OBSTETRIC NURSING

Prof. Ma. Teresa Pimentel-Vanguardia

Situation 1 - Nurse Kathy is caring for a postpartum patient. Routine postpartum care is rendered to the patient.
1. Which assessment finding would lead the nurse to suspect a postpartum hemorrhage? Blood loss of:

1000300e
e

A. Less than 300 ml/24 hours C. Less than 200 ml/2 hours
B. More than 400 ml/24 hours ·
D. More than 500 ml/ 24 hours
2. Which of the following is caused by the markedly distended uterus and&
intermittent uterine
°
contraction within 2 to 3 days after birth no bleeding?

bleeding(oA. Retained placenta -buprofes

C. Afterpains
- O bleeding
- B. Uterine atony D.-Boggy uterus- >
-

F &>
3. Some postpartum mothers will experience difficulty voiding because of the edema and trauma of the perineum. Which
S
PRIORITY nursing measures stimulate the sensation of voiding? -

-
A. Encouraging her to void. -
C. Helping the mother into the shower
uRunning water in the sink or shower
B. O
D. Providing cold tea or fluids of choice.
4. Bleeding that is↳
painless on the third trimester is caused by:
A. Placenta previa C. H-mole
--

Zetri [ D. Incompetent cervix

B. Abruptio placenta - painful
O
> -- -

5. Which of the following should be avoided by the nurse when the patient is diagnosed with placenta previa
A. IE C.-Assess bleeding -
B. O2 =>
D. Vital signs checking
Situation 2 -A postpartum mother newly delivered her baby per vagina. She keeps on asking the nurse when the basic
physiologic changes occur as her body returns to a prepregnan state.
6. The nurse explains to the mother that the uterus will return to its pre pregnancy state in

Open
____weeks
A. Six B. Three C. Four
7. In her capacity to teach , the nurse describes the changes of the uterus after childbirth to
D. Five

return to a nonpregnant state as____

A. Catabolism C. Contraction of muscle fibers
B. Subinvolution -
deld D.--Involution
8. Which of the following conditions does the nurse explains to the patient the contributory factor that slows uterine
Labor

Rela
involution?
E
A. Full bladder during labor -C. Prolonged labor
B. #
° Difficult birth ==
D. Infection during 0pregnancy
9. The nurse assesses the uterine fundus of the mother. Which part of the abdomen will the
O ,
(
nurse begin?
A. Symphysis pubis
B. Midline
00
&↳ C. Umbilicus
D. Sides of the abdomen
10. The FIRST PRIORITY nursing intervention during the immediate postpartum period is
focused on _____
A. Monitoring urinary output C. Observing postpartum hemorrhage
B. Taking the vital signs every 4 hours D. Checking level of responsiveness
Situation 3 - Evelyn a multigravida, in her 20th weeks of gestation visited the community clinic with complaints of-
-
dizziness
, vertigo, and-
>heartburns. After the physical assessment, Nurse Harper finds the patient as#
& malnourished.
11. Iron supplementation was prescribed because of her low hemoglobin level. Which statement

here dreamtea
if made by Evelyn would indicate an understanding of health instructions? [t 12-1
XA. “My body has all the iron it needs and I don't need to take supplements.”
XB. “Meat does not provide iron and should be avoided.” ⑭ -
C. “”The iron is best absorbed if taken on an empty stomach.”
X “Iron supplements will give green color to my stool.
D.
-
i
T
12. Evelyn was given iron as a supplement vitamin to prevent maternal anemia. She asks if it will not be affected because
she is regularly taking vitamin C. Which of the following would be
the BEST response of the nurse?
A. “Take two other vitamins separately .” C. “Absorption of iron is enhanced with vit C.”
B. “Take the iron after a full meal.” D. “Drink milk when taking the iron supplement.”
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Vit D sunlight
② ⑳
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Fat ↳
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13. Evelyn was also advised to take calcium supplements on the 2nd 3rd trimester of
pregnancy. Which of the following would ENHANCE her intestinal absorption of calcium?

