Postpartum Complications Ch13 Exam Questions - Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack by Luanne Linnard Palmer. DOCX document preview.
Chapter 13: Postpartum Complications
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A postpartum nurse completes an assessment on a patient who delivered 12 hours earlier. Which finding prompts the nurse to take additional measures?
1) | Slight bruising to breasts bilaterally |
2) | A blood pressure of 129/70 and a heart rate of 98 |
3) | A firm fundus at the midline |
4) | Vaginal bleeding with peripad saturation in 15 minutes or less |
____ 2. A nurse educates a new mother preparing for discharge on postpartum depression. Which statement indicates the need for additional explanation related to postpartum depression?
1) | “I will ask my husband for help with the nightly feedings.” |
2) | “It’s okay to cry and be sad during the first few weeks after having a baby.” |
3) | “I will take naps when the baby is sleeping.” |
4) | “It’s okay to ask for help if I’m feeling overwhelmed.” |
____ 3. Which of the following situations would most likely cause uterine atony?
1) | A G4 P3 laboring for 18 hours |
2) | A scheduled cesarean delivery |
3) | A patient laboring for 6 hours |
4) | A G1 P1 laboring for 18 hours |
____ 4. The nurse is called to the patient’s room because she is experiencing heavy bleeding. Which of the following actions should NOT be performed by the nurse during a postpartum hemorrhage?
1) | Weighing peripads |
2) | Expressing clots by over-massage |
3) | Performing fundal massage |
4) | Inserting a Foley catheter |
____ 5. The postpartum nurse is caring for a patient 24 hours post-vaginal delivery who complains of constant pain and pressure in the vaginal and rectal area. Which condition does the nurse suspect based on the patient’s complaint?
1) | Hematoma |
2) | Infection |
3) | Hemorrhage |
4) | Constipation |
____ 6. The nurse is caring for a woman who has lost over 2,000 mL of blood during cesarean delivery. Which of the following are late signs of a patient with significant blood loss?
1) | Tachycardia and elevated blood pressure |
2) | Tachycardia and low blood pressure |
3) | Tachycardia and pink, dry skin |
4) | Bradycardia and pink, dry skin |
____ 7. The nurse is conducting an educational program for a group of new graduate nurses on postpartum depression. Which response by one of the new nurses indicates the need for further instruction?
1) | Antidepressants are not recommended if breastfeeding. |
2) | Monitor for signs of suicidal thoughts or thoughts to harm the baby. |
3) | Encourage the patient to seek counseling. |
4) | Advise the patient to get rest and nap when the baby sleeps. |
____ 8. Which patient has the highest risk of developing postpartum psychosis?
1) | History of depression as a teenager |
2) | Illegal drug use |
3) | History of bipolar disorder |
4) | History of depression as an adult |
____ 9. The nurse responds to a rapid response call for a woman experiencing a PPH. Which of the following medications would the nurse anticipate after receiving oxytocin (Pitocin)?
1) | Ondansetron |
2) | Cefoxitin |
3) | Hemabate |
4) | Misoprostol |
____ 10. The nurse is auditing a patient’s chart in preparation of a Joint Commission inspection. Which finding in the chart demonstrates the need for further education on the prevention of catheter-related infections?
1) | Donned sterile gloves prior to catheter insertion. |
2) | Sterile technique was performed during catheter insertion. |
3) | The catheter was removed after the epidural was discontinued. |
4) | The catheter was removed 72 hours after cesarean delivery. |
____ 11. A woman who is 12 days postpartum presents to the clinic with fever, malaise, and a burning sensation while breastfeeding. Which diagnosis is likely responsible for the woman’s symptoms?
1) | Hematoma |
2) | Thrombus |
3) | Mastitis |
4) | Endometritis |
____ 12. Which term is used to describe the failure of the uterus returning to its pre-pregnancy size?
1) | Involution |
2) | Subinvolution |
3) | Anhedonia |
4) | Endometritis |
____ 13. The nurse receives report on a patient who delivered 4 hours earlier and lost 700 mL of blood during a vaginal delivery. Which of the following nursing interventions would be most appropriate in monitoring for adequate tissue perfusion?
