Ateneo de Zamboanga University

College of Nursing
Chapter 17

ERASURES AND SUPERIMPOSITIONS NOT ALLOWED!

Name : ______________________________ HPScore: 25 pts.
NCM Sec : _____ Date: __________________

Multiple Choice.
Choose the letter that BEST answers the question or completes the statement and shade the corresponding letter on the
answer sheet provided.

__B___ Ms. Tingkang is 4 hours post birth and is concerned about her own care. You would analyze her as being in which
1.
postpartal stage?
A. Taking in B. Taking hold C. Letting go D. Containment

___D_ 2. Which would be the best expected outcome for Ms. Tingkang?
A. Client voices her pain has diminished to a tolerable level.
B. Client sleeps through the night so must not be in much pain.
C. Client states that she knows her pain medicine will be effective.
D. Client voices her pain is minimal; cares for self and infant.

__A___ 3. You notice Ms. Tingkang rarely looks directly at her newborn. You would record this as
A. client does not assume an enface position with newborn.
B. client appears not to enjoy holding her new newborn.
C. Ms. Chang is having difficulty accepting mothering.
D. new mother does not hold her infant comfortably.

__B___ 4. Attachment or relating well to a newborn is frequently termed

A. negotiation. B. bonding. C. concern. D. fortitude.

___B__ 5. The process of the uterus returning to its pre-pregnant state is termed
A. atrophy. B. involution. C. retrographic change. D. endometrial discharge.

___C__ 6. Ms. Tingkang asks you if her older children should visit her in the hospital. Your best advice would be,
A. “It’s better if older children see their new sibling first in their own home.”
B. “Seeing a sibling in a hospital will make them think the newborn is ill.”
C. “Seeing their new brother or sister immediately should help bonding.”
D. “Children should never visit in a hospital or they could become infected.”

___C__ 7. Ms. Tingkang is breastfeeding. What effect does breastfeeding have on uterine size in the postpartal period?
A. It slows the process of involution by 3 or 4 days.
B. It decreases body fluid so decreases lochia flow.
C. It aids uterine contraction because of oxytocin release.
D. It causes the cervix to appear dry because of estrogen.

___D__ 8. Ms. Tingkang is 1 day postpartum. You would expect the appearance of her uterine discharge to appear
A. pink with occasional red streaking. C. brown because blood is now old.
B. white because of mucous infiltration. D. red with occasional small clots.

___C__ 9. Assessing uterine size is important during the postpartum period. If Ms. Tingkang is 1 day postpartum, you would
expect to locate her uterus at what location?
A. 1 cm under her rib cage C. 1 cm below her umbilicus
B. 3 cm below her umbilicus D. 3 cm above her symphysis pubis

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Dyana M M Saplan, RN PhD
 ___A__ 10. What is an important action to take while palpating for uterine position?
A. Place a hand at the base of the uterus to prevent inversion.
B. Insert one hand vaginally to slow vaginal flow while palpating.
C. Mark the point of the fundus on the abdomen with a pen.
D. Place ice on the abdomen to cause contraction prior to palpation.

___D__ 11. Suppose Ms. Tingkang were 4 days postpartum. What would be an expected outcome you would expect for lochia
appearance?
A. Lochia is red with pinpoint clots in it. C. Lochia’s color is now white and firm.
B. Lochia appears yellow because of serum. D. Lochia is pink with no strong odor.

___C__ 12. Ms. Tingkang tells you that she seems to be voiding a large amount of urine. The usual amount of urine women in the
postpartum period void each 24 hours is
A. 500 mL. B. 1000 mL. C. up to 3000 mL. D. 5000 mL.

___D__ 13. Ms. Tingkang worries she will develop a thrombophlebitis. Women are prone to this during the postpartal period
because
A. their blood vessels develop ulcers from the stress of labor.
B. their uterus presses on lower extremity blood vessels.
C. their fibrinogen level is still elevated from pregnancy.
D. amniotic fluid mixing with plasma causes rapid clotting.

