Question 1

Which is the initial treatment for the client diagnosed with von Willebrand disease (vWD)who experiences a postpartum hemorrhage (PPH)?

Accepted Answer

A)  Cryoprecipitate 
B)  Factor VIII and von Willebrand factor (vWf) 
C)  Desmopressin 
D)  Hemabate 
A)  Cryoprecipitate 
B)  Factor VIII and von Willebrand factor (vWf) 
C)  Desmopressin 
D)  Hemabate C

Question 2

What is one of the initial signs and symptoms of puerperal infection in the postpartum client?

Accepted Answer

A)  Fatigue continuing for longer than 1 week 
B)  Pain with voiding 
C)  Profuse vaginal lochia with ambulation 
D)  Temperature of 38° C (100.4° F)or higher on 2 successive days 
A)  Fatigue continuing for longer than 1 week 
B)  Pain with voiding 
C)  Profuse vaginal lochia with ambulation 
D)  Temperature of 38° C (100.4° F)or higher on 2 successive days D

Question 3

What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?

Accepted Answer

A)  Uterine atony 
B)  Lacerations of the genital tract 
C)  Perineal hematoma 
D)  Infection of the uterus 
A)  Uterine atony 
B)  Lacerations of the genital tract 
C)  Perineal hematoma 
D)  Infection of the uterus B

Question 4

Which condition is considered a medical emergency that requires immediate treatment?

Accepted Answer

A)  Inversion of the uterus 
B)  Hypotonic uterus 
C)  Idiopathic thrombocytopenic purpura (ITP) 
D)  Uterine atony 
A)  Inversion of the uterus 
B)  Hypotonic uterus 
C)  Idiopathic thrombocytopenic purpura (ITP) 
D)  Uterine atony

Question 5

The nurse suspects that her postpartum client is experiencing hemorrhagic shock.Which observation indicates or would confirm this diagnosis?

Accepted Answer

A)  Absence of cyanosis in the buccal mucosa 
B)  Cool,dry skin 
C)  Calm mental status 
D)  Urinary output of at least 30 ml/hr 
A)  Absence of cyanosis in the buccal mucosa 
B)  Cool,dry skin 
C)  Calm mental status 
D)  Urinary output of at least 30 ml/hr

Question 6

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the client is experiencing profuse bleeding.What is the most likely cause for this bleeding?

Accepted Answer

A)  Uterine atony 
B)  Uterine inversion 
C)  Vaginal hematoma 
D)  Vaginal laceration 
A)  Uterine atony 
B)  Uterine inversion 
C)  Vaginal hematoma 
D)  Vaginal laceration

Question 7

Which medications are used to manage postpartum hemorrhage (PPH)? (Select all that apply. )

Accepted Answer

A)  Oxytocin 
B)  Methergine 
C)  Terbutaline 
D)  Hemabate 
E)  Magnesium sulfate 
A)  Oxytocin 
B)  Methergine 
C)  Terbutaline 
D)  Hemabate 
E)  Magnesium sulfate

Question 8

Which classification of placental separation is not recognized as an abnormal adherence pattern?

Accepted Answer

A)  Placenta accreta 
B)  Placenta increta 
C)  Placenta percreta 
D)  Placenta abruptio 
A)  Placenta accreta 
B)  Placenta increta 
C)  Placenta percreta 
D)  Placenta abruptio

Question 9

Lacerations of the cervix,vagina,or perineum are also causes of postpartum hemorrhage (PPH).Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply. )

Accepted Answer

A)  Operative and precipitate births 
B)  Adherent retained placenta 
C)  Abnormal presentation of the fetus 
D)  Congenital abnormalities of the maternal soft tissue 
E)  Previous scarring from infection 
A)  Operative and precipitate births 
B)  Adherent retained placenta 
C)  Abnormal presentation of the fetus 
D)  Congenital abnormalities of the maternal soft tissue 
E)  Previous scarring from infection

Question 10

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Accepted Answer

A)  Establishing venous access 
B)  Performing fundal massage 
C)  Preparing the woman for surgical intervention 
D)  Catheterizing the bladder 
A)  Establishing venous access 
B)  Performing fundal massage 
C)  Preparing the woman for surgical intervention 
D)  Catheterizing the bladder

Question 11

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

Accepted Answer

A)  Primiparous woman (G 2,P 1-0-0-1)being prepared for an emergency cesarean birth for fetal distress 
B)  Woman with severe preeclampsia on magnesium sulfate whose labor is being induced 
C)  Multiparous woman (G 3,P 2-0-0-2)with an 8-hour labor 
D)  Primigravida in spontaneous labor with preterm twins 
A)  Primiparous woman (G 2,P 1-0-0-1)being prepared for an emergency cesarean birth for fetal distress 
B)  Woman with severe preeclampsia on magnesium sulfate whose labor is being induced 
C)  Multiparous woman (G 3,P 2-0-0-2)with an 8-hour labor 
D)  Primigravida in spontaneous labor with preterm twins

Question 12

Nurses need to understand the basic definitions and incidence data regarding post-partum hemorrhage (PPH).Which statement regarding this condition is most accurate?

