61. A nurse is caring for a woman in the taking-in phase of the puerperium. Which of the following is appropriate for the client?*1 pointA. Have her begin postpartum exercisesB. Instruct her on how to bath an infantC. Educate her about family planningD. Allow her as much rest as needed62. Your postpartum client experienced period of overwhelming sadness that resolved after a few days. What is this condition called?*1 pointA. Postpartum psychosisB. Postpartum bluesC. postpartum depressionD. postpartum hallucinations63.A breast-feeding mother should increase her daily caloric intake by how much above the intake recommended during pregnancy?*1 pointA. 500 added caloriesB. 1,000 added caloriesC. no added caloriesD. 300 added calories64.     What is the smallest diameter of the fetal head?*1 pointA. SuboccipitobregmaticB. BiparietalC. OccipitomentalD. Occipitofrontal65.  All pregnant women should be thought how to recognized preliminary signs of labor which is:*1 pointA. rupture of membranesB. bright red vaginal bleedingC. increase in level of activityD. bandl’s ring66.     This is the most common presentation in which the head is sharply flexed and allows the suboccipitobregmatic diameter to present to the cervix.*1 pointA. mentumB. faceC. vertexD. brow67.  The physician performs on Mrs. Santos. All of the following statements reflect reasons for performing an episiotomy at the beginning of the second stage of labor except:*1 pointA. an incision is easier to repair, heals faster and can be controlled directionallyB. trauma to the fetal head is decreased as the opening is enlargedC. the second stage of labor is lengthenedD. stretching and tissue necrosis of vaginal mucosa are prevented68.  The best way for the nurse to assess the amount of blood loss following delivery is to:*1 pointA. count or weigh perineal padsB. monitor pulse and blood pressureC. measure the height of the fundusD. check hemoglobin and hematocrit69.  The nurse teaches a primigravida how to measure the frequency of uterine contractions. The nurse should explain to the client that the frequency of uterine contractions is determined:*1 pointA. from the beginning of one contraction to the end of the next contractionB. from the beginning of one contraction to the end of the same contractionC. by the number of contractions that occur within a given period of timeD. by the strength of the contraction at its peak70.  A woman is admitted to a labor unit in active labor. Which of the following assessments would alert you to the possibility that she may have difficulty accepting this child?*1 pointA. ”I’m so tired of being pregnant.”B. ”I haven’t been able to sleep well lately.”C. ”I want this baby to be a boy.”D. ”I am so exhausted.

71.  Nursing care during the second stage of labor include:*1 pointA. coach breathing, encourage to bear down with each contractionB. careful evaluation of prenatal historyC. shave the perineumD. administer enema to the patient72.  The nurse is caring for a client on her 2nd postpartum day. The nurse should expect the client's lochia to be:*1 pointA. red and moderateB. brown and scantyC. continuous with red clotsD. thin and white73.  The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus?*1 pointA. 1 fingerbreadth above the umbilicusB. at the level of the umbilicusC. 1 fingerbreadth below the umbilicusD. below the symphysis pubis74. The nurse is helping to prepare a client for discharge following childbirth. During teaching a session, the nurse instructs the client to do Kegel exercise. What is the purpose of this exercise?*1 pointA. to tone the abdominal musclesB. to strengthen the perineal musclesC. to prevent urine retention .D. to relieve lower back pain75. Which of the following characteristics best describes that lochia is normal?*1 pointA. lochia amount increases with strenuous exerciseB. lochia is absent during the first 1-3 weeks after a cesarean birth.C. lochia contains no large clotsD. lochia is white for the first 1-3 days postpartum

The nurse is assessing a client who is two days postpartum and is breastfeeding her infant and reports uterine contractions while breastfeeding. The nurse should take which action?A. Perform a vaginal examinationB. Prepare the client for a pelvic ultrasoundC. Reassure the client that this is a normal findingD. Instruct the client to bottle feed the infant until the sensation subsides

