EXAM AND ACTUAL CORRECT ANSWERS.
The nurse, assessing the lochia of a client, attempts to separate a clot and
identifies the presence of tissue. Which observation would indicate the
presence of tissue? - CorreCt Answers -postpartum diuresis
The nurse is reviewing the health records of several clients who gave birth
during the previous shift. For which client would the nurse monitor more
frequently for maternal hemorrhage? - CorreCt Answers -a client diagnosed
with placenta succenturiate
Placental succenturiate is a concern for maternal hemorrhage if the
accessory lobes of the placenta are retained after delivery. The other
conditions are not associated with a higher than usual concern for
hemorrhage, although all postpartum clients are observed for hemorrhage.
A woman comes to the clinic for her first postpartum visit. She gave birth to
a healthy term neonate 2 weeks ago. As part of this visit, the woman has a
complete blood count drawn. Which result would the nurse identify as a
potential problem? - CorreCt Answers -white blood cell count 14,000/mm3
(14 ×109/L)
The white blood cell count, which increases in labor, remains elevated for
the first 4 to 6 days after birth but then falls to 6,000 to 10,000/mm3 (6 to
10 ×109/L). An elevated white blood cell count would be suspicious for
infection. The hemoglobin, hematocrit and platelet levels are within normal
parameters for this woman.
,After the abdominal dressing is removed 24 hours following a cesarean
delivery, the nurse inspects the incision and observes drainage from the
incision, redness along the suture line and moderate edema. Staples are
intact. What action would the nurse take? - CorreCt Answers -Let the health
care provider know the condition of the incision.
Which factor might result in a decreased supply of breast milk in a
postpartum client? - CorreCt Answers -supplemental feedings with formula
During the birth, the primary care provider performed an episiotomy. The
client is now reporting discomfort. To reduce this discomfort and increase
hygiene to the perineum, the nurse would encourage the client to use which
intervention? - CorreCt Answers -peribottle and warm water
During a home visit, the client mentions she is still having significant of
joint pain. The nurse explains that the changes that softened the pelvic
joints to allow for the birth were due to the hormone relaxin. The nurse
informs the client that it takes approximately how long for the joints to
return to prepregnancy status? - CorreCt Answers -6 to 8 weeks after
pregnancy
A nurse works at a facility that provides care to clients holding various
cultural beliefs. The nurse integrates understanding of the areas recognized
by other cultures that are not necessarily acknowledged by the Western
culture. Which area would the nurse need to incorporate into the plans of
care? - CorreCt Answers -balance of hot and cold
A new mother comes in for her first visit and reports pain and tenderness in
her breast just before feeding. Based on her description, the nurse
determines she is experiencing breast engorgement. Which instruction
, should the nurse provide to her? - CorreCt Answers -"Take a warm shower
just before feeding your infant."
Which client should the postpartum nurse assess first after receiving shift
report? - CorreCt Answers -The 2-day postpartum client who has a blood
pressure of 138/90 mm Hg
A multigravida client is still focusing on her difficult labor and discusses it
with the nurse at each opportunity, several hours after the birth. Which
action should the nurse prioritize after noting the client's partner is
spending more time with the infant than the client? - CorreCt Answers -
Encourage her to discuss her experience of the birth and answer any
questions or concerns she may have
The nurse is making a home visit to a woman who is 5 days' postpartum.
Which finding would concern the nurse and warrant further investigation? -
CorreCt Answers -lochia rubra
A urinalysis is done on a postpartum mother 24 hours after delivery. Which
findings would be considered normal for this client? Select all that apply. -
CorreCt Answers -moderate glycosuria
mild ketonuria
Occasional RBCs
trace WBCs
The nurse is admitting to the floor a woman who just gave birth. What
medical and pregnancy history would the labor and delivery nurse include
in the report? - CorreCt Answers -Maternal blood type