Post Partum Nclex questions

Post Partum Nclex questions 4.0 (1 review) Students also studied Terms in this set (113) Science MedicineNursing Save Postpartum - Nclex 99 terms Laura_Bailey81 Preview Postpartum NCLEX questions 74 terms ebonie_brunson Preview Antepartum NCLEX 128 terms nichole_stephens8 Preview pn NCL 81 terms and The client received epidural anesthesia during labor and had a forceps delivery after pushing for 2 hours. At 6 hours postpartum, the client's systolic blood pressure (BP) dropped 20 points, the diastolic BP dropped 10 points, and her pulse is 120 beats per minute. The client is very anxious and restless. The nurse is told that the client has a vulvar hematoma. On the basis of this diagnosis, the nurse should plan which action?Preparing the client for surgery The nurse is preparing a list of self-care instructions for a postpartum client who has been diagnosed with mastitis.Which instructions should be included on the list? Select all that apply.Rest during the acute phase.Wear a supportive, non underwire bra.Maintain a fluid intake of at least 3000 mL.Continue to breastfeed if the breasts are not too sore.A postpartum client is getting ready for discharge. The nurse suspects that the client needs further teaching related to breastfeeding when she makes which statement?"I don't need birth control because I will be breastfeeding." The nurse is assisting with caring for a postpartum client who is experiencing uterine hemorrhage. When planning to meet the psychosocial needs of the client, the nurse should plan which action?Keeping the client and her family members informed of her progress The nurse palpates the fundus and checks the character of the lochia of a postpartum client who is in the fourth stage of labor. Which lochia characteristic should the nurse expect to note?Red

After episiotomy and the delivery of a newborn, the nurse performs a perineal check on the mother. The nurse notes a trickle of bright red blood coming from the perineum. The nurse checks the fundus and notes that it is firm. Which determination should the nurse make?The bright red bleeding is abnormal and should be reported.The nurse is assigned to care for the client during the postpartum period. The client asks the nurse what the term involution means. Which description should the nurse give to the client?The progressive descent of the uterus into the pelvic cavity, which occurs at a rate of approximately 1 cm/day A mother is breastfeeding her newborn baby and experiences breast engorgement. The nurse should encourage the mother to do which to provide relief of the engorgement?Massage the breasts before feeding to stimulate let-down.After delivery the nurse checks the height of the uterine fundus. Which position of the fundus should the nurse expect to note?At the level of the umbilicus The nurse is caring for a postpartum client. At 4 hours postpartum, the client's temperature is 102° F (38.9° C).Which is the appropriate nursing action?Notify the registered nurse, who will then contact the health care provider (HCP).The nurse is assisting with planning care for a postpartum woman who has small vulvar hematomas. To assist with reducing the swelling, the nurse should perform which action?Prepare an ice pack for application to the area.The nurse is assigned to care for the client after a cesarean section. To prevent thrombophlebitis, the nurse should encourage the woman to take which priority action?Ambulate frequently.A mother is breastfeeding her newborn. The mother complains to the nurse that she is experiencing severe nipple soreness. The nurse should provide which suggestion to the client?Position the newborn infant with the ear, shoulder, and hip in straight alignment and with the baby's stomach against the mother's.The nurse is checking lochia discharge on a client in the immediate postpartum period and notes that the lochia is bright red and contains some small clots. Which interpretation should the nurse make about this finding?Is normal A postpartum client with mastitis in the right breast complains that the breast is too sore for her to breast- feed her infant. Which should the nurse tell the client?"Breast-feed from the left breast and gently pump the right breast."

A stillborn was delivered in the birthing suite a few hours ago. After the birth, the family has remained together, holding and touching the baby. Which statement by the nurse should further assist the family in their initial period of grief?"Would you like to hold your baby?" A new mother attempting breast-feeding for the first time has developed mastitis. She states, "My breasts look terrible and I think that I will stop breast-feeding." The nurse plans care knowing that the client is concerned about which problem?Body image The nurse caring for a breast-feeding postpartum client plans to include avoidance of soaps on the nipples, frequent changing of breast pads, and intermittent exposure of nipples to the air. These interventions are implemented to prevent which complication?Mastitis The new breast-feeding mother has been seen in the clinic for the treatment of mastitis. Which comment by the mother would indicate a need for further teaching?"My left breast is sore, so I will offer only my right breast frequently for breast- feeding." The nurse suspects that the client has a pulmonary embolism when the client exhibits which signs and symptoms?Dyspnea, tachypnea, and tachycardia The nurse is assigned to care for a client in the immediate postpartum period who received epidural anesthesia for delivery, and the nurse monitors the client for complications. Which would most likely indicate a hematoma?Changes in vital signs The nurse is assisting in developing a plan of care for a client in the fourth stage of labor who received an epidural. Which problem is most likely to occur during this stage?Urinary retention caused by the loss of sensation to void and rapid bladder filling The parents of a neonate who is not circumcised request information on how to clean the newborn's penis. Which is the correct response for the nurse to make to the parents?"Avoid retracting the foreskin to cleanse the glans because this may cause adhesions." Which safety measures that should be implemented when working in the newborn nursery? Select all that apply.Adhere to standard precautions.The parents should be instructed to not release their infant to anyone wearing improper identification.The mother should be fingerprinted and the infant should be footprinted on the identification card before removing the infant from the delivery room.

The nurse is assisting in administering beractant (Survanta) to a premature infant who has respiratory distress syndrome. The nurse understands that the medication should be administered by which route?Intratracheal The nurse is reviewing the procedure for vitamin K injection in a newborn. Which information is included in the procedure?Inject into skin that has been cleansed and allowed to have alcohol dry on the puncture site for 1 minute.The nurse is caring for a woman who has delivered a baby after a pregnancy with a placenta previa. Which complication would the client be at risk for?Postpartum hemorrhage A client had a cesarean delivery with a low transverse uterine incision. Which is the benefit of this type of incision?It allows a vaginal birth after cesarean (VBAC) to be possible in a subsequent pregnancy.The nurse has reinforced instructions to a postpartum client who is hepatitis B positive how to safely bottle-feed her newborn to prevent the transmission of the infection.Which action by the client indicates an understanding of this procedure?Washes and dries her hands before feeding The nurse is caring for a client who had a cesarean section to deliver a nonviable fetus as a result of abruptio placentae. The client develops signs of disseminated intravascular coagulopathy (DIC). The spouse asks the nurse what is happening, and the nurse explains the condition. The spouse becomes upset and says to the nurse, "I lost my baby and now my wife! What am I going to do?" Which appropriately describes the situation?The spouse lacks hope because of the loss of the baby and illness of his wife.The nurse provides explanation to a client prescribed methylergonovine maleate in the immediate postpartum period. Which statement made by the client demonstrates understanding of the rationale for administration?"It will help prevent and control bleeding if it occurs." Oxytocin (Pitocin) is administered to a client following the delivery of the placenta. The nurse assisting in caring for the client monitors for which effective response from the medication?Uterine contractions The nurse is checking the lochia discharge on a 1-day postpartum woman. The nurse notes that the lochia is red and has a foul odor. The nurse determines that this finding indicates which?The presence of infection