Question 1

Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH).For instance:

Accepted Answer

A)  PPH is easy to recognize early; after all, the woman is bleeding. 
B)  traditionally it takes more than 1000 mL of blood after vaginal birth and 2500 mL after cesarean birth to define the condition as PPH. 
C)  if anything, nurses and doctors tend to overestimate the amount of blood loss. 
D)  traditionally PPH has been classified as early or late with respect to birth. 
A)  PPH is easy to recognize early; after all, the woman is bleeding. 
B)  traditionally it takes more than 1000 mL of blood after vaginal birth and 2500 mL after cesarean birth to define the condition as PPH. 
C)  if anything, nurses and doctors tend to overestimate the amount of blood loss. 
D)  traditionally PPH has been classified as early or late with respect to birth. D

Question 2

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

Accepted Answer

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

Question 3

Anxiety disorders are the most common mental disorders that affect women.While providing care to the maternity patient,the nurse should be aware that one of these disorders is likely to be triggered by the process of labor and birth.This disorder is:

Accepted Answer

A)  phobias. 
B)  panic disorder. 
C)  posttraumatic stress disorder (PTS
D) . 
D)  obsessive-compulsive disorder (OC
D) . 
A)  phobias. 
B)  panic disorder. 
C)  posttraumatic stress disorder (PTS
D) . 
D)  obsessive-compulsive disorder (OC
D) . C

Question 4

Medications used to manage postpartum hemorrhage (PPH)include: (Select all that apply.)

Accepted Answer

A)  Pitocin. 
B)  Methergine. 
C)  Terbutaline. 
D)  Hemabate. 
E)  magnesium sulfate. 
A)  Pitocin. 
B)  Methergine. 
C)  Terbutaline. 
D)  Hemabate. 
E)  magnesium sulfate.

Question 5

MATCHING
PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of circulatory status can be done with noninvasive monitoring. Please match the type of noninvasive assessment that the RN would perform with the appropriate clinical manifestation or body system.

-Presence or absence of anxiety

Accepted Answer

A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement 
A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement

Question 6

Early after birth hemorrhage is defined as a blood loss greater than:

Accepted Answer

A)  500 mL in the first 24 hours after vaginal delivery. 
B)  750 mL in the first 24 hours after vaginal delivery. 
C)  1000 mL in the first 48 hours after cesarean delivery. 
D)  1500 mL in the first 48 hours after cesarean delivery. 
A)  500 mL in the first 24 hours after vaginal delivery. 
B)  750 mL in the first 24 hours after vaginal delivery. 
C)  1000 mL in the first 48 hours after cesarean delivery. 
D)  1500 mL in the first 48 hours after cesarean delivery.

Question 7

A woman delivered a 9-lb,10-ounce baby 1 hour ago.When you arrive to perform her 15-minute assessment,she tells you that she "feels all wet underneath." You discover that both pads are completely saturated and that she is lying in a 6-inch-diameter puddle of blood.What is your first action?

Accepted Answer

A)  Call for help. 
B)  Assess the fundus for firmness. 
C)  Take her blood pressure. 
D)  Check the perineum for lacerations. 
A)  Call for help. 
B)  Assess the fundus for firmness. 
C)  Take her blood pressure. 
D)  Check the perineum for lacerations.

Question 8

MATCHING
PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of circulatory status can be done with noninvasive monitoring. Please match the type of noninvasive assessment that the RN would perform with the appropriate clinical manifestation or body system.

-Arterial pulses

Accepted Answer

A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement 
A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement

Question 9

The perinatal nurse caring for the after birth woman understands that late postpartum hemorrhage (PPH)is most likely caused by:

Accepted Answer

A)  subinvolution of the placental site. 
B)  defective vascularity of the decidua. 
C)  cervical lacerations. 
D)  coagulation disorders. 
A)  subinvolution of the placental site. 
B)  defective vascularity of the decidua. 
C)  cervical lacerations. 
D)  coagulation disorders.

Question 10

The first and most important nursing intervention when a nurse observes profuse after birth bleeding is to:

Accepted Answer

A)  call the woman's primary health care provider. 
B)  administer the standing order for an oxytocic. 
C)  palpate the uterus and massage it if it is boggy. 
D)  assess maternal blood pressure and pulse for signs of hypovolemic shock. 
A)  call the woman's primary health care provider. 
B)  administer the standing order for an oxytocic. 
C)  palpate the uterus and massage it if it is boggy. 
D)  assess maternal blood pressure and pulse for signs of hypovolemic shock.

Question 11

Complicated bereavement:

Accepted Answer

A)  occurs when, in multiple births, one child dies, and the other or others live. 
B)  is a state in which the parents are ambivalent, as with an abortion. 
C)  is an extremely intense grief reaction that persists for a long time. 
D)  is felt by the family of adolescent mothers who lose their babies. 
A)  occurs when, in multiple births, one child dies, and the other or others live. 
B)  is a state in which the parents are ambivalent, as with an abortion. 
C)  is an extremely intense grief reaction that persists for a long time. 
D)  is felt by the family of adolescent mothers who lose their babies.

Question 12

A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:

Accepted Answer

A)  establish venous access. 
B)  perform fundal massage. 
C)  prepare the woman for surgical intervention. 
D)  catheterize the bladder. 
A)  establish venous access. 
B)  perform fundal massage. 
C)  prepare the woman for surgical intervention. 
D)  catheterize the bladder.