1) | Assess the patient’s response to pain medication and document in the chart. |
2) | Monitor vital signs and oxygen saturation levels every 5 to 10 minutes. |
3) | Assess the client’s psychological response to the post-childbirth bleeding. |
4) | Monitor urine output and document hourly. |
____ 14. Which of the following is not a risk factor for developing postpartum depression?
1) | A recent breakup with the father of the newborn |
2) | History of bipolar disorder |
3) | History of depression |
4) | An unintended pregnancy |
____ 15. The nurse is caring for a patient 24 hours postpartum with prolonged labor during vaginal delivery and a second-degree laceration. Which assessment finding would require the nurse to notify the provider?
1) | Vaginal bleeding with one peripad saturation every hour |
2) | Foul-smelling lochia |
3) | Breast tenderness |
4) | Firm fundus |
____ 16. Management of postpartum depression typically includes all of the following except __________.
1) | Antidepressants |
2) | Antipsychotic therapy |
3) | Counseling |
4) | Support groups |
____ 17. The nurse is caring for a patient who has been on strict bedrest and subsequently developed a deep vein thrombosis (DVT). Which laboratory value should be monitored when the patient is receiving anticoagulant therapy?
1) | CRP |
2) | CBC |
3) | INR |
4) | BUN |
____ 18. Which term would best describe the postpartum woman who recently tells the nurse that she doesn’t enjoy spending time with her friends or exercising any longer?
1) | Psychosis |
2) | Ambivalence |
3) | Euphoria |
4) | Anhedonia |
____ 19. Treatment for venous thromboembolism (VTE) typically includes all of the following except ________.
1) | Heparin |
2) | Compression stockings |
3) | Coumadin |
4) | Aspirin |
____ 20. All of the following are common causes of hemorrhage in the postpartum woman except _______.
1) | Tone |
2) | Tremors |
3) | Trauma |
4) | Tissue |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. A woman develops a vaginal hematoma after a prolonged delivery resulting in the use of forceps. Which of the following statements would reflect the appropriate medical management of a hematoma? (Select all that apply.)
1) | Antibiotics as prescribed |
2) | Warm sitz baths as needed |
3) | Massage as needed |
4) | Applying an ice pack for 20 minutes every 2 hours for 12 hours |
5) | Pain medication as prescribed |
____ 22. A patient presents to the clinic complaining of a fever and drainage coming from her cesarean incision for the past 2 days. Which orders would the nurse expect to see as part of this patient’s medical management? (Select all that apply.)
1) | Obtaining a CBC |
2) | Obtaining a urine culture |
3) | Administering antibiotics |
4) | Obtaining a wound culture |
5) | Administering antiemetics |
____ 23. Which of the following increases a postpartum patient’s risk of developing venous thromboembolism (VTE)? (Select all that apply.)
1) | Obesity |
2) | Bedrest |
3) | Excessive exercise |
4) | Advanced maternal age |
5) | Smoking |
____ 24. A postpartum nurse is caring for a 36-year-old woman who vaginally delivered a 10 lb baby girl 4 hours ago. The woman appears anxious and has saturated six peripads in the past hour despite frequent fundal massages. Vital signs: BP: 92/60, HR:114, O2: 94%. The nurse recognizes that this patient is experiencing a postpartum hemorrhage. Which nursing diagnoses would be appropriate for this patient experiencing a PPH? (Select all that apply.)
1) | Fluid volume deficit related to uterine atony and evidenced by vaginal bleeding and increased heart rate and decreased blood pressure |
2) | Impaired skin integrity related to chronic disease state |
3) | Anxiety and fear related to excessive blood loss and the threat of death |
4) | Ineffective tissue perfusion related to vaginal bleeding |
5) | Ineffective gas exchange related to smoking |
____ 25. Which of the following antibiotics may be used to treat a urinary tract infection (UTI) in the postpartum woman? (Select all that apply.)
1) | Cephalexin |
2) | Cefoxitin |
3) | Ciprofloxacin |
4) | Dicloxacillin |
5) | Gentamicin |
Chapter 13: Postpartum Complications
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Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack
By Luanne Linnard Palmer