OB Postpartum(100% Guaranteed)
A 3-day postpartum client, who is not immune to rubella, is to receive the vaccine at discharge.
Which of the following must the nurse include in her discharge teaching regarding the vaccine?
1. The woman should not become pregnant for at least 4 weeks.
2. The woman should pump and dump her breast milk for 1 week.
3. The mother must wear a surgical mask when she cares for the baby.
4. Passive antibodies transported across the placenta will protect the baby. correct answers 1. The
rubella vaccine is a live attenuated vaccine. Severe birth defects can develop if the woman
becomes pregnant within 4 weeks of receiving the injection.
TEST-TAKING TIP: If rubella is contracted during pregnancy, the fetus is at very high risk for
injury. Whenever gravid clients are found to be nonimmune to rubella, they are advised to
receive the vaccine during the early postpartum period and are counseled regarding the
teratogenic properties of the vaccine.
A 3-day-postpartum client questions why she is to receive the rubella vaccine before leaving the
hospital. Which of the following rationales should guide the nurse's response?
1. The client's obstetric status is optimal for receiving the vaccine.
2. The client's immune system is highly responsive during the postpartum period.
3. The client's baby will be high risk for acquiring rubella if the woman does not receive the
vaccine.
4. The client's insurance company will pay for the shot if it is given during the immediate
postpartum period. correct answers 1. Because the vaccine is teratogenic, the best time to
administer it is when the client is not pregnant.
TEST-TAKING TIP: The correct answer did not explicitly state that the vaccine is administered
during the immediate postpartum period because the woman is not pregnant and is unlikely to
become pregnant within the next 4 weeks. But the test taker must know that a woman's obstetric
status immediately after delivery is optimal for receiving the medication precisely because she is
not pregnant and very unlikely to become pregnant.
A patient, G2P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2oF.
Which of the following is the appropriate nursing intervention at this time?
1. Notify the doctor to get an order for acetaminophen.
2. Request an infectious disease consult from the doctor.
3. Provide the woman with cool compresses.
4. Encourage intake of water and other fluids. correct answers 4. It is likely that this client is
dehydrated. She should be advised to drink fluids.
TEST-TAKING TIP: In the early postpartum period, up to 24 hours after delivery, the most
common reason for clients to have slight temperature elevations is dehydration. During labor,
clients work very hard, often utilizing breathing techniques as a form of pain control. As a result,
the clients lose fluids through insensible loss via the respiratory system.
, To prevent infection, the nurse teaches the postpartum client to perform which of the following
tasks?
1. Apply antibiotic ointment to the perineum daily. 2. Change the peripad at each voiding.
3. Void at least every two hours.
4. Spray the perineum with a povidone-iodine solution after toileting. correct answers 2. Clients
should be advised to change their pads at each voiding.
TEST-TAKING TIP: Postpartum women should be advised to perform three actions to prevent
infections: (1) change their peripads at each toileting because blood is an excellent medium for
bacterial growth; (2) spray the perineum, from front to back, with clear water to cleanse the area;
and (3) wipe the perineum after toileting from front to back to prevent the rectal flora from
contaminating sterile sites.
A 3-day-postpartum breastfeeding woman is being assessed. Her breasts are firm and warm to
the touch. When asked when she last fed the baby her reply is, "I fed the baby last evening. I let
the nurses feed him in the nursery last night. I needed to rest." Which of the following actions
should the nurse take at this time?
1. Encourage the woman exclusively to breastfeed her baby.
2. Have the woman massage her breasts hourly.
3. Obtain an order to culture her expressed breast milk.
4. Take the temperature and pulse rate of the woman. correct answers 1. Clients should be
strongly encouraged exclusively to breastfeed their babies to prevent engorgement.
TEST-TAKING TIP: The lactating breast produces milk in response to being stimulated. When a
feeding is skipped, milk is still produced for the baby. When the baby is not fed, breast
congestion or engorgement results. Engorgement is not only uncomfortable, but it also
gives the body the message to stop producing milk, resulting in an insufficient milk supply.
A breastfeeding woman has been counseled on how to prevent engorgement. Which of the
following actions by the mother shows that the teaching was effective?
1. She pumps her breasts after each feeding.
2. She feeds her baby every 2 to 3 hours.
3. She feeds her baby 10 minutes on each side.
4. She supplements each feeding with formula. correct answers 2. The best way to prevent
engorgement is to feed the baby every 2 to 3 hours.
TEST-TAKING TIP: This question is similar to the preceding question except that this question
tests the nurse's ability to evaluate a client's response rather than to perform a nursing action.
A 2-day-postpartum breastfeeding woman states, "I am sick of being fat. When can I go on a
diet?" Which of the following responses is appropriate?
1. "It is fine for you to start dieting right now as long as you drink plenty of milk."
2. "Your breast milk will be low in vitamins if you start to diet while breastfeeding."
3. "You must eat at least 3000 calories per day in order to produce enough milk for your baby."
4. "Many mothers lose weight when they breastfeed because the baby consumes about 600
calories a day." correct answers 4. Many mothers who consume approximately the same number
A 3-day postpartum client, who is not immune to rubella, is to receive the vaccine at discharge.
