Question: On the first postpartum day, the nurse teaches the client about breastfeeding. Two hours later, she remembers very little. Why?
Answer Options:
A. The letting-go period
B. The taking-in period
C. Postpartum hemorrhage
D. The taking-hold phase
Answer: B — The taking-in period
Question: A client is diagnosed with pelvic inflammatory disease (PID). Which of the following symptoms should the nurse expect the client to experience?
Answer Options:
A. Excessive vaginal bleeding during menstruation
B. Itching and irritation of the vaginal area without discharge
C. Sudden-onset, sharp chest pain with dyspnea
D. Severe abdominal pain, fever, and foul-smelling vaginal discharge
Answer: D — Severe abdominal pain, fever, and foul-smelling vaginal discharge
Question: Scenario: Intake and output tracking from an image (oral water 250 mL, broth 200 mL, IV fluids 1000 mL; output: urine 650 mL, lochia pad 100 g, stool 80 g).
Answer Options:
N/A (computation question)
Answer: Intake = 1450 mL, Output = 830 mL
Question: During a postpartum examination of a client who delivered an 8-pound newborn 6 hours ago, the following assessment findings are noted: fundus firm and at the umbilicus, and moderate lochia rubra with a steady trickle of blood from the vagina. What is the assessment finding that would necessitate follow-up?
Answer Options:
A. Firm fundus
B. Fundus at the umbilical level
C. Moderate lochia rubra
D. Steady trickle of blood
Answer: D — Steady trickle of blood
Question: A 24-year-old postpartum client presents to the emergency department 2 days after vaginal delivery with a sudden high fever, hypotension, diffuse sunburn-like rash, vomiting, and diarrhea. She reports using super-absorbent tampons prior to delivery and recently resumed their use due to heavy lochia. Based on these findings, which nursing action is the priority?
Answer Options:
A. Monitor temperature every 2 hours
B. Initiate aggressive IV fluid resuscitation
C. Teach the client about tampon safety
D. Remove the tampon and obtain cultures
Answer: B — Initiate aggressive IV fluid resuscitation
Question: The nurse is caring for a client who has delivered a stillborn child. Which question asked by the nurse will best identify the client’s religious needs?
Answer Options:
A. “Would you like me to call a chaplain or spiritual advisor for you?”
B. “Do you believe that the loss was God’s Will?”
C. “What religious or spiritual practices are important to you right now?”
D. “Do you want to see your baby one last time?”
Answer: C — “What religious or spiritual practices are important to you right now?”
Question: A mother experiencing a perinatal loss is unsure whether she wants to hold her infant. The nurse explains the benefits of memory-making, such as photographs, footprints, or handprints. What is the best nursing action?
Answer Options:
A. Avoid discussing memory-making to prevent causing more emotional pain.
B. Offer options and allow the mother to choose which memory-making activities, if any, she wants.
C. Encourage only the father to participate in memory-making, not the mother.
D. Force the mother to participate in memory-making to prevent future regret.
Answer: B — Offer options and allow the mother to choose which memory-making activities, if any, she wants.
Question: The nurse is preparing new parents for discharge with their newborn. The father asks the nurse why the baby’s head is so pointed and puffy-looking. What is the best response by the nurse?
Answer Options:
A. “His head is molded from fitting through the birth canal, it will become more round in a couple of days.”
B. “We refer to that as ‘cone head,’ which is a temporary condition that goes away.”
C. “It might mean that your baby sustained brain damage during birth, and could have delays.”
D. “I think he looks just like you. Your head is much the same shape as your baby’s.”
Answer: A — “His head is molded from fitting through the birth canal, it will become more round in a couple of days.”
Question: In caring for the family after perinatal loss, what nursing intervention is most helpful for the nurse to perform?
Answer Options:
A. Allow the family to continue to hold the baby as needed
B. Encourage the family to focus on future pregnancies.
C. Avoid discussing the loss to prevent emotional distress.
D. Prepare family members on the importance of disposing the infant’s toys, furniture, etc. to avoid unnecessary trauma
Answer: A — Allow the family to continue to hold the baby as needed
Question: A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time?
