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What is characteristic of a late (secondary) PPH?
- A. occurs within the first 24 hours
- B. is caused by subinvolution of the uterus
- C. does not occur after cesarean births
- D. cannot be treated with Methergine
Correct Answer: B
Rationale: Late (secondary) postpartum hemorrhage is typically caused by subinvolution of the uterus and may occur after the first 24 hours.
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The nurse places one hand above the symphysis pubis during uterine massage to:
- A. Make the massage more comfortable for the woman.
- B. Increase the effectiveness of the procedure.
- C. Help prevent the uterus from inverting.
- D. Help determine the firmness of the uterus.
Correct Answer: C
Rationale: By placing a hand above the symphysis pubis, the nurse can help prevent uterine inversion and provide better support during the massage.
What assessment finding suggests a possible infection?
- A. painful fundal massage
- B. breast-feeding every 2–3 hours
- C. pulse 72
- D. WBCs 10,000
Correct Answer: D
Rationale: Painful fundal massage can indicate a potential infection.
The nurse is caring for a postpartum client who experienced a second-degree perineal laceration at delivery 2 hours ago. Which of the following interventions should the nurse perform at this time?
- A. Apply an ice pack to the perineum.
- B. Advise the woman to use a sitz bath after every voiding.
- C. Advise the woman to sit on a pillow.
- D. Teach the woman to insert nothing into her rectum.
Correct Answer: A
Rationale: Applying an ice pack to the perineum helps reduce swelling and provides pain relief after a perineal laceration.
The nurse is caring for a postpartum woman and her 2-hour-old baby. The new mother has been preoccupied with breastfeeding and visitors, but suddenly she complains of dizziness and is light-headed. Which response by the nurse is appropriate?
- A. Explain that she needs to drink more fluids and eat because she needs to replace fluids and calories.
- B. Encourage the patient to rest, and ask a family member to watch the newborn in the crib.
- C. Tell the patient that the dizziness is probably caused by her pain medication and that it is normal.
- D. Obtain vital signs, assess fundal tone, and observe for excessive lochia.
Correct Answer: D
Rationale: Obtaining vital signs, assessing fundal tone, and observing for excessive lochia is appropriate to identify the cause of dizziness.
The home health nurse visits a client who is 6 days postdelivery. The client appears sad, weeps frequently, and states, 'I don 't know what is wrong with me. I feel terrible. I should be happy, but I 'm not. ' Which of the following nursing diagnoses is appropriate for this client?
- A. Suicidal thoughts related to psychotic ideations.
- B. Post-trauma response related to traumatic delivery.
- C. Ineffective individual coping related to hormonal shifts.
- D. Spiritual distress related to immature belief systems.
Correct Answer: C
Rationale: The client 's symptoms suggest ineffective coping due to hormonal shifts commonly experienced during the postpartum period, possibly indicating postpartum blues.