NSG 333 EXAM 3 STUDY GUIDE &
PRACTICE QUESTIONS 2026/2027
1 of 60
Term
A woman who has recently given birth reports pain and tenderness in
her leg. On physical examination, the nurse notices warmth and
redness over an enlarged, hardened area. Which condition should the
nurse suspect, and how will it be confirmed?
a. Disseminated intravascular coagulation (DIC); asking for laboratory
tests
b. von Willebrand disease (vWD); noting whether bleeding times have
been extended
c. Thrombophlebitis; using real-time and color Doppler ultrasound
d. Idiopathic or immune thrombocytopenic purpura (ITP); drawing
blood for
laboratory analysis
Give this one a try later!
,a. Temperature 37.9 C, HR 120bpm, RR 20, BP 90/50
An EBL of 1500 ml with tachycardia and hypotension suggests hypovolemia caused
by excessive blood loss. Temperature 37.4° C, heart rate 88 bpm, respirations 36
breaths per minute, and blood pressure 126/68 mm Hg are normal vital signs except
for an increased respiratory rate, which may be secondary to pain from the birth.
Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and blood
pressure 110/80 mm Hg are normal vital signs except for the temperature, which may
increase to 38° C during the first 24 hours as a result of the dehydrating effects of
labor. Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute,
and blood pressure 140/90 mm Hg are normal vital signs, although the blood
pressure is slightly elevated, which may be attributable to the use of oxytocic
medications.
c. Loss of increased blood volume associated with pregnancy
Within 12 hours of birth, women begin to lose the excess tissue fluid that has
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 causes chills and possibly
dehydration, not diaphoresis and diuresis. Diaphoresis and diuresis are sometimes
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.
c. Thrombophlebitis; using real-time and color Doppler ultrasound
Pain and tenderness in the extremities, which show warmth, redness, and
hardness, is likely
thrombophlebitis. A Doppler ultrasound examination is a common noninvasive
way to
confirm the diagnosis. A diagnosis of DIC is made according to clinical
findings and
laboratory markers. With DIC, a physical examination will reveal symptoms that
may
include unusual bleeding, petechiae around a blood pressure cuff on the
, woman's arm,
and/or excessive bleeding from the site of a slight trauma such as a
venipuncture site.
Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes,
prolonged bleeding tine, and factor VIII deficiency. A risk for PPH exists with
vWD but does not exhibit a warm or reddened area in an extremity. ITP is an
autoimmune disorder in which the life span of antiplatelet antibodies is
decreased. Increased bleeding time is a diagnostic finding, and the risk of
postpartum uterine bleeding is increased.
c. The woman refers to the baby as "sweetie" since she has not given the baby a
name yet
If the mother is having difficulty naming her new infant, it may be a signal that she is
not adapting well to parenthood. Other red flags include a refusal to hold or feed
the baby, a lack of interaction with the infant, and becoming upset when the baby
vomits or needs a diaper change. A new mother who is having difficulty is unwilling
to discuss her labor and birth experience. An appropriate nursing diagnosis might
be Need for health teaching, related to a long, difficult labor or unmet expectations
of birth. A mother who is willing to discuss her birth experience is making a healthy
personal adjustment. The mother who is not coping well finds her baby unattractive
and messy. She may also be overly disappointed in the baby's sex. The client might
voice concern that the baby reminds her of a family member whom she does not
like. Having a partner and/or other family members react positively is an indication
that this new mother has a good support system in place. This support system helps
reduce anxiety related to her new role as a mother.
Don't know?
2 of 60
Term
A 25yo multiparous woman gave birth to an infant boy 1 day ago. Today
her husband brings a large container of brown seaweed soup to the
hospital. When the nurse enters the room, the husband asks for help
, with warming the soup so that his wife can eat it. What is the nurse's
most appropriate response?
a. "Didn't you like your lunch?"
b. "Does your health care provider know that you are planning to eat
that?"
c. "What is that anyway?"
d. "I'll warm the soup in the microwave for you."
Give this one a try later!
b. Apply ice to the breasts for comfort
Applying ice packs and cabbage leaves to the breasts for comfort is an appropriate
intervention for treating engorgement in a mother who is bottle feeding. The ice
packs should be applied for 15 minutes on and 45 minutes off to avoid rebound
engorgement. A bottle-feeding mother should avoid any breast stimulation,
including pumping or expressing milk. A bottle-feeding mother should continuously
wear a well-fitted support bra or breast binder for at least the first 72 hours after
giving birth. A loose-fitting bra will not aid lactation suppression. Furthermore, the
shifting of the bra against the breasts may stimulate the nipples and thereby
stimulate lactation.
d. "I'll warm the soup in the microwave for you."
Offering to warm the food shows cultural sensitivity to the dietary preferences
of the woman and is the most appropriate response. Cultural dietary
preferences must be respected. Women may request that family members
bring favorite or culturally appropriate foods to the hospital. Asking the
woman to identify her food does not show cultural sensitivity. Both remaining
options demonstrate insensitivity.
