Prep U OB Exam Review
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of
tissue. Which observation would indicate the presence of tissue? - ANS postpartum diuresis
The nurse should identify postpartum diuresis as the potential cause for urinary frequency. Urinary
overflow occurs if the bladder is not completely emptied. Urinary tract infection may be accompanied by
fever and a burning sensation. Trauma to pelvic muscles does not affect urinary frequency.
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of
tissue. Which observation would indicate the presence of tissue? - ANS difficult to separate clots
If tissue is identified in the lochia, it is difficult to separate clots. Yellowish-white lochia indicates
increased leukocytes and decreased fluid content. Easily separable lochia indicates the presence of clots
only. Foul-smelling lochia indicates endometritis.
A client gave birth to a healthy boy 2 days ago. Both mother and baby have had a smooth recovery. The
nurse enters the room and tells the client that she and her baby will be discharged home today. The
client states, "I do not want to go home." What is the nurse's most appropriate response? - ANS Ask the
client to explain why she does not want to go home.
It is important for the nurse to identify the client's concerns and reasons for wanting to stay in the
hospital. Open-ended questioning facilitates both effective and therapeutic communication and allows
the nurse to address concerns appropriately. Asking about supports at home implies that the nurse has
made assumptions about why the client may not want to go home. Informing the care provider or telling
the client that discharge is hospital policy is not appropriate at this time because the nurse has not
addressed the underlying reason for the client's comment. The client may have safety-related concerns,
undisclosed fears, or a need for increased support before discharge. It is imperative that the nurse not
make assumptions but further explore concerns.
,A nurse is monitoring the vital signs of a client 24 hours after birth. She notes that the client's blood
pressure is 100/60 mm Hg. Which postpartum complication should the nurse most suspect in this client,
based on this finding? - ANS bleeding
Blood pressure should also be monitored carefully during the postpartum period because a decrease in
BP can also indicate bleeding. In contrast, an elevation above 140 mm Hg systolic or 90 mm Hg diastolic
may indicate the development of postpartum gestational hypertension, an unusual but serious
complication of the puerperium. An infection would best be indicated by an elevated oral temperature.
Diabetes would be indicated by an elevated blood glucose level.
While caring for a client following a lengthy labor and birth, the nurse notes that the client repeatedly
reviews her labor and birth and is very dependent on her family for care. The nurse is correct in
identifying the client to be in which phase of maternal role adjustment? - ANS taking-in
The taking-in phase occurs during the first 24 to 48 hours following the birth of the newborn and is
characterized by the mother taking on a very passive role in caring for herself, as well as recounting her
labor experience. The second maternal adjustment phase is the taking-hold phase and usually lasts
several weeks after the birth. This phase is characterized by both dependent and independent behavior,
with increasing autonomy. During the letting-go phase the mother reestablishes relationships with
others and accepts her new role as a parent. Acquaintance/attachment phase is a newer term that
refers to the first 2 to 6 weeks following birth when the mother is learning to care for her baby and is
physically recuperating from the pregnancy and birth.
A nurse is describing the many changes that will occur during the early postpartum period with a group
of young parents. The nurse reviews common reports experienced as the woman's body returns to her
prepregnancy state. The nurse determines that the teaching was successful when the participants
identify which report as being most common during the first week that will indicate their fluid volume is
returning to normal? - ANS diaphoresis
The profuse diaphoresis is common during the early postpartum period. Many women will wake up
drenched with perspiration. This diaphoresis is a mechanism to reduce the amount of fluids retained
during pregnancy and restore prepregnant body fluid levels. It is common, especially at night during the
first week after birth. Nocturia, urinary frequency, or urinary urgency are not associated with this fluid
shift.
,A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn.
During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we
have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet
resumed. Which suggestion by the nurse would be most appropriate?
You Selected: - ANS "You might try using a water-soluble lubricant to ease the discomfort."
Coital discomfort and localized dryness usually plague most postpartum women until menstruation
returns. Water-soluble lubricants can reduce discomfort during intercourse. Although it may take some
time for the woman's body to return to its prepregnant state, telling the woman this does not address
her concern. Telling her that dyspareunia is normal and that it takes time to resolve also ignores her
concern. Kegel exercises are helpful for improving pelvic floor tone but would have no effect on vaginal
dryness.
While providing care to a postpartum client on her first day at home, the nurse observes which behavior
that would indicate the new mother is in the taking-hold phase? - ANS Showing increased confidence
when caring for the newborn
Independence with self-care is an important aspect of the taking-hold phase. During the letting-go
phase, the woman assumes responsibility and care for the newborn with increased confidence.
Recounting her labor experience is usually part of the taking-in phase. Identifying specific features of the
newborn is typical of the taking-in phase. Feelings of grief, guilt, and anxiety are part of the letting-go
phase where the mother accepts the infant as it is and lets go of any fantasies.
