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Maternal Semi F Wps Office
Maternal Semi F Wps Office
Try to answer!
1.)The perinatal nurse is caring for a woman in the immediate post birth period. Assessment reveals that
the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:
a. Uterine atony.
b. Uterine inversion.
c. Vaginal hematoma.
d. Vaginal laceration.
ANS: A
2.) A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage
associated with uterine atony is to:
ANS: B
3.) The perinatal nurse caring for the postpartum woman understands that late postpartum hemorrhage
(PPH) is most likely caused by:
c. Cervical lacerations.
d. Coagulation disorders.
ANS: A
4.) Which woman is at greatest risk for early postpartum hemorrhage (PPH)?
a. A primiparous woman (G 2 P 1 0 0 1) being prepared for an emergency cesarean birth for fetal distress
b. A woman with severe preeclampsia who is receiving magnesium sulfate and whose labor is being
induced
c. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor
ANS: B
6.) The first and most important nursing intervention when a nurse observes profuse postpartum
bleeding is to:
d. Assess maternal blood pressure and pulse for signs of hypovolemic shock.
ANS: C
7.) When caring for a postpartum woman experiencing hemorrhagic shock, the nurse recognizes that
the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:
c. Diminished restlessness.
ANS: D
8.) One of the first symptoms of puerperal infection to assess for in the postpartum woman is:
ANS: D
9.) The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized
by:
a. Washing the nipples and breasts with mild soap and water once a day
ANS: B
10.) Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH).
For instance:
b. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500 mL after cesarean birth
to define the condition as PPH.
c. If anything, nurses and doctors tend to overestimate the amount of blood loss.
d. Traditionally PPH has been classified as early or late with respect to birth.
ANS: D
11.) A woman who has recently given birth complains of pain and tenderness in her leg. On physical
examination the nurse notices warmth and redness over an enlarged, hardened area. The nurse should
suspect __________ and should confirm the diagnosis by ___________.
b. von Willebrand disease; noting whether bleeding times have been extended
ANS: C
12.) What PPH conditions are considered medical emergencies that require immediate treatment?
ANS: A
13.) What infection is contracted mostly by first-time mothers who are breastfeeding?
a. Endometritis
b. Wound infections
c. Mastitis
ANS: C
14.) Despite popular belief, there is a rare type of hemophilia that affects women of childbearing age.
von Willebrand disease is the most common of the hereditary bleeding disorders and can affect males
and females alike. It results from a factor VIII deficiency and platelet dysfunction. Although factor VIII
levels increase naturally during pregnancy, there is an increased risk for postpartum hemorrhage from
birth until 4 weeks after delivery as levels of von Willebrand factor (vWf) and factor VIII decrease. The
treatment that should be considered first for the client with von Willebrand disease who experiences a
postpartum hemorrhage is:
a. Cryoprecipitate.
c. Desmopressin.
d. Hemabate.
ANS: C
15.) The nurse should be aware that a pessary would be most effective in the treatment of what
disorder?
a. Cystocele
b. Uterine prolapse
c. Rectocele
ANS: B
16.) A mother in late middle age who is certain she is not pregnant tells the nurse during an office visit
that she has urinary problems and sensations of bearing down and of something in her vagina. The
nurse would realize that the client most likely is suffering from:
a. Pelvic relaxation.
c. Uterine displacement.
d. Genital fistulas.
ANS: B
17.) The prevalence of urinary incontinence (UI) increases as women age, with more than one third of
women in the United States suffering from some form of this disorder. The symptoms of mild to
moderate UI can be successfully decreased by a number of strategies. Which of these should the nurse
instruct the client to use first?
c. Surgery
d. Medications
ANS: B
18.) When a woman is diagnosed with postpartum depression (PPD) with psychotic features, one of the
main concerns is that she may:
ANS: C
19.) According to Becks studies, what risk factor for postpartum depression is likely to have the greatest
effect on the womans condition?
a. Prenatal depression
b. Single-mother status
ANS: A
20.) To provide adequate postpartum care, the nurse should be aware that postpartum depression
(PPD)without psychotic features:
a. Means that the woman is experiencing the baby blues. In addition she has a visit with a counselor or
psychologist.
b. Is more common among older, Caucasian women because they have higher expectations.
ANS: C
21.) To provide adequate postpartum care, the nurse should be aware that postpartum depression
(PPD)with psychotic features:
b. Is rarely delusional and then is usually about someone trying to harm her (the mother).
