N144 Exam 1 Questions and Answers Fully Solved
1. A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this
woman's 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 - 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 after birth 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.
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 - 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.
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 after birth period is:
a. elevated temperature caused by after birth 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. - 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.
The nurse caring for the after birth woman understands that breast engorgement is caused by:
a. overproduction of colostrum.
b. accumulation of milk in the lactiferous ducts.
c. hyperplasia of mammary tissue.
d. congestion of veins and lymphatics. - Answers d. congestion of veins and lymphatics.
Breast engorgement is caused by the temporary congestion of veins and lymphatics, not by
overproduction of colostrum, overproduction of milk, or hyperplasia of mammary tissue.
A woman gave birth to a 7-lb, 6-ounce infant girl 1 hour ago. The birth was vaginal, and the estimated
blood loss (EBL) was approximately 1500 mL. When assessing the woman's vital signs, the nurse would
be concerned to see:
a. temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP) 90/50.
b. temperature 37.4° C, heart rate 88, respirations 36, BP 126/68.
c. temperature 38° C, heart rate 80, respirations 16, BP 110/80.
d. temperature 36.8° C, heart rate 60, respirations 18, BP 140/90. - Answers a. temperature 37.9° C,
heart rate 120, respirations 20, blood pressure (BP) 90/50.
An EBL of 1500 mL with tachycardia and hypotension suggests hypovolemia caused by excessive blood
loss. An increased respiratory rate of 36 may be secondary to pain from the birth. Temperature may
increase to 38° C during the first 24 hours as a result of the dehydrating effects of labor. A BP of 140/90
is slightly elevated, which may be caused by the use of oxytocic medications.
,The interval between the birth of the newborn and the return of the reproductive organs to their
normal nonpregnant state is called the:
a. involutionary period because of what happens to the uterus.
b. lochia period because of the nature of the vaginal discharge.
c. mini-tri period because it lasts only 3 to 6 weeks.
d. puerperium, or fourth trimester of pregnancy. - Answers d. puerperium, or fourth trimester of
pregnancy.
The puerperium, also called the fourth trimester or the after birth period of pregnancy, lasts about 3 to
6 weeks. Involution marks the end of the puerperium, or the fourth trimester of pregnancy. Lochia
refers to the various vaginal discharges during the puerperium, or fourth trimester of pregnancy.
The self-destruction of excess hypertrophied tissue in the uterus is called:
a. autolysis.
b. subinvolution.
c. afterpain.
d. diastasis. - Answers a. autolysis.
Autolysis is caused by a decrease in hormone levels. Subinvolution is failure of the uterus to return to a
nonpregnant state. Afterpain is caused by uterine cramps 2 to 3 days after birth. Diastasis refers to the
separation of muscles.
With regard to the after birth uterus, nurses should be aware that:
a. at the end of the third stage of labor it weighs approximately 500 g.
b. after 2 weeks after birth it should not be palpable abdominally.
c. after 2 weeks after birth it weighs 100 g.
d. it returns to its original (prepregnancy) size by 6 weeks after birth. - Answers b. after 2 weeks after
birth it should not be palpable abdominally.
After 2 weeks after birth, the uterus should not be palpable abdominally; however, it has not yet
returned to its original size. At the end of the third stage of labor, the uterus weighs approximately 1000
, g. It takes 6 full weeks for the uterus to return to its original size. After 2 weeks after birth the uterus
weighs about 350 g, not its original size. The normal self-destruction of excess hypertrophied tissue
accounts for the slight increase in uterine size after each pregnancy.
With regard to after birth pains, nurses should be aware that these pains are:
a. caused by mild, continuous contractions for the duration of the after birth period.
b. more common in first-time mothers.
c. more noticeable in births in which the uterus was overdistended.
d. alleviated somewhat when the mother breastfeeds. - Answers c. more noticeable in births in which
the uterus was overdistended.
A large baby or multiple babies overdistend the uterus. The cramping that causes after birth pains arises
from periodic, vigorous contractions and relaxations, which persist through the first part of the after
birth period. After birth pains are more common in multiparous women because first-time mothers have
better uterine tone. Breastfeeding intensifies after birth pain because it stimulates contractions.
Post birth uterine/vaginal discharge, called lochia:
a. is similar to a light menstrual period for the first 6 to 12 hours.
b. is usually greater after cesarean births.
c. will usually decrease with ambulation and breastfeeding.
d. should smell like normal menstrual flow unless an infection is present. - Answers d. should smell like
normal menstrual flow unless an infection is present.
An offensive odor usually indicates an infection. Lochia flow should approximate a heavy menstrual
period for the first 2 hours and then steadily decrease. Less lochia usually is seen after cesarean births
and usually increases with ambulation and breastfeeding.
As relates to the condition and reconditioning of the urinary system after childbirth, nurses should be
aware that:
a. kidney function returns to normal a few days after birth.
b. diastasis recti abdominis is a common condition that alters the voiding reflex.
c. fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2
kg during the puerperium.
