Postpartum Nursing Care Test Questions & Answers Chapter 12 - Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack by Luanne Linnard Palmer. DOCX document preview.
Chapter 12: Postpartum Nursing Care
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. While reviewing laboratory values, the nurse sees a postpartum patient’s white blood cell count is 26,699 mg/dL, and her neutrophil count is also elevated. Which is the nurse’s priority action?
1) | Assessing the episiotomy for signs of infection |
2) | Notifying the RN and/or provider |
3) | Continuing to monitor laboratory findings |
4) | Obtaining STAT vital signs |
____ 2. The nurse is assessing a postpartum patient 1 hour after delivery. Where should the nurse expect to palpate the fundus?
1) | Between the umbilicus and the symphysis pubis |
2) | Even with the umbilicus |
3) | Even with the symphysis pubis |
4) | 1 cm above the symphysis pubis |
____ 3. Which events after delivery of the placenta cause the uterus to contract and begin shrinking to nonpregnant size?
1) | Reduced estrogen and progesterone levels |
2) | Reduced estrogen and oxytocin levels |
3) | Reduced progesterone and oxytocin levels |
4) | Estrogen, progesterone, and oxytocin levels decline. |
____ 4. The nurse is assessing a student’s knowledge of postpartum care. Which of the following statements regarding nursing care during the first hour after delivery is incorrect?
1) | “I should observe the patient’s peripads for the amount of lochia, color, odor, and the presence of clots.” |
2) | “I should check vital signs, including pulse and blood pressure, every hour.” |
3) | “I should palpate the fundus of the uterus for firmness and location every 15 minutes.” |
4) | “The first hour after delivery is the most dangerous hour in childbearing because of the risk of hemorrhage after delivery.” |
____ 5. The nurse is assessing a postpartum patient within the first hour after delivery and notes that her peripad is saturated. Which is the nurse’s priority action?
1) | Call the provider immediately. |
2) | Obtain consent for blood transfusion. |
3) | Change the peripad and document findings. |
4) | Put the patient in the Trendelenberg position. |
____ 6. A woman reports that she has not urinated since delivering 8 hours ago and says she has no urge to void despite drinking adequate fluids postpartum. The nurse attributes this to what?
1) | The woman was dehydrated and has not fully hydrated yet to produce urine. |
2) | The woman’s bladder tone is reduced, and she does not feel the urge to urinate. |
3) | The bladder has more room to expand and can hold more urine because of a smaller uterus. |
4) | The woman is experiencing a release of epinephrine, causing absence of bladder sensation. |
____ 7. The nurse is caring for a woman who delivered her third child 2 days ago and who says, “I am having pain; it feels like labor pain. I never experienced this with my other children, and it is worse when I breastfeed.” Which is the nurse’s priority response?
1) | Further assess the pain’s location, intensity, and frequency. |
2) | Explain the purpose of afterpains and reassure the patient. |
3) | Immediately obtain vital signs and monitor vital signs every 15 minutes. |
4) | Administer a narcotic analgesic to control pain. |
____ 8. The nurse is explaining afterpains to a postpartum patient. Which of the following statements is correct?
1) | Afterpains are more painful for women who have not given birth previously. |
2) | Oxytocin may be administered to resolve afterpains. |
3) | Afterpains usually last for 3 weeks. |
4) | Afterpains can be noticed while breastfeeding as a result of nipple stimulation. |
____ 9. A patient who is 6 weeks postpartum asks the nurse when she will start her menstrual cycle. How should the nurse respond?
1) | “You should start your cycle in 2 weeks.” |
2) | “How much sleep are you getting?” |
3) | “Are you breastfeeding?” |
4) | “You should begin your period the month after delivery.” |
____ 10. The nurse is preparing a postpartum patient for discharge. The nurse educates the patient to call the provider if she experiences which symptom?
1) | Lochia rubra after transition to serosa or alba |
2) | Breast tenderness |
3) | Difficulty sleeping |
4) | Vaginal soreness |
____ 11. The nurse is assessing a postpartum patient’s peripad 6 hours after delivery. How should the nurse document lochia that is 5 inches in diameter?
1) | Scant |
2) | Light |
3) | Moderate |
4) | Heavy |
____ 12. Before massaging the fundus, the nurse should look for which of the following?
1) | Amount of lochia |
2) | Bladder distention |
3) | Breast engorgement |
4) | Hemorrhoids |
____ 13. The nurse is assessing a postpartum woman’s understanding of sitz baths. Which statement made by the patient indicates the need for further teaching?
1) | “I should add soap to warm water to prepare the sitz bath at home.” |
2) | “Sitz baths will provide pain relief for my episiotomy.” |
3) | “I can prepare a sitz bath in the tub or in a basin.” |
4) | “I can sit on a soft wet towel in the warm sitz bath water for 10 to 15 minutes three times a day.” |
____ 14. The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic. Which assessment finding is incorrect to document as part of this examination?