When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as
normal? - ANS a moderate amount of lochia rubra
The client should have lochia rubra for 3 to 4 days postpartum. The client would then progress to lochia
serosa being expelled from day 3 to 10. Last the client would have lochia alba from day 10 to 14 until 3
to 6 weeks.
, The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. During
discharge education, which type of lochia pattern should the nurse tell the woman is abnormal and
needs to be reported to her health care provider immediately? - ANS moderate lochia serosa on day 4
postpartum, increasing in volume and changing to rubra on day 5
Lochia by day 4 should be decreasing in amount, and the color should be changing to pink tinge. Red
rubra on day 4 may indicate bleeding, and the health care provider should be notified. A moderate flow
of lochia rubra on day 3 postpartum, changing to serosa on day 5, is a normal finding. Lochia progressing
from rubra to serosa to alba within 10 days of delivery is a normal finding. Moderate lochia rubra on day
3, mixed serosa and rubra on day 4, and light serosa on day 5 is a normal finding.
The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the
client's history reveals a prepartum hemoglobin of 14 g/dl (140 g/L) and hematocrit of 42% (0.42).
Which result should the nurse prioritize? - ANS Hemoglobin 9 g/dl (90 g/L) and hematocrit 32% (0.32) in
a woman who has given birth by cesarean
First, the nurse needs to determine the amount of blood loss during the delivery. For every 250 ml of
blood lost during the delivery process, the hemoglobin should decrease by 1 g/dl (10 g/L) and the
hematocrit by 2%. The acceptable amount of blood loss during a normal vaginal delivery is
approximately 300 ml to 500 m and for a cesarean delivery approximately 500 mL to 1000 ml. The loss
of hemoglobin from 14 gm/dl (140 g/L) to 9 gm/dl (90 g/L) is 5 and for the hematocrit from 42% to 32%
is 10. This would indicate the client lost approximately 1250 ml of blood during the cesarean delivery (5
x 250 = 1250); this is too much and should be reported to the health care provider immediately. The
other choices would be considered to be within normal range.
The nursing instructor is leading a discussion on the physical changes to a woman's body after the birth
of the baby. The instructor determines the session is successful after the students correctly point out
which process results in the return of nonpregnant size and function of the female organs? - ANS
Involution
Involution is the term used to describe the process of the return to nonpregnancy size and function of
reproductive organs. Evolution is change in the genetic material of a population of organisms from one
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of
tissue. Which observation would indicate the presence of tissue? - ANS postpartum diuresis
The nurse should identify postpartum diuresis as the potential cause for urinary frequency. Urinary
overflow occurs if the bladder is not completely emptied. Urinary tract infection may be accompanied by
fever and a burning sensation. Trauma to pelvic muscles does not affect urinary frequency.
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of
tissue. Which observation would indicate the presence of tissue? - ANS difficult to separate clots
If tissue is identified in the lochia, it is difficult to separate clots. Yellowish-white lochia indicates
increased leukocytes and decreased fluid content. Easily separable lochia indicates the presence of clots
only. Foul-smelling lochia indicates endometritis.
A client gave birth to a healthy boy 2 days ago. Both mother and baby have had a smooth recovery. The
nurse enters the room and tells the client that she and her baby will be discharged home today. The
client states, "I do not want to go home." What is the nurse's most appropriate response? - ANS Ask the
client to explain why she does not want to go home.
It is important for the nurse to identify the client's concerns and reasons for wanting to stay in the
hospital. Open-ended questioning facilitates both effective and therapeutic communication and allows
the nurse to address concerns appropriately. Asking about supports at home implies that the nurse has
made assumptions about why the client may not want to go home. Informing the care provider or telling
the client that discharge is hospital policy is not appropriate at this time because the nurse has not
addressed the underlying reason for the client's comment. The client may have safety-related concerns,
undisclosed fears, or a need for increased support before discharge. It is imperative that the nurse not
make assumptions but further explore concerns.
,A nurse is monitoring the vital signs of a client 24 hours after birth. She notes that the client's blood
pressure is 100/60 mm Hg. Which postpartum complication should the nurse most suspect in this client,
based on this finding? - ANS bleeding
Blood pressure should also be monitored carefully during the postpartum period because a decrease in
BP can also indicate bleeding. In contrast, an elevation above 140 mm Hg systolic or 90 mm Hg diastolic
may indicate the development of postpartum gestational hypertension, an unusual but serious
complication of the puerperium. An infection would best be indicated by an elevated oral temperature.
Diabetes would be indicated by an elevated blood glucose level.
While caring for a client following a lengthy labor and birth, the nurse notes that the client repeatedly
reviews her labor and birth and is very dependent on her family for care. The nurse is correct in
identifying the client to be in which phase of maternal role adjustment? - ANS taking-in
The taking-in phase occurs during the first 24 to 48 hours following the birth of the newborn and is
characterized by the mother taking on a very passive role in caring for herself, as well as recounting her
labor experience. The second maternal adjustment phase is the taking-hold phase and usually lasts
several weeks after the birth. This phase is characterized by both dependent and independent behavior,
with increasing autonomy. During the letting-go phase the mother reestablishes relationships with
others and accepts her new role as a parent. Acquaintance/attachment phase is a newer term that
refers to the first 2 to 6 weeks following birth when the mother is learning to care for her baby and is
physically recuperating from the pregnancy and birth.
