Question 1

A positive sign of thrombophlebitis includes

Accepted Answer

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

Question 2

A postpartum patient has developed deep vein thrombosis (DVT) and treatment with warfarin (Coumadin) has been initiated. Which dietary selection should be modified in view of this treatment regimen?

Accepted Answer

A)   Fresh fruits
B)   Milk
C)   Lentils
D)   Soda C

Question 3

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. D

Question 4

As you receive a report, which assessment finding should you recognize as an indication 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)   Patient requested pain medication twice during last shift

Question 5

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

Accepted Answer

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

Question 6

Prior to ambulating the patient whose admission hemoglobin level was 10.2 g/dL to the bathroom, the nurse should

Accepted Answer

A)   request repeat hemoglobin and hematocrit.
B)   assess the resting pulse rate.
C)   dangle her on the side of the bed.
D)   administer the ordered oral analgesic.

Question 7

If a late postpartum hemorrhage is documented on a patient who delivered 3 days ago, the nurse recognizes that this hemorrhage occurred

Accepted Answer

A)   on the first postpartum day.
B)   during recovery phase of labor.
C)   during the third stage of labor.
D)   on the second postpartum day.

Question 8

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

Accepted Answer

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

Question 9

The visiting nurse must be aware that women who have had a postpartum hemorrhage are subject to a variety of complications after discharge from the hospital. These include which of the following? (Select all that apply.)

Accepted Answer

A)   Anemia
B)   Dehydration
C)   Exhaustion
D)   Postpartum infection
E)   Failure to attach to her infant

Question 10

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.

Question 11

If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is appropriate to correct the cause of this condition?

Accepted Answer

A)   Hysterectomy
B)   Laparoscopy
C)   Laparotomy
D)   Dilation and curettage (D&
C)

Question 12

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 patient on bed rest, with the affected leg elevated.

Question 13

The nurse observes the patient as she ambulates to the bathroom. Which clinical finding might 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

Question 14

The nurse understands that late postpartum hemorrhage may 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.

Question 15

A patient with mastitis is concerned about breastfeeding while she has an active infection. Which is an appropriate response by the nurse?

Accepted Answer

A)   Organisms will be inactivated by gastric acid.
B)   Organisms that cause mastitis are not passed through the milk.
C)   The infant is not susceptible to the organisms that cause mastitis.
D)   The infant is protected from infection by immunoglobulins in the breast milk.

Question 16

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.

Question 17

A postpartum patient 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.

Question 18

The patient who is being treated for endometritis is placed in the Fowler position because this position

Accepted Answer

A)   promotes comfort and rest.
B)   facilitates drainage of lochia.
C)   prevents spread of infection to the urinary tract.
D)   decreases tension on the reproductive organs.

Question 19

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 grapefruit juice and carbonated beverages.
D)   discouraging voiding until the sensation of a full bladder is present.

Question 20

A patient has been treated with oxytocin (Pitocin) for postpartum hemorrhage. Bleeding has stabilized and slowed down considerably. The peripad in place reveals a moderate amount of bright red blood, with no clots expelled when massaging the fundus. The patient now complains of having difficulty breathing. Auscultation of breath sounds reveals adventitious sounds. Based on this clinical presentation, the priority nursing action is to

Accepted Answer

A)   evaluate intake and output of the past 12 hours following birth.
B)   initiate a rapid response intervention.
C)   obtain an order from the physician for type and crossmatch of 2 units packed red blood cells (PRBCs) .
D)   reposition the patient and reassess in 15 minutes. Initiate frequent vital sign assessments.

Exam 18: Postpartum Maternal Complications