Question 1

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 D

Question 2

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

Question 3

The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:

Accepted Answer

A)  Involutionary period because of what happens to the uterus.
B)  Lochia period because of the nature of the vaginal discharge.
C)  Mini-tri period because it lasts only 3 to 6 weeks.
D)  Puerperium, or fourth trimester of pregnancy. D

Question 4

Which description of postpartum restoration or healing times is accurate?

Accepted Answer

A)  The cervix shortens, becomes firm, and returns to form within a month postpartum.
B)  Vaginal rugae reappear by 3 weeks postpartum.
C)  Most episiotomies heal within a week.
D)  Hemorrhoids usually decrease in size within 2 weeks of childbirth.

Question 5

If the patient's white blood cell (WBC)count is 25,000/mm on her second postpartum day,the nurse should:

Accepted Answer

A)  Tell the physician immediately.
B)  Have the laboratory draw blood for reanalysis.
C)  Recognize that this is an acceptable range at this point postpartum.
D)  Begin antibiotic therapy immediately.

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 postpartum period is:

Accepted Answer

A)  Elevated temperature caused by postpartum 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

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

Accepted Answer

A)  Caused by mild, continuous contractions for the duration of the postpartum 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 8

Postbirth 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.

Question 9

A postpartum patient asks,"Will these stretch marks go away?" The nurse's best response is:

Accepted Answer

A)  "They will continue to fade and should be gone by your 6-week checkup."
B)  "No, never."
C)  "Yes, eventually."
D)  "They will fade to silvery lines but won`t disappear completely."

Question 10

With regard to postpartum 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.

Question 11

Which woman is most likely to experience strong afterpains?

Accepted Answer

A)  A woman who experienced oligohydramnios
B)  A woman who is a gravida 4, para 4-0-0-4
C)  A woman who is bottle-feeding her infant
D)  A woman whose infant weighed 5 pounds, 3 ounces

Question 12

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

Accepted Answer

A)  Estrogen
B)  Progesterone
C)  Prolactin
D)  Human placental lactogen

Question 13

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 postpartum 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 postpartum
D)  Hypertension
E)  Hypoventilation

Question 14

The self-destruction of excess hypertrophied tissue in the uterus is called:

Accepted Answer

A)  Autolysis.
B)  Subinvolution.
C)  Afterpain.
D)  Diastasis.

Question 15

A woman gave birth to an infant boy 10 hours ago.Where would the nurse expect to locate this woman's fundus?

Accepted Answer

A)  One centimeter above the umbilicus
B)  Two centimeters below the umbilicus
C)  Midway between the umbilicus and the symphysis pubis
D)  Nonpalpable abdominally

Question 16

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 client 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."

Question 17

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 postpartum 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 postpartum
D)  Hypertension
E)  Hypoventilation

Question 18

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 postpartum nurse may encounter with the probable cause:

-Excessive use of oxytocin

Accepted Answer

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

Question 19

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.

Question 20

A woman gave birth to a 7-pound,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 postpartum 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.

Exam 18: Maternal Physiologic Changes

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?

The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:

Which description of postpartum restoration or healing times is accurate?

If the patient's white blood cell (WBC) count is 25,000/mm on her second postpartum day,the nurse should:

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 postpartum period is:

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

Postbirth uterine/vaginal discharge,called lochia:

A postpartum patient asks,"Will these stretch marks go away?" The nurse's best response is:

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

Which woman is most likely to experience strong afterpains?

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

The self-destruction of excess hypertrophied tissue in the uterus is called:

A woman gave birth to an infant boy 10 hours ago.Where would the nurse expect to locate this woman's fundus?

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