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WorksheetsOB Ch 20
Total questions: 23
Worksheet time: 1hrs 9mins
A woman gave birth to an infant boy 10 hours ago. Where does the nurse expect to locate this woman’s fundus?
1 centimeter above the umbilicus
2 centimeters below the umbilicus
Midway between the umbilicus and the symphysis pubis
Nonpalpable abdominally
What are the most common causes for subinvolution of the uterus?
Postpartum hemorrhage and infection
Multiple gestation and postpartum hemorrhage
Uterine tetany and overproduction of oxytocin
Retained placental fragments and infection
Which client is most likely to experience strong and uncomfortable afterpains?
A woman who experienced oligohydramnios
A woman who is a gravida 4, para 4-0-0-4
A woman who is bottle-feeding her infant
A woman whose infant weighed 5 pounds, 3 ounces
A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client?
Lochia rubra
Lochia sangra
Lochia alba
Lochia serosa
Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
Estrogen
Progesterone
Prolactin
Human placental lactogen
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. Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?
Elevated temperature caused by postpartum infection
Increased basal metabolic rate after giving birth
Loss of increased blood volume associated with pregnancy
Increased venous pressure in the lower extremities
Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?
Involutionary period because of changes to the uterus
Lochia period because of the nature of the vaginal discharge
Mini-tri period because it lasts only 3 to 6 weeks
Puerperium, or fourth trimester of pregnancy
A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman’s vital signs, which finding would be of greatest concern to the nurse?
Temperature 37.9° C, heart rate 120 beats per minute (bpm), respirations 20
breaths per minute, and blood pressure 90/50 mm Hg
Temperature 37.4° C, heart rate 88 bpm, respirations 36 breaths per minute, and
blood pressure 126/68 mm Hg
Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and
blood pressure 110/80 mm Hg
Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute, and
blood pressure 140/90 mm Hg
A client is concerned that her breasts are engorged and uncomfortable. What is the nurse’s explanation for this physiologic change?
Overproduction of colostrum
Accumulation of milk in the lactiferous ducts and glands
Hyperplasia of mammary tissue
Congestion of veins and lymphatic vessels
After delivery, excess hypertrophied tissue in the uterus undergoes a period of self-destruction. What is the correct term for this process?
Autolysis
Subinvolution
Afterpains
Diastasis
Which statement regarding the postpartum uterus is correct?
At the end of the third stage of labor, the postpartum uterus weighs approximately
500 g
After 2 weeks postpartum, it should be abdominally nonpalpable.
After 2 weeks postpartum, it weighs 100 g
Postpartum uterus returns to its pre-pregnancy size by 6 weeks postpartum.
Which explanation concerning postpartum ovary function is most accurate?
Almost 75% of women who do not breastfeed resume menstruating within 1
month after birth
Ovulation occurs slightly earlier for breastfeeding women
Because of menstruation and ovulation schedules, contraception considerations can
be postponed until after the puerperium
The first menstrual flow after childbirth usually is heavier than normal.
The nurse should be cognizant of which postpartum physiologic alteration?
Cardiac output, pulse rate, and stroke volume all return to prepregnancy normal
values within 48 hours of childbirth
Respiratory function returns to nonpregnant levels by 6 to 8 weeks after childbirth
Lowered white blood cell count after pregnancy can lead to false-positive results
on tests for infections
Hypercoagulable state protects the new mother from thromboembolism, especially
after a cesarean birth
Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium?
Varicosities of the legs
Carpal tunnel syndrome
Periodic numbness and tingling of the fingers
Headaches
Several delivery 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?
Nail brittleness
Darker pigmentation of the areolae and linea nigra
Striae gravidarum on the breasts, abdomen, and thighs
Spider nevi
Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?
“My first menstrual cycle will be lighter than normal and then will get heavier
every month thereafter.”
“My first menstrual cycle will be heavier than normal and will return to my
prepregnant volume within three or four cycles.”
“I will not have a menstrual cycle for 6 months after childbirth.”
“My first menstrual cycle will be heavier than normal and then will be light for
several months after.”
The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge, called lochia. Which statement is the most appropriate?
Lochia is similar to a light menstrual period for the first 6 to 12 hours
It is usually greater after cesarean births.
Lochia will usually decrease with ambulation and breastfeeding
It should smell like normal menstrual flow unless an infection is present.
Which description of postpartum restoration or healing times is accurate?
The cervix shortens, becomes firm, and returns to form within a month postpartum
Vaginal rugae reappear by 3 weeks postpartum
Most episiotomies heal within a week
Hemorrhoids usually decrease in size within 2 weeks of childbirth.
Which statement, related to the reconditioning of the urinary system after childbirth, should the nurse understand?
Kidney function returns to normal a few days after birth
Diastasis recti abdominis is a common condition that alters the voiding reflex
Fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2 kg during the puerperium
With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth
What should the nurse’s next action be if the client’s white blood cell (WBC) count is 25,000/mm3 on her second postpartum day?
Immediately inform the health care provider
Have the laboratory draw blood for reanalysis
Recognize that this count is an acceptable range at this point postpartum
Immediately begin antibiotic therapy
Which documentation on a woman’s chart on postpartum day 14 indicates a normal involution process?
Moderate bright red lochial flow
Breasts firm and tender
Fundus below the symphysis and nonpalpable
Episiotomy slightly red and puffy
The breast-feeding mother should be taught to expect which changes to the condition of the breasts? (Select all that apply.)
Breast tenderness is likely to persist for approximately 1 week after the start of
lactation
As lactation is established, a mass may form that can be distinguished from cancer
by its positional shift from day to day
In nonlactating mothers, colostrum is present for the first few days after childbirth
If suckling is never begun or is discontinued, then lactation ceases within a few
days to a week
Little change occurs to the breasts in the first 48 hours
2. Changes in blood volume after childbirth depend on several factors such as blood loss during childbirth and the amount of extravascular water (physiologic edema) mobilized and excreted. What amount of blood loss does the postpartum nurse anticipate? (Select all that apply.)
100 ml
250 ml or less
300 to 500 ml
500 to 1000 ml
1500 ml or greater
