Deck 9: The Family After Birth

Question 1

What would the nurse expect to find when assessing the fundus of the uterus immediately after delivery?

A) Well-contracted with its upper border at or just below the umbilicus
B) Well-contracted with its upper border three or four fingerbreadths above the umbilicus
C) Relaxed with its upper border level with the umbilicus
D) Relaxed with its upper border two or three fingerbreadths below the umbilicus

Answer 1

Well-contracted with its upper border at or just below the umbilicus

Question 2

What will the nurse's instructions for a new mother to care for the infant's umbilical cord include?

A) Keeping the area covered with a sterile dressing
B) Dressing the stump with antibiotic ointment at every diaper change
C) Fastening the diaper low to allow for air circulation
D) Giving the newborn a daily tub bath until the cord falls off

Answer 2

Fastening the diaper low to allow for air circulation

Question 3

The nurse is counseling a lactating mother about diet.What would the nurse include with this information?

A) Consume 500 more calories than her usual prepregnancy diet.
B) Eat less meat and more fruits and vegetables.
C) Drink 3 to 4 tall glasses of fluid daily.
D) Eat 1000 more calories than her usual prepregnancy diet.

Answer 3

Consume 500 more calories than her usual prepregnancy diet.

Question 4

A new mother states her preference to formula feed her newborn.What will the nurse planning discharge instructions tell her to help suppress lactation and promote comfort?

A) Wear a well-fitting bra continuously for several days.
B) Stand in a warm shower, letting the water spray over the breasts.
C) Express small amounts of milk from the breasts several times a day.
D) Massage the breasts when they ache.

Question 5

After birth,the nurse quickly dries and wraps the newborn in a blanket.How does this action prevent heat loss?

A) Conduction
B) Radiation
C) Evaporation
D) Convection

Question 6

In the recovery room,the nurse checks the newly delivered woman's fundus following a cesarean section.How would the nurse proceed with this assessment?

A) Palpate from the midline to the side of the body.
B) Palpate from the symphysis to the umbilicus.
C) Palpate from the side of the uterus to the midline.
D) Massage the abdomen in a circular motion.

Question 7

A postpartum woman is not immune to rubella.What will the nurse expect?

A) The rubella virus vaccine should be administered before discharge.
B) The woman should receive the rubella virus vaccine at her 6-week postpartum checkup.
C) The woman should be instructed not to get pregnant until she receives the rubella vaccine.
D) No intervention is indicated at this time because the woman is not at risk for rubella.

Question 8

A woman asks about resumption of her menstrual cycle after childbirth.What should the nurse respond?

A) A woman will not ovulate in the absence of menstrual flow.
B) Most nonlactating women resume menstruation about 2 months postpartum.
C) Generally, a woman does not ovulate in the first few cycles after childbirth.
D) The return of menstruation is delayed when a woman does not breastfeed.

Question 9

A primipara tells the nurse,"My afterpains get worse when I am breastfeeding." What is the most appropriate nursing response?

A) "I'll get you some aspirin to relieve the cramping that you feel."
B) "Afterpains are more intense with your first baby."
C) "Breastfeeding releases a hormone that causes your uterus to contract."
D) "A change of position when you're breastfeeding might help."

Question 10

The nurse instructed a postpartum woman about storing and freezing breast milk.What statement by the woman leads the nurse to determine that the teaching was effective?

A) "I can thaw frozen breast milk in the microwave."
B) "I'll put enough breast milk for one day in a container."
C) "Breast milk can be stored in glass containers."
D) "Breast milk can be kept in the refrigerator for up to 3 months."

Question 11

Which statement indicates the new mother is breastfeeding correctly?

A) "I will alternate breasts when feeding the baby."
B) "I keep the baby on a 4-hour feeding schedule."
C) "I let the baby stay on the first breast only 5 minutes."
D) "I put only the nipple in the baby's mouth when I am breastfeeding."

Question 12

What type of lochia will the nurse assess initially after delivery?

A) Serosa
B) Rubra
C) Alba
D) Vaginalis

Question 13

In what situation will the physician order RhoGAM?

A) An unsensitized Rh-negative mother has an Rh-positive infant.
B) An Rh-negative mother becomes sensitized.
C) A sensitized infant has a rising bilirubin level.
D) An unsensitized infant exhibits no outward signs.

Question 14

A woman will be discharged 48 hours after a vaginal delivery.When planning discharge teaching,the nurse would include what information about lochia?

A) Lochia should disappear 2 to 4 weeks postpartum.
B) It is normal for the lochia to have a slightly foul odor.
C) A change in lochia from pink to bright red should be reported.
D) A decrease in flow will be noticed with ambulation and activity.

Question 15

The nurse is assessing a newborn.What sign of hypoglycemia does the nurse record?

A) Increased nasal mucus
B) Increased temperature
C) Active muscle movements
D) High-pitched cry

Question 16

After delivery,the nurse's assessment reveals a soft,boggy uterus located above the level of the umbilicus.What is the most appropriate nursing intervention?

