Chapter 15: Caring for the Postpartal Woman and Her Family

Chapter 15: Caring for the Postpartal Woman and Her Family

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The perinatal nurse demonstrates the correct technique of postpartum uterine palpation for a student nurse. The nurse explains that support for the lower uterine segment is critical, because without it there is an increased risk of which complication?

A.	Incorrect measurement
B.	Intensifying the patient’s pain
C.	Uterine edema
D.	Uterine inversion

 

 

ANS:  D

The uterine fundus is palpated by placing one hand on the base of the uterus immediately above the symphysis pubis and the other hand at the level of the umbilicus. The nurse presses inward and downward with the hand positioned on the umbilicus until the fundus is located. The uterus should never be palpated without supporting the lower uterine segment. Failure to do so may result in uterine inversion and hemorrhage.

 

Cognitive Level: Comprehension/Understanding

Content Area: Pediatrics/Maternity

Patient Needs: Health Promotion and Maintenance

Integrated Process: Teaching/Learning

Difficulty: Moderate

 

PTS:   1

 

2. The perinatal nurse and student nurse are conducting an assessment on a postpartal woman. The nurse demonstrates percussion of the bladder. They hear a dull, thudding sound. How should the nurse document this information?

A.	A bladder containing about 500 cc of urine
B.	A full bladder
C.	An empty bladder
D.	An overdistended bladder

 

 

ANS:  C

To percuss the bladder, the nurse places one finger flat on the patient’s abdomen over the bladder and taps it with the finger of the other hand. A full bladder produces a resonant sound. An empty bladder has a dull, thudding sound.

 

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Safe and Effective Care Environment: Management of Care

Integrated Process: Communication and Documentation

Difficulty: Moderate

 

PTS:   1

 

3. The perinatal nurse describes the need for an assessment for deep vein thrombosis (DVT) in the postpartum patient. Which of the following is one test that can be used as a screening measure for DVT?

A.	Chadwick’s sign
B.	Homans’ sign
C.	Grey Turner’s sign
D.	McBurney’s sign

 

 

ANS:  B

Homans’ sign is often used in the assessment for deep venous thrombosis (DVT) in the leg. To assess for Homans’ sign, the patient’s legs should be extended and relaxed, with the knees flexed. The examiner grasps the foot and sharply dorsiflexes it. No pain or discomfort should be present. The other leg is assessed in the same manner. If calf pain is elicited, a positive Homans’ sign is present. The pain occurs from inflammation of the blood vessel and is believed to be associated with the presence of a thrombosis. Pain on dorsiflexion is indicative of DVT in approximately 50% of patients. A negative Homans’ sign does not rule out DVT. Chadwick’s sign is a bluish discoloration of the cervix that may indicate pregnancy. Grey Turner’s sign is a bruising or bluish discoloration of the flank, often seen in acute pancreatitis. McBurney’s sign, an indicator of appendicitis, is a deep tenderness to palpation at McBurney’s point.

 

Cognitive Level: Knowledge/Remembering

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Physiological Adaptation

Integrated Process: Nursing Process: Assessment

Difficulty: Moderate

 

PTS:   1

 

4. A woman gave birth 12 hours ago. The patient complains of severe abdominal cramping when she breastfeeds her infant. The perinatal nurse should document this condition as which of the following?

A.	Afterpains
B.	Bladder hypertonia
C.	Rectus abdominis diastasis
D.	Uterine hypertonia

 

 

ANS:  A

Afterpains (afterbirth pains) are intermittent uterine contractions that occur during the process of involution. Afterpains are more pronounced in patients with decreased uterine tone due to overdistension, which is associated with multiparity and macrosomia. Breastfeeding and the administration of exogenous oxytocin usually produce pronounced afterpains because both cause powerful uterine contractions. Patients often describe the sensation as a discomfort similar to menstrual cramps.

 

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Safe and Effective Care Environment: Management of Care

Integrated Process: Communication and Documentation

Difficulty: Moderate

 

PTS:   1

 

5. A postpartum woman is Rh_o(D)-negative and needs an injection of Rh_o(D) immune globulin. Which of the following doses would the perinatal nurse expect to be ordered?

A.	120 µg
B.	250 µg
C.	300 µg
D.	350 µg

 

 

ANS:  C

Nonsensitized women who are Rh_o(D)-negative and have given birth to an Rh(D)-positive infant should receive 300 µg of Rh_o(D) immune globulin (RhoGAM) within 72 hours after giving birth. RhoGAM should be given whether or not the mother received RhoGAM during the antepartum period. In some situations (e.g., hemorrhage, exchange of maternal–fetal blood), a larger dose of RhoGAM may be indicated.

 

Cognitive Level: Knowledge/Remembering

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

Integrated Process: Nursing Process: Implementation

Difficulty: Easy

 

PTS:   1