⑭& - O
A. Fat-soluble vitamins C. Minerals
&

B. Proteins D. Water soluble vitamins

14. Nurse Harper observes Evelyn has a knowledge deficit regarding fetal nutrition. Nurse
harper has to explain that the MAIN SOURCE of nutrition for the baby is which of the
following? placent al ee
A. Amniotic fluid C. Placenta
B. Uterus D. Chorionic villi
15. Nurse Harper provides health instruction to the patient experiencing heartburn. Which statement by the patient
e
indicates a NEED for further instructions? I have to _____
A. Drinko milk between meals C. Avoid fatty or spicy foods
B. Eat small frequent meals D. Lie down after eating
-

Situation: In the maternity ward, Nurse Sarah is providing care to a patient who has just experienced a spontaneous
abortionE(miscarriage) at #10 weeks gestation. The patient is emotionally distressed and experiencing physical discomfort.
Nurse Sarah is assessing and managing the patient's care to ensure both emotional support and physical well-being.
16. The patient is visibly upset and tearful after the spontaneous abortion. What is the most appropriate action for Nurse
Sarah to provide emotional support? (t)
A) Offer a detailed explanation of the miscarriage process.
B) Encourage the patient to express her feelings and provide a listening ear.
C) Advise the patient to avoid discussing the miscarriage to prevent further distress.
D) Quickly move on to discussing future pregnancy plans to shift the focus.
X - -

17. The patient is experiencing moderate pelvic pain. Which intervention is the priority for Nurse Sarah in managing the
patient's pain?
X
A) Administering over-the-counter pain medication.
B) Offering a warm compress to the abdominal area.
⑳
C) Assessing the pain intensity and administering prescribed analgesics.
X Advising the patient to tolerate the pain to avoid medication dependence.
D)

Rampl
18. During the physical examination, Nurse Sarah notes excessive bleeding. What action should the nurse take to
address this issue?
A) Reassure the patient that some bleeding is normal after a miscarriage.
B) Document the amount of bleeding and continue monitoring.
C) Notify the healthcare provider immediately.
D) Instruct the patient to rest and avoid any movement.
19. The patient asks about future pregnancies and potential risks. What information should Nurse Sarah provide to the
patient?
X -
A) Assure the patient that miscarriages are rare and unlikely to recur.
O An
O
B) Discuss potential causes of the miscarriage and recommend genetic counseling.

*
C) Advise the patient to avoid future pregnancies to prevent complications.
D) Dismiss concerns, stating that spontaneous abortions are normal at this gestational age.
20. Nurse Sarah observes that the patient is withdrawing from family and friends. What is the most appropriate action to
address the patient's psychosocial needs?
A) Recommend joining a support group for individuals who have experienced pregnancy loss.
B) Encourage the patient to keep her feelings to herself to avoid burdening others.
C) Advise the patient to focus on getting pregnant again to overcome the loss.
D) Minimize the emotional impact, emphasizing the commonality of miscarriages.
Situation:
Mrs. Johnson, a 32-year-old pregnant woman at 36 weeks gestation, is admitted to the antenatal unit with suspected
pregnancy-induced hypertension (PIH). She complains of sudden swelling in her hands and face, along with a persistent
headache. Nurse Lisa is assigned to care for Mrs. Johnson and assess her condition.
- -

21. Mrs. Johnson mentions sudden swelling in her hands and face. What is the nurse's priority action to assess this

-140/710
symptom? &

A) Record the observation for later documentation.

B) Administer a diuretic to reduce swelling immediately.
C) Measure② blood pressure and check for other signs of PIH.
D) Dismiss the symptom as a common occurrence in late pregnancy.
22. To confirm the diagnosis of pregnancy-induced hypertension, what vital sign should Nurse Lisa primarily monitor?
A)
↳°Respiratory rate C) Blood pressure
B) Heart rate D) Temperature

*
A) PIH poses no risks to the mother or baby.
⑳
23. Mrs. Johnson is curious about the potential risks of PIH. What should Nurse Lisa emphasize during patient education?

B) Early delivery may be necessary to prevent complications.

 -
C) PIH is a normal part of pregnancy and requires no intervention.
D) Headaches and swelling are common ine ↳
all pregnancies.
24. If Mrs. Johnson is diagnosed with PIH, which medication is commonly prescribed to manage hypertension during
pregnancy?
A) Aspirin C) Magnesium sulfate
B) Ibuprofen D) Methotrexate
25. Mrs. Johnson asks if she can continue her regular exercise routine. What is Nurse Lisa's best advice regarding
②
physical activity for a patient with suspected PIH?
-A) Encourage high-intensity workouts to maintain fitness.

--
B) Recommend bed rest to reduce the risk of complications.
- -

C) Suggest moderate, low-impact exercise after consulting with the healthcare provider.
-

D) Discourage any form of physical activity to prevent further stress on the body.
Situation: Mrs. Rodriguez, a 28-year-old pregnant woman at 32 weeks gestation, is admitted to the antenatal unit due to
concerns about her blood pressure. She reports persistent headaches and blurred vision. Nurse James is responsible for
her care and needs to assess and manage the situation.
26. To further evaluate Mrs. Rodriguez's condition, which diagnostic test is commonly used to- assess organ damage
-

associated with pregnancy-induced hypertension (PIH)?

