OB Exam Questions And Answers
A PP nurse is preparing to care for a woman who has just delivered a healthy newborn infant. In the immediate PP period the nurse plans to take the woman's vital signs every? - ANSW- Every 15 minutes during the first hour and then every 30 minutes for the next tw...
A PP nurse is preparing to care for a woman who has just delivered a healthy newborn
infant. In the immediate PP period the nurse plans to take the woman's vital signs
every? - ANSW- Every 15 minutes during the first hour and then every 30 minutes for
the next two hours.
A PP nurse is taking the VS of a woman who delivers a healthy newborn infant 4 hours
ago. The nurse notes that the mother's temperature is 100.2F. Which of the following
actions would be most appropriate? - ANSW- Increase hydration by encouraging oral
fluids.
The mother's temperature may be taken every 4 hours while she is awake.
Temperatures up to 100.4 F (38 C) in the first 24 hours after birth are often related to
the dehydrating effects of labor. The most appropriate action is to increase hydration by
encouraging oral fluids, which should bring the temperature to a normal reading.
• Option C: Although the nurse would document the findings, the most appropriate
action would be to increase the hydration.
The nurse is assessing a client who is 6 hours PP after delivering a full-term healthy
infant. The client complains to the nurse of feelings of faintness and dizziness. Which of
the following nursing actions would be most appropriate?
lightheadedness and dizziness have subsided. - ANSW- Instruct the mother to
request help when getting out of bed.
Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings of
faintness or dizziness are signs that should caution the nurse to be aware of the client's
safety. The nurse should advise the mother to get help the first few times the mother
gets out of bed.
• Option A: Obtaining an H/H requires a physician's order.
A nurse is preparing to perform a fundal assessment on a postpartum client. The initial
nursing action in performing this assessment is which of the following? - ANSW- Ask
the mother to urinate and empty her bladder.
Before starting the fundal assessment, the nurse should ask the mother to empty her
bladder so that an accurate assessment can be done.
• Options A and B: When the nurse is performing a fundal assessment, the nurse asks
the woman to lie flat on her back with the knees flexed.
• Option D: Massaging the fundus is not appropriate unless the fundus is boggy and
soft, and then it should be massaged gently until firm.
,The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia
is red and has a foul-smelling odor. The nurse determines that this assessment finding
is: - ANSW- Indicates the presence of infection.
Lochia, the discharge present after birth, is red for the first 1 to 3 days and gradually
decreases in amount. Foul smelling or purulent lochia usually indicates infection, and
these findings are not normal.
• Option A: Normal lochia has a fleshy odor.
• Options C and D: Encouraging the woman to drink fluids or increase ambulation is not
an accurate nursing intervention.
When performing a PP assessment on a client, the nurse notes the presence of clots in
the lochia. The nurse examines the clots and notes that they are larger than 1 cm.
Which of the following nursing actions is most appropriate?
D. Encourage increased intake of fluids. - ANSW- Notify the physician.
Normally, one may find a few small clots in the first 1 to 2 days after birth from pooling
of blood in the vagina. Clots larger than 1 cm are considered abnormal. The cause of
these clots, such as uterine atony or retained placental fragments, needs to be
determined and treated to prevent further blood loss. Although the findings would be
documented, the most appropriate action is to notify the physician.
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected
lochia drainage. The nurse instructs the mother that the normal amount of lochia may
vary but should never exceed the need for: - ANSW- Eight peripads per day.
The normal amount of lochia may vary with the individual but should never exceed 4 to
8 peripads per day. The average number of peripads is 6 per day.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn
infant. The nurse instructs the mother that she should expect normal bowel elimination
to return: - ANSW- 3 days PP.
After birth, the nurse should auscultate the woman's abdomen in all four quadrants to
determine the return of bowel sounds. Normal bowel elimination usually returns 2 to 3
days PP. Surgery, anesthesia, and the use of narcotics and pain control agents also
contribute to the longer period of altered bowel function.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn
infant. The nurse instructs the mother that she should expect normal bowel elimination
to return: - ANSW- A and C.
In the PP period, cervical healing occurs rapidly and cervical involution occurs.
, After 1 week the muscle begins to regenerate and the cervix feels firm and the external
os, is the width of a pencil. The fundus begins to descent into the pelvic cavity after 24
hours, a process known as involution.
• Option B: Although the vaginal mucosa heals and vaginal distention decreases, it
takes the entire PP period for complete involution to occur and muscle tone is never
restored to the pregravid state.
• Option D: Despite blood loss that occurs during delivery of the baby, a transient
increase in cardiac output occurs. The increase in cardiac output, which persists about
48 hours after childbirth, is probably caused by an increase in stroke volume because
Bradycardia is often noted during the PP period.
• Option E: Soon after childbirth, digestion begins to begin to be active, and the new
mother is usually hungry because of the energy expended during labor.
A nurse is caring for a PP woman who has received epidural anesthesia and is
monitoring the woman for the presence of a vulva hematoma. Which of the following
assessment findings would best indicate the presence of a hematoma?
D. Signs of heavy bruising - ANSW- Changes in vital signs.
Changes in vitals indicate hypovolemia in the anesthetized PP woman with vulvar
hematoma.
• Options A and B: Because the woman has had epidural anesthesia and is
anesthetized, she cannot feel pain, pressure, or a tearing sensation.
• Option D: Heavy bruising may be visualized, but vital sign changes indicate hematoma
caused by blood collection in the perineal tissues.
A nurse is developing a plan of care for a PP woman with a small vulvar hematoma.
The nurse includes which specific intervention in the plan during the first 12 hours
following the delivery of this client? - ANSW- Prepare an ice pack for application to the
area.
Application of ice will reduce swelling caused by hematoma formation in the vulvar area.
• Options A, B, and C: The other options are not interventions that are specific to the
plan of care for a client with a small vulvar hematoma.
A new mother received epidural anesthesia during labor and had a forceps delivery
after pushing 2 hours. At 6 hours PP, her systolic blood pressure has dropped 20
points, her diastolic BP has dropped 10 points, and her pulse is 120 beats per minute.
The client is anxious and restless. On further assessment, a vulvar hematoma is
verified. After notifying the health care provider, the nurse immediately plans to: -
ANSW- Prepare the client for surgery.
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