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

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

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.

46. You checked a postpartum client frequently for bleeding after delivery. What’s considered excessive bleeding?*1 pointA. One perineal pad soaked through in 30 minutes or lessB. One perineal pad soaked through per hourC. One perineal pad soaked through in 15 minutes or lessD. One perineal pad soaked through in 2 hours47. The intrapartum period starts:*1 pointA. At conceptionB. At the onset of contractionsC. During the second trimesterD. After delivery of the neonate and placenta48. A pregnant woman has begun her third stage of labor. The third stage of labor lasts from:*1 pointA. delivery of the fetus to delivery of the placentaB. the onset of contractions to full dilation of the cervixC. delivery of the placenta to 2 hours after deliveryD. dilation of the cervix to delivery of the fetus49. When Mrs. Richard experiences a sudden increase in the amount of “bloody show”, you assess her:*1 pointA. hemorrhageB. rupture of membranesC. premature separation of the placentaD. increased cervical dilatation50. Mrs. Richard begins to hyperventilate during her labor process. Which of the following is the most common symptom of hyperventilation during labor?*1 pointA. headacheB. shortness of breathC. tremors of extremitiesD. tingling of face, fingers and feet

A client who is pregnant at 39 weeks gestation spontaneously ruptured her membranes while ambulating to the bathroom. After the client returns to bed, which of the following should be the nurse's initial action?A. Assess the color of the amniotic fluidB. Perform a vaginal examination to assess the cervix for dilationC. Inform the client she is now on strict bed rest until further noticeD. Assess the fetal heart tones