Accepted Answer

A)  PPH is easy to recognize early;after all,the woman is bleeding. 
B)  Traditionally,it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH. 
C)  If anything,nurses and physicians tend to overestimate the amount of blood loss. 
D)  Traditionally,PPH has been classified as early PPH or late PPH with respect to birth. 
A)  PPH is easy to recognize early;after all,the woman is bleeding. 
B)  Traditionally,it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH. 
C)  If anything,nurses and physicians tend to overestimate the amount of blood loss. 
D)  Traditionally,PPH has been classified as early PPH or late PPH with respect to birth.

Question 13

If nonsurgical treatment for late postpartum hemorrhage (PPH)is ineffective,which surgical procedure would be appropriate to correct the cause of this condition?

Accepted Answer

A)  Hysterectomy 
B)  Laparoscopy 
C)  Laparotomy 
D)  Dilation and curettage (D&
C)  
A)  Hysterectomy 
B)  Laparoscopy 
C)  Laparotomy 
D)  Dilation and curettage (D&
C)

Question 14

What is the most common reason for late postpartum hemorrhage (PPH)?

Accepted Answer

A)  Subinvolution of the uterus 
B)  Defective vascularity of the decidua 
C)  Cervical lacerations 
D)  Coagulation disorders 
A)  Subinvolution of the uterus 
B)  Defective vascularity of the decidua 
C)  Cervical lacerations 
D)  Coagulation disorders

Question 15

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy for the nurse to adopt?

Accepted Answer

A)  Large doses of vitamin C during pregnancy 
B)  Prophylactic antibiotics 
C)  Strict aseptic technique by all health care personnel 
D)  Limited protein and fat intake 
A)  Large doses of vitamin C during pregnancy 
B)  Prophylactic antibiotics 
C)  Strict aseptic technique by all health care personnel 
D)  Limited protein and fat intake

Question 16

A woman who has recently given birth reports pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.Which condition should the nurse suspect,and how will it be confirmed?

Accepted Answer

A)  Disseminated intravascular coagulation (DI
C) ;asking for laboratory tests 
B)  von Willebrand disease (vW
D) ;noting whether bleeding times have been extended 
C)  Thrombophlebitis;using real-time and color Doppler ultrasound 
D)  Idiopathic or immune thrombocytopenic purpura (ITP);drawing blood for laboratory analysis 
A)  Disseminated intravascular coagulation (DI
C) ;asking for laboratory tests 
B)  von Willebrand disease (vW
D) ;noting whether bleeding times have been extended 
C)  Thrombophlebitis;using real-time and color Doppler ultrasound 
D)  Idiopathic or immune thrombocytopenic purpura (ITP);drawing blood for laboratory analysis

Exam 33: Postpartum Complications

Which is the initial treatment for the client diagnosed with von Willebrand disease (vWD)who experiences a postpartum hemorrhage (PPH)?

What is one of the initial signs and symptoms of puerperal infection in the postpartum client?

What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?

Which condition is considered a medical emergency that requires immediate treatment?

The nurse suspects that her postpartum client is experiencing hemorrhagic shock.Which observation indicates or would confirm this diagnosis?

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the client is experiencing profuse bleeding.What is the most likely cause for this bleeding?

Which medications are used to manage postpartum hemorrhage (PPH)? (Select all that apply. )

Which classification of placental separation is not recognized as an abnormal adherence pattern?

Lacerations of the cervix,vagina,or perineum are also causes of postpartum hemorrhage (PPH).Which factors influence the causes and incidence of obstetric lacerations of the lower genital tract? (Select all that apply. )

What is the primary nursing responsibility when caring for a client who is experiencing an obstetric hemorrhage associated with uterine atony?

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

Nurses need to understand the basic definitions and incidence data regarding post-partum hemorrhage (PPH).Which statement regarding this condition is most accurate?

If nonsurgical treatment for late postpartum hemorrhage (PPH)is ineffective,which surgical procedure would be appropriate to correct the cause of this condition?

What is the most common reason for late postpartum hemorrhage (PPH)?

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy for the nurse to adopt?

A woman who has recently given birth reports pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.Which condition should the nurse suspect,and how will it be confirmed?

21st Century Maternity and Womens Health Nursing

Community Care: the Family and Culture

Nursing and Genomics

Assessment and Health Promotion

Violence Against Women

Reproductive System Concerns

Sexually Transmitted and Other Infections

Contraception and Abortion

Infertility

Problems of the Breast

Structural Disorders and Neoplasms of the Reproductive System

Conception and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Labor and Birth Processes

Maximizing Comfort for the Laboring Woman

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Postpartum Physiologic Changes

Nursing Care of the Family During the Postpartum Period

Transition to Parenthood

Physiologic and Behavioral Adaptations of the Newborn

Nursing Care of the Newborn and Family

Newborn Nutrition and Feeding

Assessment of High Risk Pregnancy

Hypertensive Disorders

Hemorrhagic Disorders

Endocrine and Metabolic Disorders

Medical-Surgical Disorders

Mental Health Disorders and Substance Abuse

Labor and Birth Complications

Nursing Care of the High Risk Newborn

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Perinatal Loss, bereavement, and Grief

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