Question 1

A client is concerned that her breasts are engorged and uncomfortable.What is the nurse's explanation for this physiologic change?

Accepted Answer

A)  Overproduction of colostrum 
B)  Accumulation of milk in the lactiferous ducts and glands 
C)  Hyperplasia of mammary tissue 
D)  Congestion of veins and lymphatic vessels 
A)  Overproduction of colostrum 
B)  Accumulation of milk in the lactiferous ducts and glands 
C)  Hyperplasia of mammary tissue 
D)  Congestion of veins and lymphatic vessels D

Question 2

What should the nurse's next action be if the client's white blood cell (WBC)count is 25,000/mm3 on her second postpartum day?

Accepted Answer

A)  Immediately inform the health care provider. 
B)  Have the laboratory draw blood for reanalysis. 
C)  Recognize that this count is an acceptable range at this point postpartum. 
D)  Immediately begin antibiotic therapy. 
A)  Immediately inform the health care provider. 
B)  Have the laboratory draw blood for reanalysis. 
C)  Recognize that this count is an acceptable range at this point postpartum. 
D)  Immediately begin antibiotic therapy. C

Question 3

Which client is most likely to experience strong and uncomfortable afterpains?

Accepted Answer

A)  A woman who experienced oligohydramnios 
B)  A woman who is a gravida 4,para 4-0-0-4 
C)  A woman who is bottle-feeding her infant 
D)  A woman whose infant weighed 5 pounds,3 ounces 
A)  A woman who experienced oligohydramnios 
B)  A woman who is a gravida 4,para 4-0-0-4 
C)  A woman who is bottle-feeding her infant 
D)  A woman whose infant weighed 5 pounds,3 ounces B

Question 4

A woman gave birth to a 7-pound,6-ounce infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL)was 1500 ml.When evaluating the woman's vital signs,which finding would be of greatest concern to the nurse?

Accepted Answer

A)  Temperature 37.9° C,heart rate 120 beats per minute (bpm),respirations 20 breaths per minute,and blood pressure 90/50 mm Hg 
B)  Temperature 37.4° C,heart rate 88 bpm,respirations 36 breaths per minute,and blood pressure 126/68 mm Hg 
C)  Temperature 38° C,heart rate 80 bpm,respirations 16 breaths per minute,and blood pressure 110/80 mm Hg 
D)  Temperature 36.8° C,heart rate 60 bpm,respirations 18 breaths per minute,and blood pressure 140/90 mm Hg 
A)  Temperature 37.9° C,heart rate 120 beats per minute (bpm),respirations 20 breaths per minute,and blood pressure 90/50 mm Hg 
B)  Temperature 37.4° C,heart rate 88 bpm,respirations 36 breaths per minute,and blood pressure 126/68 mm Hg 
C)  Temperature 38° C,heart rate 80 bpm,respirations 16 breaths per minute,and blood pressure 110/80 mm Hg 
D)  Temperature 36.8° C,heart rate 60 bpm,respirations 18 breaths per minute,and blood pressure 140/90 mm Hg

Question 5

The breast-feeding mother should be taught to expect which changes to the condition of the breasts? (Select all that apply. )

Accepted Answer

A)  Breast tenderness is likely to persist for approximately 1 week after the start of lactation. 
B)  As lactation is established,a mass may form that can be distinguished from cancer by its positional shift from day to day. 
C)  In nonlactating mothers,colostrum is present for the first few days after childbirth. 
D)  If suckling is never begun or is discontinued,then lactation ceases within a few days to a week. 
E)  Little change occurs to the breasts in the first 48 hours. 
A)  Breast tenderness is likely to persist for approximately 1 week after the start of lactation. 
B)  As lactation is established,a mass may form that can be distinguished from cancer by its positional shift from day to day. 
C)  In nonlactating mothers,colostrum is present for the first few days after childbirth. 
D)  If suckling is never begun or is discontinued,then lactation ceases within a few days to a week. 
E)  Little change occurs to the breasts in the first 48 hours.

Question 6

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?

Accepted Answer

A)  Involutionary period because of changes to the uterus 
B)  Lochia period because of the nature of the vaginal discharge 
C)  Mini-tri period because it lasts only 3 to 6 weeks 
D)  Puerperium,or fourth trimester of pregnancy 
A)  Involutionary period because of changes to the uterus 
B)  Lochia period because of the nature of the vaginal discharge 
C)  Mini-tri period because it lasts only 3 to 6 weeks 
D)  Puerperium,or fourth trimester of pregnancy

Question 7

The nurse should be cognizant of which postpartum physiologic alteration?

