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

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

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

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

11. The nurse is aware that a client at 40 weeks’ gestation is experiencing true labor if:*1 pointA. cervical dilatation has occurredB. the pains become more noticeableC. her membranes have rupturedD. the fetal heart rate baseline decreases12. A postpartum nurse is caring for a client who delivered a viable newborn infant 2 hours ago. The nurse palpates the fundus and notes the character of the lochia. Which characteristic of the lochia would the nurse expect to note at this time?*1 pointA. white-colored lochiaB. serosanguinous lochiaC. pink-colored lochiaD. dark red-colored lochia13. A nurse is monitoring a postpartum client in the fourth stage of labor. Which of the following findings, if noted by the nurse, would indicate a complication related to a laceration of the birth canal?*1 pointA. Presence of dark red lochiaB. Palpation of the fundus at the level of the umbilicusC. Palpation of the uterus as a firm contracted ballD. The saturation of more than one perineal pad per hour14. It has been 12 hours since the client’s delivery of a newborn. The nurse assesses the mother to the process of involution and documents that it is progressing normally when palpation of the client’s fundus is noted:*1 pointA. at the level of the umbilicusB. midway between the umbilicus and the symphysis pubisC. one finger breath below the umbilicusD. two finger breadths below the umbilicus15.  Mr. Young’s wife cervix is dilated 8cm. There is a sudden increase in the amount of bloody show. She vomits and her legs begin to tremble. She then becomes very irritable and cries out, “I can’t take it anymore.” At this time which of the following actions is most appropriate:*1 pointA. give her a dose of PRN of her pain relief medicationB. notify her physician of the possibility of hemorrhageC. review the breathing techniques with her againD. explain that she is progressing normally through labor16. A nurse is assisting in caring for a woman in labor who is receiving oxytoxin by intravenous infusion. The nurse monitors the client, knowing that which of the following indicates an adequate contraction pattern?*1 pointA. Three to five contractions in a 10-minute period, with resultant cervical dilatationB. One contraction per minute, with resultant cervical dilatationC. Four contractions every 5 minutes, with resultant cervical dilatationD. One contraction every 10 minutes without resultant cervical dilatation17. Approximately 15 minutes after delivery of a viable term neonate, a multiparous patient complains of chilling sensation. Which of the following would the nurse do next?*1 pointA. decrease the rate of IV fluidsB. assess the patient’s pulse rateC. assess the amount of blood lossD. provide the patient with warm blanket18. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as sign of:*1 pointA. uterine atonyB. hematomaC. placental separationD. placenta previa19. A postpartal client has been complaining about the “afterpains” that occur while breastfeeding and questions you about them. You explain to her that they are due to the fact that:*1 pointA. the baby is sucking too vigorously and should nurse more oftenB. the baby’s sucking stimulates the uterus to contractC. she is tense during breastfeeding, resulting in uterine spasmsD. she is probably recalling her labor experience at feeding20.  A nurse performs an assessment on a client who is 4 hours postpartum. The nurse notes that the client has cool, clammy skin and is restless and excessively thirsty. The nurse prepares immediately to:*1 pointA. begin fundal massage and start oxygen by maskB. begin hourly pad counts and reassure the clientC. elevate the head of the bed and assess vital signsD. assess for hypovolemia and notify the health care provider

The nurse is aware that a client at 40 weeks’ gestation is experiencing true labor if:*1 pointA. cervical dilatation has occurredB. the pains become more noticeableC. her membranes have rupturedD. the fetal heart rate baseline decreases