Question 1

With regard to after birth ovarian function,nurses should be aware that:

Accepted Answer

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

Question 2

MATCHING
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. Please match the vital signs finding that the after birth nurse may encounter with the 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 after birth 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours after birth 
D) Hypertension 
E) Hypoventilation B

Question 3

MATCHING
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. Please match the vital signs finding that the after birth nurse may encounter with the 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 after birth 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours after birth 
D) Hypertension 
E) Hypoventilation E

Question 4

A woman gave birth to a 7-lb,6-ounce infant girl 1 hour ago.The birth was vaginal,and the estimated blood loss (EBL)was approximately 1500 mL.When assessing the woman's vital signs,the nurse would be concerned to see:

Accepted Answer

A)  temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP) 90/50. 
B)  temperature 37.4° C, heart rate 88, respirations 36, BP 126/68. 
C)  temperature 38° C, heart rate 80, respirations 16, BP 110/80. 
D)  temperature 36.8° C, heart rate 60, respirations 18, BP 140/90. 
A)  temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP) 90/50. 
B)  temperature 37.4° C, heart rate 88, respirations 36, BP 126/68. 
C)  temperature 38° C, heart rate 80, respirations 16, BP 110/80. 
D)  temperature 36.8° C, heart rate 60, respirations 18, BP 140/90.

Question 5

With regard to the after birth uterus,nurses should be aware that:

Accepted Answer

A)  at the end of the third stage of labor it weighs approximately 500 g. 
B)  after 2 weeks after birth it should not be palpable abdominally. 
C)  after 2 weeks after birth it weighs 100 g. 
D)  it returns to its original (prepregnancy) size by 6 weeks after birth. 
A)  at the end of the third stage of labor it weighs approximately 500 g. 
B)  after 2 weeks after birth it should not be palpable abdominally. 
C)  after 2 weeks after birth it weighs 100 g. 
D)  it returns to its original (prepregnancy) size by 6 weeks after birth.

Question 6

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.One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early after birth period is:

Accepted Answer

A)  elevated temperature caused by after birth 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 after birth 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 7

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 8

Which finding 12 hours after birth requires further assessment?

Accepted Answer

A)  The fundus is palpable two fingerbreadths above the umbilicus. 
B)  The fundus is palpable at the level of the umbilicus. 
C)  The fundus is palpable one fingerbreadth below the umbilicus. 
D)  The fundus is palpable two fingerbreadths below the umbilicus. 
A)  The fundus is palpable two fingerbreadths above the umbilicus. 
B)  The fundus is palpable at the level of the umbilicus. 
C)  The fundus is palpable one fingerbreadth below the umbilicus. 
D)  The fundus is palpable two fingerbreadths below the umbilicus.

Question 9

A woman gave birth to a 7-lb,3-ounce infant boy 2 hours ago.The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline.In the immediate after birth period,the most serious consequence likely to occur from bladder distention is:

Accepted Answer

A)  urinary tract infection. 
B)  excessive uterine bleeding. 
C)  a ruptured bladder. 
D)  bladder wall atony. 
A)  urinary tract infection. 
B)  excessive uterine bleeding. 
C)  a ruptured bladder. 
D)  bladder wall atony.

Question 10

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

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 11

As relates to the condition and reconditioning of the urinary system after childbirth,nurses should be aware that:

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 usually is 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 usually is restored 2 to 3 weeks after childbirth.

Question 12

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.A after birth nurse anticipates blood loss of: (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 13

With regard to after birth pains,nurses should be aware that these pains are:

Accepted Answer

A)  caused by mild, continuous contractions for the duration of the after birth period. 
B)  more common in first-time mothers. 
C)  more noticeable in births in which the uterus was overdistended. 
D)  alleviated somewhat when the mother breastfeeds. 
A)  caused by mild, continuous contractions for the duration of the after birth period. 
B)  more common in first-time mothers. 
C)  more noticeable in births in which the uterus was overdistended. 
D)  alleviated somewhat when the mother breastfeeds.

