • Administer a stool softener

    • Call the health-care provider (HCP) to report the pain level

    • Encourage ambulation

    • Closely reinspect the perineum

    Correct Answer
    A. Closely reinspect the perineum
    Explanation
    The correct answer is to closely reinspect the perineum. The client's report of continuing perineal pain and rectal pressure after receiving analgesic medication and ice application suggests that there may be an underlying issue with the perineum. By closely reinspect the perineum, the nurse can assess for any signs of trauma, infection, or other complications that may be causing the pain and pressure. This will help guide further interventions and ensure the client's well-being.

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  • 36. 

    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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  • 37. 

    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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  • 38. 

    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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  • 39. 

    A registered nurse (RN) is caring for a postpartum client who is 16 hours postdelivery. A student nurse is assisting with the care. The RN evaluates that the student needs more education about uterine assessment when the student is observed doing which of the following?

    • Observing the abdomen before beginning palpation.

    • Supporting the lower uterine segment during the assessment.

    • Elevating the client’s head 30 degrees before beginning the assessment.

    • Gently palpating the uterine fundus.

    Correct Answer
    A. Elevating the client’s head 30 degrees before beginning the assessment.
    Explanation
    The correct answer is "Elevating the client’s head 30 degrees before beginning the assessment." This is because elevating the client's head 30 degrees is not necessary for uterine assessment. It does not affect the palpation of the fundus or the assessment of the lower uterine segment. Therefore, the student nurse needs more education about this aspect of uterine assessment.

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  • 40. 

    A nurse is planning the care of a 2-hour-old infant at 38 weeks gestation whose mother has type 1 diabetes mellitus. The nurse writes the following NANDA diagnosis: “Altered Nutrition: less than body requirements” and appropriately adds which “related to” statement?

    • Increased amounts of body water

    • Increased glucose metabolism secondary to hyperinsulinemia

    • Decreased amounts of total body fat secondary to decreased growth hormone

    • Decreased amounts of red blood cells secondary to low erythropoietin levels

    Correct Answer
    A. Increased glucose metabolism secondary to hyperinsulinemia
    Explanation
    The nurse appropriately adds the "related to" statement of "Increased glucose metabolism secondary to hyperinsulinemia" because infants born to mothers with type 1 diabetes mellitus are at risk for developing hyperinsulinemia due to exposure to high levels of glucose in utero. Hyperinsulinemia can lead to increased glucose metabolism and utilization by the infant's body, which can result in altered nutrition and decreased body requirements.

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  • 41. 

    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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  • 42. 

    A postpartum client, who is 24 hours postcesarean section, tells a nurse that she has had much less lochial discharge after this birth than she had with her vaginal birth 2 years ago. The client asks the nurse if this is a normal response to a cesarean birth. Which statement should be the basis for the nurse’s response?

    • A decrease in lochia is not expected after cesarean section and further assessment is needed.

    • Women normally have less lochia after cesarean births.

    • Women usually have increased lochial discharge after cesarean births.

    • The amount of lochial discharge after cesarean section is related to method of placental delivery and whether the surgery was emergent or planned.

    Correct Answer
    A. Women normally have less lochia after cesarean births.
    Explanation
    Women normally have less lochia after cesarean births. This is because during a cesarean section, the uterus is manually emptied, reducing the amount of blood and tissue that needs to be expelled postpartum. Additionally, the incision made during the surgery may result in less uterine contractions, which can also decrease the amount of lochia. It is important for the nurse to provide this information to the client to reassure her that her experience is normal and expected.

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  • 43. 

    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

    Correct Answer
    A. The combined oral contraceptive (COC) pill
    Explanation
    birth control pill containing progesterone and estrogen COC can cause a decrease in milk volume and might affect the quality of milk.

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  • 44. 

    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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  • 45. 

    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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  • 46. 

    The nurse is preparing for beginning of the shift rounds on assigned postpartum clients.  After reviewing the assignment, the nurse plans to assess for hematoma formation in which client, who is at greatest risk for this complication?

    • A 26-year-old client with gestational diabetes and forceps.

    • A 17-year-old client who gave birth to a small-for gestational age infant.

    • 35-year-old client having twins.

    • A 40-year-old client having her first infant.

    Correct Answer
    A. A 26-year-old client with gestational diabetes and forceps.
    Explanation
    A hematoma is a collection of blood in the pelvic tissue caused by damage to a blood vessel wall without tissue laceration. A client with gestational diabetes is more prone to have a large infant that could cause tissue trauma during delivery. This client was also delivered with forceps, which is another high-risk factor for developing a postpartum hematoma. Increasing maternal age and delivery of an SGA infant do not increase risk of hematoma formation.

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  • 47. 

    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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  • 48. 

    On the second postpartum day, where would a nurse expect to palpate the fundus?

    • 2 cm above the umbillicus.

    • At the level of the umbillicus.

    • 1 cm below the umbillicus.

    • 2 cm below the umbillicus.

    Correct Answer
    A. 2 cm below the umbillicus.
    Explanation
    On the second postpartum day, a nurse would expect to palpate the fundus 2 cm below the umbilicus. This is because after childbirth, the fundus (the top portion of the uterus) gradually descends as the uterus involutes and returns to its pre-pregnancy size. By the second postpartum day, the fundus should be located approximately 2 cm below the umbilicus as it continues to shrink.

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  • 49. 

    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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Quiz Review Timeline (Updated): Mar 22, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Dec 03, 2015
    Quiz Created by
    Deysirill

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