NEW
Font size
Worksheets2205 Exam 3 pt.2
Total questions: 50
Worksheet time: 25mins
A postpartum client has persistent bleeding with a firm uterus. Which assessment finding most strongly suggests a genital tract laceration rather than uterine atony?
Boggy fundus
Bleeding that increases with fundal massage
Continuous bright-red bleeding despite a firm uterus
Fundus above the umbilicus
A nurse reviews laboratory results for a client with suspected DIC. Which result requires immediate action?
Fibrinogen 90 mg/dL
Hematocrit 32%
White blood cell count 16,000/mm³
Potassium 4.1 mEq/L
Which finding best demonstrates therapeutic effectiveness of tranexamic acid in a postpartum client?
Increased urine output
Decreased vaginal bleeding
Lowered blood pressure
Reduced uterine tenderness
A postpartum client reports worsening unilateral perineal pain and pressure. The nurse notes increasing swelling but no visible bleeding. What is the priority nursing action?
Apply warm compresses
Reassess in 30 minutes
Notify the provider immediately
Encourage ambulation
Which manifestation most clearly differentiates pulmonary embolism from pneumonia in a postpartum client?
Productive cough
Sudden onset dyspnea
Crackles on auscultation
Fever
A nurse identifies excessive postpartum bleeding. Which action should be performed first?
Administer prescribed antibiotics
Prepare for surgical intervention
Massage the uterine fundus
Obtain blood for laboratory studies
Which assessment finding is most consistent with postpartum endometritis?
Increased diuresis
Fever and uterine tenderness
Lochia serosa on day 3
Fundus firm and nontender
Which physiologic change most commonly explains postpartum night sweats?
Decreased renal perfusion in early postpartum
Elevated progesterone concentration
Mobilization of excess extracellular fluid
Increased prolactin secretion
Which nursing assessment best evaluates postpartum diuresis within the first days after birth?
Assessment of skin turgor daily
Strict intake and output records
Monitoring of daily weight trends
Serial measurements of blood pressure
A client had induced labor with prolonged oxytocin administration. Which history increases the risk for postpartum hemorrhage the most?
Early initiation of breastfeeding in recovery
Short second stage of labor with rapid pushing
Induced labor with prolonged oxytocin use
Spontaneous vaginal birth without complications
Which intervention best promotes maternal role attainment in the early postpartum period?
Separating mother and infant for rest
Encouraging maternal participation in care
Assigning routine infant care to staff
Limiting maternal decision‑making early
Which finding indicates subinvolution of the uterus during postpartum recovery?
Lochia progresses from rubra to alba
Uterus remains enlarged with prolonged lochia rubra
Fundus descends one fingerbreadth daily
Mild intermittent uterine cramping
After cesarean birth, which discharge instruction is most important to reduce complications such as infection or thrombosis?
Restrict ambulation during the first week
Report signs of infection or thrombosis promptly
Avoid lifting the infant for four weeks
Expect heavy bleeding for the first two weeks
A postpartum client reports calf pain and redness. Which nursing response is most appropriate to address possible thrombophlebitis?
Apply heat to the calf for comfort
Remain in bed and notify the provider
Massage the area gently to relieve pain
This discomfort is expected after delivery
Which physiological change commonly occurs within the first week postpartum and helps reduce extracellular fluid volume?
Orthostatic hypotension from blood loss
Subinvolution due to retained placental fragments
Maternal role attainment through bonding behaviors
Postpartum diuresis with increased urine output
Night sweats during the early postpartum period are best explained by which mechanism?
Milk ejection reflex triggering sweating
Thyroid storm elevating metabolism
Infection causing febrile diaphoresis
Hormonal shifts increasing fluid excretion
A firm, midline fundus with heavier than expected lochia on day 5 postpartum suggests which complication?
Uterine atony immediately after birth
Secondary postpartum hemorrhage
Subinvolution of the uterus
Endometritis with uterine tenderness
Which discharge instruction is priority for a client after cesarean birth?
Avoid ambulation for one week
Report fever, wound redness, or drainage
Increase abdominal exercises immediately
Remove Steri-Strips on day two
Which finding requires immediate provider notification in a postpartum client?
Lochia rubra saturating one pad per hour
Diuresis averaging 2,500 mL per day
Mild leukocytosis typical postpartum
Fundus firm and midline on palpation
After uterine replacement, which medication is administered to maintain uterine tone?
Terbutaline to relax uterine muscle
Magnesium sulfate for seizure prophylaxis
Oxytocin to stimulate contractions
Nifedipine as a tocolytic agent
Which assessment finding is most indicative of deep vein thrombosis in a postpartum client?
Calf pain with unilateral swelling
Bilateral ankle edema without pain
Dependent edema relieved by elevation
Warmth in both lower extremities
Which technique is essential during fundal massage to prevent uterine prolapse?