Question 14

MATCHING
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. Please match the vital signs finding that the after birth nurse may encounter with the 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 after birth 
D) Hypertension 
E) Hypoventilation 
A) Elevated temperature within the first 24 hours 
B) Rapid pulse 
C) Elevated temperature at 36 hours after birth 
D) Hypertension 
E) Hypoventilation

Question 15

Which documentation on a woman's chart on after birth 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 not palpable 
D)  Episiotomy slightly red and puffy 
A)  Moderate bright red lochial flow 
B)  Breasts firm and tender 
C)  Fundus below the symphysis and not palpable 
D)  Episiotomy slightly red and puffy

Question 16

Post birth uterine/vaginal discharge,called lochia:

Accepted Answer

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

Question 17

Childbirth may result in injuries to the vagina and uterus.Pelvic floor exercises also known as Kegel exercises will help to strengthen the perineal muscles and encourage healing.The nurse knows that the patient understands the correct process for completing these conditioning exercises when she reports:

Accepted Answer

A)  "I contract my thighs, buttocks, and abdomen." 
B)  "I do 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 midstream." 
A)  "I contract my thighs, buttocks, and abdomen." 
B)  "I do 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 midstream."

Question 18

Knowing that the condition of the new mother's breasts will be affected by whether she is breastfeeding,nurses should be able to tell their patients all the following statements except:

Accepted Answer

A)  breast tenderness is likely to persist for about a week after the start of lactation. 
B)  as lactation is established, a mass may form that can be distinguished from cancer by its position 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), lactation ceases within a few days to a week. 
A)  breast tenderness is likely to persist for about a week after the start of lactation. 
B)  as lactation is established, a mass may form that can be distinguished from cancer by its position 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), lactation ceases within a few days to a week.

Question 19

MATCHING
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. Please match the vital signs finding that the after birth nurse may encounter with the probable cause:

-Puerperal sepsis

Accepted Answer

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

Question 20

The nurse caring for the after birth woman understands that breast engorgement is caused by:

Accepted Answer

A)  overproduction of colostrum. 
B)  accumulation of milk in the lactiferous ducts. 
C)  hyperplasia of mammary tissue. 
D)  congestion of veins and lymphatics. 
A)  overproduction of colostrum. 
B)  accumulation of milk in the lactiferous ducts. 
C)  hyperplasia of mammary tissue. 
D)  congestion of veins and lymphatics.

Exam 18: Postpartum Physiologic Changes

With regard to after birth ovarian function,nurses should be aware that:

A woman gave birth to a 7-lb,6-ounce infant girl 1 hour ago.The birth was vaginal,and the estimated blood loss (EBL)was approximately 1500 mL.When assessing the woman's vital signs,the nurse would be concerned to see:

With regard to the after birth uterus,nurses should be aware that:

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.One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early after birth period is:

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

Which finding 12 hours after birth requires further assessment?

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

As relates to the condition and reconditioning of the urinary system after childbirth,nurses should be aware that:

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.A after birth nurse anticipates blood loss of: (Select all that apply.)

With regard to after birth pains,nurses should be aware that these pains are:

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

Post birth uterine/vaginal discharge,called lochia:

Knowing that the condition of the new mother's breasts will be affected by whether she is breastfeeding,nurses should be able to tell their patients all the following statements except:

The nurse caring for the after birth woman understands that breast engorgement is caused by:

21st Century Maternity Nursing

The Family, culture, spirituality, and Home Care

Assessment and Health Promotion

Reproductive System Concerns

Infertility, contraception, and Abortion

Genetics, conception, and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Assessment of High-Risk Pregnancy

High-Risk Perinatal Care: Preexisting Conditions

High-Risk Perinatal Care: Gestational Conditions

Labor and Birth Processes

Maximizing Comfort for the Laboring Woman

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Labor and Birth Complications

Nursing Care of the Family During the Postpartum Period

Transition to Parenthood

Postpartum Complications

Physiologic and Behavioral Adaptations of the Newborn

Nursing Care of the Newborn and Family

Newborn Nutrition and Feeding

The High-Risk Newborn

21st Century Pediatric Nursing

Family, social, cultural, and Religious Influences on Child Health Promotion

Developmental and Genetic Influences on Child Health Promotion

Communication and Physical Assessment of the Child and Family

Pain Assessment and Management in Children

The Infant and Family

The Toddler and Family

The Preschooler and Family

The School-Age Child and Family

The Adolescent and Family

Impact of Chronic Illness, disability, or End-Of-Life Care for the Child and Family

Impact of Cognitive or Sensory Impairment on the Child and Family

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Variations of Nursing Interventions

The Child With Respiratory Dysfunction

The Child With Gastrointestinal Dysfunction

The Child With Cardiovascular Dysfunction

The Child With Hematologic or Immunologic Dysfunction

The Child With Cancer

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The Child With Endocrine Dysfunction

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