PRACTICE QUESTIONS 2026/2027
1 of 60
Term
A woman who has recently given birth reports pain and tenderness in
her leg. On physical examination, the nurse notices warmth and
redness over an enlarged, hardened area. Which condition should the
nurse suspect, and how will it be confirmed?
a. Disseminated intravascular coagulation (DIC); asking for laboratory
tests
b. von Willebrand disease (vWD); noting whether bleeding times have
been extended
c. Thrombophlebitis; using real-time and color Doppler ultrasound
d. Idiopathic or immune thrombocytopenic purpura (ITP); drawing
blood for
laboratory analysis
Give this one a try later!
,a. Temperature 37.9 C, HR 120bpm, RR 20, BP 90/50
An EBL of 1500 ml with tachycardia and hypotension suggests hypovolemia caused
by excessive blood loss. Temperature 37.4° C, heart rate 88 bpm, respirations 36
breaths per minute, and blood pressure 126/68 mm Hg are normal vital signs except
for an increased respiratory rate, which may be secondary to pain from the birth.
Temperature 38° C, heart rate 80 bpm, respirations 16 breaths per minute, and blood
pressure 110/80 mm Hg are normal vital signs except for the temperature, which may
increase to 38° C during the first 24 hours as a result of the dehydrating effects of
labor. Temperature 36.8° C, heart rate 60 bpm, respirations 18 breaths per minute,
and blood pressure 140/90 mm Hg are normal vital signs, although the blood
pressure is slightly elevated, which may be attributable to the use of oxytocic
medications.
c. Loss of increased blood volume associated with pregnancy
Within 12 hours of birth, women begin to lose the excess tissue fluid that has
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 causes chills and possibly
dehydration, not diaphoresis and diuresis. Diaphoresis and diuresis are sometimes
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.
c. Thrombophlebitis; using real-time and color Doppler ultrasound
Pain and tenderness in the extremities, which show warmth, redness, and
hardness, is likely
thrombophlebitis. A Doppler ultrasound examination is a common noninvasive
way to
confirm the diagnosis. A diagnosis of DIC is made according to clinical
findings and
laboratory markers. With DIC, a physical examination will reveal symptoms that
may
include unusual bleeding, petechiae around a blood pressure cuff on the
, woman's arm,
and/or excessive bleeding from the site of a slight trauma such as a
venipuncture site.
Symptoms of vWD, a type of hemophilia, include recurrent bleeding episodes,
prolonged bleeding tine, and factor VIII deficiency. A risk for PPH exists with
vWD but does not exhibit a warm or reddened area in an extremity. ITP is an
autoimmune disorder in which the life span of antiplatelet antibodies is
decreased. Increased bleeding time is a diagnostic finding, and the risk of
postpartum uterine bleeding is increased.
c. The woman refers to the baby as "sweetie" since she has not given the baby a
name yet
If the mother is having difficulty naming her new infant, it may be a signal that she is
not adapting well to parenthood. Other red flags include a refusal to hold or feed
the baby, a lack of interaction with the infant, and becoming upset when the baby
vomits or needs a diaper change. A new mother who is having difficulty is unwilling
to discuss her labor and birth experience. An appropriate nursing diagnosis might
be Need for health teaching, related to a long, difficult labor or unmet expectations
of birth. A mother who is willing to discuss her birth experience is making a healthy
personal adjustment. The mother who is not coping well finds her baby unattractive
and messy. She may also be overly disappointed in the baby's sex. The client might
voice concern that the baby reminds her of a family member whom she does not
like. Having a partner and/or other family members react positively is an indication
that this new mother has a good support system in place. This support system helps
reduce anxiety related to her new role as a mother.
Don't know?
2 of 60
Term
A 25yo multiparous woman gave birth to an infant boy 1 day ago. Today
her husband brings a large container of brown seaweed soup to the
hospital. When the nurse enters the room, the husband asks for help
, with warming the soup so that his wife can eat it. What is the nurse's
most appropriate response?
a. "Didn't you like your lunch?"
b. "Does your health care provider know that you are planning to eat
that?"
c. "What is that anyway?"
d. "I'll warm the soup in the microwave for you."
Give this one a try later!
b. Apply ice to the breasts for comfort
Applying ice packs and cabbage leaves to the breasts for comfort is an appropriate
intervention for treating engorgement in a mother who is bottle feeding. The ice
packs should be applied for 15 minutes on and 45 minutes off to avoid rebound
engorgement. A bottle-feeding mother should avoid any breast stimulation,
including pumping or expressing milk. A bottle-feeding mother should continuously
wear a well-fitted support bra or breast binder for at least the first 72 hours after
giving birth. A loose-fitting bra will not aid lactation suppression. Furthermore, the
shifting of the bra against the breasts may stimulate the nipples and thereby
stimulate lactation.
d. "I'll warm the soup in the microwave for you."
Offering to warm the food shows cultural sensitivity to the dietary preferences
of the woman and is the most appropriate response. Cultural dietary
preferences must be respected. Women may request that family members
bring favorite or culturally appropriate foods to the hospital. Asking the
woman to identify her food does not show cultural sensitivity. Both remaining
options demonstrate insensitivity.
