N8 Postpartum Qs Ch 20-23

Wong, et al.: Maternal Child Nursing Care, 3rd Edition
Review Questions Chapter 20
1.
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is one day postpartum. An expected finding would be:

A. Soft, non-tender; colostrum is present
B. Leakage of milk at let down
C. Swollen, warm, and tender upon palpation
D. A few blisters and a bruise on each areola
2.
Following the birth of her baby, a woman expresses concern about the weight she gained during pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the expected pattern of weight loss, should begin by telling this woman that:

A. Return to prepregnant weight is usually achieved by the end of the postpartum period
B. Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3 pound weight loss
C. The expected weight loss immediately after birth averages about 11 to 13 pounds
D. Lactation will inhibit weight loss since caloric intake must increase to support milk production
3.
The breasts of a bottle feeding woman are engorged. The nurse should tell her to:

A. Wear a snug, supportive bra
B. Allow warm water to soothe the breasts during a shower
C. Express milk from breasts occasionally to relieve discomfort
D. Place absorbent pads with plastic liners into her bra to absorb leakage

Review Questions Chapter 21
1.
When palpating the fundus of a woman 18 hours after birth, the nurse notes that it is firm, 2 finger breaths above the umbilicus, and deviated to the left of midline. The nurse should:

A. Massage the fundus
B. Administer Methergine 0.2 mg, po that has been ordered prn
C. Assist the woman to empty her bladder
D. Recognize this as an expected finding during the first 24 hours following birth
2.
Which of the following findings would be a source of concern if noted during the assessment of a woman who is 12 hours postpartum?

A. Postural hypotension
B. Temperature of 100.4°F
C. Bradycardia — pulse rate of 55 BPM
D. Pain in left calf with dorsiflexion of left foot
3.
The nurse examines a woman one hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action would be to:

A. Place her on a bedpan to empty her bladder
B. Massage her fundus
C. Call the physician
D. Administer Methergine 0.2 mg IM which has been ordered prn
4.
When performing a postpartum check, the nurse should:

A. Assist the woman into a lateral position with upper leg flexed forward to facilitate the examination of her perineum
B. Assist the woman into a supine position with her arms above her head and her legs extended for the examination of her abdomen
C. Instruct the woman to avoid urinating just before the examination since a full bladder will facilitate fundal palpation
D. Wash hands and put on sterile gloves before beginning the check
5.
Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:

A. Uses soap and warm water to wash the vulva and perineum
B. Washes from symphysis pubis back to episiotomy
C. Changes her perineal pad every 2 - 3 hours
D. Uses the peribottle to rinse upward into her vagina
6.
Which measure would be least effective in preventing postpartum hemorrhage?

A. Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered
B. Encourage the woman to void every 2 hours
C. Massage the fundus every hour for the first 24 hours following birth
D. Teach the woman the importance of rest and nutrition to enhance healing

Review Questions Chapter 22
1.
When making a visit to the home of a postpartum woman one week after birth, the nurse should recognize that the woman would characteristically:

A. Express a strong need to review events and her behavior during the process of labor and birth
B. Exhibit a reduced attention span, limiting readiness to learn
C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn
D. Have reestablished her role as a spouse/partner
2.
Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should:

A. Tell the woman she can rest after she feeds her baby
B. Recognize this as a behavior of the taking-hold stage
C. Record the behavior as ineffective maternal-newborn attachment
D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time
3.
Parents can facilitate the adjustment of their other children to a new baby by:

A. Having the children choose or make a gift to give to the new baby upon its arrival home
B. Emphasizing activities that keep the new baby and other children together
C. Having the mother carry the new baby into the home so she can show the other children the new baby
D. Reducing stress on other children by limiting their involvement in the care of the new baby
4.
A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment following birth. The nurse, recognizing the needs of women during this stage, should:

A. Foster an active role in the baby's care
B. Provide time for the mother to reflect on the events of and her behavior during childbirth
C. Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session now
D. Promote maternal independence by encouraging her to meet her own hygiene and comfort needs

Review Questions Chapter 23
1.
Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse would suspect:

A. Bladder distension
B. Uterine atony
C. Constipation
D. Hematoma formation
2.
Postpartum women experience an increased risk for urinary tract infection. A prevention measure the nurse could teach the postpartum woman would be:

A. Acidify the urine by drinking 3 glasses of orange juice each day
B. Maintain a fluid intake of 1 - 2 liters each day
C. Empty bladder every 4 hours throughout the day
D. Perform perineal care on a regular basis