ANS: D
22.) With shortened hospital stays, new mothers are often discharged before they begin to experience
symptoms of the baby blues or postpartum depression. As part of the discharge teaching, the nurse can
prepare the mother for this adjustment to her new role by instructing her regarding self-care activities
to help prevent postpartum depression. The most accurate statement as related to these activities is to:
b. Be certain that you are the only caregiver for your baby, to facilitate infant attachment.
ANS: D
23.) A newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection. The
parents speak to the neonatologist, who informs them of their sons prognosis. When the father sees his
son, he says, He looks just fine to me. I cant understand what all this is about. The most appropriate
response by the nurse would be:
b. This must be a difficult time for you. Tell me how youre doing.
ANS: B
24.)After giving birth to a stillborn infant, the woman turns to the nurse and says, I just finished painting
the babys room. Do you think that caused my baby to die? The nurses best response to this woman is:
a. Thats an old wives tale; lots of women are around paint during pregnancy, and this doesnt happen to
them.
b. Thats not likely. Paint is associated with elevated pediatric lead levels.
c. Silence.
d. I can understand your need to find an answer to what caused this. What else are you thinking about?
ANS: D
25.) Which options for saying goodbye would the nurse want to discuss with a woman who is diagnosed
with having a stillborn girl?
a. The nurse shouldnt discuss any options at this time; there is plenty of time after the baby is born.
c. When your baby is born, would you like to see and hold her?
d. What funeral home do you want notified after the baby is born?
ANS: C
26.) A woman experienced a miscarriage at 10 weeks of gestation and had a dilation and curettage
(D&C). She states that she is just fine and wants to go home as soon as possible. While you are assessing
her responses to her loss, she tells you that she had purchased some baby things and had picked out a
name. On the basis of your assessment of her responses, what nursing intervention would you use first?
c. Ask her whether she would like to see what was obtained from her D&C.
d. Ask her what name she had picked out for her baby.
ANS: D
27.) A woman is diagnosed with having a stillborn. At first, she appears stunned by the news, cries a little,
and then asks you to call her mother. The phase of bereavement the woman is experiencing is called:
a. Anticipatory grief.
b. Acute distress.
c. Intense grief.
d. Reorganization.
ANS: B
28.) During the initial acute distress phase of grieving, parents still must make unexpected and
unwanted decisions about funeral arrangements and even naming the baby. The nurses role should be
to:
ANS: C
29.) The nurse caring for a family during a loss may notice that survival guilt sometimes is felt at the
death of an infant by the childs:
a. Siblings.
b. Mother.
c. Father.
d. Grandparents.
ANS: D
a. Occurs when, in multiple births, one child dies, and the other or others live.
ANS: C
ANS: A
32.) A woman delivered a 9-lb, 10-oz baby 1 hour ago. When you arrive to perform her 15-minute
assessment, she tells you that she feels all wet underneath. You discover that both pads are completely
saturated and that she is lying in a 6-inch-diameter puddle of blood. What is your first action?
ANS: B
33.) A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:
a. Uterine atony.
c. Perineal hematoma.
ANS: B
34.) Which instructions should be included in the discharge teaching plan to assist the patient in
recognizing early signs of complications?
b. Notify the physician of any increase in the amount of lochia or a return to bright red bleeding.
ANS: B
35.) If nonsurgical treatment for late postpartum hemorrhage is ineffective, which surgical procedure is
appropriate to correct the cause of this condition?
a. Hysterectomy
b. Laparoscopy
c. Laparotomy
d. D&C
ANS: D
36.) A mother with mastitis is concerned about breastfeeding while she has an active infection. The
nurse should explain that:
c. The organisms that cause mastitis are not passed to the milk.
ANS: C
37.) Which condition is a transient, self-limiting mood disorder that affects new mothers after childbirth?
a. Postpartum depression
b. Postpartum psychosis
d. Postpartum blues
ANS: D
38.) Anxiety disorders are the most common mental disorders that affect women. While providing care
to the maternity patient, the nurse should be aware that one of these disorders is likely to be triggered
by the process of labor and birth. This disorder is:
a. Phobias.
b. Panic disorder.
39.) Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply):
a. Pitocin.
b. Methergine.
c. Terbutaline.
d. Hemabate.
e. Magnesium sulfate.
ANS: A, B, D
40.) Possible alternative and complementary therapies for postpartum depression (PPD) for
breastfeeding mothers include (Select all that apply):
a. Acupressure.
b. Aromatherapy.
d. Wine consumption.
e. Yoga.
ANS: A, B, E