test bank for chapter 10 nursing care of women with complications following birth
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MATERNITY AND PEDIATRIC NURSING
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INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 88
Chapter 10: Nursing Care of Women with Complications After Birth
MULTIPLE CHOICE
1. What is the first sign of hypovolemic shock from postpartum hemorrhage?
a. Cold, clammy skin
b. Tachycardia
c. Hypotension
d. Decreased urinary output
ANS: B
Tachycardia is usually the first sign of inadequate blood volume.
2. Although the nurse has massaged the uterus every 15 minutes, it remains flaccid, and the patient continues to
pass large clots. What does the nurse recognize these signs indicate?
a. Uterine atony
b. Uterine dystocia
c. Uterine hypoplasia
d. Uterine dysfunction
ANS: A
Atony describes a lack of normal muscle tone. If the uterus is atonic, then muscle fibers are flaccid and will not
compress bleeding vessels.
3. What should the nurses first action be when postpartum hemorrhage from uterine atony is suspected?
a. Teach the patient how to massage the abdomen and then get help.
b. Start IV fluids to prevent hypovolemia and then notify the registered nurse.
c. Begin massaging the fundus while another person notifies the physician.
d. Ask the patient to void and reassess fundal tone and location.
ANS: C
When the uterus is boggy, the nurse should immediately massage it until it becomes firm.
4. The nurse assesses a boggy uterus with the fundus above the umbilicus and deviated to the side. What
should the nurses next assessment be?
a. Fullness of the bladder
b. Amount of lochia
c. Blood pressure
d. Level of pain
ANS: A
Bladder distention can cause uterine atony. The uterus is massaged to firmness and then the bladder is emptied.
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 89
5. Massage and putting the infant to the breast of a postpartum patient have been ineffective in controlling a
boggy uterus. What will the nurse anticipate might be ordered by the physician?
a. Ritodrine
b. Magnesium sulfate
c. Oxytocin
d. Bromocriptine
ANS: C
Oxytocin (Pitocin) is the most common drug ordered to control uterine atony.
6. A 4-week postpartum patient with mastitis asks the nurse if she can continue to breastfeed. What is the
nurses most helpful response?
a. Stop breastfeeding until the infection clears.
b. Pump the breasts to continue milk production, but do not give breast milk to the infant.
c. Begin all feedings with the affected breast until the mastitis is resolved.
d. Breastfeeding can continue unless there is abscess formation.
ANS: D
The woman with mastitis can continue to breastfeed unless an abscess forms.
DIF: Cognitive Level: Application REF: Page 256
TOP: Mastitis and Breastfeeding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
7. A woman had a vaginal delivery two days ago and is preparing for discharge. What will the nurse plan to
NURSINGTB.COM
teach the woman to report to help prevent postpartum complications?
a. Fever
b. Change in lochia from red to white
c. Contractions
d. Fatigue and irritability
ANS: A
Increased temperature is a sign of infection. The other choices are normal in the postpartum period.
DIF: Cognitive Level: Application REF: Page 254
TOP: Puerperal Infections KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
8. One day after discharge, the postpartum patient calls the clinic complaining of a reddened area on her lower
leg, temperature elevation of 37 C (99.8 F), rust-colored lochia, and sore breasts. What does the nurse suspect
from these symptoms?
a. Phlebitis
b. Puerperal infection
c. Late postpartum hemorrhage
d. Mastitis
ANS: A
The complaints related to the leg are indicative of phlebitis. The other signs are normal in the postpartum
patient.
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