NCLEX Review about Obstetrical Malpractice (96-100)

NCLEX Review about Obstetrical Malpractice

96. A nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment findings would the nurse expect to note? Select all that apply

a) uterine rigidity
b) uterine tenderness
c) severe abdominal pain
d) bright red vaginal bleeding
e) soft, relaxed, nontender uterus
f) fundal height may be greater than expected fro gestational age

97. A nurse is caring for four 1-day postpartum clients. Which client has an abnormal finding that would require further intervention?

a) the client with mild after pains
b) the client with a pulse rate of 60 bpm
c) the client with colostrum discharge from both breast
d) the client with lochia that is red and has foul-smelling odor  

98. A nursing student is preparing to perform a cardiovascular assessment on a postpartum client. A nursing instructor asks the student about the procedure to elicit Homan's sign. Which response by the nursing student would indicate an understanding of this assessment technique?

a) I will ask the client to raise her legs up to her waist and then to lower her legs slowly
b) I will ask the client to raise her legs and to try to lower them against pressure from my hand
c) I will ask the client to extend her legs flat on the bed, and I will grasp her foot gently dorsiflex it forward
d) I will ask the client to extend her legs flat on the bed, and I will grasp her foot and sharply extend it backward

99. A nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. The client had a midline episiotomy and has several hemorrhoids. What is the priority nursing diagnosis for this client?

a) acute pain
b) disturbed body image
c) impaired urinary elimination
d) risk for imbalanced fluid volume

100. A nurse is providing postpartum instructions to a client who will be breast-feeding her newborn. The nurse determines that the client has understood the instructions if she makes which of the following statements? Select all that apply.

a) I will use soap to wash my breasts often
b) drinking alcohol can affect my milk supply
c) the use of caffeine can decrease my milk supply
d) I will start my estrogen birth control pills again as soon as I get home
e) I know if my breasts get engorged I will limit my breast-feeding and supplement the baby
f) I plan on having bottled water available in the refrigerator so I can get additional fluids easily




NCLEX Review about Obstetrical Malpractice:
ANSWERS AND RATIONALE

96) D, E, F
- painless, bright red vaginal bleeding in the second or third trimester of pregnancy is a sign of placenta previa. The client will have a soft, relaxed, nontender uterus, and the fundal height may be more than expected for gestational age. In abruptio placentae, severe abdominal pain is present. Uterine tenderness accompanies placental abruption. Additionally, in abruptio placentae, the abdomen will feel hard and board-like on palpation as the blood penetrates the myometrium and causes uterine irritability.

97) D
- lochia, the discharge present after birth, is red for the first 1 to 3 days and gradually decreases in amount. Normal lochia has a fleshy odor or an odor similar to menstrual flow. Foul-smelling or purulent lochia usually indicates infection, and these findings are not normal. The other options are normal findings for 1-day postpartum client.

98) C
- to elicit Homan's sign, the nurse asks the client to extend her legs flat on bed. The nurse grasps the foot and dorsiflexes it forward. If this causes any discomfort or resistance, the nurse should notify the physician or midwife that Homan'ss sign is present. Option A, B, and D are incorrect descriptions of this assessment technique.

99) A
- the priority nursing diagnosis for a client who delivered 2 hours ago and who has a midline episiotomy and hemorrhoids is acute pain. Most clients have some degree of discomfort during the immediate postpartum period. There is no data in the question that indicate the presence of Disturbed body image, Impaired urinary elimination, Risk for imbalanced fluid volume.

100) B, C, F
- breast-feeding client should increase their daily fluid intake; therefore, having bottled water available indicates that the postpartum client understands the importance of increasing fluids. If engorgement occurs, the client should not limit breast-feeding, but should breast-feed frequently. Oral contraceptives containing estrogen are not recommended fro breast-feeding mothers and soap should not be used on the breasts because it tends to remove natural oils, which increases the chance of cracked nipples. Common causes of decreased milk supply include formula use, inadequate rest or diet, smoking by the mother or others in the home, and use of caffeine, alcohol, or other medications.

Related Topics:

• Go back to NCLEX Review about Obstetrical Malpractice 1-5 to start the practice test from the beginning.