Test Bank for Introductory Maternity and Pediatric

Nursing 2nd Edition by Klossner

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Test Bank for Introductory Maternity and Pediatric Nursing 2nd Edition by Klossner

1. Twelve hours after delivery, the fundus of a woman who has just delivered her fifth
child after 14 hours of labor is two fingers above the umbilicus and her uterus feels soft
and spongy. What should you do first?
A) Put on the call button to summon help
B) Gently massage the fundus until it tones up
C) Administer oxytocics to prevent uterine atony
D) Teach the woman to perform periodic self-fundal massage

2. Which lochia pattern should you report immediately to the RN or primary practitioner?
A) Moderate lochia serosa on day 4 postpartum, increasing in volume and changing to
rubra on day 5
B) Moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5
C) Lochia progresses from rubra to serosa to alba within 10 days
D) Moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on
day 5

3. Louisa has just delivered her second child and will breast-feed. Although she wants
“lots of kids,” she doesn't want to become pregnant again until her second child is at
least 2 years old. You counsel her to start using birth control at what point?
A) As soon as she stops breast-feeding
B) Within 18 months
C) Within 6 weeks
D) As soon as she resumes sexual activity

4. Given a prepartum hemoglobin value of 14 gm/dL and hematocrit of 42 percent, which

postpartum measurements should you report to the RN?
A) Hemoglobin 13 gm/dL and hematocrit 40 percent in a woman who has given birth
vaginally
B) Hemoglobin 12 gm/dL and hematocrit 38 percent in a woman who has given birth
vaginally
C) Hemoglobin 11 gm/dL and hematocrit 34 percent in a woman who has given birth
by cesarean
D) Hemoglobin 9 gm/dL and hematocrit 32 percent in a woman who has given birth
by cesarean

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5. A woman has just delivered a baby. Her prelabor vital signs were T - 98.8 B/P-P-R
120/70, 80, 20. Which combination of findings during the early postpartum period
should be reported immediately to the RN?
A) Shaking chills with a fever of 100.3
B) B/P-P-R 90/50, 120, 24
C) Bradycardia and excessive, soaking diaphoresis
D) Blood loss of 250 mL and WBC 25,000 cells/mL

6. For several hours after delivery, Norah, a multigravida who experienced a much more
difficult labor this time than any time previously, wants to talk about why the birthing
process was so hard for her this time. In fact, she's focusing on this aspect to the point
that she seems relatively indifferent to her newborn. How should you handle this
situation?
A) Redirect her attention to the baby by reminding her of the details of newborn care
B) Ask her to describe how she plans to integrate the newcomer into her existing
family, including any actions she has taken to prepare the siblings
C) Encourage her to discuss her experience of the birth and answer any questions or
concerns she may have
D) Point out positive features of her baby and encourage her to hold and cuddle the
baby

7. Which maternal reaction is cause for concern and should prompt a consultation with the
RN?
A) She hesitates to take her newborn when offered and expresses disappointment with
the way the baby looks
B) She neglects to engage with or provide care for the baby and shows little interest in
it
C) She is tearful for several days and has difficulty eating and sleeping
D) She expresses doubt about her ability to care for the baby as well as the nurse can

8. You are providing postpartum care to a woman who has delivered by cesarean section.
According to her records, simethicone, diphenhydramine, and naloxone have been
ordered. Which of the following signs and symptoms should you report immediately to
the RN or anesthesiologist?
A) Intense itching manifested by scratching
B) Abdominal distension and pain
C) Difficulty coughing and turning
D) Slow respiration, less than 12 breaths per minute

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 9. You are readying a new mother for discharge. You note that she is not rubella-immune,
so you administer rubella vaccine. She will breast-feed her infant and plans to get
pregnant again as soon as possible. What is the most important information you should
give her about this immunization?
A) Advise her that the vaccine is excreted in breast milk
B) Warn her not to attempt another pregnancy for at least 3 months
C) Tell her that she may experience rash, sore throat, headache, general malaise, or
some combination of these symptoms within 2 to 4 weeks of the injection
D) Advise her that the immunization will prevent hemolytic disease of the infant in
her next pregnancy

10. During a postpartum exam on the day of delivery, the woman complains that she is still
so sore that she can't sit comfortably. You examine her perineum and find the edges of
the episiotomy approximated without signs of a hematoma. Which intervention will be
most beneficial at this point?
A) Notify the RN
B) Apply a warm washcloth
C) Place an ice pack
D) Put on a witch hazel pad.

11. The process by which the reproductive organs return to the nonpregnant size and
function is termed what?
A) Evolution
B) Involution
C) Decrement
D) Progression

12. What is the primary function of uterine contractions after delivery of the infant and
placenta?
A) Return the uterus to normal size
B) Seal off the blood vessels at the site of the placenta
C) Stop the flow of blood
D) Close the cervix

13. While educating a class of postpartum patients before discharge home after delivery,
one woman asks when “will I stop bleeding?” How should the nurse respond?
A) The bleeding may continue for 6 weeks
B) Bleeding may occur on and off for the next 2 to 3 weeks
C) You should stop bleeding and have no discharge in the next 1 to 2 weeks
D) The bleeding may slowly decrease over the next 1 to 3 weeks, changing color to a
white discharge, which may continue for up to 6 weeks

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14. One postpartum patient, delivering 2 days prior, is asking when she needs to use
“protection to not get pregnant again right now.” How should the nurse respond?
A) You should not have intercourse until you are cleared by the provider
B) Ovulation may return as soon as 3 weeks after delivery
C) You will not ovulate until your menstrual cycle returns
D) Ovulation does not return for 6 months after delivery

