Homework answers / question archive / CHAPTER 16 1)The perinatal nurse is aware that a key factor contributing to suboptimal outcomes for pregnant women and their families is: A)  Lack of family support during pregnancy B)  Lack of or delayed communication between health care provider call groups C)  Lack of nursing resources to provide adequate care during labor and birth D)  Decreased knowledge regarding signs and symptoms of postpartum hemorrhage   2

CHAPTER 16 1)The perinatal nurse is aware that a key factor contributing to suboptimal outcomes for pregnant women and their families is: A)  Lack of family support during pregnancy B)  Lack of or delayed communication between health care provider call groups C)  Lack of nursing resources to provide adequate care during labor and birth D)  Decreased knowledge regarding signs and symptoms of postpartum hemorrhage   2

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CHAPTER 16

1)The perinatal nurse is aware that a key factor contributing to suboptimal outcomes for pregnant women and their families is:

A)  Lack of family support during pregnancy

B)  Lack of or delayed communication between health care provider call groups

C)  Lack of nursing resources to provide adequate care during labor and birth

D)  Decreased knowledge regarding signs and symptoms of postpartum hemorrhage

 

2.   The perinatal nurse accurately defines postpartum hemorrhage by including a decrease in hematocrit levels from pre to postbirth by:

A)  5%

B)  8%

C)  10%

D)  15%

 

3.   The perinatal nurse recognizes that a common organism responsible for postpartum infection leading to uterine subinvolution is:

A)  Chlamydia trachomatis

B)  Group B streptococcus

C)  Escherichia coli

D)  Treponema pallidum

 

4.   As a member of the health care team, the perinatal nurse finds it helpful following a maternal emergency such as a postpartum hemorrhage to engage in:

Select all answers that apply:

A)  Time off to resolve any conflict with other staff members

B)  Debriefing of the situation with the other staff members involved in the patient' s care

C)  A family meeting to encourage communication and understanding

D)  A resolution of the emergency by determining any fault in the care provided

 

5.   The perinatal nurse teaches the postpartum woman about warning signs regarding development of postpartum infection.  Signs and symptoms that merit assessment by the health care provider include the development of a fever and:

A)  Breast engorgement

B)  Uterine tenderness

C)  Diarrhea

D)  Emotional lability

 

6.   The perinatal nurse administers Heparin as ordered to the postpartum woman with newly diagnosed deep vein thrombosis.  The perinatal nurse is aware that the primary purpose of this medication is to:

A)  Prevent new clot formation only

B)  Assist with breakdown of the thromboses

C)  Prevent extension of the clot and new clot formation

D)  Decrease clotting time and circulatory clotting factors

 

7.   The perinatal nurse knows that a prenatal dose of heparin is higher than would be given to a non-pregnant woman because the pregnant woman has:

A)  A greater blood plasma volume

B)  A greater receptivity to heparin

C)  A decreased renal clearance

D)  An increased risk of hypocoagulation in pregnancy

 

8.   The perinatal nurse recognizes that a risk factor for postpartum depression is:

A)  Adolescence

B)  Age >35 years

C)  Gestational hypertension

D)  Regular schedule of prenatal care

 

9.   Karen, a G2, TPAL, 2002, experienced a precipitous birth 90 minutes ago.  Her infant is 4200 grams and a repair of a 2nd degree laceration was needed following the birth.  As part of the nursing assessment, the nurse discovers that Karen's uterus is boggy and deviated to the right. Furthermore, it is noted that Karen's vaginal bleeding has increased.  The nurse's most appropriate first action is to:

A)  Assess vital signs including blood pressure and pulse

B)  Massage the uterine fundus with continual lower segment support

C)  Measure and document each perineal pad changed in order to assess blood loss

D)  Ensure appropriate lighting for a perineal repair if it is needed

 

10. Karen continues to have an excessive blood loss and the perinatal nurse notifies the health care provider.  Which medication would the nurse expect would be given first:

A)  Methergine

B)  Ergotrate

C)  Carboprost

D)  Oxytocin or pitocin

 

11. The health care provider has now administered several medications and performed fundal massage on Karen.  There is no decrease in the amount of active vaginal bleeding.  The physician briefly explains to Karen and her family that the next step in this process will be a surgical one.  The perinatal nurse prepares Karen for:

A)  Dilatation and curettage

B)  Abdominal hysterectomy

C)  Uterine artery ligation

D)  Uterine artery cauterization

 

12. Karen has now recovered and is ready for discharge from the hospital with her baby.  Karen identifies the supports that she will have at home as her mother-in-law and her partner.  She describes having some “sad feelings” after her last baby and wonders what she should watch for this time.  The perinatal nurse provides information including the need for extra rest and stresses that after:

A)  Two weeks of continuous sad feelings she should seek help

B)  Three weeks of continuous sad feelings she should seek help

C)  One month of continuous sad feelings she should seek help

D)  Six weeks of continuous sad feelings she should seek help

 

13. Approximately eight hours ago, Juanita, a 32-year-old G1, TPAL 1001, gave birth after two and one-half hours of pushing.  She required an episiotomy and an assisted birth (forceps) due to the weight and size of her baby (9lb.–9oz.).  The perinatal nurse is performing an assessment of Juanita's perineal area.  A slight bulge is palpated and the presence of ecchymoses to the right of the episiotomy is noted.  The area feels “full” and is approximately 4 cm. in diameter.  Juanita describes this area as “tender”.  The most likely cause of these signs and symptoms is:

A)  Hematoma formation

B)  Sepsis in the episiotomy site

C)  Inadequate repair of the episiotomy

D)  Postpartum hemorrhage

 

14. The perinatal nurse notifies the physician of the findings related to Juanita's assessment.  The first step in care will most likely be to:

A)  Prepare Juanita for surgery

B)  Administer intravenous fluids

C)  Apply ice to the perineum

D)  Insert a urinary catheter

 

15. Misty, a 26-year-old G3, TPAL 3004 postpartum woman, has a deep vein thrombosis related to antenatal bedrest therapy, multiple gestation (giving birth to twins) and an operative birth.  She is now 48 hours postpartum and states, “I feel anxious and have some pain in my chest”.  Misty's respiratory rate is 28 breaths/minute.  The perinatal nurse's most appropriate first step would be to:

A)  Summon help

B)  Initiate oxygen therapy

C)  Assess Misty's blood pressure and pulse

D)  Assist Misty into a Trendelenberg position

 

16. The perinatal nurse suspects that Misty's symptoms most likely are related to:

A)  Amniotic fluid embolus

B)  Pulmonary embolus

C)  Pulmonary edema

D)  Myocardial infarction

 

17. Misty's condition is now stable and she has been transferred to an intensive care unit.  The perinatal nurse continues to have a critical role regarding the immediate care of Misty's family.  At this time, the perinatal nurse should provide the family with information about infant care and:

A)  Provide information concerning Misty's risk for future deep vein thrombosis

B)  Advocate for infant visitation in the intensive care unit and breast pumping if desired by Misty

C)  Provide information about the hospital policies and procedures, including visiting hours

D)  Provide information about the need for Misty to follow up with her family physician after discharge from the hospital

 

18. The clinic nurse sees Xiao and her infant in the clinic for their 2-week follow-up visit.  Xiao appears to be tired, her clothes and hair appear unwashed and she does not make eye contact with her infant.  She is carrying her son in the infant carrier and when asked to put him on the examining table, she holds him away from her body.  The clinic nurse's most appropriate question to ask would be:

A)  “What has happened to you?”

B)  “Do you have help at home?”

C)  “Is there anything wrong with your son?”

D)  “Would you tell me about the first few days at home?”

 

19. In discussion with Xiao, the clinic nurse develops further concerns about this family.  The most appropriate action to assist with appropriate care for this family would be to:

A)  Notify Children and Family Services

B)  Provide information on postpartum blues

C)  Administer the Edinburgh Postnatal Depression Scale

D)  Notify the Community Health Department to set up a nursing visitation promptly

 

20. The perinatal nurse is aware that a hematoma is the collection of blood beneath the intact skin layer following an injury to a blood vessel.

A)  True

B)  False

 

21. The perinatal nurse makes certain to have the antidote, protamine sulfate, readily available when administering heparin therapy.

A)  True

B)  False

 

22. The perinatal nurse places one hand in a ___ position just above the ______________ in order to provide lower segment support when performing fundal massage.

 

 

23. The perinatal nurse is aware that the development of a large hematoma can place the postpartum woman at risk for __________

 

 

24. The perinatal nurse explains to a new mother that the first sign of a postpartum infection will most likely be an increased _______________.

 

 

25. The perinatal nurse administers __________________ as ordered to the postpartum breastfeeding mother with deep vein thromboses.

 

 

26. The perinatal nurse works together with a multidisciplinary team in the provision of care to the woman with deep vein thromboses.  The team members may include a __________, _______________ and a __________________.

 

 

27. The perinatal nurse is asked about the use of herbal medications during the postpartum period.  ____________ is an herb that may be beneficial to prevent and treat infections.

 

 

28. The perinatal nurse provides information about postpartum depression to all families because of the potential danger not only to the mother but also to the _________.

 

 

29. The perinatal nurse recognizes that a postpartum woman who describes symptoms of hallucinations and suicidal thoughts is most likely experiencing postpartum ________.