Which of the following must the nurse include in her discharge teaching regarding the vaccine?
1. The woman should not become pregnant for at least 4 weeks.
2. The woman should pump and dump her breast milk for 1 week.
3. The mother must wear a surgical mask when she cares for the baby.
4. Passive antibodies transported across the placenta will protect the baby. correct answers 1. The
rubella vaccine is a live attenuated vaccine. Severe birth defects can develop if the woman
becomes pregnant within 4 weeks of receiving the injection.
TEST-TAKING TIP: If rubella is contracted during pregnancy, the fetus is at very high risk for
injury. Whenever gravid clients are found to be nonimmune to rubella, they are advised to
receive the vaccine during the early postpartum period and are counseled regarding the
teratogenic properties of the vaccine.
A 3-day-postpartum client questions why she is to receive the rubella vaccine before leaving the
hospital. Which of the following rationales should guide the nurse's response?
1. The client's obstetric status is optimal for receiving the vaccine.
2. The client's immune system is highly responsive during the postpartum period.
3. The client's baby will be high risk for acquiring rubella if the woman does not receive the
vaccine.
4. The client's insurance company will pay for the shot if it is given during the immediate
postpartum period. correct answers 1. Because the vaccine is teratogenic, the best time to
administer it is when the client is not pregnant.
TEST-TAKING TIP: The correct answer did not explicitly state that the vaccine is administered
during the immediate postpartum period because the woman is not pregnant and is unlikely to
become pregnant within the next 4 weeks. But the test taker must know that a woman's obstetric
status immediately after delivery is optimal for receiving the medication precisely because she is
not pregnant and very unlikely to become pregnant.
A patient, G2P1102, who delivered her baby 8 hours ago, now has a temperature of 100.2oF.
Which of the following is the appropriate nursing intervention at this time?
1. Notify the doctor to get an order for acetaminophen.
2. Request an infectious disease consult from the doctor.
3. Provide the woman with cool compresses.
4. Encourage intake of water and other fluids. correct answers 4. It is likely that this client is
dehydrated. She should be advised to drink fluids.
TEST-TAKING TIP: In the early postpartum period, up to 24 hours after delivery, the most
common reason for clients to have slight temperature elevations is dehydration. During labor,
clients work very hard, often utilizing breathing techniques as a form of pain control. As a result,
the clients lose fluids through insensible loss via the respiratory system.
, To prevent infection, the nurse teaches the postpartum client to perform which of the following
tasks?
1. Apply antibiotic ointment to the perineum daily. 2. Change the peripad at each voiding.
3. Void at least every two hours.
4. Spray the perineum with a povidone-iodine solution after toileting. correct answers 2. Clients
should be advised to change their pads at each voiding.
TEST-TAKING TIP: Postpartum women should be advised to perform three actions to prevent
infections: (1) change their peripads at each toileting because blood is an excellent medium for
bacterial growth; (2) spray the perineum, from front to back, with clear water to cleanse the area;
and (3) wipe the perineum after toileting from front to back to prevent the rectal flora from
contaminating sterile sites.
A 3-day-postpartum breastfeeding woman is being assessed. Her breasts are firm and warm to
the touch. When asked when she last fed the baby her reply is, "I fed the baby last evening. I let
the nurses feed him in the nursery last night. I needed to rest." Which of the following actions
should the nurse take at this time?
1. Encourage the woman exclusively to breastfeed her baby.
2. Have the woman massage her breasts hourly.
3. Obtain an order to culture her expressed breast milk.
4. Take the temperature and pulse rate of the woman. correct answers 1. Clients should be
strongly encouraged exclusively to breastfeed their babies to prevent engorgement.
TEST-TAKING TIP: The lactating breast produces milk in response to being stimulated. When a
feeding is skipped, milk is still produced for the baby. When the baby is not fed, breast
congestion or engorgement results. Engorgement is not only uncomfortable, but it also
gives the body the message to stop producing milk, resulting in an insufficient milk supply.
A breastfeeding woman has been counseled on how to prevent engorgement. Which of the
following actions by the mother shows that the teaching was effective?
1. She pumps her breasts after each feeding.
2. She feeds her baby every 2 to 3 hours.
3. She feeds her baby 10 minutes on each side.
4. She supplements each feeding with formula. correct answers 2. The best way to prevent
engorgement is to feed the baby every 2 to 3 hours.
TEST-TAKING TIP: This question is similar to the preceding question except that this question
tests the nurse's ability to evaluate a client's response rather than to perform a nursing action.
A 2-day-postpartum breastfeeding woman states, "I am sick of being fat. When can I go on a
diet?" Which of the following responses is appropriate?
1. "It is fine for you to start dieting right now as long as you drink plenty of milk."
2. "Your breast milk will be low in vitamins if you start to diet while breastfeeding."
3. "You must eat at least 3000 calories per day in order to produce enough milk for your baby."
4. "Many mothers lose weight when they breastfeed because the baby consumes about 600
calories a day." correct answers 4. Many mothers who consume approximately the same number
