N144 Exam 4 Practice Questions With
Correct Answers
The perinatal nurse is caring for a woman in the immediate postbirth
| | | | | | | | | | | |
period. Assessment reveals that the woman is experiencing profuse
| | | | | | | | |
bleeding. The most likely etiology for the bleeding is:
| | | | | | | |
a. Uterine atony.
| | |
b. Uterine inversion.
| | |
c. Vaginal hematoma.
| |
d. Vaginal laceration.
| |
a. Uterine atony.
| | |
Uterine atony is marked hypotonia of the uterus. It is the leading cause
| | | | | | | | | | | | |
of postpartum hemorrhage. Uterine inversion may lead to hemorrhage,
| | | | | | | | |
but it is not the most likely source of this client's bleeding. Furthermore,
| | | | | | | | | | | |
if the woman were experiencing a uterine inversion, it would be
| | | | | | | | | | | |
,evidenced by the presence of a large, red, rounded mass protruding
| | | | | | | | | | |
from the introitus. A vaginal hematoma may be associated with
| | | | | | | | | |
hemorrhage. However, the most likely clinical finding would be pain, not
| | | | | | | | | |
the presence of profuse bleeding. A vaginal laceration may cause
| | | | | | | | | | |
hemorrhage, but it is more likely that profuse bleeding would result
| | | | | | | | | | |
from uterine atony. A vaginal laceration should be suspected if vaginal
| | | | | | | | | | |
bleeding continues in the presence of a firm, contracted uterine fundus.
| | | | | | | | | |
A primary nursing responsibility when caring for a woman experiencing
| | | | | | | | | |
an obstetric hemorrhage associated with uterine atony is to:
| | | | | | | |
a. Establish venous access.
| | |
b. Perform fundal massage.
| | |
c. Prepare the woman for surgical intervention.
| | | | | |
d. Catheterize the bladder.
| | |
b. Perform fundal massage.
| | |
,The initial management of excessive after birth bleeding is firm massage
| | | | | | | | | |
of the uterine fundus. Although establishing venous access may be a
| | | | | | | | | | | |
necessary intervention, the initial intervention would be fundal
| | | | | | | |
massage. The woman may need surgical intervention to treat her after
| | | | | | | | | | |
birth hemorrhage, but the initial nursing intervention would be to
| | | | | | | | | |
assess the uterus. After uterine
| | | |
massage the nurse may want to catheterize the patient to eliminate any
| | | | | | | | | | | |
bladder distention that may be preventing the uterus from contracting
| | | | | | | | | |
properly.
The perinatal nurse caring for the postpartum woman understands that
| | | | | | | | | |
late postpartum hemorrhage (PPH) is most likely caused by:
| | | | | | | |
a. Subinvolution of the placental site.
| | | | | |
b. Defective vascularity of the decidua.
| | | | |
c. Cervical lacerations.
| |
d. Coagulation disorders.
| |
, a. Subinvolution of the placental site.
| | | | | |
Late PPH may be the result of subinvolution of the uterus, pelvic
| | | | | | | | | | | |
infection, or retained placental fragments. Late PPH is not typically a
| | | | | | | | | | |
result of defective vascularity of the decidua, cervical lacerations, or
| | | | | | | | | |
coagulation disorders. |
Which woman is at greatest risk for early postpartum hemorrhage
| | | | | | | | | |
(PPH)?
a. A primiparous woman (G 2 P 1 0 0 1) being prepared for an
| | | | | | | | | | | | | | |
emergency cesarean birth for fetal distress
| | | | |
b. A woman with severe preeclampsia who is receiving magnesium
| | | | | | | | | |
sulfate and whose labor is being induced
| | | | | |
c. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor
| | | | | | | | | | | | | |
d. A primigravida in spontaneous labor with preterm twins
| | | | | | | |
Correct Answers
The perinatal nurse is caring for a woman in the immediate postbirth
| | | | | | | | | | | |
period. Assessment reveals that the woman is experiencing profuse
| | | | | | | | |
bleeding. The most likely etiology for the bleeding is:
| | | | | | | |
a. Uterine atony.
| | |
b. Uterine inversion.
| | |
c. Vaginal hematoma.
| |
d. Vaginal laceration.
| |
a. Uterine atony.
| | |
Uterine atony is marked hypotonia of the uterus. It is the leading cause
| | | | | | | | | | | | |
of postpartum hemorrhage. Uterine inversion may lead to hemorrhage,
| | | | | | | | |
but it is not the most likely source of this client's bleeding. Furthermore,
| | | | | | | | | | | |
if the woman were experiencing a uterine inversion, it would be
| | | | | | | | | | | |
,evidenced by the presence of a large, red, rounded mass protruding
| | | | | | | | | | |
from the introitus. A vaginal hematoma may be associated with
| | | | | | | | | |
hemorrhage. However, the most likely clinical finding would be pain, not
| | | | | | | | | |
the presence of profuse bleeding. A vaginal laceration may cause
| | | | | | | | | | |
hemorrhage, but it is more likely that profuse bleeding would result
| | | | | | | | | | |
from uterine atony. A vaginal laceration should be suspected if vaginal
| | | | | | | | | | |
bleeding continues in the presence of a firm, contracted uterine fundus.
| | | | | | | | | |
A primary nursing responsibility when caring for a woman experiencing
| | | | | | | | | |
an obstetric hemorrhage associated with uterine atony is to:
| | | | | | | |
a. Establish venous access.
| | |
b. Perform fundal massage.
| | |
c. Prepare the woman for surgical intervention.
| | | | | |
d. Catheterize the bladder.
| | |
b. Perform fundal massage.
| | |
,The initial management of excessive after birth bleeding is firm massage
| | | | | | | | | |
of the uterine fundus. Although establishing venous access may be a
| | | | | | | | | | | |
necessary intervention, the initial intervention would be fundal
| | | | | | | |
massage. The woman may need surgical intervention to treat her after
| | | | | | | | | | |
birth hemorrhage, but the initial nursing intervention would be to
| | | | | | | | | |
assess the uterus. After uterine
| | | |
massage the nurse may want to catheterize the patient to eliminate any
| | | | | | | | | | | |
bladder distention that may be preventing the uterus from contracting
| | | | | | | | | |
properly.
The perinatal nurse caring for the postpartum woman understands that
| | | | | | | | | |
late postpartum hemorrhage (PPH) is most likely caused by:
| | | | | | | |
a. Subinvolution of the placental site.
| | | | | |
b. Defective vascularity of the decidua.
| | | | |
c. Cervical lacerations.
| |
d. Coagulation disorders.
| |
, a. Subinvolution of the placental site.
| | | | | |
Late PPH may be the result of subinvolution of the uterus, pelvic
| | | | | | | | | | | |
infection, or retained placental fragments. Late PPH is not typically a
| | | | | | | | | | |
result of defective vascularity of the decidua, cervical lacerations, or
| | | | | | | | | |
coagulation disorders. |
Which woman is at greatest risk for early postpartum hemorrhage
| | | | | | | | | |
(PPH)?
a. A primiparous woman (G 2 P 1 0 0 1) being prepared for an
| | | | | | | | | | | | | | |
emergency cesarean birth for fetal distress
| | | | |
b. A woman with severe preeclampsia who is receiving magnesium
| | | | | | | | | |
sulfate and whose labor is being induced
| | | | | |
c. A multiparous woman (G 3 P 2 0 0 2) with an 8-hour labor
| | | | | | | | | | | | | |
d. A primigravida in spontaneous labor with preterm twins
| | | | | | | |