A) Blood glucose test -
C) Liver function tests
B) Complete blood count (CBC) D) 24-hour urine collection for protein
kichu
27. If left untreated, pregnancy-induced hypertension can progress to a more severe condition. What potential severe
-

complication is Nurse James most concerned about?

A) Gestational diabetes ② C) Eclampsia
B) Preterm labor D) Gestational thrombocytopenia
-=
28. Mrs. Rodriguez is thirsty and asks if increasing her fluid intake can help manage her symptoms. What is the nurse's
best response?
A) Encourage increased fluid intake to promote kidney function. Co
RAAS O
-
↑ volume

②
B) Restrict fluid intake to reduce swelling and blood pressure. ->

C) Advise maintaining normal fluid intake as excessive can worsen hypertension.

D) Suggest a specific type of fluid to alleviate symptoms.
-
29. To assess the -
well-being of the fetus in the context of PIH, which fetal monitoring method is commonly employed?
> EHRC
-

A) Ultrasound for-
fetal size
-

estimation ,
FM-
C) Maternal-fetal movement count
-
-

>
- B) Non-stress test (NST) ↳ ⑬ D)
- Fetal kick count chart
30. If Mrs. Rodriguez's condition worsens, and delivery becomes necessary, what is the primary mode of delivery
recommended to manage pregnancy-induced hypertension?
A) Cesarean section C) Vacuum-assisted delivery
B) Vaginal delivery with forceps D) Induction of labor
Situation: Mrs. Turner, a 30-year-old pregnant woman at 28 weeks gestation, has been diagnosed with gestational
diabetes. She is concerned about managing her condition to ensure a healthy pregnancy. Nurse Karen is assigned to
provide education and support to Mrs. Turner.
31. To assess Mrs. Turner's blood glucose levels at home, what is the recommended frequency for self-monitoring?
A) Once a week C) Monthly
B) Twice a day D) Only when symptoms arise
32. Mrs. Turner is unsure about her dietary restrictions. What dietary advice should Nurse Karen provide to help manage
gestational diabetes?
A) Consume a high-carbohydrate diet for energy.
B) Limit intake of simple sugars and refined carbohydrates.
C) Avoid all types of carbohydrates.
D) Increase saturated fat intake to stabilize blood sugar levels.
33. If diet and exercise are not sufficient to control Mrs. Turner's blood glucose levels, what intervention may be
considered?
A) Increasing carbohydrate intake C) Insulin therapy
B) Oral hypoglycemic medications D) Reducing protein intake
O
34. To assess the impact of gestational diabetes on the fetus, which antenatal test is frequently performed?
A)
- Amniocentesis C) Non-stress test (NST)
B) Doppler ultrasound for blood flow D) Maternal-fetal movement count
35. After delivery, Mrs. Turner is concerned about her future risk of developing diabetes. What guidance should Nurse
Karen provide regarding postpartum monitoring?
A) Gestational diabetes has no impact on future diabetes risk.
B) Regular follow-up blood glucose testing is essential.
C) Discontinue monitoring as gestational diabetes is temporary.
D) Postpartum monitoring is only necessary if the baby had complications.
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-
fetal head compression
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REACTIVE-GAHR
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POSITIE< DeceleratEGATIVE-
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 Situation: Mrs. Anderson, a 29-year-old pregnant woman at 20 weeks gestation, has been diagnosed with an incompetent
cervix. She has a history of late-term pregnancy loss and is anxious about the current pregnancy. Nurse Jessica is
providing care to address Mrs. Anderson's concerns and educate her about managing an incompetent cervix.
36. To prevent the cervix from opening prematurely, what surgical intervention is commonly recommended for women
with an incompetent cervix?
A) Hysterectomy C) Endometrial ablation
B) Cervical cerclage D) Oophorectomy
37. Mrs. Anderson is worried about preterm labor. What signs and symptoms should Nurse Jessica instruct her to monitor
Or
for and report?

