Test Bank For Current Diagnosis & Treatment Obstetrics
& Gynecology 12th Edition by Alan H. DeCherney, Ashley
S. Roman, Lauren Nathan, Neri Laufer 9780071833905
Chapter 1-62 Complete Guide.
Within 12 hours after delivery, the fundus may be approximately 1 cm above the
umbilicus. The fundus descends about 1 to 2 cm every 24 hours. Within 12 hours
after delivery, the fundus may be approximately 1 cm above the umbilicus. By
the sixth after birth week the fundus normally is halfway between the symphysis
pubis and the umbilicus. The fundus should be easily palpated using the
maternal umbilicus as a reference point.
Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 lbs, 3 ounces - ANS: B
Afterpains are more common in multiparous women. Afterpains are more
noticeable with births in which the uterus was greatly distended, as in a woman
who experienced polyhydramnios or a woman who delivered a large infant.
Breastfeeding may cause afterpains to intensify.
A woman gave birth to an infant boy 10 hours ago. Where would the nurse
expect to locate this woman's fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally - ANS: A
,A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would
the nurse expect to find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
c. Lochia alba
d. Lochia serosa - ANS: D
Lochia serosa, which consists of blood, serum, leukocytes, and tissue debris,
generally occurs around day 3 or 4 after childbirth. Lochia rubra consists of
blood and decidual and trophoblastic debris. The flow generally lasts 3 to 4 days
and pales, becoming pink or brown. There is no such term as lochia sangra.
Lochia alba occurs in most women after day 10 and can continue up to 6 weeks
after childbirth.
Which hormone remains elevated in the immediate after birth period of the
breastfeeding woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen - ANS: C
Prolactin levels in the blood increase progressively throughout pregnancy. In
women who breastfeed, prolactin levels remain elevated into the sixth week
after birth. Estrogen and progesterone levels decrease markedly after expulsion
of the placenta and reach their lowest levels 1 week into the after birth period.
Human placental lactogen levels decrease dramatically after expulsion of the
placenta.
Two days ago a woman gave birth to a full-term infant. Last night she awakened
several times to urinate and noted that her gown and bedding were wet from
profuse diaphoresis. One mechanism for the diaphoresis and diuresis that this
woman is experiencing during the early after birth period is:
,a. elevated temperature caused by after birth infection.
b. increased basal metabolic rate after giving birth.
c. loss of increased blood volume associated with pregnancy.
d. increased venous pressure in the lower extremities. - ANS: C
Within 12 hours of birth women begin to lose the excess tissue fluid that has
accumulated during pregnancy. One mechanism for reducing these retained
fluids is the profuse diaphoresis that often occurs, especially at night, for the
first 2 or 3 days after childbirth. Postpartal diuresis is another mechanism by
which the body rids itself of excess fluid. An elevated temperature would cause
chills and may cause dehydration, not diaphoresis, and diuresis. Diaphoresis
and diuresis sometimes are referred to as reversal of the water metabolism of
pregnancy, not as the basal metabolic rate. Postpartal diuresis may be caused
by the removal of increased venous pressure in the lower extremities.
A woman gave birth to a 7-lb, 3-ounce infant boy 2 hours ago. The nurse
determines that the woman's bladder is distended because her fundus is now 3
cm above the umbilicus and to the right of the midline. In the immediate after
birth period, the most serious consequence likely
to occur from bladder distention is:
a. urinary tract infection.
b. excessive uterine bleeding.
c. a ruptured bladder.
d. bladder wall atony. - ANS: B
Excessive bleeding can occur immediately after birth if the bladder becomes
distended because it pushes the uterus up and to the side and prevents it from
contracting firmly. A urinary tract infection may result from overdistention of the
bladder, but it is not the most serious consequence. A ruptured bladder may
result from a severely overdistended bladder. However, vaginal bleeding most
likely would occur before the bladder reaches this level of overdistention.
, Bladder distention may result from bladder wall atony. The most serious
concern associated with bladder distention is excessive uterine bleeding.
The nurse caring for the after birth woman understands that breast
engorgement is caused by:
a. overproduction of colostrum.
b. accumulation of milk in the lactiferous ducts.
c. hyperplasia of mammary tissue.
d. congestion of veins and lymphatics. - ANS: D
Breast engorgement is caused by the temporary congestion of veins and
lymphatics, not by
overproduction of colostrum, overproduction of milk, or hyperplasia of
mammary tissue.
A woman gave birth to a 7-lb, 6-ounce infant girl 1 hour ago. The birth was
vaginal, and the estimated blood loss (EBL) was approximately 1500 mL. When
assessing the woman's vital signs, the nurse would be concerned to see:
a. temperature 37.9° C, heart rate 120, respirations 20, blood pressure (BP)
90/50.
b. temperature 37.4° C, heart rate 88, respirations 36, BP 126/68.
c. temperature 38° C, heart rate 80, respirations 16, BP 110/80.
d. temperature 36.8° C, heart rate 60, respirations 18, BP 140/90. - ANS: A
An EBL of 1500 mL with tachycardia and hypotension suggests hypovolemia
caused by excessive blood loss. An increased respiratory rate of 36 may be
secondary to pain from the birth. Temperature may increase to 38° C during the
first 24 hours as a result of the dehydrating effects of labor. A BP of 140/90 is
slightly elevated, which may be caused by the use of oxytocic medications.