3. The client asks the nurse about regaining her pre-pregnant weight. The nurse explains that the physiologic changes that results to weight loss during the first six weeks postpartum is due to the following EXCEPT:*1 pointA. Uterine bleedingB. Lochial dischargeC. Increase urine outputD. Increase perspiration4. The nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4 hours ago. The nurse notes that the mother’s temperature is 37. 8 ˚C. Which of the following actions would be most appropriate?*1 pointA. Retake the temperature in 15 minutesB. Document the findingsC. Notify the physicianD. Increased hydration by encouraging oral fluids5. A fully dilated woman was rushed in the delivery unit. As the head is being delivered, which action should the nurse do next?*1 pointA. Place a slight pressure on the fundusB. Deliver the posterior shoulder of the neonateC. Check the neonate’s neck for umbilical cordD. Suction the mouth of the neonate6. Glessy determines that a client is in the second stage of labor and may start pushing. What marks the beginning of the second stage and what marks the end?*1 pointA. Cervical dilation of 7 to 8 cm; complete cervical dilationB. Complete cervical dilation; delivery of the neonateC. Cervical dilation of 7 to 8cm; delivery of the placentaD. Complete cervical dilation; delivery of the placenta7. Nurse Glessy is aware that the following would be an inappropriate indication of placental detachment?*1 pointA. Abrupt lengthening of the cordB. Increase in the number of contractionsC. Relaxation of the uterusD. Increased vaginal bleeding8. Karen didn’t recognize for over an hour that she was in labor. A sign of true labor is:*1 pointA. Sudden increase energy from epinephrine releaseB. “Nagging” but constant pain in the lower backC. Urinary urgency from increased bladder pressureD. “Show” or release of the cervical mucus plug9. Karen asks you which fetal position and presentation are ideal. Your best answer would be:*1 pointA. Right Occipitoanterior with full flexionB. Left transverse anterior in moderate flexionC. Right occipitoposterior with no flexionD. Left sacroanterior with full flexion10.  During the assessment of a client in labor the cervix is determined to be 4cm dilated. The nurse understands that this client is in the stage of labor known as:*1 pointA. FirstB. SecondC. ThirdD. Fourth

The nurse is teaching a postpartum client about caring for her episiotomy. Which of the following statement by the client would indicate a correct understanding of the teaching?A. "I can expect to have pain and urgency with urination."B. "I should increase my fluid and fiber intake."C. "I will clean the area with hot, soapy water."D. "I should wipe in a continuous motion using a washcloth."

21. Aware of the signs of an impending postpartum hemorrhage secondary to laceration of the cervix, the nurse assesses a postpartum client for a firm uterus and:*1 pointA. a decrease in pulse rateB. persistent muscular twitchingC. an increase in blood pressureD. continuous trickling of blood22. A new mother’s episiotomy is edematous, red and painful 8 hours after delivery. Which of the following interventions should you plan initially?*1 pointA. teach the client on how to immerse the buttocks and perineum in warm waterB. call the physician for additional pain medicationC. apply an ice bag to the perineumD. suggest a warm shower with water directly at the perineum23. Which of the following physiological responses is typical for the early postpartum period?*1 pointA. Rapid diuresis of 2,000 to 3,000 mlB. Increased motility of the GI systemC. Rapid decreased in blood pressureD. A feeling of urinary urgency and dysuria24. As a primigravida progresses with her labor, she begins to bear down with her contractions. You tell her that pushing in the absence of contractions before the cervix is fully dilated will lead to:*1 pointA. more rapid dilationB. cord prolapsedC. more rapid effacementD. development of cervical edema25. Complete flexion of the fetal head is advantageous for vaginal delivery because:*1 pointA. the fetus presents the smallest anteroposterior diameter of his skullB. the occipitomental diameter will be presented for deliveryC. the fetus presents the largest anteroposterior diameter of his skullD. the long axis of the fetus is parallel to the mother’s spine26. A postpartum nurse is providing instructions to a client after delivery of a healthy newborn infant. The nurse instructs the client that she should expect normal bowel elimination to return:*1 pointA. 3 days postpartumB. 7 days postpartumC. On the day of deliveryD. Within 2 weeks postpartum27. Mr. Young’s wife has requested her PRN medicines for pain. Of the following actions, which has the highest priority in relation to administering the medications?*1 pointA. providing privacy during the injectionB. assessing maternal vital signs and fetal heart rateC. assessing uterine contractions and the progress of laborD. informing her that she may become drowsy and/or nauseated28. The nurse encourages a multigravida to empty her bladder every 2 to 3 hours while she is in labor because:*1 pointA. a full bladder impedes the descent of the fetusB. a full bladder may rupture during laborC. a bruised bladder may predispose to pyelonephritisD. urine specimens are needed for glucose and albumin29. Which of the following fetal heart rates would be expected in the fetus of a laboring woman who is full -term?    *1 pointA. 80-100 beats per minuteB. 100-120 beats per minuteC. 120-160 beats per minuteD. 160-180 beats per minute30. Best time to get FHT:*1 pointA. at the beginning of uterine contractionB. just after a uterine contractionC. 10 minutes after a uterine contractionD. at the beginning and at the end of contraction