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Worksheets2205 Exam 3 pt.1
Total questions: 49
Worksheet time: 25mins
A postpartum client continues to have brisk vaginal bleeding despite a firm, midline uterus. Which finding most strongly indicates disseminated intravascular coagulation?
Platelet count of 78000/mm^3
Blood pressure 88/54 mm Hg
Boggy uterine tone
Saturated perineal pads every 30 minutes
A nurse evaluates the effectiveness of methylergonovine following administration for postpartum hemorrhage. Which assessment finding best indicates the medication is working?
Blood pressure increases to 150/92 mm Hg
Lochia changes from rubra to serosa
Uterus becomes firm with decreased bleeding
Heart rate decreases from 112 to 96 bpm
A client with postpartum hemorrhage is prescribed tranexamic acid. Which mechanism of action explains how this medication reduces bleeding?
Stimulates uterine smooth muscle contraction
Enhances platelet aggregation
Inhibits fibrinolysis and stabilizes clots
Replaces depleted clotting factors
A postpartum client reports severe vaginal pressure and escalating pain unrelieved by analgesics. The nurse notes minimal lochia. Which complication should the nurse suspect?
Endometritis
Vulvar hematoma
Uterine atony
Retained placental fragments
A client develops sudden dyspnea, chest pain, and anxiety on postpartum day 2. Which diagnostic test should the nurse anticipate to confirm the suspected condition?
Chest X-ray
Doppler ultrasound of the legs
CT pulmonary angiography
Electrocardiogram
Which nursing action is the priority when a postpartum client experiences heavy vaginal bleeding with signs of hypovolemia?
Administer prescribed uterotonics
Massage the uterine fundus
Activate the obstetric hemorrhage protocol
Insert an indwelling urinary catheter
A postpartum client develops fever, uterine tenderness, and foul-smelling lochia. Which factor most likely contributed to this condition?
Prolonged labor with frequent vaginal exams
Early ambulation
Rapid uterine involution
Effective breastfeeding
Which postpartum finding reflects normal physiologic diaphoresis?
Profuse sweating accompanied by fever
Night sweats without elevated temperature
Diaphoresis with uterine tenderness
Sweating associated with hypotension
A nurse assesses postpartum urinary output of 3,200 mL in 24 hours. How should this finding be interpreted?
Indicator of hypovolemia
Expected postpartum diuresis
Early sign of renal failure
Complication of oxytocin therapy
Which risk factor places a postpartum client at greatest risk for hemorrhage?
Precipitous labor
Prolonged labor with uterine overdistention
Early ambulation
Breastfeeding initiation
Which nursing intervention best supports maternal–infant bonding in a Baby-Friendly environment?
Limiting visitors for 48 hours
Encouraging rooming-in
Scheduling feedings every 4 hours
Providing formula supplementation
Subinvolution of the uterus is most commonly caused by which condition?
Early ambulation
Retained placental fragments
Decreased estrogen levels
Effective uterine contractions
A nurse reviews discharge instructions with a client following a cesarean birth. Which statement by the client indicates understanding?
“I will avoid walking until my incision heals.”
“I should notify my provider if I develop calf pain.”
“Vaginal bleeding should stop within 24 hours.”
“Incisional pain should worsen each day.”
A postpartum client reports unilateral leg warmth and redness. What is the nurse’s priority action?
Encourage ambulation
Apply warm compresses
Maintain bed rest and notify the provider
Massage the affected extremity
Which complication is most likely if a postpartum urinary tract infection is untreated?
Endometritis
Pyelonephritis
Uterine atony
Hematoma formation
Which postpartum assessment finding should be reported immediately?
Lochia rubra on day 2
Fundus firm at the umbilicus
Sudden shortness of breath
Mild perineal edema
Which medication is administered to relax the uterus prior to manual correction of uterine inversion?
Oxytocin
Methylergonovine
Terbutaline
Misoprostol
A postpartum client experiences unilateral calf pain and edema. Which complication is most concerning?
Thrombophlebitis
Hematoma
Endometritis
Subinvolution
Which nursing intervention is appropriate when performing postpartum fundal massage?
Apply firm pressure continuously
Support the lower uterine segment
Massage only if the uterus is firm
Perform massage every 4 hours
Which assessment finding best confirms postpartum hemorrhage?
Decreased hematocrit
Blood loss exceeding expected parameters
Hypotension alone
Tachycardia alone
Which action should the nurse take first when administering methylergonovine?
Assess uterine tone
Measure blood pressure
Evaluate lochia color
Check hemoglobin level
Which nursing intervention is included in the initial management of postpartum hemorrhage?