- B) Lower backache
-
A) Increased fetal movement C) Decreased urinary frequency
-
D)
- Mild uterine contractions
38. Mrs. Anderson asks about the necessity of bed rest. What advice should Nurse Jessica provide regarding bed rest in
cases of an incompetent cervix? - >
x
A) Extended bed rest throughout the entire pregnancy is recommended.
B) Limited activity and modified bed rest are often advised.
C) Bed rest is not necessary unless contractions occur.
* O
D) Bed rest is only required during the first trimester.
39. Mrs. Anderson is curious about the long-term impact of an incompetent cervix on future pregnancies. What
- -

information should Nurse Jessica convey during prenatal education?

A) An incompetent cervix has no impact on future pregnancies.
B) The risk of recurrence is low with appropriate interventions.
C) Future pregnancies are not recommended.
- -
D) Cervical insufficiency resolves on its own after delivery.
40. As Mrs. Anderson approaches term, what delivery method is commonly considered for women with an incompetent
cervix and>cervical cerclage in place?
A) Induction of labor C) Vaginal delivery with possible removal of the
B) Cesarean section cerclage
-

D) Natural childbirth without medical intervention

Situation: Mrs. Ramirez, a 35-year-old pregnant woman at 32 weeks gestation, is admitted to the labor and delivery unit
with suspected abruptio placenta. She complains of sudden, severe abdominal pain and vaginal bleeding. Nurse Maria is
assigned to provide immediate care and support.
41. Mrs. Ramirez is experiencing sudden, severe abdominal pain and vaginal bleeding. What assessment finding is most
indicative of abruptio placenta?
A) Mild cramping and light spotting C) Severe abdominal pain with uterine contractions
B) Absence of abdominal pain with heavy bleeding D) Dull, intermittent abdominal discomfort

A) Non-stress test (NST)

⑳
42. To assess the well-being of the fetus in the context of abruptio placenta, what fetal monitoring method is crucial?
C) Maternal-fetal movement count
B) Doppler ultrasound for-blood flow D) Fetal kick count chart
43. In the initial management of abruptio placenta, what intervention should Nurse Maria prioritize to address the severe
abdominal pain and bleeding?
A) Administering pain medication and observing
B) Encouraging the patient to rest in a lateral position
C) Administering IV fluids and preparing for an emergency cesarean section
D) Advising the patient to remain upright to ease pressure on the uterus
44. Mrs. Ramirez is concerned about the cause of abruptio placenta. What risk factors should Nurse Maria inquire about
during the patient's history assessment?
A) Prolonged bed rest during pregnancy C) Trauma or injury to the abdomen
B) A history of gestational diabetes D) Maternal age above 40 years
45. After the delivery of the baby, what postpartum complication is Mrs. Ramirez at increased risk for, and requires vigilant

-
monitoring?
XA) Ovarian cyst formation
B) Endometritis *
C) Thyroid dysfunction
D) Urinary incontinence ↳ E
4m -1 stateo

To
46. The nurse assesses the pregnant client who comes to the triage unit and determines that she is at 4/50/—l and that
↳ 50
the fetal HR is 148. What priority information should the nurse collect before proceeding?
A. Time and amount of last meal C. Who is attending the delivery ↳ cm/
%

statine
%
B. Number of weeks’ gestation D. History of previous illnesses
47. The nurse, admitting a 40-week primigravida to the labor unit, just documented the results of a recent vaginal exam:
OOL
3/lOO/—2, RSP. How should the oncoming shift nurse interpret this documentation?
3m
-
A. The fetus is approximately 2 cmX below maternal ischial spines.
x and effaced, with fetal engagement.
B. The cervix is totally dilated
C. The fetus is- -
breech and posterior to the client’s pelvis.
D. The fetal lie is transverse, and the fetal attitude is flexion.
48. The nurse is caring for the low-risk laboring client during the first stage of labor. When should the nurse assess the
FHR pattern? °
°Select @all that apply. -
O A. Before administering medications XC. During a hard contraction
B. At least every fifteen minutes ·
D. When giving oxytocin m
49. The laboring client in the first stage of labor is talking and laughing with her husband. The nurse should conclude that
- -
the client is probably in what phase?
A. Transition B. Active C. Active pushing D. Latent
50. The nurse is caring for the client in labor. Which assessment finding would help the nurse determine whether the client
is in the third stage of labor?
A. Lengthening of fetal cord C. A strong urge to push
B. Increased bloody show D. More frequent contractions
-
-+
51. The laboring multigravida client’s last vaginal examination was000
8/90/+1. The client new
O states feeling rectal pressure.
L
-

Which action should the nurse perform first?