Answer Options:
A. Express small amounts of milk from the breasts to relieve the pressure.
B. Apply ice to the breasts for comfort.
C. Run warm water on her breasts during a shower.
D. Wear a loose-fitting bra to prevent nipple irritation.
Answer: B — Apply ice to the breasts for comfort.
Question: Scenario: A postpartum client’s intake includes water 250 mL, broth 200 mL, IV fluids 1000 mL. Output includes urine 650 mL, pad weight (120 g–20 g), stool 80 g. Calculate total intake and output.
Answer Options:
N/A (computation question)
Answer: Intake = 1450 mL, Output = 830 mL
Question: The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia before delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push?
Answer Options:
A. Respiratory rate is 18 breaths/min
B. Serum magnesium level is 12 mg/dL
C. Patella reflexes are rated at zero
D. Urinary output remains at 30 mL/hr
Answer: C — Patella reflexes are rated at zero
Question: The new graduate nurse is preparing a care plan for an adolescent client who has suffered perinatal loss. Which planning strategy documented by the nurse needs correction?
Answer Options:
A. Provide age-appropriate resources on grief and bereavement.
B. Encourage the adolescent to verbalize feelings about the loss.
C. Advising the client to talk to women who have not suffered perinatal loss.
D. Using therapeutic communication to develop a good rapport with the client.
Answer: C — Advising the client to talk to women who have not suffered perinatal loss.
Question: (Select All That Apply) A couple has delivered a 28-week stillborn baby. Which nursing actions are appropriate?
Answer Options:
A. Advise the couple that the baby’s death was probably for the best
B. Discuss funeral options for the baby
C. Ask the couple if they would like to hold the baby
D. Encourage the couple to try to get pregnant again soon
E. Swaddle the baby in a baby blanket
Answer: B, C, E
Question: A postpartum client has just received the rubella vaccination. The client understands the teaching associated with administration of this vaccine when she states:
Answer Options:
A. “I must avoid getting pregnant for at least 1 month.”
B. “I will need another vaccination in 3 months.”
C. “This will prevent me from getting chickenpox.”
D. “This will protect my newborn from getting rubella.”
Answer: A — “I must avoid getting pregnant for at least 1 month.”
Question: A postpartum patient calls the obstetric office 8 days following a vaginal delivery. The patient reports concern regarding vaginal bleeding. Which patient-reported symptom causes the nurse the most concern?
Answer Options:
A. Bleeding that is described as brown in color.
B. Increased flow noticed only with physical activity.
C. Discharge that is noted to have a fleshy odor.
D. A description of the lochia as being bright red in color.
Answer: D — A description of the lochia as being bright red in color.
Question: A 28-year-old G2P1 client at 12 weeks gestation is Rh-negative. Her first child was Rh-positive, and she received Rho(D) immune globulin postpartum. She asks the nurse why she needs additional injections during this pregnancy. Which is the nurse’s best response?
Answer Options:
A. “Rh-negative women don’t need any medication during subsequent pregnancies.”
B. “You only need Rh immunoglobulin if your blood type changes during this pregnancy.”
C. “Since your first baby was Rh-positive, your immune system is already sensitized, so Rho(D) won’t help this time.”
D. “The Rho(D) immune globulin from your first pregnancy is no longer effective, you need another dose to prevent your body from forming antibodies against this fetus.”
Answer: D — “The Rho(D) immune globulin from your first pregnancy is no longer effective, you need another dose to prevent your body from forming antibodies against this fetus.”
Question: To assess the healing of the uterus at the placental site, what does the nurse assess during her focused postpartum assessment?
Answer Options:
A. Lab values
B. Uterine size
C. Type, amount, and consistency of lochia
D. Blood pressure
Answer: C — Type, amount, and consistency of lochia
Question: A 9-week pregnant client complains of vaginal bleeding and cramping. A sterile speculum examination finds the cervix closed. This assessment is indicative of what type of spontaneous abortion?
Answer Options:
A. Inevitable
B. Threatened
C. Incomplete
D. Missed
Answer: B — Threatened