Question 1

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 D

Question 2

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 what happens 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 what happens 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 D

Question 3

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." B

Question 4

The physiologic changes that occur during the reversal of the processes of pregnancy are distinctive; however, they are normal. To provide care during this recovery period, the nurse must synthesize knowledge regarding anticipated maternal changes and deviations from normal. Match the vital signs finding that the postpartum nurse may encounter with its probable cause.

-Dehydrating effects of labor

Accepted Answer

A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation

Question 5

Changes in blood volume after childbirth depend on several factors such as blood loss during childbirth and the amount of extravascular water (physiologic edema)mobilized and excreted.What amount of blood loss does the postpartum nurse anticipate?
(Select all that apply).

Accepted Answer

A)  100 ml 
B)  250 ml or less 
C)  300 to 500 ml 
D)  500 to 1000 ml 
E)  1500 ml or greater 
A)  100 ml 
B)  250 ml or less 
C)  300 to 500 ml 
D)  500 to 1000 ml 
E)  1500 ml or greater

Question 6

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

Accepted Answer

A)  Estrogen 
B)  Progesterone 
C)  Prolactin 
D)  Human placental lactogen 
A)  Estrogen 
B)  Progesterone 
C)  Prolactin 
D)  Human placental lactogen

Question 7

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 8

The physiologic changes that occur during the reversal of the processes of pregnancy are distinctive; however, they are normal. To provide care during this recovery period, the nurse must synthesize knowledge regarding anticipated maternal changes and deviations from normal. Match the vital signs finding that the postpartum nurse may encounter with its probable cause.

-Puerperal sepsis

Accepted Answer

A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation

Question 9

The physiologic changes that occur during the reversal of the processes of pregnancy are distinctive; however, they are normal. To provide care during this recovery period, the nurse must synthesize knowledge regarding anticipated maternal changes and deviations from normal. Match the vital signs finding that the postpartum nurse may encounter with its probable cause.

-Unusually high epidural or spinal block

Accepted Answer

A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation

Question 10

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 11

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 12

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 13

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 14

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 physician. 
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 physician. 
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.

Question 15

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

Question 16

Pelvic floor exercises,also known as Kegel exercises,will help to strengthen the perineal muscles and encourage healing after childbirth.The nurse requests the client to repeat back instructions for this exercise.Which response by the client indicates successful learning?

Accepted Answer

A)  "I contract my thighs, buttocks, and abdomen." 
B)  "I perform 10 of these exercises every day." 
C)  "I stand while practicing this new exercise routine." 
D)  "I pretend that I am trying to stop the flow of urine in midstream." 
A)  "I contract my thighs, buttocks, and abdomen." 
B)  "I perform 10 of these exercises every day." 
C)  "I stand while practicing this new exercise routine." 
D)  "I pretend that I am trying to stop the flow of urine in midstream."

Question 17

A client asks the nurse when her ovaries will begin working again.Which explanation by the nurse 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 18

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 19

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.

Question 20

The physiologic changes that occur during the reversal of the processes of pregnancy are distinctive; however, they are normal. To provide care during this recovery period, the nurse must synthesize knowledge regarding anticipated maternal changes and deviations from normal. Match the vital signs finding that the postpartum nurse may encounter with its probable cause.

-Hypovolemia resulting from hemorrhage

Accepted Answer

A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours postpartum 
D) Hypertension 
E) Hypoventilation

Exam 20: Postpartum Physiologic Changes

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

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

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

Changes in blood volume after childbirth depend on several factors such as blood loss during childbirth and the amount of extravascular water (physiologic edema)mobilized and excreted.What amount of blood loss does the postpartum nurse anticipate? (Select all that apply).

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

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

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

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

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?

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?

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?

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

Pelvic floor exercises,also known as Kegel exercises,will help to strengthen the perineal muscles and encourage healing after childbirth.The nurse requests the client to repeat back instructions for this exercise.Which response by the client indicates successful learning?

A client asks the nurse when her ovaries will begin working again.Which explanation by the nurse is most accurate?

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?

Which description of postpartum restoration or healing times is accurate?

21st Century Maternity and Women’s 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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