MULTIPLE CHOICE
1. Which statement by a postpartum client indicates that further teaching is not needed regarding thrombus formation?
a.“I’ll keep my legs elevated with pillows.”
b.“I’ll sit in my rocking chair most of the time.”
c.“I’ll stay in bed for the first 3 days after my baby is born.”
d.“I’ll put my support stockings on every morning before rising.”
2. The nurse knows that late postpartum hemorrhage can be prevented by:
a.manually removing the placenta.
b.inspecting the placenta after birth.
c.administering broad-spectrum antibiotics.
d.pulling on the umbilical cord to hasten the birth of the placenta.
3. A multiparous client is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the client void and massages her fundus, but the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?
a.Recheck vital signs.
b.Insert a Foley catheter.
c.Notify the health care provider.
d.Continue to massage the fundus.
4. Early postpartum hemorrhage is defined as a blood loss greater than:
a.500 mL within 24 hours after a vaginal birth.
b.750 mL within 24 hours after a vaginal birth.
c.1000 mL within 48 hours after a cesarean birth.
d.1500 mL within 48 hours after a cesarean birth.
5. A steady trickle of bright red blood from the vagina in the presence of a firm fundus suggests:
a.uterine atony.
b.perineal hematoma.
c.infection of the uterus.
d.lacerations of the genital tract.
6. A postpartum client would be at increased risk for postpartum hemorrhage if she delivered a(n):
a.5-lb, 2-oz infant with outlet forceps.
b.6.5-lb infant after a 2-hour labor.
c.7-lb infant after an 8-hour labor.
d.8-lb infant after a 12-hour labor.
7. Which instruction should be included in the discharge teaching plan to assist the client in recognizing early signs of complications?
a.Palpate the fundus daily to ensure that it is soft.
b.Report any decrease in the amount of brownish red lochia.
c.The passage of clots as large as an orange can be expected.
d.Notify the health care provider of any increase in the amount of lochia or a return to bright red bleeding.
8. The nurse should expect medical intervention for subinvolution to include:
a.oral fluids to 3000 mL/day.
b.intravenous fluid and blood replacement.
c.oxytocin intravenous infusion for 8 hours.
d.oral methylergonovine maleate (Methergine) for 48 hours.
9. If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is appropriate to correct the cause of this condition?
a.Hysterectomy
b.Laparoscopy
c.Laparotomy
d.Dilation and curettage (D&C)
10. A sign of thrombophlebitis is:
a.visible varicose veins.
b.positive Homans sign.
c.pedal edema in the affected leg.
d.local tenderness, heat, and swelling.
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