A. Encourage the client to push. C. Help the client to the bathroom.
B. Notify the obstetrician or midwife. D. Complete another vaginal exam. - jou
-

②
52. The laboring client’s amniotic membranes have just ruptured. Which nursing action should be priority?
A. Monitor maternal temperature. C. Perform a sterile vaginal examination.
B. Inspect characteristics of the fluid. D. Assess the fetal heart rate pattern.
↳°
53. The nurse explained the process of cervical effacement to the client in early labor. Which statement by the client
indicates that she understands the information? > dilatating
- -

A. “The cervix will widen from less than 1 cm to about 10 cm.”

B. “The cervix will pull or draw up and become paper-thin.”
C. “The cervical changes will cause my membranes to rupture.”
D. “The cervical changes will help my baby to change position.” &URosi-sta
ee
54. The nurse observes on the monitor tracing of the client in the transition phase of labor that the baseline FHR is 160
and that there is moderate variability with V-shaped decelerations unrelated to contractions. What should the nurse do
first? ④ Late dec = t variability
A. Prepare for delivery. C. Apply oxygen nasally. ⑬ Late decj variability
B. Notify the obstetrician. D. Reposition the client.
\

55. The nurse is caring for the pregnant client. Which assessment findings help the nurse determine that she may be in
· fahren
true labor, except?
67
A. Progressive cervical dilation and effacement C. Warm tub baths and rest lessen contractions
B. Walking usually increases contraction intensity D. Discomfort is usually in the client’s back
A
56. The nurse is assessing the laboring client who is morbidly O
obese. The nurse is unable to determine the fetal position.
e
- -

E
Which action should be performed by the nurse to obtain the most accurate method of detemiining fetal position in this
client?

* -
A. Inspect the client’s abdomen. C. Perform a vaginal examination.
B. Palpate the client’s abdomen. D. Perform transabdominal ultrasound.
57. The laboring client is experiencing dyspnea, diaphoresis, tachycardia, and hypotension while lying on her back. Which
intervention should the nurse implement immediately? ↳
A. Turn the client onto her left side- C. Notify the attending obstetrician.
B. Turn the client onto her right side. D. Apply oxygen by nasal cannula.
=
58. The nurse is caring for the client who is being evaluated for a suspected malpresentation. The fetus’s long axis is lying
across the maternal abdomen, and the contour of the abdomen is elongated. Which should be the nurse’s documentation

t
of the lie of the fetus?
A. Vertex C. Transverse
B. Breech D. Brow
59. The pregnant client presents with regular contractions that she describes as strong in intensity. Her cervical exam
indicates that she is dilated toO
3 cm. Which conclusion should the nurse make based on this information?
C
A. The client is experiencing early labor. Latero
- -
C.
- The client has experienced
- cervical ripening.
B. The client is experiencing false labor. D. The client has experienced lightening.
-

60. The nurse is about to auscultate an F HR on the client in triage. What information should the nurse determine first in
order to find the correct placement for auscultation?
A. Position of the fetus C. Presence of contractions
B. Position of the placenta D. Where to apply the ultrasonic gel

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61. The full-term pregnant client presents with dark red vaginal bleeding and intense abdominal pain. Her BP is 150/96
mm Hg, and her pulse is 109 bpm. The nurse should immediately implement interventions for which possible
complication?
A. Placenta previa C. Bloody show
B. Placental abruption D. Succenturiate placenta
·Cre ate
Abort e

> BELOW
CEPHAU -

AVL -

or
·
⑭ >
- OXYTOCIN
↳ full bladder

ALGEIA
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-
-

↳ LATENT
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-
Esia

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62. During a vaginal examination, the nurse palpates fetal buttocks that are facing the left posterior and are 1 cm above
the ischial spines. Which of the following is consistent with this assessment?
A. LOA -1 station.
- -
C. LMP +1 station.
-
+ LSP
-
B. LSP -1 station. D. LSA +1 station.
63. When performing Leopold’s maneuvers, the nurse notes that the fetus is in theO left occiput
anterior position. Where should the nurse place a fetoscope best to hear the fetal heart beat?
A. Left upper quadrant.
- C. Left lower quadrant.
B.
-- Right upper quadrant. D. Right lower quadrant.
64. 29. A client is complaining of severe back labor. Which of the following nursing interventions would be most effective?
A. Assist mother with childbirth breathing. C. Provide direct sacral pressure.
B. Encourage mother to have an epidural. D. Use a hydrotherapy tub.

