Question 1

If the nurse suspects a pulmonary embolism in the client who suddenly complains of chest pain, she or he should immediately:

Accepted Answer

A)  assess for abnormal breath sounds. 
B)  apply O2 via tight face mask at 8 to 10 L/min. 
C)  position the client in a supine position with the head of the bed flat. 
D)  monitor pulse oximetry for decreased oxygen saturation. 
A)  assess for abnormal breath sounds. 
B)  apply O2 via tight face mask at 8 to 10 L/min. 
C)  position the client in a supine position with the head of the bed flat. 
D)  monitor pulse oximetry for decreased oxygen saturation.

Question 2

Early postpartum hemorrhage is defined as a blood loss greater than:

Accepted Answer

A)  500 mL within 24 hours after a vaginal birth. 
B)  750 mL within 24 hours after a vaginal birth. 
C)  1000 mL within 48 hours after a cesarean birth. 
D)  1500 mL within 48 hours after a cesarean birth. 
A)  500 mL within 24 hours after a vaginal birth. 
B)  750 mL within 24 hours after a vaginal birth. 
C)  1000 mL within 48 hours after a cesarean birth. 
D)  1500 mL within 48 hours after a cesarean birth.

Question 3

The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the midline, and 2 cm above the umbilicus. What is the nurse's priority action?

Accepted Answer

A)  Massage the fundus of the uterus. 
B)  Assist the patient out of bed to void. 
C)  Increase the infusion of oxytocin (Pitocin). 
D)  Ask another nurse to bring in a straight catheter tray. 
A)  Massage the fundus of the uterus. 
B)  Assist the patient out of bed to void. 
C)  Increase the infusion of oxytocin (Pitocin). 
D)  Ask another nurse to bring in a straight catheter tray.

Question 4

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:

Accepted Answer

A)  uterine atony. 
B)  perineal hematoma. 
C)  infection of the uterus. 
D)  lacerations of the genital tract. 
A)  uterine atony. 
B)  perineal hematoma. 
C)  infection of the uterus. 
D)  lacerations of the genital tract.

Question 5

Following a vaginal birth, a client has lost a significant amount of blood and is starting to experience signs of hypovolemic shock. Which clinical signs would be consistent with this clinical diagnosis?

Accepted Answer

A)  Decrease in blood pressure, with an increase in pulse pressure 
B)  Compensatory response of tachycardia and decreased pulse pressure 
C)  Decrease in heart rate and an increase in respiratory effort 
D)  Flushed skin 
A)  Decrease in blood pressure, with an increase in pulse pressure 
B)  Compensatory response of tachycardia and decreased pulse pressure 
C)  Decrease in heart rate and an increase in respiratory effort 
D)  Flushed skin

Question 6

The nurse knows that late postpartum hemorrhage can be prevented by:

Accepted Answer

A)  manually removing the placenta. 
B)  inspecting the placenta after birth. 
C)  administering broad-spectrum antibiotics. 
D)  pulling on the umbilical cord to hasten the birth of the placenta. 
A)  manually removing the placenta. 
B)  inspecting the placenta after birth. 
C)  administering broad-spectrum antibiotics. 
D)  pulling on the umbilical cord to hasten the birth of the placenta.

Question 7

For the patient experiencing a postpartum hemorrhage, the health care provider prescribes methylergonovine (Methergine). What assessment must the nurse perform prior to administering this medication?

Accepted Answer

A)  Heart rate 
B)  Temperature 
C)  Blood pressure 
D)  Respiratory rate 
A)  Heart rate 
B)  Temperature 
C)  Blood pressure 
D)  Respiratory rate

Question 8

A sign of thrombophlebitis is:

Accepted Answer

A)  visible varicose veins. 
B)  positive Homans sign. 
C)  pedal edema in the affected leg. 
D)  local tenderness, heat, and swelling. 
A)  visible varicose veins. 
B)  positive Homans sign. 
C)  pedal edema in the affected leg. 
D)  local tenderness, heat, and swelling.

Question 9

Which statement by a postpartum client indicates that further teaching is not needed regarding thrombus formation?

Accepted Answer

A)  "I'll keep my legs elevated with pillows." 
B)  "I'll sit in my rocking chair most of the time." 
C)  "I'll stay in bed for the first 3 days after my baby is born." 
D)  "I'll put my support stockings on every morning before rising." 
A)  "I'll keep my legs elevated with pillows." 
B)  "I'll sit in my rocking chair most of the time." 
C)  "I'll stay in bed for the first 3 days after my baby is born." 
D)  "I'll put my support stockings on every morning before rising."

Question 10

Which data collected during your assessment may indicate a vaginal wall hematoma?

Accepted Answer

A)  Firm uterus at U-1 
B)  Pulse rate of 110 bpm 
C)  Moderate lochia 
D)  Soreness of perineum 
A)  Firm uterus at U-1 
B)  Pulse rate of 110 bpm 
C)  Moderate lochia 
D)  Soreness of perineum

Question 11

To determine an adverse response to carboprost tromethamine (Hemabate), the nurse should frequently assess:

Accepted Answer

A)  temperature. 
B)  lochial flow. 
C)  fundal height. 
D)  breath sounds. 
A)  temperature. 
B)  lochial flow. 
C)  fundal height. 
D)  breath sounds.

Question 12

Which nursing measure would be appropriate to prevent thrombophlebitis in the recovery period following a cesarean birth?

