Obstetric Nursing-Postpartum ||Latest
Exam
A postpartum nurse is preparing to care for a woman who has just delivered a healthy
newborn infant. In the immediate postpartum period the nurse plans to take the
woman's vital signs:
Every 30 minutes during the first hour and then every hour for the next two hours.
Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
Every hour for the first 2 hours and then every 4 hours
Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours. -
CORRECT ANSWER 2
A postpartum nurse is taking the vital signs of a woman who delivered a healthy
newborn infant 4 hours ago. The nurse notes that the mother's temperature is 100.2*F.
Which of the following actions would be most appropriate?
Retake the temperature in 15 minutes
Notify the physician
Document the findings
Increase hydration by encouraging oral fluids -CORRECT ANSWER 4. The mother's
temperature may be taken every 4 hours while she is awake. Temperatures up to 100.4
(38 C) in the first 24 hours after birth are often related to the dehydrating effects of
labor. The most appropriate action is to increase hydration by encouraging oral fluids,
which should bring the temperature to a normal reading. Although the nurse would
document the findings, the most appropriate action would be to increase the hydration.
The nurse is assessing a client who is 6 hours PP after delivering a full-term healthy
infant. The client complains to the nurse of feelings of faintness and dizziness. Which of
the following nursing actions would be most appropriate?
Obtain hemoglobin and hematocrit levels
Instruct the mother to request help when getting out of bed
Elevate the mother's legs
Inform the nursery room nurse to avoid bringing the newborn infant to the mother until
the feelings of light-headedness and dizziness have subsided. -CORRECT ANSWER 2.
Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings of
faintness or dizziness are signs that should caution the nurse to be aware of the client's
safety. The nurse should advise the mother to get help the first few times the mother
gets out of bed. Obtaining an H/H requires a physicians order.
A nurse is preparing to perform a fundal assessment on a postpartum client. The initial
nursing action in performing this assessment is which of the following?
,Ask the client to turn on her side
Ask the client to lie flat on her back with the knees and legs flat and straight.
Ask the mother to urinate and empty her bladder
Massage the fundus gently before determining the level of the fundus. -CORRECT
ANSWER 3. Before starting the fundal assessment, the nurse should ask the mother to
empty her bladder so that an accurate assessment can be done. When the nurse is
performing fundal assessment, the nurse asks the woman to lie flat on her back with the
knees flexed. Massaging the fundus is not appropriate unless the fundus is boggy and
soft, and then it should be massaged gently until firm.
The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia
is red and has a foul-smelling odor. The nurse determines that this assessment finding
is:
Normal
Indicates the presence of infection
Indicates the need for increasing oral fluids
Indicates the need for increasing ambulation -CORRECT ANSWER 2. Lochia, the
discharge present after birth, is red for the first 1 to 3 days and gradually decreases in
amount. Normal lochia has a fleshy odor. Foul smelling or purulent lochia usually
indicates infection, and these findings are not normal. Encouraging the woman to drink
fluids or increase ambulation is not an accurate nursing intervention.
When performing a PP assessment on a client, the nurse notes the presence of clots in
the lochia. The nurse examines the clots and notes that they are larger than 1 cm.
Which of the following nursing actions is most appropriate?
Document the findings
Notify the physician
Reassess the client in 2 hours
Encourage increased intake of fluids. -CORRECT ANSWER 2. Normally, one may find
a few small clots in the first 1 to 2 days after birth from pooling of blood in the vajayjay.
Clots larger than 1 cm are considered abnormal. The cause of these clots, such as
uterine atony or retained placental fragments, needs to be determined and treated to
prevent further blood loss. Although the findings would be documented, the most
appropriate action is to notify the physician.
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected
lochia drainage. The nurse instructs the mother that the normal amount of lochia may
vary but should never exceed the need for:
One peripad per day
Two peripads per day
Three peripads per day
, Eight peripads per day -CORRECT ANSWER 4. The normal amount of lochia may vary
with the individual but should never exceed 4 to 8 peripads per day. The average
number of peripads is 6 per day.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn
infant. The nurse instructs the mother that she should expect normal bowel elimination
to return:
One the day of the delivery
3 days PP
7 days PP
within 2 weeks PP -CORRECT ANSWER 2. After birth, the nurse should auscultate the
woman's abdomen in all four quadrants to determine the return of bowel sounds.
