Answers
Which patient would be most likely to have severe afterbirth pains an request a narcotic
analgesic?
a. gravida 5, para 5
b. primipara who delivered a 7lb boy
c. patient who is bottle feeding her child
d. patient who is breastfeeding h her second child - ANS gravida 5, para 5
Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes
the pelvic inlet?
a. External Rotation
b. Engagement
c. Extension
d. Internal rotation - ANS Engagement
Uncontrolled maternal hyperventilation during labor results in
a. metabolic acidosis
b. metabolic alkalosis
c.respiratory acidosis
d. respiratory alkalosis - ANS respiratory alkalosis
Which physiologic event is the key indicator of the commencement of true labor?
a. bloody show
B. Cervical dilation and effacement
C. fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes - ANS Cervical dilation and effacement
Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the
pelvis?
a. station
b. flexion
c. descent
d. engagement - ANS flexion
An increase of urinary frequency and leg cramps after the 36th week of pregnancy are
indication of
a. lightening
,b. breech presentation
c. urinary tract infection
d. onset of Braxton-Hicks contractions - ANS Lightening
A patient whose cervix is dilated to 6 cm is considered to be in which phase of labor?
a. latent phase
b. active phase
c. second stage
d. third stage - ANS active phase
A patient in labor presents with a breech presentation. The nurse understands that this is
associated with
a. more rapid labor
b. a high risk of infection
c. maternal perineal trauma
d. umbilical cord compression - ANS umbilical cord compression
The primary difference between labor of a nullipara and that of a multipara is
a. total duration of labor
b. level pain experienced
c. amount of cervical dialation
d. sequence of labor mechanisms - ANS total duration of labor
Which maternal event is abnormal in the early postpartal period?
a. diuresis and diaphoresis
b. flatulence and constipation
c. extreme hunger and thirst
d. lochial color cchanges from rubra to alba - ANS lochial changes from rubra to alba
Which fundal assessment findings at 12 hours after birth requires further assessment?
a. The fundus is palpable at the level of the umbilicus
b. The fundus is palpable two fingerbreadths above the umbilicus
c. The fundus is palpable one fingerbreadth below the umbilicus
d. The fundus is palpable two finger breaths below the umbilicus - ANS The fundus is
palpable two fingerbreadths above the umbilicus
If the patient's white blood cell count is 25,000 on her second postpartum day, which action
should the nurse take?
a. document the findings
b. inform the health care provider
c. begin antibiotic therapy
d. have the lab draw blood for reanalysis - ANS document the findings
Postpartal overdistention of the bladder and urinary retention can lead to which complication?
, a. fever and increased blood pressure
b. postpartum hemorrhage and eclampsia
c. urinary tract infection and uterine rupture
d. postpartum hemorrhage and urinary tract infection - ANS postpartum hemorrhage and
urinary tract infection
A postpartum patient asks, "Will these stretch marks ever go away? Which the nurse responds?
a. NO
b. Yes, eventually
c. They will fade to silvery lines but won't disappear completely
d. They will continue to fade and should be gone by your 6 week checkup - ANS They will
fade to silvery lines but won't disappear completely
Which finding will the nurse suspect if the fundus is palpable on the right of the abdomen and
above the expected level
a. distended bladder
b. normal involution
c. been lying on her right side too long
d. stretched ligaments that are unable to support the uterus - ANS distended bladder
Which situation would require the administration of Rho (D) immune globulin?
a. Mother RH-negative, baby RH positive
b. Mother Rh Negative, baby Rh Negative
c. Mother Rh positive, baby Rh Negative
d. Mother Rh positive, baby Rh positive - ANS Mother RH-negative, baby RH positive
If rubella vaccine is indicated for the postpartum patient which instructions should be provided?
a. no specific instructions
b. drinking plenty of fluids will prevent fever
c. Recommendation to stop breastfeeding for 24 hours after the injection
d. Explanation of the risks of becoming pregnant within 28days after injection - ANS
Explanation of the risks of becoming pregnant within 28days after injection
Which measure is option in order to prevent abdominal distention following a cesarean birth?
a. rectal suppositories
b. carbonated beverages
c. early and frequent ambulation
d. TIghtening and relaxing abdominal muscles - ANS early and frequent ambulation
To access fundal contractions 6 hours after c-section, which technique should the nurse use?
a. Assess lochial Flow rather than palpating the fundus
b. Palpate forcefully through the abdominal dressing
c. Place hands on both sides of the abdomen and press downward