Accepted Answer

A)  Limit the client's oral intake of fluids for the first 24 hours. 
B)  Assist the client in performing leg exercises every 2 hours. 
C)  Ambulate the client as soon as her vital signs are stable. 
D)  Roll a bath blanket and place it firmly behind the client's knees. 
A)  Limit the client's oral intake of fluids for the first 24 hours. 
B)  Assist the client in performing leg exercises every 2 hours. 
C)  Ambulate the client as soon as her vital signs are stable. 
D)  Roll a bath blanket and place it firmly behind the client's knees.

Question 13

As you receive a report, which assessment finding should you recognize as indicative of a vaginal laceration?

Accepted Answer

A)  Fundus firm at the umbilicus 
B)  Pulse of 90 bpm, blood pressure of 110/78 mm Hg 
C)  Bright red continuous trickle of blood from vagina 
D)  Client requested pain medication twice during last shift 
A)  Fundus firm at the umbilicus 
B)  Pulse of 90 bpm, blood pressure of 110/78 mm Hg 
C)  Bright red continuous trickle of blood from vagina 
D)  Client requested pain medication twice during last shift

Question 14

Nursing measures that help prevent postpartum urinary tract infection include:

Accepted Answer

A)  forcing fluids to at least 3000 mL/day. 
B)  promoting bed rest for 12 hours after birth. 
C)  encouraging the intake of orange, grapefruit, or apple juice. 
D)  discouraging voiding until the sensation of a full bladder is present. 
A)  forcing fluids to at least 3000 mL/day. 
B)  promoting bed rest for 12 hours after birth. 
C)  encouraging the intake of orange, grapefruit, or apple juice. 
D)  discouraging voiding until the sensation of a full bladder is present.

Question 15

A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a(n):

Accepted Answer

A)  5-lb, 2-oz infant with outlet forceps. 
B)  6.5-lb infant after a 2-hour labor. 
C)  7-lb infant after an 8-hour labor. 
D)  8-lb infant after a 12-hour labor. 
A)  5-lb, 2-oz infant with outlet forceps. 
B)  6.5-lb infant after a 2-hour labor. 
C)  7-lb infant after an 8-hour labor. 
D)  8-lb infant after a 12-hour labor.

Question 16

To evaluate the desired response of methylergonovine (Methergine), the nurse would assess the client's:

Accepted Answer

A)  uterine tone. 
B)  pain level. 
C)  blood pressure. 
D)  last voiding. 
A)  uterine tone. 
B)  pain level. 
C)  blood pressure. 
D)  last voiding.

Question 17

If a DVT (deep vein thrombosis) is suspected, the nurse should:

Accepted Answer

A)  perform a Homans sign on the affected leg. 
B)  dorsiflex the foot of the affected leg. 
C)  palpate the affected leg for edema and pain. 
D)  place the client on bed rest, with the affected leg elevated. 
A)  perform a Homans sign on the affected leg. 
B)  dorsiflex the foot of the affected leg. 
C)  palpate the affected leg for edema and pain. 
D)  place the client on bed rest, with the affected leg elevated.

Question 18

Which observation of your client as she ambulates could indicate development of a DVT (deep vein thrombosis)?

Accepted Answer

A)  Slow gait 
B)  Shuffling gait 
C)  Stiffness of right leg 
D)  Leans on husband for support 
A)  Slow gait 
B)  Shuffling gait 
C)  Stiffness of right leg 
D)  Leans on husband for support

Question 19

A white blood cell (WBC) count of 35,000 cells/mm³ on the morning of the first postpartum day indicates:

Accepted Answer

A)  possible infection. 
B)  normal WBC limit. 
C)  serious infection. 
D)  suspicion of a sexually transmitted disease. 
A)  possible infection. 
B)  normal WBC limit. 
C)  serious infection. 
D)  suspicion of a sexually transmitted disease.

Question 20

Before administering methylergonovine (Methergine), the nurse checks the:

Accepted Answer

A)  color of the lochia. 
B)  blood pressure. 
C)  location of the fundus. 
D)  last administration of analgesics. 
A)  color of the lochia. 
B)  blood pressure. 
C)  location of the fundus. 
D)  last administration of analgesics.

Exam 28: Postpartum Maternal Complications

If the nurse suspects a pulmonary embolism in the client who suddenly complains of chest pain, she or he should immediately:

Early postpartum hemorrhage is defined as a blood loss greater than:

The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the midline, and 2 cm above the umbilicus. What is the nurse's priority action?

A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:

Following a vaginal birth, a client has lost a significant amount of blood and is starting to experience signs of hypovolemic shock. Which clinical signs would be consistent with this clinical diagnosis?

The nurse knows that late postpartum hemorrhage can be prevented by:

For the patient experiencing a postpartum hemorrhage, the health care provider prescribes methylergonovine (Methergine). What assessment must the nurse perform prior to administering this medication?

A sign of thrombophlebitis is:

Which statement by a postpartum client indicates that further teaching is not needed regarding thrombus formation?

Which data collected during your assessment may indicate a vaginal wall hematoma?

To determine an adverse response to carboprost tromethamine (Hemabate), the nurse should frequently assess:

Which nursing measure would be appropriate to prevent thrombophlebitis in the recovery period following a cesarean birth?

As you receive a report, which assessment finding should you recognize as indicative of a vaginal laceration?

Nursing measures that help prevent postpartum urinary tract infection include:

A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a(n):

To evaluate the desired response of methylergonovine (Methergine), the nurse would assess the client's:

If a DVT (deep vein thrombosis) is suspected, the nurse should:

Which observation of your client as she ambulates could indicate development of a DVT (deep vein thrombosis)?

A white blood cell (WBC) count of 35,000 cells/mm³ on the morning of the first postpartum day indicates:

Before administering methylergonovine (Methergine), the nurse checks the:

Maternity and Women's Health Care Today

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