Maternity and Women's Health Care
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Role of the Nurse in
Contemporary Care
Stem: A nurse on a busy postpartum unit
receives report for a new admission: a 28-year-
old G1P1, vaginal birth 2 hours ago, with a firm
fundus at the umbilicus and lochia rubra
saturating one peripad in 30 minutes. What is
the nurse’s priority action?
A. Assist the client to ambulate to the bathroom
to assess urine output.
,B. Massage the fundus and reassess bleeding.
C. Notify the physician to prepare for possible
transfusion.
D. Offer the client a warm blanket and monitor
vital signs in one hour.
Correct Answer: B
Rationale — Correct: Fundal massage is the
immediate nursing action for uterine atony to
promote uterine contraction and reduce
hemorrhage. It is a rapid, evidence-based
intervention initiated by the nurse.
Rationale — Incorrect:
A. Ambulation may increase bleeding if uterine
atony is present and is not the immediate
action.
C. Notifying the physician for transfusion may
be necessary later, but immediate bedside
interventions (massage) come first.
D. Comfort measures and delayed monitoring
are inappropriate when active bleeding is
,present.
Teaching Point: Fundal massage is the first
action for suspected postpartum uterine atony.
Citation: Lowdermilk et al., 2023, Ch. 1: Role of
the Nurse in Contemporary Care
2
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Patient Safety &
Team Communication
Stem: During morning rounds, a nurse notes a
discrepancy between the electronic record
(oxytocin infusion running at 10 mU/min) and
the infusion pump (set at 40 mU/min). What
should the nurse do first?
A. Stop the infusion immediately and notify the
provider.
B. Leave the infusion running and document the
discrepancy.
, C. Verify the client’s uterine activity and
maternal vital signs, then correct the pump
setting.
D. Disconnect the infusion and replace with
normal saline.
Correct Answer: C
Rationale — Correct: Verify the patient’s
current clinical status (uterine activity, vitals)
before changing therapy; then safely correct
the pump and notify the team per safety
protocols. Clinical assessment guides urgency.
Rationale — Incorrect:
A. Stopping oxytocin without assessment could
precipitate uterine atony or alter planned
therapy; assessment first.
B. Documentation alone without corrective
action risks patient harm.
D. Disconnecting without provider direction
risks abrupt therapy changes and is not first
action.
13th Edition
Author(s)Deitra Lowdermilk
TEST BANK
1
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Role of the Nurse in
Contemporary Care
Stem: A nurse on a busy postpartum unit
receives report for a new admission: a 28-year-
old G1P1, vaginal birth 2 hours ago, with a firm
fundus at the umbilicus and lochia rubra
saturating one peripad in 30 minutes. What is
the nurse’s priority action?
A. Assist the client to ambulate to the bathroom
to assess urine output.
,B. Massage the fundus and reassess bleeding.
C. Notify the physician to prepare for possible
transfusion.
D. Offer the client a warm blanket and monitor
vital signs in one hour.
Correct Answer: B
Rationale — Correct: Fundal massage is the
immediate nursing action for uterine atony to
promote uterine contraction and reduce
hemorrhage. It is a rapid, evidence-based
intervention initiated by the nurse.
Rationale — Incorrect:
A. Ambulation may increase bleeding if uterine
atony is present and is not the immediate
action.
C. Notifying the physician for transfusion may
be necessary later, but immediate bedside
interventions (massage) come first.
D. Comfort measures and delayed monitoring
are inappropriate when active bleeding is
,present.
Teaching Point: Fundal massage is the first
action for suspected postpartum uterine atony.
Citation: Lowdermilk et al., 2023, Ch. 1: Role of
the Nurse in Contemporary Care
2
Reference: Ch. 1: 21st-Century Maternity and
Women’s Health Nursing — Patient Safety &
Team Communication
Stem: During morning rounds, a nurse notes a
discrepancy between the electronic record
(oxytocin infusion running at 10 mU/min) and
the infusion pump (set at 40 mU/min). What
should the nurse do first?
A. Stop the infusion immediately and notify the
provider.
B. Leave the infusion running and document the
discrepancy.
, C. Verify the client’s uterine activity and
maternal vital signs, then correct the pump
setting.
D. Disconnect the infusion and replace with
normal saline.
Correct Answer: C
Rationale — Correct: Verify the patient’s
current clinical status (uterine activity, vitals)
before changing therapy; then safely correct
the pump and notify the team per safety
protocols. Clinical assessment guides urgency.
Rationale — Incorrect:
A. Stopping oxytocin without assessment could
precipitate uterine atony or alter planned
therapy; assessment first.
B. Documentation alone without corrective
action risks patient harm.
D. Disconnecting without provider direction
risks abrupt therapy changes and is not first
action.