Perform massage with the client upright
Use circular motions only on fundus
Massage continuously for five minutes
Support the lower uterine segment
Which clinical finding best defines postpartum hemorrhage?
Any vaginal bleeding after delivery
Hemoglobin less than ten grams per deciliter
Hypotension as the only abnormal sign
Blood loss greater than expected with instability
Which assessment must be completed prior to administering methylergonovine?
Oxygen saturation for hypoxia risk
Blood pressure to rule out hypertension
Respiratory rate for distress signs
Temperature to screen for infection
Which nursing action helps control postpartum hemorrhage by reducing uterine displacement?
Elevating the legs
Applying ice packs
Emptying the bladder
Encouraging oral fluids
Which finding most strongly suggests a postpartum complication rather than a normal change?
Leukocytosis
Mild afterpains
Persistent uterine tenderness
Chills within 24 hours
Which assessment finding supports a diagnosis of uterine atony?
Tender uterus with fever
Boggy uterus with excessive bleeding
Firm uterus with heavy bleeding
Enlarged uterus without bleeding
Which postpartum mental health condition poses the greatest risk to the infant?
Adjustment disorder
Postpartum blues
Postpartum psychosis
Postpartum depression
Which diagnostic study is most specific for confirming pulmonary embolism?
Arterial blood gas
ECG
Chest X-ray
Ventilation–perfusion scan
Which laboratory trend indicates worsening DIC?
Stabilized hemoglobin
Rising platelet count
Increasing fibrinogen levels
Prolonged PT and aPTT
Which assessment finding best indicates successful treatment of endometritis?
Decreased lochia
Increased appetite
Reduced uterine size
Normalization of temperature
A postpartum client reports sadness, tearfulness, and mood swings that resolve within 10 days. How should this be interpreted?
Normal postpartum blues
Postpartum psychosis
Postpartum depression
Anxiety disorder
Which nursing intervention best reduces the risk of venous thromboembolism postpartum?
Applying warm compresses
Prolonged bed rest
Early ambulation
Restricting fluids
Which laboratory value most strongly supports a diagnosis of DIC?
Hemoglobin 10.8 g/dL
Platelets 58,000/mm³
Sodium 138 mEq/L
WBC 17,000/mm³
Which action is contraindicated when DVT is suspected?
Massaging the leg
Maintaining bed rest
Administering anticoagulants
Elevating the affected limb
Which postpartum condition presents with pain, warmth, and erythema along a superficial vein?
Uterine atony
Thrombophlebitis
Endometritis
Pulmonary embolism
Which finding suggests delayed uterine involution?
Mild uterine cramping
Persistent lochia rubra beyond expected timeframe
Lochia progresses normally
Fundus descends daily
Which medication should the nurse anticipate when hemorrhage persists despite uterotonics?
Misoprostol
Oxytocin
Tranexamic acid
Methylergonovine
Which assessment is critical before administering carboprost for postpartum hemorrhage?
Respiratory history
Blood pressure
Urine output
Temperature
Which assessment finding most strongly supports pulmonary embolism?
Tachycardia alone
Mild chest discomfort
Anxiety
Acute hypoxia
Which postpartum teaching best reduces infection risk?
Performing perineal care after voiding
Using vaginal douches
Limiting fluid intake
Avoiding ambulation
Which factor most increases the risk of uterine inversion?
Macrosomia
Excessive cord traction
Prolonged labor
Multiparity
Which postpartum client has the highest risk for hemorrhage?
Client with prolonged labor and uterine fatigue
Client breastfeeding frequently
Client with spontaneous vaginal delivery
Client ambulating early
Which laboratory finding is expected during normal postpartum leukocytosis?
Decreased neutrophils
Thrombocytopenia
Decreased hemoglobin
WBC 22,000/mm³ without fever
Which nursing action best prevents bladder overdistention postpartum?
Restricting fluids
Encouraging voiding every 2–3 hours
Delaying ambulation
Maintaining Foley catheter
Which assessment finding differentiates uterine atony from laceration?
Heavy bleeding with boggy uterus
Pain at incision site
Bright-red bleeding
Heavy bleeding with firm uterus
Which postpartum mental health condition is characterized by hallucinations and delusions?
Postpartum blues
Adjustment disorder
Postpartum depression
Postpartum psychosis
Which finding indicates failure of postpartum hemorrhage interventions?
Increased urine output
Continued heavy bleeding
Decreasing heart rate
Firm fundus
Which finding best indicates improvement in DVT?
Decreased pulses
Increased warmth
Reduced limb circumference
New chest pain
Which postpartum statement by a client requires further teaching?
"Foul-smelling lochia should be reported."
"I will call if I soak a pad in an hour."
"I should report chest pain immediately."
"Leg redness and pain are normal after birth."
