Exam (elaborations)
Chapter 21: Postpartum Complications NCLEX-Qs & As
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Chapter 21: Postpartum Complications NCLEX-Qs & As
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Chapter 21: Postpartum Complications NCLEX-Qs & AsB
(Rationale: Cardiac output increases immediately after delivery as blood that had been
diverted to the uterus reenters the central circulation. A client who cannot tolerate these
changes may experience cardiac decompensation and cardiac failure. After delivery, renal
function increases. There is usually not an increase in pain after delivery except for small
increments attributable to uterine cramps, perineal discomfort and breast tenderness.
Although hepatic blood flow decreases to normal levels after delivery, this does not affect
cardiac function.) Correct Ans-A client with cardiac disease delivers a baby. Afterwards, the
nurse assesses the client for signs of cardiac decompensation. During the postpartum period,
which condition can cause cardiac decompensation?
A. Increased pain
B. Increased cardiac output
C. Decreased renal function
D. Decreased hepatic blood flow
A
, Chapter 21: Postpartum Complications NCLEX-Qs & As
(During the early postpartum period, lochia rubra should be moderate to significant. Scant
lochia may indicate that large clots are blocking the flow. Thirst, fatigue and a temperature up
to 100.4oF (38oC) are normal within the first 24 hours. Immediately after delivery, vasomotor
changes may cause a shaking chill.) Correct Ans-The nurse assesses a client who delivered
24 hours ago. Which of the following suggests the need for further assessment?
A. Scant lochia rubra
B. Chills
C. Thirst and fatigue
D. A temperature of 100.2oF (37.9oC)
C
(Rationale: Since the client is already hemorrhaging, it is inappropriate to initiate a pad count.
Fundal massage and administration of oxytocics would be indicated if the hemorrhage is due
to uterine atony. If a full bladder is displacing the uterus and preventing it from contracting,
insertion of an indwelling catheter would be an appropriate response.) Correct Ans-A
, Chapter 21: Postpartum Complications NCLEX-Qs & As
woman is experiencing an early postpartum hemorrhage. Which of the following actions
would be inappropriate?
A. Insertion of an indwelling urinary catheter
B. Fundal massage
C. Pad count
D. Administration of oxytocics
D
(Rationale: A woman that develops postpartum psychosis usually does so within four weeks
of delivery. Only 1% of women develop this disorder. Suicide and infanticide are common and
the disorder is considered a medical emergency. Delusions and hallucinations accompany the
disorder and the woman usually has a past history of a psychiatric disorder and treatment.)
Correct Ans-The clinic nurse is caring for a woman who is suspected of developing
postpartum psychosis. Which of the following statements characterizes this disorder:
A. Symptoms start within several days of delivery
B. The disorder is common in postpartum women
, Chapter 21: Postpartum Complications NCLEX-Qs & As
C. Suicide and infanticide are uncommon in this disorder
D. Delusions and hallucinations accompany this disorder
C
(A parent that is grieving over a recent loss (in the process of detachment) will have the most
difficulty bonding with the new baby. Knowledge of parent-infant attachment or being an only
child are not related to successful bonding. A job loss does not have the impact that death of
a family member does.) Correct Ans-During the early postpartum period, the nurse is
evaluating a client's attachment to her neonate. Which type of parent has the most difficulty
attaching to her newborn?
A. One who has little knowledge of parent-infant attachment
B. One who recently lost a job
C. One whose father recently died
D. One who is an only child
A
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