O
65. The nurse is assessing a client who states, “I think I’m in labor.” Which of the following findings would positively
confirm the client’s belief?
A. She is contracting irregularly
-
activa C. Her membranes have ruptured.
ambulatin
+
B. Her cervix has dilated from 2 to 4 cm. - D. The fetal head is engaged. - -

-④
>
66. Rita, 27 years old, is a gravida 1 in the active phase of labor. Fetal position is LOA, and cervix is 4 cm dilated. Rita
↳
wants to walk about in the labor room. Which of the following criteria will help the nurse determine whether she should
walk?
a. Whether membranes are intact c. Fetal position X
b. Frequency of contraction d. Fetal station O

67. When planning comfort measures to help Rita in active labor to tolerate her pain, the nurse must consider which of the
following?
*a. Early labor contractions are usually regular, coordinated, and very
° painful
* e
b. If women are properly prepared, they will require no pain medication to manage their pain
*c. Pain ↳
medication given during theColatent phase of labor is↳
=>>
not likely to impair contractions -
- -
> hypotonic
-
-
d. The acceleration phase of labor can be a time of true discomfort and high anxiety
④ #
O
68. When her membranes rupture, the nurse should expect to see: ⑭ ↓
⑲ a. A large amount↳of bloody fluid c. A small amount ofE
greenish fluid
b. A moderate amount of clear to straw-colored fluid d. A small segment of the umbilical cord
69. When her membranes rupture, the nurse's first action should be to:
a. Notify the physician because delivery is imminent c. Count the fetal heart rate
b. Measure the amount of fluid d. Perform a vaginal exam
70. During the third stage of labor, the nurse may have which of the following responsibilities?

T
in a. Administer intramuscular Oxytocin to facilitate uterine contractility
jo b. Monitor for blood loss greater than 100 cc, which would indicate gross hemorrhage
c. Note if the placenta makes a Schultz presentation, which is a sign of gross complication
d. Push down on the relaxed uterus to aid in the removal of the placenta

·
Situation: A nurse is managing postpartum patients. The following questions are related to the post partum period.
71. The delivery nurse is reporting to the postpartum nurse about the client who just delivered her first baby, a term
newborn. Which number should the delivery nurse report for the client’s parity?
A. 1 C. 3
B. 2 D. 0
-
72. Immediately after delivery of the client’s placenta, the nurse palpates the client’s uterine fundus. The fundus is firm
and located halfway between the umbilicus and symphysis pubis. Which action should the nurse take based on the
assessment findings?
A. Immediately begin to massage the uterus C. Assess the client for bladder distention
B. Document the findings of the fundus D. Monitor for increased vaginal bleeding
②
- °@
°
⑦
73. The client, who delivered a 4200-g baby 4 hours ago, continues to have bright red, heavy vaginal bleeding. The nurse
assesses the client’s fundus and finds it to be firm and midway between the symphysis pubis and umbilicus. What should
the nurse do next? lacerations
A. Continue to monitor the client’s bleeding and weigh the peripads.
↓ reginal
B. Call the client’s HCP and request an additional visual examination.
C. Prepare to give oxytocin to stimulate uterine muscle contraction. ↳ ↳-
arrical-
D. Document the findings as normal with no interventions needed at that time.
74.. When looking in the mirror at her abdomen, the postpartum client says to the nurse, “My stomach still looks like I’m
pregnant!” The nurse explains that the abdominal muscles, which separate during pregnancy, will undergo which change?

08
A. Regain tone Within the first week after birth
-
B. Regain prepregnancy tone with exercise
C.
. Remain separated, giving the abdomen a slight bulge
D. Regain tone as the weight gained during pregnancy is lost
 --
75. The clinic nurse reviews the laboratory results illustrated from the postpartum client who is 3 days postdelivery. What
should the nurse do in response to these results?Hct 35%, Hgb 11g/dL WBC 20,000/mm3
A. Document the laboratory report findings C. Assess the client’s temperature orally
B. Assess the client for increased lochia D. Notify the health care provider immediately

=>
76. The Caucasian postpartum client asks the nurse if the stretch marks (striae gravidarum) on her abdomen will ever go
away. Which response by the nurse is most accurate?

ec
A. “Your stretch marks should totally disappear over the next month.”
B. “Your stretch marks will always appear raised and reddened.”
C. “Your stretch marks will lighten in color with good skin hydration.”
p
D. “Your stretch marks will fade to pale white over the next 3 to 6 months.”
-