Accepted Answer

A)  Cardiac output,pulse rate,and stroke volume all return to prepregnancy normal values within 48 hours of childbirth. 
B)  Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth. 
C)  Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. 
D)  Hypercoagulable state protects the new mother from thromboembolism,especially after a cesarean birth. 
A)  Cardiac output,pulse rate,and stroke volume all return to prepregnancy normal values within 48 hours of childbirth. 
B)  Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth. 
C)  Lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections. 
D)  Hypercoagulable state protects the new mother from thromboembolism,especially after a cesarean birth.

Question 8

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

Accepted Answer

A)  Moderate bright red lochial flow 
B)  Breasts firm and tender 
C)  Fundus below the symphysis and nonpalpable 
D)  Episiotomy slightly red and puffy 
A)  Moderate bright red lochial flow 
B)  Breasts firm and tender 
C)  Fundus below the symphysis and nonpalpable 
D)  Episiotomy slightly red and puffy

Question 9

After delivery,excess hypertrophied tissue in the uterus undergoes a period of self-destruction.What is the correct term for this process?

Accepted Answer

A)  Autolysis 
B)  Subinvolution 
C)  Afterpains 
D)  Diastasis 
A)  Autolysis 
B)  Subinvolution 
C)  Afterpains 
D)  Diastasis

Question 10

Which explanation concerning postpartum ovary function is most accurate?

Accepted Answer

A)  Almost 75% of women who do not breastfeed resume menstruating within 1 month after birth. 
B)  Ovulation occurs slightly earlier for breastfeeding women. 
C)  Because of menstruation and ovulation schedules,contraception considerations can be postponed until after the puerperium. 
D)  The first menstrual flow after childbirth usually is heavier than normal. 
A)  Almost 75% of women who do not breastfeed resume menstruating within 1 month after birth. 
B)  Ovulation occurs slightly earlier for breastfeeding women. 
C)  Because of menstruation and ovulation schedules,contraception considerations can be postponed until after the puerperium. 
D)  The first menstrual flow after childbirth usually is heavier than normal.

Question 11

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

Accepted Answer

A)  "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." 
B)  "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." 
C)  "I will not have a menstrual cycle for 6 months after childbirth." 
D)  "My first menstrual cycle will be heavier than normal and then will be light for several months after." 
A)  "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." 
B)  "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." 
C)  "I will not have a menstrual cycle for 6 months after childbirth." 
D)  "My first menstrual cycle will be heavier than normal and then will be light for several months after."

Question 12

Which statement,related to the reconditioning of the urinary system after childbirth,should the nurse understand?

Accepted Answer

A)  Kidney function returns to normal a few days after birth. 
B)  Diastasis recti abdominis is a common condition that alters the voiding reflex. 
C)  Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. 
D)  With adequate emptying of the bladder,bladder tone is usually restored 2 to 3 weeks after childbirth. 
A)  Kidney function returns to normal a few days after birth. 
B)  Diastasis recti abdominis is a common condition that alters the voiding reflex. 
C)  Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium. 
D)  With adequate emptying of the bladder,bladder tone is usually restored 2 to 3 weeks after childbirth.

Question 13

What are the most common causes for subinvolution of the uterus?

Accepted Answer

A)  Postpartum hemorrhage and infection 
B)  Multiple gestation and postpartum hemorrhage 
C)  Uterine tetany and overproduction of oxytocin 
D)  Retained placental fragments and infection 
A)  Postpartum hemorrhage and infection 
B)  Multiple gestation and postpartum hemorrhage 
C)  Uterine tetany and overproduction of oxytocin 
D)  Retained placental fragments and infection

Question 14

Several delivery changes in the integumentary system that appear during pregnancy disappear after birth,although not always completely.What change is almost certain to be completely reversed?

Accepted Answer

A)  Nail brittleness 
B)  Darker pigmentation of the areolae and linea nigra 
C)  Striae gravidarum on the breasts,abdomen,and thighs 
D)  Spider nevi 
A)  Nail brittleness 
B)  Darker pigmentation of the areolae and linea nigra 
C)  Striae gravidarum on the breasts,abdomen,and thighs 
D)  Spider nevi

Question 15

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge,called lochia.Which statement is the most appropriate?

