Question 1

The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:

Accepted Answer

A) Washing the nipples and breasts with mild soap and water once a day 
B) Using proper breastfeeding techniques 
C) Wearing a nipple shield for the first few days of breastfeeding 
D) Wearing a supportive bra 24 hours a day 
A) Washing the nipples and breasts with mild soap and water once a day 
B) Using proper breastfeeding techniques 
C) Wearing a nipple shield for the first few days of breastfeeding 
D) Wearing a supportive bra 24 hours a day B

Question 2

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the woman is experiencing profuse bleeding.The most likely etiology for the bleeding is:

Accepted Answer

A) Uterine atony 
B) Uterine inversion 
C) Vaginal hematoma 
D) Vaginal laceration 
A) Uterine atony 
B) Uterine inversion 
C) Vaginal hematoma 
D) Vaginal laceration A

Question 3

One of the first symptoms of puerperal infection to assess for in the postpartum woman is:

Accepted Answer

A) Fatigue continuing for longer than 1 week 
B) Pain with voiding 
C) Profuse vaginal bleeding with ambulation 
D) Temperature of 38° C (100.4° F)or higher on 2 successive days starting 24 hours after birth 
A) Fatigue continuing for longer than 1 week 
B) Pain with voiding 
C) Profuse vaginal bleeding with ambulation 
D) Temperature of 38° C (100.4° F)or higher on 2 successive days starting 24 hours after birth D

Question 4

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

Question 5

Lacerations of the cervix,vagina,or perineum are also causes of PPH.Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except:

Accepted Answer

A) Operative or precipitate birth 
B) Adherent retained placenta 
C) Abnormal presentation of the fetus 
D) Congenital abnormalities of the maternal soft parts 
A) Operative or precipitate birth 
B) Adherent retained placenta 
C) Abnormal presentation of the fetus 
D) Congenital abnormalities of the maternal soft parts

Question 6

When caring for a postpartum 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

Question 7

A woman who has recently given birth complains of pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.The nurse should suspect ______ and should confirm the diagnosis by ________.

Accepted Answer

A) Disseminated intravascular coagulation (DI
C) ;asking for laboratory tests 
B) von Willebrand disease (vW
D) ;noting whether bleeding times have been extended 
C) Thrombophlebitis;using real-time and color Doppler ultrasound 
D) Thrombocytopenic purpura;drawing blood for laboratory analysis 
A) Disseminated intravascular coagulation (DI
C) ;asking for laboratory tests 
B) von Willebrand disease (vW
D) ;noting whether bleeding times have been extended 
C) Thrombophlebitis;using real-time and color Doppler ultrasound 
D) Thrombocytopenic purpura;drawing blood for laboratory analysis

Question 8

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

Accepted Answer

A) A primiparous woman (G 2,P 1-0-0-1)being prepared for an emergency cesarean birth for fetal distress 
B) A woman with severe preeclampsia on magnesium sulfate whose labor is being induced 
C) A multiparous woman (G 3,P 2-0-0-2)with an 8-hour labor 
D) A primigravida in spontaneous labor with preterm twins 
A) A primiparous woman (G 2,P 1-0-0-1)being prepared for an emergency cesarean birth for fetal distress 
B) A woman with severe preeclampsia on magnesium sulfate whose labor is being induced 
C) A multiparous woman (G 3,P 2-0-0-2)with an 8-hour labor 
D) A primigravida in spontaneous labor with preterm twins

Question 9

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

Accepted Answer

A) Oxytocin 
B) Methergine 
C) Terbutaline 
D) Hemabate 
E) Magnesium sulfate 
A) Oxytocin 
B) Methergine 
C) Terbutaline 
D) Hemabate 
E) Magnesium sulfate

Question 10

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy?

Accepted Answer

A) Large doses of vitamin C during pregnancy 
B) Prophylactic antibiotics 
C) Strict aseptic technique,including handwashing,by all health care personnel 
D) Limited protein and fat intake 
A) Large doses of vitamin C during pregnancy 
B) Prophylactic antibiotics 
C) Strict aseptic technique,including handwashing,by all health care personnel 
D) Limited protein and fat intake

Question 11

It is important for the perinatal nurse to be knowledgeable regarding conditions of abnormal adherence of the placenta.This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua.Which classification of separation is not recognized as an abnormal adherence pattern?

Accepted Answer

A) Placenta accreta 
B) Placenta increta 
C) Placenta percreta 
D) Placenta abruptio 
A) Placenta accreta 
B) Placenta increta 
C) Placenta percreta 
D) Placenta abruptio

Question 12

A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH)is most likely caused by:

Accepted Answer

A) Subinvolution of the uterus 
B) Defective vascularity of the decidua 
C) Cervical lacerations 
D) Coagulation disorders 
A) Subinvolution of the uterus 
B) Defective vascularity of the decidua 
C) Cervical lacerations 
D) Coagulation disorders

Question 13

____________________ is the most common postpartum infection.

Accepted Answer

Endometritis
Endometritis usually begins

Question 14

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

Exam 34: Postpartum Complications

The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:

A perinatal nurse is caring for a woman in the immediate postbirth period.Assessment reveals that the woman is experiencing profuse bleeding.The most likely etiology for the bleeding is:

One of the first symptoms of puerperal infection to assess for in the postpartum woman is:

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

Lacerations of the cervix,vagina,or perineum are also causes of PPH.Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except:

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

A woman who has recently given birth complains of pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.The nurse should suspect ______ and should confirm the diagnosis by ________.

Which client is at greatest risk for early postpartum hemorrhage (PPH)?

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

The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy?

A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH)is most likely caused by:

____________________ is the most common postpartum infection.

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

21st Century Maternity and Womens Health Nursing

Community Care: the Family and Culture

Clinical Genetics

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

Maternal and Fetal Nutrition

Nursing Care of the Family During Pregnancy

Labor and Birth Processes

Pain Management

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Postpartum Physiology

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 for Risk Factors in Pregnancy

Hypertensive Disorders in Pregnancy

Antepartum Hemorrhagic Disorders

Endocrine and Metabolic Disorders in Pregnancy

Medical-Surgical Problems in Pregnancy

Obstetric Critical Care

Mental Health Disorders and Substance Abuse in Pregnancy

Labor and Birth Complications

Acquired Problems of the Newborn

Hemolytic Disorders and Congenital Anomalies

Nursing Care of the High Risk Newborn

Perinatal Loss and Grief

Filters

A woman who has recently given birth complains of pain and tenderness in her leg.On physical examination,the nurse notices warmth and redness over an enlarged,hardened area.The nurse should suspect and should confirm the diagnosis by __.