Maternal-Infant Nursing (Postpartum Period) Question

1.    Angelina, a  breast-feeding client is diagnosed with mastitis. Which nursing intervention would be most helpful to her?
a.    Instructing her to breast-feed the neonate at least every 4 hours
b.    Teaching her to apply a cold compress to the affected breast after each feeding
c.    Recommending that she wear a special brassiere when breast-feeding
d.    Advising her to massage the affected area gently while breast-feeding

2.    Nurse Lucia is aware that lochia normally progresses in which of the following patterns?
a.    Rubra, serosa, alba
b.    Serosa, rubra, alba
c.    Serosa, rubra, alba
d.    Rubra, alba, serosa

3.    Lina gave birth 24 hours ago continues to experience urine retention after several catheterizations. Dr. Smith prescribes bethanechol (Duvoid), 10 mg by mouth three times per day. The client asks, “How does bethanechol act on the bladder?” How should the nurse respond?
a.    “It constricts the urinary sphincter.”
b.    “It dilates the urethra.”
c.    “It stimulates the smooth muscle of the bladder.”
d.    “It inhibits the skeletal muscle of the bladder.”

4.    Nurse Jolina is caring for a client during the 1st postpartum day. The client asks the nurse how to relieve pain from her episiotomy. What should the nurse instruct the woman to do?
a.    Apply an ice pack to her perineum.
b.    Take a sitz bath.
c.    Perform perineal care after voiding or a bowel movement.
d.    Drink plenty of fluids.

5.    Nurse Farah is teaching a client how to use a diaphragm. Which instruction should the nurse provide?
a.    “Insert the diaphragm 4 hours before intercourse.”
b.    “Leave the diaphragm in place for at least 6 hours after intercourse.”
c.    “Remove the diaphragm immediately after intercourse.”
d.    “You may use the diaphragm without spermicidal jelly or cream.”

6.    Sally is using the rhythm (calendar-basal body temperature) method of family planning. In this method, the unsafe period for sexual intercourse is indicated by:
a.    return to preovulatory basal body temperature
b.    basal body temperature increase of 0.1° F to 0.2° F (0.06° C to 0.11° C) on the 2nd or 3rd day of the cycle
c.    3 full days of elevated basal body temperature and clear, thin cervical mucus
d.    breast tenderness and mittelschmerz

7.    When caring for a client who has had a cesarean section, nurse Annie is aware that the following actions is not appropriate?
a.    Removing the initial dressing for incision inspection
b.    Monitoring pain status and providing necessary relief
c.    Supporting self-esteem concerns about delivery
d.    Assisting with parental newborn bonding

8.    Nurse Winnie is aware that the following would be inappropriate to assess in a mother who’s breast-feeding?
a.    The attachment of the baby to the breast
b.    The mother’s comfort level with positioning the baby
c.    Audible swallowing
d.    The baby’s lips smacking

9.    Nurse Nina is teaching a group of clients about birth control methods. When providing instruction about subdermal contraceptive implants, the nurse should cite which of the following as the main advantage of this method?
a.    The implants can be removed easily if pregnancy occurs.
b.    The implants cost less over the long term than other contraceptive methods.
c.    The implants provide effective, continuous contraception that isn’t user dependent.
d.    The implants require a lower hormonal dose than other hormonal contraceptive methods.

10.    Nurse Paula is preparing to perform a physical examination on a postpartum client. Which statement best explains why the nurse must wear latex gloves during this examination?
a.    Gloves may protect the client against infectious organisms.
b.    Gloves guard the client against the nurse’s cold hands.
c.    Gloves may protect the nurse against infectious organisms.
d.    Gloves are required for universal precautions.

11.    In the maternal attachment process, nurse Lisa is aware that the following best describes the anticipated actions in the taking-hold phase?
a.    Mother’s needs being met first
b.    Looking at the infant
c.    Kissing, embracing, and caring for the infant
d.    Talking about the baby

12.    May has just begun taking an oral contraceptive that contains estrogen and progestin. Nurse Jane should explain that full contraceptive benefits won’t occur until the client has taken the drug for at least:
a.    10 days.
b.    2 weeks.
c.    1 month.
d.    2 months.

13.    Malou is scheduled for a vasectomy asks the nurse how soon after the procedure he can have sexual intercourse without using an alternative birth control method. How should the nurse respond?
a.    “You can safely have intercourse after 6 to 10 ejaculations.”
b.    “You can safely have intercourse when your sperm count indicates sterilization.”
c.    “You can safely have intercourse immediately after the procedure.”
d.    “You can safely have intercourse as soon as discomfort from the procedure disappears.”