Accepted Answer

A)  Lochia is similar to a light menstrual period for the first 6 to 12 hours. 
B)  It is usually greater after cesarean births. 
C)  Lochia will usually decrease with ambulation and breastfeeding. 
D)  It should smell like normal menstrual flow unless an infection is present. 
A)  Lochia is similar to a light menstrual period for the first 6 to 12 hours. 
B)  It is usually greater after cesarean births. 
C)  Lochia will usually decrease with ambulation and breastfeeding. 
D)  It should smell like normal menstrual flow unless an infection is present.

Question 16

Which condition,not uncommon in pregnancy,is likely to require careful medical assessment during the puerperium?

Accepted Answer

A)  Varicosities of the legs 
B)  Carpal tunnel syndrome 
C)  Periodic numbness and tingling of the fingers 
D)  Headaches 
A)  Varicosities of the legs 
B)  Carpal tunnel syndrome 
C)  Periodic numbness and tingling of the fingers 
D)  Headaches

Question 17

A woman gave birth to a healthy infant boy 5 days ago.What type of lochia does the nurse expect to find when evaluating this client?

Accepted Answer

A)  Lochia rubra 
B)  Lochia sangra 
C)  Lochia alba 
D)  Lochia serosa 
A)  Lochia rubra 
B)  Lochia sangra 
C)  Lochia alba 
D)  Lochia serosa

Question 18

A woman gave birth to an infant boy 10 hours ago.Where does the nurse expect to locate this woman's fundus?

Accepted Answer

A)  1 centimeter above the umbilicus 
B)  2 centimeters below the umbilicus 
C)  Midway between the umbilicus and the symphysis pubis 
D)  Nonpalpable abdominally 
A)  1 centimeter above the umbilicus 
B)  2 centimeters below the umbilicus 
C)  Midway between the umbilicus and the symphysis pubis 
D)  Nonpalpable abdominally

Question 19

Two days ago a woman gave birth to a full-term infant.Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis.Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?

Accepted Answer

A)  Elevated temperature caused by postpartum infection 
B)  Increased basal metabolic rate after giving birth 
C)  Loss of increased blood volume associated with pregnancy 
D)  Increased venous pressure in the lower extremities 
A)  Elevated temperature caused by postpartum infection 
B)  Increased basal metabolic rate after giving birth 
C)  Loss of increased blood volume associated with pregnancy 
D)  Increased venous pressure in the lower extremities

Question 20

Which description of postpartum restoration or healing times is accurate?

Accepted Answer

A)  The cervix shortens,becomes firm,and returns to form within a month postpartum. 
B)  Vaginal rugae reappear by 3 weeks postpartum. 
C)  Most episiotomies heal within a week. 
D)  Hemorrhoids usually decrease in size within 2 weeks of childbirth. 
A)  The cervix shortens,becomes firm,and returns to form within a month postpartum. 
B)  Vaginal rugae reappear by 3 weeks postpartum. 
C)  Most episiotomies heal within a week. 
D)  Hemorrhoids usually decrease in size within 2 weeks of childbirth.

Exam 20: Postpartum Physiologic Changes

A client is concerned that her breasts are engorged and uncomfortable.What is the nurse's explanation for this physiologic change?

What should the nurse's next action be if the client's white blood cell (WBC)count is 25,000/mm3 on her second postpartum day?

Which client is most likely to experience strong and uncomfortable afterpains?

A woman gave birth to a 7-pound,6-ounce infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL)was 1500 ml.When evaluating the woman's vital signs,which finding would be of greatest concern to the nurse?

The breast-feeding mother should be taught to expect which changes to the condition of the breasts? (Select all that apply. )

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?

The nurse should be cognizant of which postpartum physiologic alteration?

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

After delivery,excess hypertrophied tissue in the uterus undergoes a period of self-destruction.What is the correct term for this process?

Which explanation concerning postpartum ovary function is most accurate?

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

Which statement,related to the reconditioning of the urinary system after childbirth,should the nurse understand?

What are the most common causes for subinvolution of the uterus?

Several delivery changes in the integumentary system that appear during pregnancy disappear after birth,although not always completely.What change is almost certain to be completely reversed?

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge,called lochia.Which statement is the most appropriate?

Which condition,not uncommon in pregnancy,is likely to require careful medical assessment during the puerperium?

A woman gave birth to a healthy infant boy 5 days ago.What type of lochia does the nurse expect to find when evaluating this client?

A woman gave birth to an infant boy 10 hours ago.Where does the nurse expect to locate this woman's fundus?

Two days ago a woman gave birth to a full-term infant.Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis.Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?

Which description of postpartum restoration or healing times is accurate?

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

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

Postpartum 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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What should the nurse's next action be if the client's white blood cell (WBC)count is 25,000/mm³ on her second postpartum day?