Normal bowel elimination usually returns 2 to 3 days PP. Surgery, anesthesia, and the
use of narcotics and pain control agents also contribute to the longer period of altered
bowel function.
Select all of the physiological maternal changes that occur during the PP period.
Cervical involution ceases immediately
Vaginal distention decreases slowly
Fundus begins to descend into the pelvis after 24 hours
Cardiac output decreases with resultant tachycardia in the first 24 hours
Digestive processes slow immediately. -CORRECT ANSWER 1 and 3. In the PP
period, cervical healing occurs rapidly and cervical involution occurs. After 1 week the
muscle begins to regenerate and the cervix feels firm and the external os is the width of
a pencil. Although the vaginal mucosa heals and vaginal distention decreases, it takes
the entire PP period for complete involution to occur and muscle tone is never restored
to the pregravid state. The fundus begins to descent into the pelvic cavity after 24
hours, a process known as involution. Despite blood loss that occurs during delivery of
the baby, a transient increase in cardiac output occurs. The increase in cardiac output,
which persists about 48 hours after childbirth, is probably caused by an increase in
stroke volume because Bradycardia is often noted during the PP period. Soon after
childbirth, digestion begins to begin to be active and the new mother is usually hungry
because of the energy expended during labor.
A nurse is caring for a PP woman who has received epidural anesthesia and is
monitoring the woman for the presence of a vulva hematoma. Which of the following
assessment findings would best indicate the presence of a hematoma?
Complaints of a tearing sensation
Complaints of intense pain
Changes in vital signs
Signs of heavy bruising -CORRECT ANSWER 3. Because the woman has had epidural
anesthesia and is anesthetized, she cannot feel pain, pressure, or a tearing sensation.
Changes in vitals indicate hypovolemia in the anesthetized PP woman with vulvar
Exam
A postpartum nurse is preparing to care for a woman who has just delivered a healthy
newborn infant. In the immediate postpartum period the nurse plans to take the
woman's vital signs:
Every 30 minutes during the first hour and then every hour for the next two hours.
Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
Every hour for the first 2 hours and then every 4 hours
Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours. -
CORRECT ANSWER 2
A postpartum nurse is taking the vital signs of a woman who delivered a healthy
newborn infant 4 hours ago. The nurse notes that the mother's temperature is 100.2*F.
Which of the following actions would be most appropriate?
Retake the temperature in 15 minutes
Notify the physician
Document the findings
Increase hydration by encouraging oral fluids -CORRECT ANSWER 4. The mother's
temperature may be taken every 4 hours while she is awake. Temperatures up to 100.4
(38 C) in the first 24 hours after birth are often related to the dehydrating effects of
labor. The most appropriate action is to increase hydration by encouraging oral fluids,
which should bring the temperature to a normal reading. Although the nurse would
document the findings, the most appropriate action would be to increase the hydration.
The nurse is assessing a client who is 6 hours PP after delivering a full-term healthy
infant. The client complains to the nurse of feelings of faintness and dizziness. Which of
the following nursing actions would be most appropriate?
Obtain hemoglobin and hematocrit levels
Instruct the mother to request help when getting out of bed
Elevate the mother's legs
Inform the nursery room nurse to avoid bringing the newborn infant to the mother until
the feelings of light-headedness and dizziness have subsided. -CORRECT ANSWER 2.
Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings of
faintness or dizziness are signs that should caution the nurse to be aware of the client's
safety. The nurse should advise the mother to get help the first few times the mother
gets out of bed. Obtaining an H/H requires a physicians order.
A nurse is preparing to perform a fundal assessment on a postpartum client. The initial
nursing action in performing this assessment is which of the following?
,Ask the client to turn on her side
Ask the client to lie flat on her back with the knees and legs flat and straight.
