OB Exam 2 : OB Exam 2 Practice Exam: Questions & Answers: Updated A+ Score Guide

The perinatal nurse caring for the postpartum woman understands that late postpartum hemorrhage is most likely caused by A. Subinvolution of the uterus B. Defective vascularity of the decidua C. Cervical lacerations D. Coagulation disorders (>- ANS: A Subinvolution of the placental site. A. Late PPH may be the result of subinvolution of the uterus. Recognized causes of subinvolution included retained placental fragments and pelvic infection. B. Although defective vascularity of the decidua may cause PPH, late PPH typically results from subinvolution of the uterus, pelvic infection, or retained placental fragments. C. Although cervical lacerations may cause PPH, late PPH typically results from subinvolution of the uterus, pelvic infection, or retained placental fragments. D. Although coagulation disorders may cause PPH, late PPH typically results from subinvolution of the uterus, pelvic infection, or retained placental fragments. The mother-baby nurse must be able to recognize what sign of thrombophlebitis? (>- ANS: C Local tenderness, heat, and swelling A. Varicose veins may predispose the woman to thrombophlebitis, but are not a sign. B. A positive Homans' sign may be caused by a strained muscle or contusion. C. Tenderness, heat, and swelling are classic signs of thrombophlebitis that appear at the site of the inflammation. D. Edema may be more involved than pedal. Which condition is a transient, self-limiting mood disorder that affects new mothers after childbirth? (>- ANS: D Postpartum Blues A. Postpartum depression is not the normal worries (blues) that many new mothers experience. Many caregivers believe that postpartum depression is underdiagnosed and underreported. B. Postpartum psychosis is a rare condition that usually surfaces within 3 weeks of delivery. Hospitalization of the woman is usually necessary for treatment of this disorder. C. Bipolar disorder is one of the two categories of postpartum psychosis, characterized by both manic and depressive episodes. D. Postpartum blues or "baby blues" is a transient self-limiting disease that is believed to be related to hormonal fluctuations after childbirth. Which nursing action is designed to avoid unnecessary heat loss in the newborn? (>- ANS: A Place a blanket over the scale before weighing the infant A. Padding the scale prevents heat loss from the infant to a cold surface by conduction. B. Room temperature should be appropriate to prevent heat loss from convection. Also, if the room is warm enough, radiation will assist in maintaining body heat. C. Undressing the infant completely will expose the child to cooler room temperatures and cause a drop in body temperature due to convection. D. Hourly assessments are not necessary for a normal newborn with a stable temperature. Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother? A. Hypoglycemia B. Hypercalcemia C. Hypobilirubinemia D. Hypoinsulinemia (>- ANS:A Hypoglycemia A. The neonate is at highest risk for hypoglycemia because fetal insulin production is accelerated during pregnancy to metabolize excessive glucose from the mother. At birth, the maternal glucose supply stops and the neonatal insulin exceeds the available glucose, leading to hypoglycemia. B. Hypocalcemia is associated with preterm birth, birth trauma, and asphyxia, all common problems of the infant of a diabetic mother. C. Excess erythrocytes are broken down after birth, releasing large amounts of bilirubin into the neonate's circulation, which results in hyperbilirubinemia. D. Because fetal insulin production is accelerated during pregnancy, the neonate shows hyperinsulinemia. A woman taking magnesium sulfate has respiratory rate of 10 breaths/min. In addition to discontinuing the medication, the nurse should (>- ANS: C Administer calcium gluconate. A. Stimulation will not increase the respirations. B. This will not be successful in reversing the effects of the magnesium sulfate. C. Calcium gluconate reverses the effects of magnesium sulfate. D. Increasing her IV fluids will not reverse the effects of the medication. The primary symptom present in abruptio placentae that distinguishes it from placenta previa is A. Vaginal bleeding B. Rupture of membranes C. Presence of abdominal pain D. Changes in maternal vital signs (>- Presence of abdominal pain A. Both may have vaginal bleeding. B. Rupture of membranes may occur with both conditions. C. Pain in abruptio placentae occurs in response to increased pressure behind the placenta and within the uterus. Placenta previa manifests with painless vaginal bleeding. D. Maternal vital signs may change with both if bleeding is pronounced. Which combination of expressing pain could be demonstrated in a neonate? (>- ANS: D Cry face, eye squeeze, increase in blood pressure A. Cry and an increased heart rate are manifestations of neonatal pain. Typically, infants will close their eyes tightly when in pain, not open them wide. B. Infants may cry in response to pain. Additionally, they may display a rigid posture with the mouth open. C. A high-pitched, shrill cry is associated with genetic/neurologic anomalies. The infant may cry, withdraw limbs, and become tachycardic with pain. D. These manifestations are indicative of pain in the neonate. Because of the premature infant's decreased immune functioning, what nursing diagnosis should the nurse include in a plan of care for a premature infant? (>- ANS: D Risk for infection A. Growth and development may be affected, but only indirectly. B. Thermoregulation may be affected, but only indirectly. C. Feeding may be affected, but only indirectly. D. The nurse needs to know that decreased immune functioning increases the risk for infection. In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level? A. Necrotizing enterocolitis (NEC) B. Retinopathy of prematurity (ROP) C. Bronchopulmonary dysplasia (BPD) D. Intraventricular hemorrhage (IVH) (>- ANS: B Retinopathy of prematurity (ROP) A. NEC is due to the interference of blood supply to the intestinal mucosa. Necrotic lesions occur at that site. B. ROP is thought to occur as a result of high levels of oxygen in the blood. C. BPD is caused by the use of positive pressure ventilation against the immature lung tissue. D. IVH is due to rupture of the fragile blood vessels in the ventricles of the brain. It is most often associated with hypoxic injury, increased blood pressure, and fluctuating cerebral blood flow. What instructions should be included in the discharge teaching plan to assist the patient in recognizing early signs of complications A. Palpate the fundus daily to ensure that it is soft. B. Notify the physician of any increase in the amount of lochia or a return to bright red bleeding. C. Report any decrease in the amount of brownish red lochia. D. The passage of clots as large as an orange can be expected. (>- ANS:B