Chapter 18: Maternal Physiologic Changes(A+
Guaranteed Answers)
A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this
womans fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally correct answers a. One centimeter above the umbilicus
Within 12 hours after delivery the fundus may be approximately 1 cm above the umbilicus. 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 is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 pounds, 3 ounces correct answers b. A woman who is a
gravida 4, para 4-0-0-4
Afterpains are more common in multiparous women. Afterpains are more noticeable with births
in which the uterus was greatly distended, as in a woman who experienced polyhydramnios or a
woman who delivered a large infant. Breastfeeding may cause afterpains to intensify.
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 d. Lochia serosa
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 c. Prolactin
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 and reach their lowest
levels 1 week into the postpartum period. Human placental lactogen levels decrease dramatically
after expulsion of the placenta.
Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to
urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism
for the diaphoresis and diuresis that this woman is experiencing during the early postpartum
period is:
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 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 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 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the
womans 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, the most serious consequence likely to
occur from bladder distention is:
a. Urinary tract infection
b. Excessive uterine bleeding
c. A ruptured bladder
d. Bladder wall atony correct answers b. Excessive uterine bleeding
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 overdistention of the bladder, but it is not the most serious
consequence. A ruptured bladder may result from a severely overdistended bladder. However,
Guaranteed Answers)
A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this
womans fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally correct answers a. One centimeter above the umbilicus
Within 12 hours after delivery the fundus may be approximately 1 cm above the umbilicus. 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 is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 pounds, 3 ounces correct answers b. A woman who is a
gravida 4, para 4-0-0-4
Afterpains are more common in multiparous women. Afterpains are more noticeable with births
in which the uterus was greatly distended, as in a woman who experienced polyhydramnios or a
woman who delivered a large infant. Breastfeeding may cause afterpains to intensify.
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 d. Lochia serosa
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 c. Prolactin
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 and reach their lowest
levels 1 week into the postpartum period. Human placental lactogen levels decrease dramatically
after expulsion of the placenta.
Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to
urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism
for the diaphoresis and diuresis that this woman is experiencing during the early postpartum
period is:
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 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 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 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the
womans 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, the most serious consequence likely to
occur from bladder distention is:
a. Urinary tract infection
b. Excessive uterine bleeding
c. A ruptured bladder
d. Bladder wall atony correct answers b. Excessive uterine bleeding
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 overdistention of the bladder, but it is not the most serious
consequence. A ruptured bladder may result from a severely overdistended bladder. However,
