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Nursing Care of the Patient exam with correct answers 2024
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Question 1 of 63 During a cesarean, the provider communicates that the drapes have been suctioned out prior to the delivery of the placenta. The nurse notes the suction canister has 350 mL of blood-tinged fluid in it. The nurse quickly switches to a new suction canister prior to the delivery of t...

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  • May 3, 2024
  • 29
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • nursing care of the patient exam

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  • Nurg
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Nursing Care of the Patient exam with
correct answers 2024


Question 1 of 63

During a cesarean, the provider communicates that the drapes have been suctioned out prior to the
delivery of the placenta.

The nurse notes the suction canister has 350 mL of blood-tinged fluid in it. The nurse quickly
switches to a new suction canister prior to the delivery of the placenta. As the fascia is closed, the
provider again suctions the drape, and the nurse notes 600 mL of blood in the new canister.

Twenty sponges in 4 sponge counter bags are weighed with a total amount of 400 g. The nurse
knows the dry weight of 20 sponges and 4 counter bags is 250 g.

What amount of quantitative blood loss does the nurse record for this birth?

Select an answer.



• 600 mL

1350 ml

• 750°mL

• 1100 mL - answer-• 750°mL



Early nursing interventions in a Stage 1 hemorrhage include:

Select an answer.

• Administering uterotonics, drawing labs, and moving to the OR

• Massaging the fundus, ambulating the patient, and quantifying blood loss

• Massaging the fundus, emptying the bladder, and quantifying blood loss

O Evaluating vital signs, assessing for cervical lacerations, and administering IV fluids - answer-•
Massaging the fundus, emptying the bladder, and quantifying blood loss



Ms. Diaz expels a grapefruit-sized clot. The nurse massages Ms. Diaz fundus and informs the
physician that the patient has entered Stage 2 of hemorrhage. The physician states, "Let's just watch
her over the next hour."

What should the prudent nurse do?

Select an answer.

,Nursing Care of the Patient exam with
correct answers 2024


• State that for a Stage 2 hemorrhage, the protocol recommends that the provider evaluates the
patient and orders a uterotonic.

O Follow the physician's order, as it is the physician's call, not the nurse's.

• Tell the patient that the doctor does not seem to think her bleeding is concerning.

• Ask the senior nurse what to do, and follow that advice. - answer-• State that for a Stage 2
hemorrhage, the protocol recommends that the provider evaluates the patient and orders a
uterotonic.



A hemorrhage risk assessment is completed:



SATA



1. Upon admission

2. Throughout labor, as risk factors develop

3. Prior to birth

4. Hourly in labor - answer-1. Upon admission

2. Throughout labor, as risk factors develop

3. Prior to birth



Question 15 of 63

The nurse reports that the quantitative blood loss (QBL) from the under-buttocks drape after the
vaginal birth is 745 mL after dry weights and pre-placental fluids have been subtracted. Prior to the
provider leaving the room, the obstetric team decides to re-evaluate bleeding, fundal height, and
vital signs. The decision for heightened surveillance is made because:

Select an answer.



a. The team mistakenly diagnoses a hemorrhage despite the fact that QBL is <1000 mL.

b. Cumulative QBL is not accurate enough to diagnose obstetric hemorrhage.

c. The team correctly identifies 745 mL as an abnormal amount of blood loss for a vaginal birth,
warranting close monitoring.

, Nursing Care of the Patient exam with
correct answers 2024


d. Some providers are more cautious than others, and management depends on the individual
provider. - answer-c. The team correctly identifies 745 mL as an abnormal amount of blood loss for a
vaginal birth, warranting close monitoring.



Though the standard definition of a hemorrhage is blood loss >1000 mL, blood loss

>500 mL is abnormal in a vaginal birth and warrants close monitoring. This is considered a Stage 1
hemorrhage on AWHONN's hemorrhage staging system.

Initial interventions to manage hemorrhage are appropriate after 500 mL blood loss in a vaginal birth
(Association of Women's Health, Obstetric and Neonatal Nurses 2021a). QBL should be the main
trigger to help guide management of a hemorrhage. Standardized protocols help limit variances due
to different providers.



A cumulative quantitative blood loss after a vaginal birth that is 600 mL is considered what stage of
hemorrhage?

Select an answer.



• Severe hemorrhage

• Stage 1 hemorrhage

• Stage 3 hemorrhage

• Is not staged because it is <1000 mL - answer-• Stage 1 hemorrhage



Which of the following nursing interventions should be performed in collaboration with other
interventions during a Stage 1 obstetric hemorrhage?

Select all that apply.



1 Keep the patient warm using warmed fluids and warmer devices.

2 Directy quantify blood loss (OBL) and communicate cumulative QBL.

3 Aggressively replace blood loss with an equal amount of crystalloid fluids.

4 Avoid the use of a bladder catheter to limit the risk of infection. - answer-1 Keep the patient warm
using warmed fluids and warmer devices.

2 Directy quantify blood loss (OBL) and communicate cumulative QBL.

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