77. Twenty-four hours post—vaginal delivery, the postpartum client tells the nurse that she is concerned because she has
not had a bowel movement (BM) since before delivery. Which action should be taken by the nurse?
A. Document the data in the client’s health care records
B. Notify the health care provider immediately
-
C. Administer a laxative that has been prescribed pm
D. Assess the client’s abdomen and bowel sounds
78. The RN and the student nurse are caring for the postpartum client who is 16 hours postdelivery. The RN evaluates
that the student needs more education about uterine assessment when the student is observed doing which activity?
E A. Elevating the client’s head 30 degrees before doing the assessment
B. Supporting the lower uterine segment during the assessment
C. Gently palpating the. uterine fundus for firmness and location
D. Observing the abdomen before beginning palpation
79. The nurse is assessing the postpartum client, who is 5 hours postdelivery. Initially, the nurse is unable to palpate the
client’s uterine fundus. Prioritize the nurse’s actions to locate the client’s fundus by placing each step in the correct
sequence.
1. Place the side of one hand just above the client’s symphysis pubis.
2. Press deeply into the abdomen.
3. Place the other hand at the level of the umbilicus.
4. Massage the abdomen in a circular motion.
10 5. Position the client in the supine position.
6. If the fundus is not felt, move the upper hand lower on the abdomen and repeat the massage.
A. 5, 1, 3, 2, 4, 6 5132 C.- 5, 1, 2, 3, 4, 6
B. 5, 1, 3, 2, 6, 4 -D. 5, 1, 2, 3, 6, 4
80. The client delivered a healthy newborn 4 hours ago after being induced with oxytocin. While being assisted to the
bathroom to void for the first time after delivery, the client tells the nurse that she doesn’t feel a need to urinate. Which
explanation should the nurse provide when the client expresses surprise after voiding 900 mL of urine?
A. “A decreased sensation of bladder filling is normal after childbirth.”
B. “The oxytocin you received in labor makes it difficult to feel voiding.”
C. “You probably didn’t empty completely. I will need to scan your bladder.”
D. “Your bladder capacity is large; you likely won’t void again for 6—8 hours.”
81. When up to the bathroom for the first time after a vaginal delivery, the client states, “A friend told me that I’m going to
have trouble with urinary incontinence now that I have had a baby.” Which is the best response by the nurse?
A. “That’s not true. You won’t need to worry about this until menopause.”
B. “I will teach you how to do Kegel exercises to strengthen your muscles.”
C. “Wearing a pad similar to a sanitary pad will help contain the incontinence.”
entimen
D. “If this occurs, notify your HCP to have surgery to correct urinary incontinence.”
82. The client, who had preeclampsia and delivered vaginally 4 hours ago, is still receiving magnesium sulfate IV. When
assessing the client’s deep tendon reflexes (DTRs), the nurse finds that they are both weak, at 1+, whereas previously
they were 2+ and 3+. Which actions should the nurse plan? Select all that apply.
1. Notify the client’s HCP about the reduced DTRs.
2. Prepare to increase the magnesium sulfate dose.
3. Prepare to administer calcium gluconate IV-
4. Assess the level of consciousness and vital signs.
5. Ask the HCP about drawing a serum calcium level.
A. 1, 3, 5 C. 1, 3
B.
- 1, 2 D.- 1, 4, 5
83. The postpartum client delivered a full-term infant 2 days previously. The client states to the nurse, “My breasts seem
to be growing, and my bra no longer fits.” Which statement should be the basis for the nurse’s response to the client’s
concern?
A. Rapid enlargement of breasts usually is a symptom of infection-
B. Increasing breast tissue may be a sign of postpartum fluid retention.
C. Thrombi may form in veins of the breast and cause increased breast size-
D. Breast tissue increases in the early postpartum period as milk forms.
 84. While assessing the postpartum client who is 10 hours post—vaginal delivery, the nurse notes a perineal pad that is
totally saturated. To determine the significance of this finding, which question should the nurse ask the client first?
A. “How often are you experiencing uterine cramping?”
B. “When was the last time you changed your peri-pad?”
C. “Are you having any bladder urgency or frequency?”
D. “Did you pass clots that required changing your peri-pad?”

