Chapter 20 Flashcards

1
Q
A woman gave birth to an infant boy 12 hours ago. Where would the nurse expect to locate this woman’s fundus?
a.
One centimetre above the umbilicus
b.
Two centimetres below the umbilicus
c.
Midway between the umbilicus and the symphysis pubis
d.
Nonpalpable abdominally
A

A

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2
Q
Which woman is most likely to experience strong afterpains?
a.
A woman who experienced oligohydramnios
b.
A woman who gave birth to twins
c.
A woman who is bottle-feeding her infant
d.
A woman whose infant weighed 5 pounds, 3 ounces
A

B

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3
Q
A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse expect to find when assessing this woman?
a.
Lochia rubra
b.
Lochia sangra
c.
Lochia alba
d.
Lochia serosa
A

D

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4
Q
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
a.
Estrogen
b.
Progesterone
c.
Prolactin
d.
Human placental lactogen
A

C

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5
Q

Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis. What is responsible for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period?
a.
Elevated temperature caused by postpartum infection
b.
Increased basal metabolic rate after giving birth
c.
Loss of increased blood volume associated with pregnancy
d.
Increased venous pressure in the lower extremities

A

C

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6
Q
A woman gave birth to a 2850 g infant boy 2 hours ago. The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, what is the most serious consequence likely to occur from bladder distension?
a.
Urinary tract infection
b.
Excessive uterine bleeding
c.
A ruptured bladder
d.
Bladder wall atony
A

B

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7
Q
The nurse caring for the postpartum woman understands that breast engorgement is caused by which of the following?
a.
Overproduction of colostrum
b.
Accumulation of milk in the lactiferous ducts
c.
Hyperplasia of mammary tissue
d.
Congestion of veins and lymphatics
A

D

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8
Q

A woman gave birth to a 3100 g infant girl 1 hour ago. The birth was vaginal, and the estimated blood loss (EBL) was approximately 1500 mL. Which of the following would the nurse be concerned about?
a.
Temperature 37.9°C, heart rate 120, respirations 20, blood pressure (BP) 90/50
b.
Temperature 37.4°C, heart rate 88, respirations 36, BP 126/68
c.
Temperature 38°C, heart rate 80, respirations 16, BP 110/80
d.
Temperature 36.8°C, heart rate 60, respirations 18, BP 140/90

A

A

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9
Q

What statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?
a.
“My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter.”
b.
“My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles.”
c.
“I will not have a menstrual cycle for 6 months after childbirth.”
d.
“My first menstrual cycle will be heavier than normal and then will be light for several months after.”

A

B

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10
Q

The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is referred to as which of the following?
a.
Involutionary period, because of what happens to the uterus
b.
Lochia period, because of the nature of the vaginal discharge
c.
Mini-tri period, because it lasts only 3 to 6 weeks
d.
Puerperium, or fourth trimester of pregnancy

A

D

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11
Q
What is the term that refers to the self-destruction of excess hypertrophied tissue in the uterus?
a.
Autolysis
b.
Subinvolution
c.
Afterpain
d.
Diastasis
A

A

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12
Q

What should the nurse be aware of with regard to the postpartum uterus?
a.
At the end of the third stage of labour it weighs approximately 500 g.
b.
After 2 weeks postpartum it should not be palpable abdominally.
c.
After 2 weeks postpartum it weighs 100 g.
d.
It returns to its original (prepregnancy) size by 6 weeks, postpartum.

A

B

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13
Q

Which of the following is accurate with regard to afterbirth pains?
a.
They are caused by mild, continuous contractions for the duration of the postpartum period.
b.
They are more common in first-time mothers.
c.
They are more noticeable in births in which the uterus was overdistended.
d.
They are alleviated somewhat when the mother breastfeeds.

A

C

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14
Q

Which of the following is true about lochia?
a.
It is similar to a light menstrual period for the first 6 to 12 hours.
b.
It is usually greater after Caesarean births.
c.
It will usually decrease with ambulation and breastfeeding.
d.
It should smell like normal menstrual flow, unless an infection is present.

A

D

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15
Q

Which description of postpartum restoration or healing times is accurate?
a.
The cervix shortens, becomes firm, and returns to form within a month postpartum.
b.
The vagina gradually returns to prepregnancy size by 6 to 10 weeks after childbirth.
c.
Most episiotomies heal within a week.
d.
Hemorrhoids usually decrease in size within 2 weeks of childbirth.

A

B

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16
Q

What should the nurse be aware of with regard to postpartum ovarian function?
a.
Almost 75% of women who do not breastfeed resume menstruating within a month after birth.
b.
Ovulation occurs slightly earlier for breastfeeding women.
c.
Because of menstruation/ovulation schedules, contraception considerations can be postponed until after the puerperium.
d.
The first menstrual flow after childbirth usually is heavier than normal.

A

D

17
Q

With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware of which of the following?
a.
Kidney function returns to normal a few days after birth.
b.
Diastasis recti abdominis is a common condition that alters the voiding reflex.
c.
Fluid loss through perspiration and increased urinary output accounts for a weight loss of over 2 kg during the puerperium.
d.
With adequate emptying of the bladder, bladder tone usually is restored 2 to 3 weeks after childbirth.

A

C

18
Q
Approximately how long is engorgement expected to last?
a.
12 hours
b.
48 hours
c.
72 hours
d.
1 week
A

B

19
Q

With regard to the postpartum changes and developments in a woman’s cardiovascular system, nurses should be aware of which of the following?
a.
Cardiac output, the pulse rate, and stroke volume all return to prepregnancy normal values within a few hours of childbirth.
b.
Respiratory function returns to nonpregnant levels by 6 to 8 weeks after birth.
c.
The lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections.
d.
A hypercoagulable state protects the new mother from thromboembolism, especially after a Caesarean birth.

A

B

20
Q
Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium?
a.
Varicosities of the legs
b.
Carpal tunnel syndrome
c.
Periodic numbness and tingling of the fingers
d.
Headaches
A

D

21
Q

Several changes in the integumentary system that appear during pregnancy disappear after birth, although not always completely. What change is almost certain to be completely reversed?
a.
Nail brittleness
b.
Darker pigmentation of the areolae and linea nigra
c.
Striae gravidarum on the breasts, abdomen, and thighs
d.
Spider nevi

A

A

22
Q

Childbirth may result in injuries to the vagina and uterus. Pelvic floor exercises, also known as Kegel exercises, will help to strengthen the perineal muscles and encourage healing. The nurse knows that the patient understands the correct process for completing these conditioning exercises when she reports which of the following?
a.
“I contract my thighs, buttocks, and abdomen.”
b.
“I do 10 of these exercises every day.”
c.
“I stand while practicing this new exercise routine.”
d.
“I pretend that I am trying to stop the flow of urine midstream.”

A

D