Maternal Chapter 21: Maternal Physiological
Changes(100% Error-free answers)
A woman gave birth to an infant boy 12 hours ago. Where would the nurse expect to locate this
woman's fundus?
a. One centimetre above the umbilicus
b. Two centimetres below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally correct answers ANS: A
The fundus descends about 1 to 2 cm every 24 hours. Within 12 hours after delivery the fundus
may be approximately 1 cm above the umbilicus. By the sixth postpartum week the fundus
normally is halfway between the symphysis pubis and the umbilicus. The fundus should be
easily palpated using the maternal umbilicus as a reference point.
Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who gave birth to twins
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 2400 g correct answers ANS: B
Afterpains are more noticeable after births in which the uterus was overdistended (e.g., large
baby, multifetal gestation, polyhydramnios). Breastfeeding may cause afterpains to intensify, not
bottle-feeding. An average-weight baby does not intensify afterpains.
A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse
expect to find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
c. Lochia alba
d. Lochia serosa correct answers ANS: D
Lochia serosa, which consists of blood, serum, leukocytes, and tissue debris, generally occurs
around day 3 or 4 after childbirth. Lochia rubra consists of blood and decidual and trophoblastic
debris. The flow generally lasts 3 to 4 days and pales, becoming pink or brown. There is no such
term as lochia sangra. Lochia alba occurs in most women after day 10 and can continue up to 6
weeks after childbirth.
Which hormone remains elevated in the immediate postpartum period of the breastfeeding
woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen correct answers ANS: C
Prolactin levels in the blood increase progressively throughout pregnancy. In women who
breastfeed, prolactin levels remain elevated into the sixth week after birth. Estrogen and
progesterone levels decrease markedly after expulsion of the placenta, reaching their lowest
, levels 1 week into the postpartum period. Human placental lactogen levels decrease dramatically
after expulsion of the placenta.
What is responsible for the diaphoresis and diuresis that a woman experiences during the early
postpartum period?
a. Elevated temperature caused by postpartum infection
b. Increased basal metabolic rate after giving birth
c. Loss of increased blood volume associated with pregnancy
d. Increased venous pressure in the lower extremities correct answers ANS: C
Within 12 hours of birth women begin to lose the excess tissue fluid that accumulated during
pregnancy. One mechanism for reducing these retained fluids is the profuse diaphoresis that
often occurs, especially at night, for the first 2 or 3 days after childbirth. Postpartal diuresis is
another mechanism by which the body rids itself of excess fluid. An elevated temperature would
cause chills and may cause dehydration, not diaphoresis and diuresis. Diaphoresis and diuresis
sometimes are referred to as reversal of the water metabolism of pregnancy, not as the basal
metabolic rate. Postpartal diuresis may be caused by the removal of increased venous pressure in
the lower extremities.
A woman gave birth to a 2850 g infant boy 2 hours ago. The nurse determines that the woman's
bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the
midline. In the immediate postpartum period, what is the most serious consequence likely to
occur from bladder distension?
a. Urinary tract infection
b. Excessive uterine bleeding
c. A ruptured bladder
d. Bladder wall atony correct answers ANS: B
Excessive bleeding can occur immediately after birth if the bladder becomes distended, because
it pushes the uterus up and to the side and prevents it from contracting firmly. A urinary tract
infection may result from overdistension of the bladder, but it is not the most serious
consequence. A ruptured bladder may result from a severely overdistended bladder. However,
vaginal bleeding most likely would occur before the bladder reaches this level of overdistension.
Bladder distension may result from bladder wall atony. The most serious concern associated with
bladder distension is excessive uterine bleeding.
Which is the cause of breast engorgement?
a. Overproduction of colostrum
b. Accumulation of milk in the lactiferous ducts
c. Hyperplasia of mammary tissue
d. Congestion of veins and lymphatics correct answers ANS: D
Breast engorgement is caused by the temporary congestion of veins and lymphatics, not by
overproduction of colostrum, overproduction of milk, or hyperplasia of mammary tissue.
What information would indicate to the nurse that the newly delivered woman knows what to
expect about her menstrual activity after childbirth?
a. The first menstrual cycle will be lighter than normal and then will get heavier every month
thereafter.