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85. Two hours after the client’s vaginal delivery, she reports feeling “several large, warm gushes of fluid” from her vagina.
The nurse assesses the client’s perineum and finds a large pool of blood on the client’s bed. Which nursing action is
priority?
A. Encourage the client to ambulate to the bathroom in order to empty her bladder.
X
B. Place two hands on the uterine fundus and prepare to vigorously massage the uterus.
-

C. Reassure the client that heavy bleeding is expected in the first few hours postpartum.
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D. Support the lower uterine segment with one hand and assess the fundus with the other.
·
86. The oncoming shift nurse assesses the fundus of the postpartum client 6 hours after a vaginal birth and finds that it is
② #
firm. When the nurse then assists the client out of bed for the first time, blood begins to run down the client’s leg. Which
action by the nurse in response to the client’s bleeding is correct?
A. Explain that extra bleeding can occur with initial standing
B. Immediately assist the client back into bed
C. Push the emergency call light in the room
D. Call the HCP to report this increased bleeding
↑

87. The nurse is caring for the client who just gave birth. Which observation of the client should lead the nurse to be
(7=> Oinfant?
concerned about the client’s attachment to her male
[t]A. Asking the caregiver about how to change his diaper

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B. Comparing her newborn’s nose to her brother’s nose

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C. Calling the baby “Kelly,” which was the name selected
D. Repeatedly telling her husband that she wanted a girl

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-
88. The nurse is caring for the postpartum family. The nurse determines that paternal engrossment is occurring when
which observation is made of the newbom’s father?
X Talks to his newborn from across the room
A. -C. Expresses feeling frustrated when the infant
B. Shows similarities between his and the baby’s cries

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ears D. -Seems to be hesitant to -
touch his newborn

89. The nurse is caring for the postpartum primiparous client who is 13 hours post—vaginal delivery. The nurse observes
that the client is passive and hesitant about making decisions about her own and her newbom’s care. In response to this
observation, which interventions should be implemented by the nurse? Select all that apply.
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1. Question her closely about the presence of pain.
2. Ask if she would like to talk about her birth experience. C
E
Taking in

e 3. Encourage her to nap when her infant is napping.

4. Encourage attendance in teaching sessions about infant care. - > -- Taking hold
5. Suggest that she begin to write her birth announcements.
A.- 1, 3, 4 C. 1, 2, 4
↳B. 1, 2, 3 D. =1, 3, 5
②
90. The client has a vaginal delivery of a fiill-term newborn. Immediately after delivery, the nurse assesses that the client’s
-

perineum and labia are edematous, but she does not have an episiotomy or a perineal laceration. Which intervention
should the nurse implement?
A. Give her an ice pack to apply to the perineum. C. Apply warm packs to the affected areas.
B. Teach her to relax her buttocks before sitting. D. Provide a plastic donut cushion for sitting.
91. The nurse observes the postpartum multiparous client rubbing her abdomen. When asked if she is having pain, the
client says, “It feels like menstrual cramps.” Which intervention should the nurse implement?

* A. Offer a warm blanket for her to place on her abdomen.

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-

B. Encourage her to lie on her stomach until the cramps stop.

C. Instruct the client to avoid ambulation while having pain.
D. Check her lochia flow; pain sometimes precedes hemorrhage.
92. TWO hours after delivery, the mother tells the nurse that she will be bottle feeding. She asks what she can do to
prevent the terrible pain experienced when her milk came in with her last baby. Which response by the nurse is most
appropriate?

* D(Q)
A. “Once you have recovered from the birth, I will help you bind your breasts.”
B. “Engorgement is familial. If you had it with your last baby, it is inevitable.”

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C. “I can help you put on a =supportive bra; wear one constantly for l to 2 weeks.” -
-

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X
D. “Engorgement occurs right after birth; if you don’t have it yet, it won’t occur.”

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93. The nurse is preparing to administer 2 mg hydromorphone hydrochloride to the client who is 28 hours. post—cesarean

A. 0.5mg B. 1mg
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section. The medication available is in a concentration of 4 mg/mL. How many milliliters should the nurse administer?
↳ C. 1.5m D. 2mg
94. The postpartum client, who is 24 hours post—cesarean section, tells the nurse that she has much less lochial
discharge after this birth than with her vaginal birth 2 years ago. The client asks if this is normal after a cesarean birth.
Which statement should be the basis for the nurse’s response?
A. A decrease in her lochia is not expected; flirther assessment is needed.
B. Women usually have increased lochial discharge after cesarean births.
C. Women normally have less lochial discharge after a cesarean birth.
D. The lochia amount depends on whether surgery was emergent or planned.
95. The client, who is 12 days postpartum, telephones the clinic and tells the nurse that she is concerned that she may
have an infection because her vaginal discharge has been creamy white for two days now. Which response by the nurse
is correct?
A. “You need to come to the clinic as soon as possible.”
B. “You’ll need an antibiotic; which pharmacy do you use?”
C. “Take your temperature and let me know if it is elevated.”
D. “A creamy white discharge 10 days postpartum is normal.”

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