Question 1

Birth is unpredictable, and occasionally the outcome is unexpected, whether due to maternal or newborn complications, disability or death. The doula can BEST help in this situation by:

Accepted Answer

A)  Discontinuing her support since it is a reminder of what happened
B)  Encouraging her clients to move on
C)  Understanding the stages of grief
D)  Only sharing her concerns with her colleagues C

Question 2

It can be difficult for a mother to have her first bowel movement after the birth of her baby. Which of the following is NOT a recommendation you would share with her?

Accepted Answer

A)  Drink plenty of water.
B)  Wait to have your first bowel movement if you have had stitches for the repair of an episiotomy or laceration.
C)  Choose high fiber foods, including fresh fruits.
D)  Ask your doctor about a stool softener. B

Question 3

A client worries that her newborn has pink patches at the nape of the neck. The doula informs the mother that these patches:

Accepted Answer

A)  Occur more often in males than in females
B)  Are caused by an injury during labor
C)  Do not fade
D)  Disappear by school age without treatment C

Question 4

Postpartum depression occurs in as much as 10% of new mothers and can include all of the following symptoms EXCEPT:

Accepted Answer

A)  Frequent crying
B)  Feeling unable to cope
C)  Lack of interest in baby
D)  Hallucinations

Question 5

Creating a womb-like environment for a newborn baby facilitates the adjustment to being born. Suggestions for this include:

Accepted Answer

A)  Carrying the baby in a sling or other soft baby carrier
B)  Frequent feeding
C)  White noise
D)  All of the above

Question 6

In the immediate postpartum period, what breast changes can a new mother expect?

Accepted Answer

A)  She should have noticed leaking colostrum during pregnancy, and that's the only way she knows whether she can feed her baby at the breast or not.
B)  If her breasts did not grow at least two cup sizes during pregnancy, her milk will probably not come in.
C)  The breasts should begin filling immediately after the birth.
D)  The breasts are producing colostrum, which will transition to a full milk supply over the next couple of weeks.

Question 7

In some facilities, the doctor or midwife may give the mother a prophylactic injection of synthetic oxytocin immediately after the birth. This is done to:

Accepted Answer

A)  Help the mother sleep
B)  Decrease the mother's pain
C)  Complete the cascade of interventions
D)  Aid in uterine involution

Question 8

A postpartum mother asks you how soon she can have sex. Your BEST response is:

Accepted Answer

A)  Most doctors recommend waiting at least six weeks after the birth, but some women feel up to it sooner.
B)  You can't get pregnant again right away, so don't worry about contraception.
C)  You won't have time to even think about having sex.
D)  Leaking breasts are a turn-off.

Question 9

Postpartum bleeding, called lochia, is a normal part of the recovery process. Warning signs that should be checked by a doctor or midwife, however, include all of the following EXCEPT:

Accepted Answer

A)  Clots larger than the size of a lemon
B)  Bright red bleeding returning after several days
C)  A change in color from red to pink to brown to white
D)  A fever

Question 10

A client delivered a healthy infant by Caesarean birth. The doula might encourage the client to eat which food item to promote wound healing?

Accepted Answer

A)  Bananas
B)  Wheat bread
C)  Oranges
D)  Milk

Question 11

Which of the following is NOT a routine newborn procedure in the immediate postpartum?

Accepted Answer

A)  Weighing and measuring
B)  Prophylactic eye treatment
C)  Drying baby and covering baby's head
D)  Circumcision

Question 12

A doula is speaking with a client who gave birth to a baby girl two months ago. During the conversation, the client informs the doula that she is hearing voices and that she constantly feels empty. She has a history of clinical depression. Which of the following is the priority action of the doula?

Accepted Answer

A)  Offer compassion
B)  Protect the client and child from injury
C)  Consider counseling for the client
D)  Administer antidepressants

Question 13

A doula can facilitate a successful skin-to-skin experience in the first hour after birth by:

Accepted Answer

A)  Counseling parents before labor begins on the importance of uninterrupted skin-to-skin contact.
B)  Encouraging delivery clothing that allows baby easy access to the mother's skin.
C)  Helping to position the baby over the mother's belly with relaxed arms and legs extended.
D)  All of the above

Question 14

Recovery from a Caesarean birth takes longer than for a vaginal birth. In the immediate postpartum, a doula might help a mother by doing all of the following EXCEPT:

Accepted Answer

A)  Ensuring the mother has a support person with her so she can still room-in with her baby.
B)  Making sure the mother is comfortable
C)  Encouraging the mother to get moving as soon as she feels able after the surgery
D)  Instructing her to stay in bed as long as possible

Question 15

A doula is discussing contraceptives with a client. The client gave birth to a healthy baby girl three days ago. The doula is correct when she says that the most effective way to protect against conception is through:

Accepted Answer

A)  Natural family planning
B)  Abstinence
C)  Oral contraception
D)  Surgical methods

Question 16

Uterine involution begins as soon as the baby is born. In the first few days after birth, the uterus will:

Accepted Answer

A)  Need to be massaged
B)  Return completely to its pre-pregnancy size
C)  Occasionally contract, especially while breastfeeding, and will be about the size of a grapefruit
D)  Bleed profusely

Question 17

Which of the following is NOT TRUE about "rooming-in," or keeping mom and baby together rather than having baby be cared for in a hospital nursery?

Accepted Answer

A)  Babies cry less and are soothed more easily.
B)  Moms who room-in get more rest.
C)  Moms make more breastmilk faster when they can room-in with their babies.
D)  Most hospitals do not encourage rooming-in.

Question 18

When the umbilical cord is cut, a number of changes occur in the baby's respiratory and circulatory systems. Which of the following is NOT part of this physiologic process?

Accepted Answer

A)  The lungs inflate and begin working on their own to exchange oxygen and carbon dioxide in the bloodstream.
B)  Amniotic fluid is absorbed from the respiratory system.
C)  The pain from cutting the cord causes the infant to take the first breath.
D)  Increased blood pressure in the heart causes the foramen ovale to close.

Question 19

All newborns exhibit a "continuum of arousal" or different states of alertness. Babies interact best with caregivers during which state?

Accepted Answer

A)  Crying
B)  Quiet alert
C)  Active alert
D)  Drowsy

Question 20

A 3-day-old newborn is placed under phototherapy lights for the treatment of jaundice. The doula explains to the mother that the healthcare providers expect the newborn to pass:

Accepted Answer

A)  Blackish-green stools
B)  Bright green stools
C)  Light yellow stools
D)  Bright yellow stools

Exam 4: Post-Partum