Question 13

If nonsurgical treatment for late after birth hemorrhage is ineffective,which surgical procedure is appropriate to correct the cause of this condition?

Accepted Answer

A)  Hysterectomy 
B)  Laparoscopy 
C)  Laparotomy 
D)  D&C 
A)  Hysterectomy 
B)  Laparoscopy 
C)  Laparotomy 
D)  D&C

Question 14

To provide adequate after birth care,the nurse should be aware that postpartum depression (PPD)with psychotic features:

Accepted Answer

A)  is more likely to occur in women with more than two children. 
B)  is rarely delusional and then is usually about someone trying to harm her (the mother). 
C)  although serious, is not likely to need psychiatric hospitalization. 
D)  may include bipolar disorder (formerly called "manic depression"). 
A)  is more likely to occur in women with more than two children. 
B)  is rarely delusional and then is usually about someone trying to harm her (the mother). 
C)  although serious, is not likely to need psychiatric hospitalization. 
D)  may include bipolar disorder (formerly called "manic depression").

Question 15

With shortened hospital stays,new mothers are often discharged before they begin to experience symptoms of the baby blues or after birth depression.As part of the discharge teaching,the nurse can prepare the mother for this adjustment to her new role by instructing her regarding self-care activities to help prevent after birth depression.The most accurate statement as related to these activities is to:

Accepted Answer

A)  stay home and avoid outside activities to ensure adequate rest. 
B)  be certain that you are the only caregiver for your baby to facilitate infant attachment. 
C)  keep feelings of sadness and adjustment to your new role to yourself. 
D)  realize that this is a common occurrence that affects many women. 
A)  stay home and avoid outside activities to ensure adequate rest. 
B)  be certain that you are the only caregiver for your baby to facilitate infant attachment. 
C)  keep feelings of sadness and adjustment to your new role to yourself. 
D)  realize that this is a common occurrence that affects many women.

Question 16

MATCHING
PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of circulatory status can be done with noninvasive monitoring. Please match the type of noninvasive assessment that the RN would perform with the appropriate clinical manifestation or body system.

-Heart sounds

Accepted Answer

A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement 
A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement

Question 17

When a woman is diagnosed with postpartum depression (PPD)with psychotic features,one of the main concerns is that she may:

Accepted Answer

A)  have outbursts of anger. 
B)  neglect her hygiene. 
C)  harm her infant. 
D)  lose interest in her husband. 
A)  have outbursts of anger. 
B)  neglect her hygiene. 
C)  harm her infant. 
D)  lose interest in her husband.

Question 18

Which instruction should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?

Accepted Answer

A)  Palpate the fundus daily to ensure that it is soft. 
B)  Notify the physician of any increase in the amount of lochia or a return to bright red bleeding. 
C)  Report any decrease in the amount of brownish red lochia. 
D)  The passage of clots as large as an orange can be expected. 
A)  Palpate the fundus daily to ensure that it is soft. 
B)  Notify the physician of any increase in the amount of lochia or a return to bright red bleeding. 
C)  Report any decrease in the amount of brownish red lochia. 
D)  The passage of clots as large as an orange can be expected.

Question 19

MATCHING
PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of circulatory status can be done with noninvasive monitoring. Please match the type of noninvasive assessment that the RN would perform with the appropriate clinical manifestation or body system.

-Skin color,temperature,turgor

Accepted Answer

A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement 
A) Palpation 
B) Auscultation 
C) Inspection 
D) Observation 
E) Measurement

Question 20

When caring for a after birth woman experiencing hemorrhagic shock,the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:

Accepted Answer

A)  absence of cyanosis in the buccal mucosa. 
B)  cool, dry skin. 
C)  diminished restlessness. 
D)  urinary output of at least 30 mL/hr. 
A)  absence of cyanosis in the buccal mucosa. 
B)  cool, dry skin. 
C)  diminished restlessness. 
D)  urinary output of at least 30 mL/hr.

Exam 21: Postpartum Complications

Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH).For instance:

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

Anxiety disorders are the most common mental disorders that affect women.While providing care to the maternity patient,the nurse should be aware that one of these disorders is likely to be triggered by the process of labor and birth.This disorder is:

Medications used to manage postpartum hemorrhage (PPH)include: (Select all that apply.)

Early after birth hemorrhage is defined as a blood loss greater than:

A woman delivered a 9-lb,10-ounce baby 1 hour ago.When you arrive to perform her 15-minute assessment,she tells you that she "feels all wet underneath." You discover that both pads are completely saturated and that she is lying in a 6-inch-diameter puddle of blood.What is your first action?

The perinatal nurse caring for the after birth woman understands that late postpartum hemorrhage (PPH)is most likely caused by:

The first and most important nursing intervention when a nurse observes profuse after birth bleeding is to:

Complicated bereavement:

A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:

If nonsurgical treatment for late after birth hemorrhage is ineffective,which surgical procedure is appropriate to correct the cause of this condition?

To provide adequate after birth care,the nurse should be aware that postpartum depression (PPD)with psychotic features:

When a woman is diagnosed with postpartum depression (PPD)with psychotic features,one of the main concerns is that she may:

Which instruction should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications?

When caring for a after birth woman experiencing hemorrhagic shock,the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:

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

Postpartum Physiologic Changes

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

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

The Child With Genitourinary Dysfunction

The Child With Cerebral Dysfunction

The Child With Endocrine Dysfunction

The Child With Musculoskeletal or Articular Dysfunction

The Child With Neuromuscular or Muscular Dysfunction

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