1. A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this
woman's 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 - 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 after birth 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.
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 - 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.
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 after birth period is:
a. elevated temperature caused by after birth 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. - 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.
The nurse caring for the after birth woman understands that breast engorgement is caused by:
a. overproduction of colostrum.
b. accumulation of milk in the lactiferous ducts.
c. hyperplasia of mammary tissue.
d. congestion of veins and lymphatics. - Answers d. congestion of veins and lymphatics.
Breast engorgement is caused by the temporary congestion of veins and lymphatics, not by
overproduction of colostrum, overproduction of milk, or hyperplasia of mammary tissue.
A woman gave birth to a 7-lb, 6-ounce infant girl 1 hour ago. The birth was vaginal, and the estimated
blood loss (EBL) was approximately 1500 mL. When assessing the woman's vital signs, the nurse would
be concerned to see:
a. temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP) 90/50.
b. temperature 37.4° C, heart rate 88, respirations 36, BP 126/68.
c. temperature 38° C, heart rate 80, respirations 16, BP 110/80.
d. temperature 36.8° C, heart rate 60, respirations 18, BP 140/90. - Answers a. temperature 37.9° C,
heart rate 120, respirations 20, blood pressure (BP) 90/50.
An EBL of 1500 mL with tachycardia and hypotension suggests hypovolemia caused by excessive blood
loss. An increased respiratory rate of 36 may be secondary to pain from the birth. Temperature may
increase to 38° C during the first 24 hours as a result of the dehydrating effects of labor. A BP of 140/90
is slightly elevated, which may be caused by the use of oxytocic medications.
,The interval between the birth of the newborn and the return of the reproductive organs to their
normal nonpregnant state is called the:
a. involutionary period because of what happens to the uterus.
b. lochia period because of the nature of the vaginal discharge.
c. mini-tri period because it lasts only 3 to 6 weeks.
d. puerperium, or fourth trimester of pregnancy. - Answers d. puerperium, or fourth trimester of
pregnancy.
The puerperium, also called the fourth trimester or the after birth period of pregnancy, lasts about 3 to
6 weeks. Involution marks the end of the puerperium, or the fourth trimester of pregnancy. Lochia
refers to the various vaginal discharges during the puerperium, or fourth trimester of pregnancy.
The self-destruction of excess hypertrophied tissue in the uterus is called:
a. autolysis.
b. subinvolution.
c. afterpain.
d. diastasis. - Answers a. autolysis.
Autolysis is caused by a decrease in hormone levels. Subinvolution is failure of the uterus to return to a
nonpregnant state. Afterpain is caused by uterine cramps 2 to 3 days after birth. Diastasis refers to the
separation of muscles.
With regard to the after birth uterus, nurses should be aware that:
a. at the end of the third stage of labor it weighs approximately 500 g.
b. after 2 weeks after birth it should not be palpable abdominally.
c. after 2 weeks after birth it weighs 100 g.
d. it returns to its original (prepregnancy) size by 6 weeks after birth. - Answers b. after 2 weeks after
birth it should not be palpable abdominally.
After 2 weeks after birth, the uterus should not be palpable abdominally; however, it has not yet
returned to its original size. At the end of the third stage of labor, the uterus weighs approximately 1000
, g. It takes 6 full weeks for the uterus to return to its original size. After 2 weeks after birth the uterus
weighs about 350 g, not its original size. The normal self-destruction of excess hypertrophied tissue
accounts for the slight increase in uterine size after each pregnancy.
With regard to after birth pains, nurses should be aware that these pains are:
a. caused by mild, continuous contractions for the duration of the after birth period.
b. more common in first-time mothers.
c. more noticeable in births in which the uterus was overdistended.
d. alleviated somewhat when the mother breastfeeds. - Answers c. more noticeable in births in which
the uterus was overdistended.
A large baby or multiple babies overdistend the uterus. The cramping that causes after birth pains arises
from periodic, vigorous contractions and relaxations, which persist through the first part of the after
birth period. After birth pains are more common in multiparous women because first-time mothers have
better uterine tone. Breastfeeding intensifies after birth pain because it stimulates contractions.
Post birth uterine/vaginal discharge, called lochia:
a. is similar to a light menstrual period for the first 6 to 12 hours.
b. is usually greater after cesarean births.
c. will usually decrease with ambulation and breastfeeding.
d. should smell like normal menstrual flow unless an infection is present. - Answers d. should smell like
normal menstrual flow unless an infection is present.
An offensive odor usually indicates an infection. Lochia flow should approximate a heavy menstrual
period for the first 2 hours and then steadily decrease. Less lochia usually is seen after cesarean births
and usually increases with ambulation and breastfeeding.
As relates to the condition and reconditioning of the urinary system after childbirth, nurses should be
aware that:
a. kidney function returns to normal a few days after birth.
b. diastasis recti abdominis is a common condition that alters the voiding reflex.
c. fluid loss through perspiration and increased urinary output accounts for a weight loss of more than 2
kg during the puerperium.