Changes(100% Error-free answers)
A woman gave birth to an infant boy 12 hours ago. Where would the nurse expect to locate this
woman's fundus?
a. One centimetre above the umbilicus
b. Two centimetres below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally correct answers ANS: A
The fundus descends about 1 to 2 cm every 24 hours. Within 12 hours after delivery the fundus
may be approximately 1 cm above the umbilicus. By the sixth postpartum week the fundus
normally is halfway between the symphysis pubis and the umbilicus. The fundus should be
easily palpated using the maternal umbilicus as a reference point.
Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who gave birth to twins
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 2400 g correct answers ANS: B
Afterpains are more noticeable after births in which the uterus was overdistended (e.g., large
baby, multifetal gestation, polyhydramnios). Breastfeeding may cause afterpains to intensify, not
bottle-feeding. An average-weight baby does not intensify afterpains.
A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse
expect to find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
c. Lochia alba
d. Lochia serosa correct answers ANS: D
Lochia serosa, which consists of blood, serum, leukocytes, and tissue debris, generally occurs
around day 3 or 4 after childbirth. Lochia rubra consists of blood and decidual and trophoblastic
debris. The flow generally lasts 3 to 4 days and pales, becoming pink or brown. There is no such
term as lochia sangra. Lochia alba occurs in most women after day 10 and can continue up to 6
weeks after childbirth.
Which hormone remains elevated in the immediate postpartum period of the breastfeeding
woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen correct answers ANS: C
Prolactin levels in the blood increase progressively throughout pregnancy. In women who
breastfeed, prolactin levels remain elevated into the sixth week after birth. Estrogen and
progesterone levels decrease markedly after expulsion of the placenta, reaching their lowest
, levels 1 week into the postpartum period. Human placental lactogen levels decrease dramatically
after expulsion of the placenta.
What is responsible for the diaphoresis and diuresis that a woman experiences during the early
postpartum period?
a. Elevated temperature caused by postpartum infection
b. Increased basal metabolic rate after giving birth
c. Loss of increased blood volume associated with pregnancy
d. Increased venous pressure in the lower extremities correct answers ANS: C
Within 12 hours of birth women begin to lose the excess tissue fluid that accumulated during
pregnancy. One mechanism for reducing these retained fluids is the profuse diaphoresis that
often occurs, especially at night, for the first 2 or 3 days after childbirth. Postpartal diuresis is
another mechanism by which the body rids itself of excess fluid. An elevated temperature would
cause chills and may cause dehydration, not diaphoresis and diuresis. Diaphoresis and diuresis
sometimes are referred to as reversal of the water metabolism of pregnancy, not as the basal
metabolic rate. Postpartal diuresis may be caused by the removal of increased venous pressure in
the lower extremities.
A woman gave birth to a 2850 g infant boy 2 hours ago. The nurse determines that the woman's
bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the
midline. In the immediate postpartum period, what is the most serious consequence likely to
occur from bladder distension?
a. Urinary tract infection
b. Excessive uterine bleeding
c. A ruptured bladder
d. Bladder wall atony correct answers ANS: B
Excessive bleeding can occur immediately after birth if the bladder becomes distended, because
it pushes the uterus up and to the side and prevents it from contracting firmly. A urinary tract
infection may result from overdistension of the bladder, but it is not the most serious
consequence. A ruptured bladder may result from a severely overdistended bladder. However,
vaginal bleeding most likely would occur before the bladder reaches this level of overdistension.
Bladder distension may result from bladder wall atony. The most serious concern associated with
bladder distension is excessive uterine bleeding.
Which is the cause of breast engorgement?
a. Overproduction of colostrum
b. Accumulation of milk in the lactiferous ducts
c. Hyperplasia of mammary tissue
d. Congestion of veins and lymphatics correct answers ANS: D
Breast engorgement is caused by the temporary congestion of veins and lymphatics, not by
overproduction of colostrum, overproduction of milk, or hyperplasia of mammary tissue.
What information would indicate to the nurse that the newly delivered woman knows what to
expect about her menstrual activity after childbirth?
a. The first menstrual cycle will be lighter than normal and then will get heavier every month
thereafter.