14.    Nurse Tristan is aware that the following would be inappropriate to include in the plan of care for a client during the fourth stage of labor?
a.    Vital signs and fundal checks every 15 minutes
b.    Time with the baby to initiate breast-feeding
c.    Catheterization to protect the bladder from trauma
d.    Perineal assessments for swelling and bleeding

15.    Nurse Honey is assessing a client on the 2nd postpartum day. Under normal circumstances, the tone and location of the client’s fundus is:
a.    soft and one fingerbreadth below the umbilicus
b.    firm and two fingerbreadths below the umbilicus
c.    firm and to the right or left of midline
d.    soft and at the level of the umbilicus

16.    Nurse Tanya is aware that the following is the most important aspect of nursing care in the postpartum period?
a.    Supporting the mother’s ability to successfully feed and care for her infant
b.    Involving the family in the teaching
c.    Providing group discussions on baby care
d.    Monitoring the normal progression of lochia

17.    After a vaginal delivery, Jasmine complains of perineal discomfort when sitting. To promote comfort, the nurse should provide which instruction?
a.    “Contract your buttocks before sitting or rising.”
b.    “Support your body weight on the arms of a chair.”
c.    “Place a pillow behind your back.”
d.    “Sit on an inflatable ring.”

18.    Agnes, who’s breast-feeding has a temperature of 102° F (38.9° C) and complains that her breasts are engorged. Her breasts are swollen, hard, and red. Which of the following actions would be inappropriate in managing the client’s breast engorgement?
a.    Applying frozen cabbage leaves to the breasts
b.    Encouraging the client to shower with her back to the water
c.    Encouraging the client to nurse her baby frequently
d.    Applying a breast binder to support the breasts

19.    Nurse Marie is helping to prepare a client for discharge following childbirth. During a teaching session, the nurse instructs the client to do Kegel exercises. What is the purpose of these exercises?
a.    To prevent urine retention
b.    To relieve lower back pain
c.    To tone the abdominal muscles
d.    To strengthen the perineal muscles

20.    Nurse Luisa is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus?
a.    One fingerbreadth above the umbilicus
b.    One fingerbreadth below the umbilicus
c.    At the level of the umbilicus
d.    Below the symphysis pubis

21.    One day after a client delivers a neonate, nurse Beatriz performs a postpartum assessment. At this time, the nurse expects to find:
a.    lochia nigra
b.    lochia alba
c.    lochia serosa
d.    lochia rubra

22.    Nurse Blessy is assessing the psychosocial status of a postpartum client. Which finding is most likely to promote parent-neonate attachment?
a.    Parental desire to bond with the neonate
b.    Sustained parent-neonate contact immediately after delivery
c.    Parental understanding of the importance of parent-neonate bonding
d.    Previous positive childbirth experience

23.    Jackie, a postpartum client is ready for discharge. During discharge preparation, the nurse should instruct her to report which of the following to her primary health care provider?
a.    Episiotomy discomfort
b.    Lochia alba at 2 weeks’ postpartum
c.    Redness, warmth, and pain in the breasts
d.    A temperature of 99.2° F (37.3° C) for 24 hours or more

24.    A client says she wants to practice natural family planning. Nurse Josefina teaches her how to use the calendar method to determine when she’s fertile and advises her to avoid unprotected intercourse. When teaching her how to determine her fertile period, the nurse should instruct her to:
a.    abstain from unprotected intercourse between days 14 and 16 of the menstrual cycle.
b.    subtract 11 days from her shortest menstrual cycle and 18 days from her longest cycle.
c.    subtract 18 days from her shortest menstrual cycle and 11 days from her longest cycle.
d.    add 25 days to the 1st day of her last menstrual period and abstain from unprotected intercourse for the next 5 days.

25.    Teresa, a mother of a neonate expresses concern about how she’ll continue to breast-feed when she returns to work in 6 weeks. What is the best response by the nurse?
a.    “Why don’t you wait and see how things go? You may be tired of breast-feeding by then.”
b.    “Let your day-care provider give the baby formula in a bottle, then breast-feed when you’re home.”
c.    “Your baby won’t need breast-feeding by then, so just switch completely to formula when you return to work.”
d.    “You can continue breast-feeding after you go back to work. You can pump your breasts and put the milk in a bottle.”

Answers and rationale

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