Deck 15: Postpartum Adaptations

Question 1

A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client's fundus, expecting it to be at which location?

A) Two fingerbreadths above the umbilicus
B) At the level of the umbilicus
C) Two fingerbreadths below the umbilicus
D) Four fingerbreadths below the umbilicus

Answer 1

Two fingerbreadths below the umbilicus

Question 2

When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to be:

A) Greater than after a vaginal delivery
B) About the same as after a vaginal delivery
C) Less than after a vaginal delivery
D) Saturated with clots and mucus

Answer 2

Less than after a vaginal delivery

Question 3

The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of the following would the nurse include in the teaching plan to facilitate suppression of lactation?

A) Encouraging the woman to manually express milk
B) Suggesting that she take frequent warm showers to soothe her breasts
C) Telling her to limit the amount of fluids that she drinks
D) Instructing her to apply ice packs to both breasts every other hour

Answer 3

Instructing her to apply ice packs to both breasts every other hour

Question 4

The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which of the following would the nurse expect to find when assessing the client's fundus?

A) Cannot be palpated
B) 2 cm below the umbilicus
C) 6 cm below the umbilicus
D) 10 cm below the umbilicus

Question 5

A client who is breast-feeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contractionlike pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate?

A) "Your uterus is still shrinking in size; that's why you're feeling this pain."
B) "Let me check your vaginal discharge just to make sure everything is fine."
C) "Your body is responding to the events of labor, just like after a tough workout."
D) "The baby's sucking releases a hormone that causes the uterus to contract."

Question 6

When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation?

A) Deep red, fleshy-smelling lochia
B) Voiding of 350 cc
C) Heart rate of 120 beats/minute
D) Profuse sweating

Question 7

A postpartum client who is bottle feeding her newborn asks, "When should my period return?" Which response by the nurse would be most appropriate?

A) "It's difficult to say, but it will probably return in about 2 to 3 weeks."
B) "It varies, but you can estimate it returning in about 7 to 9 weeks."
C) "You won't have to worry about it returning for at least 3 months."
D) "You don't have to worry about that now. It'll be quite a while."

Question 8

The nurse interprets which of the following as evidence that a client is in the taking-in phase?

A) Client states, "He has my eyes and nose."
B) Client shows interest in caring for the newborn.
C) Client performs self-care independently.
D) Client confidently cares for the newborn.

Question 9

Which of the following would the nurse interpret as being least indicative of paternal engrossment?

A) Demonstrating pleasure when touching or holding the newborn
B) Identifying imperfections in the newborn's appearance
C) Being able to distinguish his newborn from others in the nursery
D) Showing feelings of pride with the birth of the newborn

Question 10

A postpartum client comes to the clinic for her 6-week postpartum checkup. When assessing the client's cervix, the nurse would expect the external cervical os to appear:

A) Shapeless
B) Circular
C) Triangular
D) Slit-like

Question 11

The nurse develops a teaching plan for a postpartum client and includes teaching about how to perform Kegel exercises. The nurse includes this information for which reason?

A) Reduce lochia
B) Promote uterine involution
C) Improve pelvic floor tone
D) Alleviate perineal pain

Question 12

A father of a newborn tells the nurse, "I may not know everything about being a dad, but I'm going to do the best I can for my son." The nurse interprets this as indicating the father is in which stage of adaptation?

A) Expectations
B) Transition to mastery
C) Reality
D) Taking-in

Question 13

A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history, which of the following would the nurse identify as being least significant to this condition?

A) Early ambulation
B) Prolonged labor
C) Large fetus
D) Use of anesthetics

Question 14

Which of the following would lead the nurse to suspect that a postpartum woman is experiencing a problem?

A) Elevated white blood cell count
B) Acute decrease in hematocrit
C) Increased levels of clotting factors
D) Pulse rate of 60 beats/minute

Question 15

A woman who gave birth 24 hours ago tells the nurse, "I've been urinating so much over the past several hours." Which response by the nurse would be most appropriate?

A) "You must have an infection, so let me get a urine specimen."
B) "Your body is undergoing many changes that cause your bladder to fill quickly."
C) "Your uterus is not contracting as quickly as it should."
D) "The anesthesia that you received is wearing off and your bladder is working again."

Question 16

A nurse is making a home visit to a postpartum woman who delivered a healthy newborn 4 days ago. The woman's breasts are swollen, hard, and tender to the touch. The nurse documents this finding as which of the following?

A) Involution
B) Engorgement
C) Mastitis
D) Engrossment

Question 17

A nurse is assessing a postpartum woman's adjustment to her maternal role. Which of the following would the nurse expect to occur first?

A) Reestablishing relationships with others
B) Demonstrating increasing confidence in care of the newborn
C) Assuming a passive role in meeting her own needs
D) Becoming preoccupied with the present

Question 18

The partner of a woman who has given birth to a healthy newborn says to the nurse, "I want to be involved, but I'm not sure that I'm able to care for such a little baby." The nurse interprets this as indicating which of the following stages?

A) Expectations
B) Reality
C) Transition to mastery
D) Taking-hold

Question 19

A group of nursing students are reviewing information about maternal and paternal adaptations to the birth of a newborn. The nurse observes the parents interacting with their newborn physically and emotionally. The nurse documents this as which of the following?

A) Puerperium
B) Lactation
C) Attachment
D) Engrossment

Question 20

After teaching a group of nursing students about the process of involution, the instructor determines that additional teaching is needed when the students identify which of the following as being involved?

A) Catabolism
B) Muscle fiber contraction
C) Epithelial regeneration
D) Vasodilation

Question 21

A nurse is visiting a postpartum woman who delivered a healthy newborn 5 days ago. Which of the following would the nurse expect to find?

A) Bright red discharge
B) Pinkish brown discharge
C) Deep red mucus-like discharge
D) Creamy white discharge

Question 22

A nurse teaches a postpartum woman about her risk for thromboembolism. Which of the following would the nurse be least likely to include as a factor increasing her risk?

A) Increased clotting factors
B) Vessel damage
C) Immobility
D) Increased red blood cell production

Question 23

A nursing student is preparing a class presentation about changes in the various body systems during the postpartum period and their effects. Which of the following would the student include as influencing a postpartum woman's ability to void? (Select all that apply.)

A) Use of an opioid anesthetic during labor
B) Generalized swelling of the perineum
C) Decreased bladder tone from regional anesthesia
D) Use of oxytocin to augment labor
E) Need for an episiotomy

Question 24

A postpartum woman who has experienced diastasis recti asks the nurse about what to expect related to this condition. Which response by the nurse would be most appropriate?

A) "You'll notice that this will fade to silvery lines."
B) "Exercise will help to improve the muscles."
C) "Expect the color to lighten somewhat."
D) "You'll notice that your shoe size will increase."

Question 25

A group of nursing students are reviewing respiratory system adaptations that occur during the postpartum period. The students demonstrate understanding of the information when they identify which of the following as a postpartum adaptation?

A) Continued shortness of breath
B) Relief of rib aching
C) Diaphragmatic elevation
D) Decrease in respiratory rate

Question 26

A woman who delivered a healthy newborn several hours ago asks the nurse, "Why am I perspiring so much?" The nurse integrates knowledge that a decrease in which hormone plays a role in this occurrence?

A) Estrogen
B) hCG
C) hPL
D) Progesterone