THE WOMAN WITH A POSTPARTUM COMPLICATION TEST BANK
Chapter 28: The Woman with a Postpartum Complication
Test Bank
MULTIPLE CHOICE
1. Which statement by a postpartum woman indicates that further teaching is not needed
regarding thrombus formation?
a. "I'll stay in bed for the first 3 days after my baby is born."
b. "I'll keep my legs elevated with pillows."
c. "I'll sit in my rocking chair most of the time."
d. "I'll put my support stockings on every morning before rising."
ANS: D
Feedback
A As soon as possible, the woman should ambulate frequently.
B The mother should avoid knee pillows because they increase pressure on the
popliteal space.
C Sitting in a chair with legs in a dependent position causes pooling of blood in the
lower extremities.
D Venous congestion begins as soon as the woman stands up. The stockings should
be applied before she rises from the bed in the morning.
PTS: 1 DIF: Cognitive Level: Application REF: p. 675
OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
2. The 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
a. Uterine atony
b. Uterine inversion
c. Vaginal hematoma
d. Vaginal laceration
ANS: A
Feedback
A Uterine atony is marked hypotonia of the uterus. It is the leading cause of
postpartum hemorrhage.
B Uterine inversion may lead to hemorrhage, but it is not the most likely source of
this patient’s bleeding. Furthermore, if the woman was experiencing a uterine
inversion, it would be evidenced by the presence of a large, red, rounded mass
protruding from the introitus.
C A vaginal hematoma may be associated with hemorrhage. However, the most
likely clinical finding would be pain, not the presence of profuse bleeding.
D A vaginal laceration may cause hemorrhage; however, it is more likely that
profuse bleeding would result from uterine atony. A vaginal laceration should be
suspected if vaginal bleeding continues in the presence of a firm, contracted
, uterine fundus.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 667
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
3. The nurse knows that a measure for preventing late postpartum hemorrhage is to
a. Administer broad-spectrum antibiotics.
b. Inspect the placenta after delivery.
c. Manually remove the placenta.
d. Pull on the umbilical cord to hasten the delivery of the placenta.
ANS: B
Feedback
A Broad-spectrum antibiotics will be given if postpartum infection is suspected.
B If a portion of the placenta is missing, the clinician can explore the uterus, locate
the missing fragments, and remove the potential cause of late postpartum
hemorrhage.
C Manual removal of the placenta increases the risk of postpartum hemorrhage.
D The placenta is usually delivered 5 to 30 minutes after birth of the baby without
pulling on the cord. That can cause uterine inversion.
PTS: 1 DIF: Cognitive Level: Application REF: p. 670
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000
g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has
the woman void and massages her fundus, but her fundus remains difficult to find, and the
rubra lochia remains heavy. The nurse should
a. Continue to massage the fundus.
b. Notify the physician.
c. Recheck vital signs.
d. Insert a Foley catheter.
ANS: B
Feedback
A The uterine muscle can be overstimulated by massage, leading to uterine atony
and rebound hemorrhage.
B Treatment of excessive bleeding requires the collaboration of the physician and
the nurses. Do not leave the patient alone.
C The nurse should call the clinician while a second nurse rechecks the vital signs.
D The woman has voided successfully, so a Foley catheter is not needed at this time.
PTS: 1 DIF: Cognitive Level: Application REF: p. 672
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. Early postpartum hemorrhage is defined as a blood loss greater than
a. 500 mL in the first 24 hours after vaginal delivery
Chapter 28: The Woman with a Postpartum Complication
Test Bank
MULTIPLE CHOICE
1. Which statement by a postpartum woman indicates that further teaching is not needed
regarding thrombus formation?
a. "I'll stay in bed for the first 3 days after my baby is born."
b. "I'll keep my legs elevated with pillows."
c. "I'll sit in my rocking chair most of the time."
d. "I'll put my support stockings on every morning before rising."
ANS: D
Feedback
A As soon as possible, the woman should ambulate frequently.
B The mother should avoid knee pillows because they increase pressure on the
popliteal space.
C Sitting in a chair with legs in a dependent position causes pooling of blood in the
lower extremities.
D Venous congestion begins as soon as the woman stands up. The stockings should
be applied before she rises from the bed in the morning.
PTS: 1 DIF: Cognitive Level: Application REF: p. 675
OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance
2. The 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
a. Uterine atony
b. Uterine inversion
c. Vaginal hematoma
d. Vaginal laceration
ANS: A
Feedback
A Uterine atony is marked hypotonia of the uterus. It is the leading cause of
postpartum hemorrhage.
B Uterine inversion may lead to hemorrhage, but it is not the most likely source of
this patient’s bleeding. Furthermore, if the woman was experiencing a uterine
inversion, it would be evidenced by the presence of a large, red, rounded mass
protruding from the introitus.
C A vaginal hematoma may be associated with hemorrhage. However, the most
likely clinical finding would be pain, not the presence of profuse bleeding.
D A vaginal laceration may cause hemorrhage; however, it is more likely that
profuse bleeding would result from uterine atony. A vaginal laceration should be
suspected if vaginal bleeding continues in the presence of a firm, contracted
, uterine fundus.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 667
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
3. The nurse knows that a measure for preventing late postpartum hemorrhage is to
a. Administer broad-spectrum antibiotics.
b. Inspect the placenta after delivery.
c. Manually remove the placenta.
d. Pull on the umbilical cord to hasten the delivery of the placenta.
ANS: B
Feedback
A Broad-spectrum antibiotics will be given if postpartum infection is suspected.
B If a portion of the placenta is missing, the clinician can explore the uterus, locate
the missing fragments, and remove the potential cause of late postpartum
hemorrhage.
C Manual removal of the placenta increases the risk of postpartum hemorrhage.
D The placenta is usually delivered 5 to 30 minutes after birth of the baby without
pulling on the cord. That can cause uterine inversion.
PTS: 1 DIF: Cognitive Level: Application REF: p. 670
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000
g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has
the woman void and massages her fundus, but her fundus remains difficult to find, and the
rubra lochia remains heavy. The nurse should
a. Continue to massage the fundus.
b. Notify the physician.
c. Recheck vital signs.
d. Insert a Foley catheter.
ANS: B
Feedback
A The uterine muscle can be overstimulated by massage, leading to uterine atony
and rebound hemorrhage.
B Treatment of excessive bleeding requires the collaboration of the physician and
the nurses. Do not leave the patient alone.
C The nurse should call the clinician while a second nurse rechecks the vital signs.
D The woman has voided successfully, so a Foley catheter is not needed at this time.
PTS: 1 DIF: Cognitive Level: Application REF: p. 672
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. Early postpartum hemorrhage is defined as a blood loss greater than
a. 500 mL in the first 24 hours after vaginal delivery