Encourage oral fluids
Empty the bladder
Administer anticoagulants
Apply cold packs
Which manifestation is characteristic of thrombophlebitis rather than DVT?
Sudden dyspnea
Localized vein tenderness
Chest pain
Hypotension
Which finding is most consistent with uterine atony?
Firm uterus displaced laterally
Boggy uterus with heavy bleeding
Rigid uterus with minimal bleeding
Tender uterus with foul lochia
Which postpartum mental health condition requires immediate psychiatric intervention?
Postpartum blues
Postpartum depression
Postpartum psychosis
Adjustment disorder
Which bladder-related change increases the risk of postpartum hemorrhage?
Increased urinary output
Bladder overdistention
Frequent voiding
Decreased renal perfusion
Which finding is expected at approximately 12 hours postpartum?
Fundus at the symphysis pubis
Lochia serosa
Fundus at or slightly above the umbilicus
Absence of uterine cramping
Which diagnostic study confirms pulmonary embolism in a postpartum client?
Venous Doppler
Ventilation–perfusion scan
Chest auscultation
Arterial blood gas
Which assessment finding indicates worsening DIC?
Decreasing fibrinogen levels
Rising platelet count
Improved uterine tone
Stabilized vital signs
Which finding best indicates effective treatment of postpartum endometritis?
Decreased uterine size
Resolution of fever
Lochia becomes serosa
Increased appetite
A postpartum client reports feeling overwhelmed and unable to sleep but denies thoughts of harm. Symptoms persist beyond two weeks. Which condition is most likely?
Postpartum blues
Postpartum psychosis
Postpartum depression
Acute stress disorder
Which nursing action reduces the risk of DVT in postpartum clients?
Prolonged bed rest
Early ambulation
Restricting fluids
Elevating the legs continuously
Which lab value is most concerning in postpartum hemorrhage?
Hemoglobin 11 g/dL
Platelets 60,000/mm3
WBC 18,000/mm^3
Hematocrit 35%
Which nursing action is contraindicated in a client with suspected DVT?
Bed rest
Leg elevation
Massage of the extremity
Anticoagulant therapy
Which postpartum complication presents with localized pain, swelling, and redness along a vein?
Pulmonary embolism
Endometritis
Thrombophlebitis
Uterine inversion
Which assessment finding indicates ineffective uterine involution?
Fundus descends 1 cm per day
Persistent lochia rubra
Mild uterine cramping
Increased diuresis
Which medication should the nurse anticipate for ongoing hemorrhage unresponsive to uterotonics?
Oxytocin
Misoprostol
Tranexamic acid
Terbutaline
Which nursing action is essential before administering carboprost?
Assess bowel sounds
Assess blood pressure
Assess respiratory history
Assess urine output
Which finding differentiates pulmonary embolism from anxiety in a postpartum client?
Tachycardia
Sudden hypoxia
Restlessness
Chest tightness
Which postpartum teaching is most important to prevent infection?
Frequent vaginal douching
Proper perineal hygiene
Limiting fluid intake
Avoiding ambulation
Which condition most increases the risk of uterine inversion?
Prolonged labor
Excessive traction on the umbilical cord
Large infant
Multiple gestation
Which postpartum client is at highest risk for hemorrhage?
Primiparous client
Client with prolonged oxytocin infusion
Client breastfeeding frequently
Client ambulating early
Which assessment finding is expected during normal postpartum leukocytosis?
Fever above 38.5∘C
Elevated WBC without infection
Decreased neutrophils
Increased platelet destruction
Which intervention best prevents bladder distention postpartum?
Limiting oral fluids
Encouraging voiding every 2–3 hours
Maintaining indwelling catheter
Delaying ambulation
Which clinical manifestation is most consistent with uterine atony rather than laceration?
Firm uterus with bleeding
Boggy uterus with bleeding
Minimal bleeding with pain
Localized swelling
Which postpartum disorder is characterized by intrusive thoughts and hallucinations?
Postpartum blues
Postpartum depression
Postpartum psychosis
Adjustment disorder
Which finding suggests ineffective treatment of postpartum hemorrhage?
Decreasing heart rate
Firm uterine tone
Continued heavy bleeding
Improved urine output
Which assessment finding indicates resolution of DVT?
Decreased limb circumference
Absence of pedal pulses
Increased warmth
New-onset dyspnea
Which postpartum teaching requires further clarification?
“I will call my provider for foul-smelling lochia.”
“Leg pain and redness can be normal.”
“Heavy bleeding should be reported.”
“Shortness of breath is an emergency.”