15. The nurse is assigned to a patient on postpartum day 1. Prior to assessing her uterus,
where should the nurse anticipate she will locate the fundus?
A) At level of umbilicus
B) 1cm above the umbilicus
C) 1cm below the umbilicus
D) At the symphysis pubis

16. The vital signs of a postpartum patient on day 1 after delivery are: Temp 99.0F, RR 18,
HR 78, BP 140/90. What is the appropriate intervention by the nurse?
A) Notify the RN of the slight elevation in BP
B) Nothing, the vital signs are with in normal limits
C) Re-check all vital signs in 30 minutes
D) Re-check only the BP in 30 minutes

17. Which of the following patients would the nurse be most concerned about on post
partum day 1?
A) Temp: 99.4F, HR 90, RR 18, BP 112/67
B) Temp: 97.0F, HR 80, RR 20, BP 120/72
C) Temp: 100.4F, HR 65, RR 22, BP 130/78
D) Temp: 98.6F, HR 74, RR 16, BP 150/85

18. On assessment of a 2-day postpartum patient the nurses finds the fundus is boggy, at U
and slightly to the right. What is the most likely cause of this assessment finding?
A) Uteruine atony
B) Full bowel
C) Bladder distention
D) Poor bladder tone

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19. A woman who delivered her infant 1 week ago calls the clinic to complain of pain with
urination and increased frequency. What response by the nurse is appropriate?
A) “This is normal, give it a few days and then call back.”
B) “After delivery it is easier to develop an infection in the urinary system, we need to
see you today.”
C) “Are you washing and providing good perineal hygiene? If not, this may be the
reason for the irritation.”
D) “It is common for women to have yeast problems, try an over the counter cream
and let us know if this continues.”

20. A patient who delivered her infant 3 days ago and was discharged home calls her
provider's office with a complaint of sweating all night. What is the cause of the
increased perspiration?
A) Change in pregnancy hormone
B) Body secreting the excess fluids from pregnancy
C) The patient may be drinking too much fluid
D) The body is trying to get rid of the extra blood made during pregnancy

21. A nurse is assigned to a postpartum patient who delivered 3 hours prior. The patient's
temperature is 102.4F. The appropriate intervention by the nurse is which of the
following?
A) Notify the RN, she will notify the provider
B) Administer an anti-pyretic
C) Assist the client in ambulation
D) Continue to monitor for another hour

22. A new mother adapts to her role as a mother through four developmental stages. Which
stage is the first stage of adaptation?
A) Maternal identify
B) Physical restoration and learning to care for infant
C) Shift in normal life to “new normal”
D) Beginning attachment and preparation for family

23. Bonding between a mother and her infant can be defined how?
A) A process of developing an attachment and becoming acquainted with each other
B) The skin to skin contact that occurs in the delivery room
C) An ongoing process in the year after delivery
D) Family growing closer together after the birth of a new baby

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24. The nurse is concerned with the interactions between a mother and her 2-day-old infant.
The nurse observes signs of impaired bonding and attachment. Which of the following
should the nurse document as a cause for concern?
A) Making eye contact with the baby
B) Breastfeeding the infant on demand
C) Calling the baby it or they
D) Asking for assistance changing a diaper

25. The nurse is aware the complication of most concern with the highest priority for
assessment in the first hour is what?
A) Infection
B) Dehydration
C) Hemorrhage
D) Bladder distention

26. The nurse is assessing a postpartum patient's uterus. Which position will the nurse have
the patient for this assessment?
A) Semi-fowlers
B) High-fowlers
C) Supine
D) Left-lateral side lying

27. Charting on the nursing care plan patient care, which nursing diagnosis has the highest
priority for a postpartum patient?
A) Acute pain related to afterpains or episiotomy discomfort
B) Risk for infection related to multiple portals of entry for pathogens, including the
former site of the placenta, episiotomy, bladder and breasts
C) Risk for injury: postpartum hemorrhage related to uterine atony
D) Risk for injury: falls related to postural hypotension and fainting

28. The nurse is assessing a breastfeeding mom 72 hours after delivery. When assessing her
breast, the patient complains of bilateral breast pain around the entire breast. What is the
most likely cause of the pain?
A) Mastitis
B) Blocked milk duct
C) Engorgement
D) Interductal yeast infection

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29. The nurse is providing education to a mother who is going to bottle feed her infant.
What information will the nurse provide to this mom regarding breast care?
A) Run warm water over the breast in the shower
B) Massage the breast when they are painful
C) Wear a tight, supportive bra
D) Express small amounts of milk when they are too full

30. The patient under your care is complaining she has not had a bowel moment since her
infant was born 2 days ago. She asks the nurse what she can do to help her have a bowel
movement. What intervention is appropriate to encourage having a bowel movement?
A) Offer the patient a stimulant laxative
B) Encourage the patient to eat more fiber rich foods
C) Add dairy products to the patient's diet
D) Have her hold her feces until she really feels the need to defecate

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Test Bank for Introductory Maternity and Pediatric Nursing 2nd Edition by Klossner

Answer Key
1. B
2. A
3. D
4. D
5. B
6. C
7. B
8. D
9. B
10. C
11. B
12. B
13. D
14. B
15. C
16. A
17. D
18. C
19. B
20. B
21. A
22. D
23. A
24. C
25. C
26. C
27. C
28. C
29. C
30. B

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