Nokea
What is a risk factor for uterine atony?
- A. small for gestational age
- B. primipara
- C. multiple gestation
- D. intrauterine growth restriction
Correct Answer: C
Rationale: Risk factors for uterine atony include multiple gestation and large infants.
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A woman had a cesarean section yesterday. She states that she needs to cough but that she is afraid to. Which of the following is the nurse 's best response?
- A. I know that it hurts but it is very important for you to cough.
- B. Let me check your lung fields to see if coughing is really necessary.
- C. If you take a few deep breaths in, that should be as good as coughing.
- D. If you support your incision with a pillow, coughing should hurt less.
Correct Answer: D
Rationale: Supporting the incision with a pillow while coughing reduces the strain on the surgical site, making it less painful.
A 2-day-postpartum breastfeeding woman states, 'I am sick of being fat. When can I go on a diet? ' Which of the following responses is appropriate?
- A. It is fine for you to start dieting right now as long as you drink plenty of milk. '
- B. Your breast milk will be low in vitamins if you start to diet while breastfeeding. '
- C. You must eat at least 3,000 calories per day in order to produce enough milk for your baby. '
- D. Many mothers lose weight when they breastfeed because the baby consumes about 600 calories a day. '
Correct Answer: D
Rationale: Breastfeeding can help with postpartum weight loss, as the body burns calories producing milk.
Choose the best independent nursing action to aid episiotomy healing in the woman who is 24 hours postpartum.
- A. Apply antibiotic cream to the area three times each day.
- B. Squirt warm water over the perineum after voiding or stooling.
- C. Maintain cold packs to the area at all times for the first 3 days.
- D. Check the leukocyte level daily and report changes.
Correct Answer: B
Rationale: Squatting warm water over the perineum after voiding or stooling helps to soothe and cleanse the area, promoting healing.
The nurse is providing postpartum care for a patient after a vaginal delivery. Which assessment finding causes the nurse to suspect endometritis from beta-hemolytic streptococcus?
- A. Scant amount of odorless lochia
- B. Presence of headache, malaise, and chills
- C. Pain or discomfort in the midline lower abdomen
- D. Elevated temperature greater than 100.4°F (38°C)
Correct Answer: D
Rationale: The correct answer is D, an elevated temperature greater than 100.4°F. Endometritis, an infection of the uterine lining, commonly caused by beta-hemolytic streptococcus, often presents with a fever. This is a key sign of infection, indicating the presence of an inflammatory process. The other choices are incorrect because:
A: Scant amount of odorless lochia is indicative of normal postpartum discharge, not necessarily endometritis.
B: Headache, malaise, and chills are non-specific symptoms that could be present in various conditions, not specific to endometritis.
C: Pain or discomfort in the midline lower abdomen could be related to postpartum uterine contractions or other causes, but it is not a specific finding for endometritis.
A bottle-feeding woman, 11 1/2 weeks postpartum from a vaginal delivery, calls the obstetric office to state that she has saturated 2 pads in the past 1 hour. Which of the following responses by the nurse is appropriate?
- A. You must be doing too much. Lie down for a few hours and call back if the bleeding has not subsided.
- B. You are probably getting your period back. You will bleed like that for a day or two and then it will lighten up.
- C. It is not unusual to bleed heavily every once in a while after a baby is born. It should subside shortly.
- D. It is important for you to be examined by the doctor today. Let me check to see when you can come in.
Correct Answer: D
Rationale: Saturating 2 pads in 1 hour could indicate abnormal bleeding or a complication. Immediate evaluation by a healthcare provider is necessary.