1) | Breasts firm and tender; patient reports sore nipples |
2) | Fundus 2 cm below umbilicus, firm |
3) | Lochia pink, small amount of drainage |
4) | Pulse strong and regular at rate of 84 beats per minute |
___ 15. The nursing instructor observes a student providing care to an adolescent postpartum patient. Which statement made by the student indicates the need for further teaching?
1) | “Let me show you a way to hold the baby when you’re giving him a bath.” |
2) | “Do you want your little friend to stay while you breastfeed?” |
3) | “You’re going to be a great mother because you really want to learn.” |
4) | “Do you have any questions or need help with anything?” |
____ 16. A new adolescent mother asks the nurse how to bathe her baby. Which is the nurse’s best approach to teach her this procedure?
1) | Have the new mother bathe the baby while the nurse talks her through the process. |
2) | Explain the procedure using pictures and diagrams. |
3) | Give the new mother a brochure and tell her to ask if she has any questions. |
4) | Let the new mother watch the nurse bathe the baby and then give a return demonstration tomorrow. |
____ 17. The nurse is making a home-care visit when the newborn starts to cry. The new mother smiles and says, “That’s his hungry cry.” The nurse interprets this as indicating the mother is in which phase of maternal role attainment?
1) | Taking-in phase |
2) | Taking-hold phase |
3) | Letting-go phase |
4) | Transitioning from taking-in to taking-hold phase |
____ 18. During which phase of postpartum adjustment to motherhood should the nurse provide praise and positive reinforcement to a mother who is learning to care for her infant?
1) | Taking-in phase |
2) | Taking-hold phase |
3) | Letting-go phase |
4) | Transitioning from taking-in to taking-hold phase |
____ 19. Which action by a postpartum mother is a sign of bonding between her and her infant?
1) | Positioning the baby facing her so she can explore the baby’s face |
2) | Spontaneously erupting in tears for unexplained reasons |
3) | Correctly positioning the baby for breastfeeding |
4) | Asking the nurse to keep the baby in the nursery |
____ 20. The nurse enters a postpartum patient’s room and finds the father staring at the newborn in the bassinet with a contemplative look on his face. How should the nurse interpret this behavior?
1) | The father may be a danger to the baby. |
2) | The father feels resentful toward the baby. |
3) | The father is uncertain about being a father. |
4) | The father is bonding with the baby. |
____ 21. It is time for a newborn to have blood collected for the newborn screening. How does the nurse turn this into a bonding opportunity for the mother?
1) | Perform the test in the mother’s room and encourage her to comfort the newborn afterward. |
2) | Take the baby to the nursery for the test to avoid upsetting the mother. |
3) | Explain the bandage on the baby’s foot when returning the baby to the mother’s room. |
4) | Perform the test without mentioning it to the mother to reduce anxiety. |
____ 22. A postpartum patient who plans to relinquish her baby for adoption says, “I’m having second thoughts. Maybe I should keep the baby.” Which is the nurse’s best response?
1) | “If you aren’t sure, you should keep the baby until you make up your mind.” |
2) | “You’ve made a promise to the adopting parents, and it’s too late to change your mind.” |
3) | “It is such a difficult decision to make. You must feel pulled in two directions.” |
4) | “I can hear the indecision in your voice. Would you like to talk about it?” |
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. A new mother asks the nurse what she can do to foster attachment between the newborn and her 8-year-old daughter. Which recommendations should the nurse make? (Select all that apply.)
1) | Have the child visit in the hospital. |
2) | Let the child help care for the baby as he or she is able. |
3) | Have Mom spend some time alone with the child. |
4) | Keep the baby away from the child as much as possible. |
5) | Anticipate unpredictable and uncomplimentary statements about the baby. |
____ 24. What does the nurse assess as part of the BUBBLE LE mnemonic? (Select all that apply.)
1) | Episiotomy or abdominal incision |
2) | Bonding and attachment |
3) | Pain |
4) | Circulation in the legs |
5) | Gait |
____ 25. Which actions performed by the nurse demonstrate appropriate uterine massage for the postpartum patient? (Select all that apply.)
1) | Positioning one hand at the fundus of the uterus |
2) | Pressing down until the fundus is palpated as a firm, hard, globular mass |
3) | Noting the position of the fundus |
4) | Placing one hand at the base of the uterus |
5) | Calling and informing the provider of the uterine location |
Chapter 12: Postpartum Nursing Care
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Safe Maternity Nursing Care 2nd Ed - Exam Resource Pack
By Luanne Linnard Palmer