Ask the mother to urinate and empty her bladder
Massage the fundus gently before determining the level of the fundus. -CORRECT
ANSWER 3. Before starting the fundal assessment, the nurse should ask the mother to
empty her bladder so that an accurate assessment can be done. When the nurse is
performing fundal assessment, the nurse asks the woman to lie flat on her back with the
knees flexed. Massaging the fundus is not appropriate unless the fundus is boggy and
soft, and then it should be massaged gently until firm.
The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia
is red and has a foul-smelling odor. The nurse determines that this assessment finding
is:
Normal
Indicates the presence of infection
Indicates the need for increasing oral fluids
Indicates the need for increasing ambulation -CORRECT ANSWER 2. Lochia, the
discharge present after birth, is red for the first 1 to 3 days and gradually decreases in
amount. Normal lochia has a fleshy odor. Foul smelling or purulent lochia usually
indicates infection, and these findings are not normal. Encouraging the woman to drink
fluids or increase ambulation is not an accurate nursing intervention.
When performing a PP assessment on a client, the nurse notes the presence of clots in
the lochia. The nurse examines the clots and notes that they are larger than 1 cm.
Which of the following nursing actions is most appropriate?
Document the findings
Notify the physician
Reassess the client in 2 hours
Encourage increased intake of fluids. -CORRECT ANSWER 2. Normally, one may find
a few small clots in the first 1 to 2 days after birth from pooling of blood in the vajayjay.
Clots larger than 1 cm are considered abnormal. The cause of these clots, such as
uterine atony or retained placental fragments, needs to be determined and treated to
prevent further blood loss. Although the findings would be documented, the most
appropriate action is to notify the physician.
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected
lochia drainage. The nurse instructs the mother that the normal amount of lochia may
vary but should never exceed the need for:
One peripad per day
Two peripads per day
Three peripads per day
, Eight peripads per day -CORRECT ANSWER 4. The normal amount of lochia may vary
with the individual but should never exceed 4 to 8 peripads per day. The average
number of peripads is 6 per day.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn
infant. The nurse instructs the mother that she should expect normal bowel elimination
to return:
One the day of the delivery
3 days PP
7 days PP
within 2 weeks PP -CORRECT ANSWER 2. After birth, the nurse should auscultate the
woman's abdomen in all four quadrants to determine the return of bowel sounds.
Normal bowel elimination usually returns 2 to 3 days PP. Surgery, anesthesia, and the
use of narcotics and pain control agents also contribute to the longer period of altered
bowel function.
Select all of the physiological maternal changes that occur during the PP period.
Cervical involution ceases immediately
Vaginal distention decreases slowly
Fundus begins to descend into the pelvis after 24 hours
Cardiac output decreases with resultant tachycardia in the first 24 hours
Digestive processes slow immediately. -CORRECT ANSWER 1 and 3. In the PP
period, cervical healing occurs rapidly and cervical involution occurs. After 1 week the
muscle begins to regenerate and the cervix feels firm and the external os is the width of
a pencil. Although the vaginal mucosa heals and vaginal distention decreases, it takes
the entire PP period for complete involution to occur and muscle tone is never restored
to the pregravid state. The fundus begins to descent into the pelvic cavity after 24
hours, a process known as involution. Despite blood loss that occurs during delivery of
the baby, a transient increase in cardiac output occurs. The increase in cardiac output,
which persists about 48 hours after childbirth, is probably caused by an increase in
stroke volume because Bradycardia is often noted during the PP period. Soon after
childbirth, digestion begins to begin to be active and the new mother is usually hungry
because of the energy expended during labor.
A nurse is caring for a PP woman who has received epidural anesthesia and is
monitoring the woman for the presence of a vulva hematoma. Which of the following
assessment findings would best indicate the presence of a hematoma?
Complaints of a tearing sensation
Complaints of intense pain
Changes in vital signs
Signs of heavy bruising -CORRECT ANSWER 3. Because the woman has had epidural
anesthesia and is anesthetized, she cannot feel pain, pressure, or a tearing sensation.
Changes in vitals indicate hypovolemia in the anesthetized PP woman with vulvar