A) Notify the physician.
B) Massage the fundus.
C) Initiate measures that encourage voiding.
D) Position the patient flat.

Question 17

What statement made by a new mother indicates she needs additional information about breastfeeding?

A) "I let the baby nurse 10 to 15 minutes on the first breast and then switch to the other breast."
B) "The baby needs to nurse at least 5 minutes on the breast to get the hindmilk."
C) "The baby has been nursing every 2 to 3 hours."
D) "If the baby gets fussy between feedings, I give her a bottle of water."

Question 18

What instruction should the nurse teach the postpartum woman about perineal self-care?

A) Perform perineal self-care at least twice a day.
B) Cleanse with warm water in a squeeze bottle from front to back.
C) Remove perineal pads from the rectal area toward the vagina.
D) Use cool water to decrease edema of the perineum.

Question 19

On the second postpartum day,a mother bathed her newborn for the first time.She tells the nurse,"I don't think I did it right." What postpartum psychological stage is this woman most likely in based on this comment?

A) Taking in
B) Taking hold
C) Letting go
D) Settling down

Question 20

A new mother has decided not to breastfeed her newborn.What information will the nurse include when planning to teach the mother about formula feeding?

A) Positioning the bottle so that the nipple is full of formula during the entire feeding
B) Heating the infant formula in a microwave
C) Burping the infant after 4 ounces and again when the bottle is empty
D) Propping a bottle for a feeding

Question 21

A woman required a cesarean section for safe delivery of her newborn.She is planning to breastfeed and verbalized concern about pain.What is the best suggestion by the nurse?

A) "Consider formula feeding for the first few days."
B) "Pumping breast milk would be best for now."
C) "Take pain medication 30 to 40 minutes prior to nursing."
D) "Use the football hold when breastfeeding."

Question 22

The nurse is instructing a woman at 6 months postpartum on weaning her infant from breastfeeding.What interventions will the nurse suggest?

A) Omit newborn's favorite feeding first.
B) Eliminate one feeding at a time.
C) Expect the need for comfort feeding.
D) Formula will need to be provided to substitute for feeding.
E) Pump breasts in place of eliminated feeding.

Question 23

The nurse assesses a 6-inch stain of lochia rubra on a pad that was worn for 2 hours.The nurse would document this as a(n)________________ amount of lochia.

Question 24

____________ refers to changes that the reproductive organs,particularly the uterus,undergo after birth to return to their prepregnancy size and condition.

Question 25

A woman has given birth to an unresponsive newborn that NICU staff are attempting to revive.The patient and her husband are grief stricken and request the child be baptized immediately.What is the nurse's most appropriate action?

A) Contact the hospital chaplain.
B) Request the couple's clergy.
C) Baptize the newborn.
D) Ask the physician to baptize the newborn.

Question 26

The nurse explains that the three infections that are contraindications to breastfeeding are _______________,_______________,and ________________.

Question 27

What postpartum exercises should the nurse teach a patient who had a vaginal delivery yesterday?

A) Abdominal tighteners
B) Head lift
C) Pelvic tilt
D) Kegel exercises
E) Leg lifts

Question 28

The nurse is giving a shower to a patient who had a cesarean section 2 days previously.What interventions should be included before,during,and after the shower?

A) Leave abdominal dressing open to air.
B) Position patient with back to water stream.
C) Cover infusion site with rubber glove.
D) Provide a shower chair.
E) Confirm ambulation ability.

Question 29

Below what blood glucose level is the newborn considered hypoglycemic?

A) Below 70 mg/dL
B) Below 60 mg/dL
C) Below 50 mg/dL
D) Below 40 mg/dL

Question 30

What should the nurse implement for security purposes when bringing the infant from the nursery to the mother?

A) Ask, "Is this your band number?"
B) Confirm room number of mother.
C) Ask the mother to identify herself verbally.
D) Check the band number of the infant with that of the mother.

Question 31

The hormone responsible for milk production is ____________________.

Question 32

Which assessments would lead the nurse to determine the gestational age of the infant as preterm?

A) Thin, transparent skin
B) Vernix only in the body creases
C) Folded ear springs back slowly
D) Breast tissue under the nipple
E) Creases over entire sole

Question 33

The hormone responsible for milk "let-down" or ejection from the breasts is ____________.

Question 34

While instructing a new mother on formula preparations,the nurse would include what types?

A) Ready-to-feed formula
B) Concentrated liquid formula
C) Powdered formula
D) Cow's milk
E) Canned evaporated milk

Question 35

The nurse is caring for a woman of Middle Eastern descent on the first postpartum day.Education is provided regarding instruction on use of a sitz bath.What documentation best indicates that the woman has understood the provided instruction?

A) Patient correctly performed return demonstration.
B) Patient indicated understanding by nodding head with instruction.
C) Patient verbalizes "I understand."
D) Family member indicates patient understands procedure.