UNIVERSITY of the ASSUMPTION

Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines

Intensive Nursing Practicum (Hospital and Community Setting)

C-NCM121RLE

ACTIVITY 2:
Board Exam Type Questions
(Maternal)

Submitted by:
Mendoza, Trixie Mae P.
BSN4-B

Submitted to:
Ma’am Aurora R. Valencia, RN, MAN, LPT
Clinical Instructor

January 30, 2024

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 UNIVERSITY of the ASSUMPTION
Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines

1. A client who delivered a healthy infant 5 days ago calls the clinic nurse and reports that her lochia is
getting lighter in color and asks when the flow will stop. How should the nurse respond?
A. 2 weeks
B. 10 days
C. When the placental site has healed
D. After the first time ovulation occurs

Rationale:.................................................................................................................................
Correct answer: C.
A. The client is describing lochia serosa, a normal change in the lochial flow (B) between days 3 and 4
after childbirth, which lasts to about day 10.
C. The placental site in the uterus usually heals (C) in 3 to 6 weeks, and the lochial flow should cease
at that time. Between 2 and 6 weeks after childbirth, lochia alba occurs in most women
D. Does not give the client the best information because ovulation varies in the postpartum period and
is influenced by lactation and hormonal responses as the client's usual menstrual cycle resumes.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

2. The nurse is teaching a postpartum mother about diet and breastfeeding. Which instruction is most
important to include in the teaching plan?
A. Avoid alcohol because it is excreted in breast milk.
B. Eat a high-roughage diet to help prevent constipation.
C. Increase caloric intake by approximately 500 cal/day.
D. Increase fluid intake to at least 3 quarts each day.

Rationale:.................................................................................................................................
Correct answer: A
A. Alcohol should be avoided while breastfeeding because it is excreted in breast milk and may cause a
variety of problems, including slower growth and cognitive impairment for the infant.
B, C, and D. Should also be included in diet teaching for a breastfeeding mother; however, because
these do not involve safety of the infant, they do not have the same degree of importance as (A).

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

3. The nurse is assessing a patient who recently delivered a child. The laboratory reports of both the
mother and the child show high amounts of lead in the blood. What clinical condition observed in the
mother during pregnancy could be the reason for the abnormal levels of lead?
A. Pica
B. Anemia
C. Malnutrition
D. Preeclampsia

Rationale:.................................................................................................................................
Correct answer: A.
A. Pica refers to the practice of consuming nonfood substances, such as clay and dirt.
Consumption of soil and pulverized pottery causes high levels of lead in the mother and the
child because of lead contamination of the soil. Anemia is usually caused by a lack of red blood

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 UNIVERSITY of the ASSUMPTION
Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines

cells (RBCs).
B. An anemic patient may possibly be at risk for pica and may develop cravings for metallic items
but will not show excessive amounts of lead in the body.
C. Malnutrition in the mother leads to several severe risks like premature labor, miscarriage, or
lack of nutrition in the child. Preeclampsia is the condition for high blood pressure and excess
of protein in the urine of a pregnant woman.
D. Preeclampsia may be caused by an imbalanced diet, but it does not show unusually high levels
of lead in the body.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

4. A PP mother is changing the diaper of her 21-hour-old newborn and asks why the stool is almost
black. Which response by the nurse would be most appropriate?
A. "You probably took iron during your pregnancy."
B. "This is meconium stool, normal for a newborn."
C. "I'll take a sample and check it for possible bleeding."
D. "This is unusual and I need to report this."

Rationale:.................................................................................................................................
Correct answer: B.
A. Iron can cause stool to turn black, but this would not be the case here.
B. The mother is describing meconium. Meconium is greenish-black and tarry and usually passed within
12 to 24 hours of birth. This is a normal finding.
C and D. The stool is a normal occurrence and does not need to be checked for blood or reported.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

5. Which of the following is the priority focus of nursing practice with the current early postpartum
discharge?
A. Promoting comfort and restoration of health
B. Exploring emotional status of the family
C. Facilitating safe and effective self and newborn care
D. Teaching about the importance of family planning

Rationale:.................................................................................................................................
Correct answer: C.
A. After a vaginal birth, recovery can take anywhere from three weeks if the woman didn’t tear to six
weeks or more if she had a perineal tear or an episiotomy. If the woman is delivered by C-section,
expect to spend the first three to four days postpartum in the hospital recovering; it will take four to six
weeks before the woman will feel back to normal.
B. Having a baby is a life-changing experience. Almost every mom faces a bout of the baby blues due
to a roller coaster of hormones, lack of sleep, and the struggle to adjust to that tiny new human at
home. That said, if the woman has symptoms of postpartum depression — including feeling
persistently hopeless, sad, isolated, irritable, worthless, or anxious — for more than two weeks
postpartum, she should talk to a doctor.
C. Because of early postpartum discharge and limited time for teaching, the nurse’s priority is to
facilitate the safe and effective care of the client and newborn.
D. Teaching about family planning is important in postpartum/newborn nursing care, but they are not
the priority focus in the limited time presented by early postpartum discharge.