A nurse is describing the many changes that will occur during the early postpartum period with a group
of young parents. The nurse reviews common reports experienced as the woman's body returns to her
prepregnancy state. The nurse determines that the teaching was successful when the participants
identify which report as being most common during the first week that will indicate their fluid volume is
returning to normal? - ANS diaphoresis
The profuse diaphoresis is common during the early postpartum period. Many women will wake up
drenched with perspiration. This diaphoresis is a mechanism to reduce the amount of fluids retained
during pregnancy and restore prepregnant body fluid levels. It is common, especially at night during the
first week after birth. Nocturia, urinary frequency, or urinary urgency are not associated with this fluid
shift.
,A woman comes to the clinic. She gave birth about 2 months ago to a healthy term male newborn.
During the visit, the woman tells the nurse, "I've noticed that I'm a bit uncomfortable now when we
have sexual intercourse. Is there anything that I can do?" The woman's menstrual period has not yet
resumed. Which suggestion by the nurse would be most appropriate?
You Selected: - ANS "You might try using a water-soluble lubricant to ease the discomfort."
Coital discomfort and localized dryness usually plague most postpartum women until menstruation
returns. Water-soluble lubricants can reduce discomfort during intercourse. Although it may take some
time for the woman's body to return to its prepregnant state, telling the woman this does not address
her concern. Telling her that dyspareunia is normal and that it takes time to resolve also ignores her
concern. Kegel exercises are helpful for improving pelvic floor tone but would have no effect on vaginal
dryness.
While providing care to a postpartum client on her first day at home, the nurse observes which behavior
that would indicate the new mother is in the taking-hold phase? - ANS Showing increased confidence
when caring for the newborn
Independence with self-care is an important aspect of the taking-hold phase. During the letting-go
phase, the woman assumes responsibility and care for the newborn with increased confidence.
Recounting her labor experience is usually part of the taking-in phase. Identifying specific features of the
newborn is typical of the taking-in phase. Feelings of grief, guilt, and anxiety are part of the letting-go
phase where the mother accepts the infant as it is and lets go of any fantasies.
When assessing the uterus of a 2-day postpartum client, which finding would the nurse evaluate as
normal? - ANS a moderate amount of lochia rubra
The client should have lochia rubra for 3 to 4 days postpartum. The client would then progress to lochia
serosa being expelled from day 3 to 10. Last the client would have lochia alba from day 10 to 14 until 3
to 6 weeks.
, The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. During
discharge education, which type of lochia pattern should the nurse tell the woman is abnormal and
needs to be reported to her health care provider immediately? - ANS moderate lochia serosa on day 4
postpartum, increasing in volume and changing to rubra on day 5
Lochia by day 4 should be decreasing in amount, and the color should be changing to pink tinge. Red
rubra on day 4 may indicate bleeding, and the health care provider should be notified. A moderate flow
of lochia rubra on day 3 postpartum, changing to serosa on day 5, is a normal finding. Lochia progressing
from rubra to serosa to alba within 10 days of delivery is a normal finding. Moderate lochia rubra on day
3, mixed serosa and rubra on day 4, and light serosa on day 5 is a normal finding.
The nurse has received the results of a client's postpartum hemoglobin and hematocrit. Review of the
client's history reveals a prepartum hemoglobin of 14 g/dl (140 g/L) and hematocrit of 42% (0.42).
Which result should the nurse prioritize? - ANS Hemoglobin 9 g/dl (90 g/L) and hematocrit 32% (0.32) in
a woman who has given birth by cesarean
First, the nurse needs to determine the amount of blood loss during the delivery. For every 250 ml of
blood lost during the delivery process, the hemoglobin should decrease by 1 g/dl (10 g/L) and the
hematocrit by 2%. The acceptable amount of blood loss during a normal vaginal delivery is
approximately 300 ml to 500 m and for a cesarean delivery approximately 500 mL to 1000 ml. The loss
of hemoglobin from 14 gm/dl (140 g/L) to 9 gm/dl (90 g/L) is 5 and for the hematocrit from 42% to 32%
is 10. This would indicate the client lost approximately 1250 ml of blood during the cesarean delivery (5
x 250 = 1250); this is too much and should be reported to the health care provider immediately. The
other choices would be considered to be within normal range.
The nursing instructor is leading a discussion on the physical changes to a woman's body after the birth
of the baby. The instructor determines the session is successful after the students correctly point out
which process results in the return of nonpregnant size and function of the female organs? - ANS
Involution
Involution is the term used to describe the process of the return to nonpregnancy size and function of
reproductive organs. Evolution is change in the genetic material of a population of organisms from one