__A___ 14. Ms. Pla Centa is 1 day postpartum. Her temperature is 38°C. You would evaluate this as
A. she must be developing a postpartal infection.
B. this is a normal finding for the first day postpartal.
C. her temperature is subnormal for 24 hours post delivery.
D. she must be developing a toxic reaction to her newborn.

___A_ 15. On the third day postpartum, Ms. Ceres tells you her breasts feel warm and tender. It would be BEST to tell her that
A. this sounds like engorgement occurring, which is normal.
B. her infant must be draining too much milk at feedings.
C. this suggests a breast infection (mastitis) is developing.
D. she needs to drink more fluid to reduce inflammation.

__C__ 16. A postpartum client tells you she does not want to use a sitz bath. You would alert her that
A. sitz baths help decrease perineal pain because they are cold.
B. not using them is a wise choice as they tend to cause infection.
C. sitz baths can help reduce perineal edema and reduce pain.
D. none of us like a lot of things, but we have to do them anyway.

___B__ 17. Glenda, a postpartum woman reports she is afraid to have a bowel movement because that may cause pain. You would
advise her that
A. it would be very rare if a bowel movement caused pain after birth.
B. she should ask her doctor for a prescription for a stool softener.
C. she should eat soft foods for the next 3 days to increase peristalsis.
D. it would be good to feel pain because that means nerves are not severed.

___D__ 18. Ms. Tingkang is 3 days postpartum. The most effective pain-relief measure for perineal pain at this time is the
application of
A. ice. B. crushed aspirin. C. alcohol. D. heat.

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Dyana M M Saplan, RN PhD
 ___A__ 19. Which of the following reasons explains the mist important reason Kegel exercises are advantageous to clients after
the birth of a newborn?
A. They promote blood flow, allowing for healing and strengthening the musculature
B. They assist in lochia removal
C. They promote the return of normal bowel function
D. They assist the client in burning calories for rapid postpartum weight loss

__B___ 20. When giving a postpartum client self-care instructions, the nurse instructs her to report heavy vaginal bleeding. Which
of the following would indicate heavy bleeding?
A. saturating a pad in 1 hour. C. saturating a pad in 8 hours.
B. saturating a pad in 15minutes. D. saturating a pad in 10 to 12 hours.

___B__ 21. The nurse is caring for a breastfeeding primipara who has been diagnosed with mastitis on the tenth postpartum day.
The nurse has instructed the client about measures to treat the condition. The nurse determines that the client has
understood the instruction when the client says
A. “should continue to breastfeed unless it becomes too painful” <
B. “I should stop breastfeeding for a couple of weeks”
C. “I shouldn't breastfeed as long as I am on antibiotic therapy”
D. “Mastitis can be associated with breast cancer later in life”

___A__ 22. Which of the following behaviors characterizes the postpartum client in the taking-in phase:
A. passive and dependent. C. curious and interested in care of the newborn.
B. striving for independence and autonomy. D. exhibiting maximum readiness for new learning.

___A__ 23. Which of the following findings would lead you to suspect that a woman is developing a postpartum complication?
A. An absence of lochia. C. Lochia that is the color of menstrual blood.
B. Red-colored lochia for the first 24 hours. D. Lochia appearing pinkish brown on the fourth day.

___D___ 24. When doing a health assessment, at which of the following locations would you expect to palpate the fundus in a
woman on the second postpartal day?
A. Fundus height 4 cm below umbilicus and midline.
B. Fundus 2 fingerbreadths above symphysis pubis and hard.
C. Fundus 4 cm above symphysis pubis and firm.
D. Fundus 2 fingerbreadths below umbilicus and firm.

__D___ 25. Which of the following actions would lead you to assess that a postpartal woman is entering the taking-hold phase of
the postpartal period?
A. She sits and rocks her infant for long intervals. C. She is eager to talk about her delivery experience.
B. She has not asked for anything for pain all day. D. She did her perineal care independently.

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Dyana M M Saplan, RN PhD