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N144 Week 1 Elsevier Skills Modules Exam Questions With Complete Solutions

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N144 Week 1 Elsevier Skills Modules Exam Questions With Complete Solutions

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N144 Week 1 Elsevier Skills Modules Exam
Questions With Complete Solutions

As the nurse is performing an initial postpartum fundal check, the
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patient asks what the nurse is feeling for. Which would be the most
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appropriate response from the nurse? | | | |




A. "I'm checking your uterus. It should be soft, and the top should be
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just above your navel."
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B. "I'm checking your uterus. It should be soft, and the top should be at
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or just below your navel."
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C. "I'm checking your uterus. It should be firm, and the top should be
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above your navel."| |




D. "I'm checking your uterus. It should be firm, and the top should be at
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or just below your navel."
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D. “I’m checking your uterus. It should be firm, and the top should be at
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or just below your navel.”
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Rationale: The fundus should be at midline, firm, and at or below the
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umbilicus. In some cases, the nurse may find the fundus above the
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umbilicus (e.g., after delivery of a large-for-gestational-age newborn or
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with multiparity); however, this finding should always be investigated
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further. A boggy fundus is not a normal finding and requires further
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interventions.

,While assessing the perineum of a patient who has recently delivered a
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newborn, the nurse notices that the perineal pad is approximately 50%
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saturated. Which assessment will best help determine the amount of
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bleeding in this patient? | | |




A. How long the perineal pad has been in place
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B. Whether clots are present
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C. The source of bleeding
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D. The patient's normal bleeding amount during menstruation
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A. How long the perineal pad has been in place
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Rationale: The nurse needs to determine how long the perineal pad has
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been in place before determining the amount of bleeding that has
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occurred. The nurse should also assess for the presence of clots and for
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the source of bleeding; however, neither this information nor the
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patient’s menstrual history will change the quantification process.
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,A primipara delivered a newborn by vaginal birth 2 days ago. The
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patient reports pain in the area of the episiotomy and last had
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ibuprofen 3 hours ago. Which intervention would be most appropriate?
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A. Encouraging rest
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B. Offering to help reposition to a prone position
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C. Offering to help with breastfeeding
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D. Offering to assist with a sitz bath
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D. Offering to assist with a sitz bath
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Rationale: Using nonpharmacologic as well as pharmacologic
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interventions is appropriate to manage postpartum pain; a warm sitz
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bath will increase blood flow to the area, decrease local discomfort, and
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|promote healing. It is most effective after 24 hours. A simple
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nonpharmacologic method of pain relief for an episiotomy or | | | | | | | | |



lacerations is to encourage the patient to be side lying when possible.
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Lying in a prone position helps ease the discomfort associated with
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uterine contractions (afterpains). Although assisting with breastfeeding
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is always important, that has no impact on episiotomy pain. Rest is
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important in the postpartum period, but it may not relieve the patient’s
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pain.

, The nurse has completed an assessment of the patient's fundus and
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bladder. What should the nurse ask the patient to do to prepare for
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inspection of the perineum? | | |




A. Turn to the side and flex the upper leg.
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B. Lie supine, bring up both legs, and let the knees relax to the sides.
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C. Lie supine and lift the legs.
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D. Pull back the perineal pad.
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A. Turn to the side and flex the upper leg.
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Rationale: The optimal patient positioning to inspect the perineum is
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with the patient side lying with the upper leg flexed. The other positions
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will provide only a partial view of the perineum.
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Because of cardiovascular and hematologic changes during pregnancy
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and in the postpartum period, what should the nurse look for during
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assessment of the lower extremities? | | | |




A. Redness
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B. Edema, redness, and warmth
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C. Erythema and ecchymosis
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