Question 1

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 2

If the nurse suspects a complication of a low forceps birth labor, she should immediately

Accepted Answer

A)  administer a strong oral analgesic. 
B)  assess the perineal and vaginal areas. 
C)  assess the position of the uterine fundus. 
D)  review the labor record for duration of second stage. 
A)  administer a strong oral analgesic. 
B)  assess the perineal and vaginal areas. 
C)  assess the position of the uterine fundus. 
D)  review the labor record for duration of second stage.

Question 3

Which statement by a postpartum patient indicates that further teaching regarding thrombus formation is unnecessary?

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 4

Which temperature indicates the presence of postpartum infection?

Accepted Answer

A)  37.5°C (99.6°F) in the first 48 hours 
B)  37.7°C (100°F) for 2 days postpartum 
C)  38°C (100.4°F) in the first 24 hours 
D)  38.2°C (100.8°F) on the second and third postpartum days 
A)  37.5°C (99.6°F) in the first 48 hours 
B)  37.7°C (100°F) for 2 days postpartum 
C)  38°C (100.4°F) in the first 24 hours 
D)  38.2°C (100.8°F) on the second and third postpartum days

Question 5

Which patient data received during report should the nurse recognize as being at risk for postpartum complications?

Accepted Answer

A)  Gravida 5, para 5 
B)  Labor duration of 4 hours 
C)  Infant weight greater than 3800 g 
D)  Epidural anesthesia for labor and birth 
A)  Gravida 5, para 5 
B)  Labor duration of 4 hours 
C)  Infant weight greater than 3800 g 
D)  Epidural anesthesia for labor and birth

Question 6

Which measure may prevent mastitis in a breastfeeding patient?

Accepted Answer

A)  Wearing a tight-fitting bra. 
B)  Applying ice packs prior to feeding. 
C)  Initiating early and frequent feedings. 
D)  Nursing the infant for 5 minutes on each breast. 
A)  Wearing a tight-fitting bra. 
B)  Applying ice packs prior to feeding. 
C)  Initiating early and frequent feedings. 
D)  Nursing the infant for 5 minutes on each breast.

Question 7

To prevent infection of the reproductive tract, the nurse should instruct the patient to

Accepted Answer

A)  change the peripad once per shift. 
B)  cleanse the perineum from front to back. 
C)  perform pericare at least twice during the shift. 
D)  increase fluid intake to 2500 to 3000 mL/day. 
A)  change the peripad once per shift. 
B)  cleanse the perineum from front to back. 
C)  perform pericare at least twice during the shift. 
D)  increase fluid intake to 2500 to 3000 mL/day.

Question 8

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 9

Following a difficult vaginal birth of a singleton pregnancy, the patient starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline. Vital signs are 37.6°C (99.8°F), pulse 90 beats/minute, respirations 20 breaths per minute, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?

Accepted Answer

A)  Oxytocin (Pitocin) to be administered in a piggyback solution 
B)  Administration of methylergonovine (Methergine) 
C)  Administration of prostaglandin analog 
D)  Increase in parenteral fluids 
A)  Oxytocin (Pitocin) to be administered in a piggyback solution 
B)  Administration of methylergonovine (Methergine) 
C)  Administration of prostaglandin analog 
D)  Increase in parenteral fluids

Question 10

The nurse suspecting a uterine infection in a postpartum patient should assess the

Accepted Answer

A)  episiotomy site. 
B)  odor of the lochia. 
C)  abdomen for distention. 
D)  pulse and blood pressure. 
A)  episiotomy site. 
B)  odor of the lochia. 
C)  abdomen for distention. 
D)  pulse and blood pressure.

Question 11

The nurse should expect medical intervention for subinvolution to include

Accepted Answer

A)  oral fluids to 3000 mL/day. 
B)  intravenous fluid and blood replacement. 
C)  oxytocin intravenous infusion for 8 hours. 
D)  oral methylergonovine maleate (Methergine) for 48 hours. 
A)  oral fluids to 3000 mL/day. 
B)  intravenous fluid and blood replacement. 
C)  oxytocin intravenous infusion for 8 hours. 
D)  oral methylergonovine maleate (Methergine) for 48 hours.

Question 12

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

Accepted Answer

A)  assess for abnormal breath sounds. 
B)  apply OS1U1B12S1U1B0 via tight face mask at 8 to 10 L/minute. 
C)  position the patient 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 OS1U1B12S1U1B0 via tight face mask at 8 to 10 L/minute. 
C)  position the patient in a supine position with the head of the bed flat. 
D)  monitor pulse oximetry for decreased oxygen saturation.

Question 13

A multiparous patient is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the patient void and massages her fundus; however, the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?

Accepted Answer

A)  Recheck vital signs. 
B)  Insert a Foley catheter. 
C)  Notify the health care provider. 
D)  Continue to massage the fundus. 
A)  Recheck vital signs. 
B)  Insert a Foley catheter. 
C)  Notify the health care provider. 
D)  Continue to massage the fundus.

Question 14

Which information should the nurse recognize as contributing to mastitis in the breastfeeding mother? (Select all that apply.)

Accepted Answer

A)  Insufficient emptying 
B)  Feeding every 2 hours 
C)  Supplementing feedings 
D)  Blisters on both nipples 
E)  Alternating breastfeeding positions 
A)  Insufficient emptying 
B)  Feeding every 2 hours 
C)  Supplementing feedings 
D)  Blisters on both nipples 
E)  Alternating breastfeeding positions

Question 15

Following a vaginal birth, a patient has lost a significant amount of blood and is starting to experience signs of hypovolemic shock. Which clinical signs would be consistent with this 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 16

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 18: Postpartum Maternal Complications

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

If the nurse suspects a complication of a low forceps birth labor, she should immediately

Which statement by a postpartum patient indicates that further teaching regarding thrombus formation is unnecessary?

Which temperature indicates the presence of postpartum infection?

Which patient data received during report should the nurse recognize as being at risk for postpartum complications?

Which measure may prevent mastitis in a breastfeeding patient?

To prevent infection of the reproductive tract, the nurse should instruct the patient to

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?

The nurse suspecting a uterine infection in a postpartum patient should assess the

The nurse should expect medical intervention for subinvolution to include

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

Which information should the nurse recognize as contributing to mastitis in the breastfeeding mother? (Select all that apply.)

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

Before administering methylergonovine (Methergine), the nurse checks the

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