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 UNIVERSITY of the ASSUMPTION
Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

6. A woman and her hospital roommate each delivered a child 4 days ago. One is breastfeeding and
one is using formula. Which of the following instructions can the nurse give to both mothers?
A. Wear a good, well-supporting bra
B. Apply warm compresses to breasts if too full
C.Apply cold compresses to breasts if too full
D. Do not apply soap to your nipples

Rationale:.................................................................................................................................
Correct answer: A.
A. Both women should wear supportive bras so that the breast ligaments are not overstretched by
being engorged.
B. A woman who is bottle feeding and suppressing her lactation should use cold compresses while
C. a breast feeding mother should use warm compresses to stimulate relief of engorgement.
D. Only a breast feeding mother should avoid soap on the nipples.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

7. A woman delivered a male infant yesterday. While caring for her on her first postpartum day, which of
the following behaviors would you expect?
A. Concern about when her bowels will move
B. Frequent crying spells for unexplained reasons
C. Asking specific questions about home care of the infant
D. Acceptance of the on nurse's suggestions about baby care

Rationale:.................................................................................................................................
Correct answer: A.
A. The woman is normally in the "taking in" phase of adjustment to motherhood where she is primarily
concerned about her own needs.
B. Crying spells may indicate the postpartum "blues" or something more serious but would probably
come after the mother is discharged
C and D. Asking about baby care and acceptance of nurse's suggestions come during the "taking hold"
phase.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

8. A woman had a vaginal delivery of her second child 2 days ago. She is breastfeeding the baby
without difficulty. During a postpartum assessment, the nurse would expect the following normal
finding:
A. Complaints of after pains
B. Pinkish to brownish lochia
C. Voiding frequently, 50-75 ml. Per void
D. Fundus 1 cm. above the umbilicus

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 UNIVERSITY of the ASSUMPTION
Unisite Subdivision, Del Pilar, City of San Fernando 2000, Pampanga, Philippines

Rationale:.................................................................................................................................
Correct answer: A.
A. The fact that this woman just had her second child predisposes her to after pains.
B. Pinkish to brownish lochia would not be seen until later in the postpartum period.
C. Voiding in large amounts would be expected. Hormones such as progesterone cause frequent
urges to urinate.
D. Fundus should be well below the umbilicus at this point, particularly because the woman is
breastfeeding.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.

9. To prevent cracked nipples while she is breastfeeding, the nurse should tell a new mother to:
A. Apply lanolin just prior to feedings
B. Nurse at least 20 minutes on each breast the first day
C. Use plastic bra liners
D. Wash her nipples with water only

Rationale:.................................................................................................................................
Correct answer: D
A. Lanolin is usually applied between feedings and washed off with water just prior to nursing.
B. There is little evidence that the length of time the baby sucks on each breast is related to
nipple soreness/bleeding.
C. Plastic bra liners maintain a moist environment that can increase bacterial growth.
D. Using water only on the nipples prevents removal of natural oils and over drying the nipples.

Reference:.................................................................................................................................
Hinkle, J. L., & Cheever, K. H. (2014). Brunner & Suddarth's textbook of medical-surgical nursing
(Edition 13.). Wolters Kluwer Health/Lippincott Williams & Wilkins.Hinkle, J. L., & Cheever, K. H.
(2014). Brunner & Suddarth's textbook of medical-surgical nursing (Edition 13.). Wolters Kluwer
Health/Lippincott Williams & Wilkins.

10. A woman has just been admitted to the postpartum floor after delivery of a baby girl. The nurse
brings the baby in and prepares to assist her with breastfeeding. The mother says she doesn't want to try
yet. She begins to talk about her labor and delivery and how difficult it was. The nurse recognizes this
behavior is indicative of:

A. Risk for alteration in parenting related to the mother's lack of interest in her baby's needs
B. Fatigue from labor and delivery
C. Inability to accept the reality of parenthood
D. Normal developmental phase of "taking-in" during the early puerperium
Rationale:.................................................................................................................................
Correct answer: D.
Overall Rationale: Until the mother achieves closure on her labor/delivery, she will need to talk about it.
During the "taking in" phase, her concerns are about herself, her fatigue, her body's needs and not the
baby. When her needs are met, she will be able to care for the baby. This early phase has nothing to
do with not accepting the reality of parenthood

Reference:.................................................................................................................................
https://www.coursesidekick.com/nursing/966927

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