Chapter 23: Postpartal Adaptation and Nursing Assessment

1. On the first postpartum day, the nurse teaches the client about breastfeeding. Two hours
later, the client seems to remember very little of the teaching. The nurse understands this
memory lapse to be due to:
A. The taking-hold phase.
B. Postpartum hemorrhage.
C. The taking-in phase.
D. Epidural anesthesia.
Correct Answer: C
Rationale:
A. The taking-hold phase occurs by the second or third day, when the mother is ready to resume control
of life and is open to teaching.
B. Postpartum hemorrhage is a serious complication, and will need medical intervention.
C. The taking-in phase, which occurs during the first day or two following birth, is characterized by a
passive and dependent affect. The mother also might be in need of food and rest.
D. Epidural anesthesia is a pharmacologic approach to pain control.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 572

2. The nurse assesses for Homans sign by:
A. Extending the foot and inquiring about calf pain.
B. Extending the leg and inquiring about foot pain.
C. Flexing the knee and inquiring about thigh pain.
D. Dorsiflexing the foot and inquiring about calf pain.
Correct Answer: D
Rationale:
A. The pain is caused by stretching of inflamed vessels in the calf. Extending the foot and inquiring about
the calf would exert a stretch on the vessels.
B. Extending the leg and inquiring about foot pain is an incorrect assessment procedure for Homans sign.
C. Flexing the knee and inquiring about thigh pain is an incorrect assessment procedure for Homans sign.
D. Dorsiflexing the foot and inquiring about calf pain is the correct way to assess for Homans sign.
Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 584

3. A postpartum client asks the nurse to weigh her. The nurse expects an initial weight loss of:
A. 1012 pounds.
B. 58 pounds.
C. 1520 pounds.
D. 1215 pounds.
Correct Answer: A
Rationale:
A. Ten to twelve pounds is the usual initial weight loss. This weight is lost with the birth of the infant and
the expulsion of the placenta and the amniotic fluid.
B. Five to eight pounds might be the loss after a preterm birth.
C. Fifteen to twenty pounds might be the loss from a multiple birth.
D. Twelve to fifteen pounds is close, but does not match the usual weight of placenta, amniotic fluid, and
full-term infant.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle
New Jersey. Pearson Education Inc. Page 572


4. A nurse is caring for several postpartum clients. Which client is demonstrating a problem
attaching to her newborn?
A. The client who is discussing how her boy looks like her father
B. The client who is singing softly to her baby
C. The client who continues to touch her baby with only her fingertips
D. The client who picks her baby up when he cries
Correct Answer: C
Rationale:
A. Pointing out family traits or characteristics seen in the newborn is a positive sign of developing early
attachment.
B. Speaking to the baby frequently and affectionately (singing) is a positive sign of developing early
attachment.
C. During the attachment process, the client should proceed from fingertip touch to palmar contact to
enfolding the infant close to her own body. If the client continues to touch only with her fingertips, she
might not be developing adequate early attachment.
D. Being sensitive to the newborns needs (picking the baby up when the baby cries) is a positive sign of
developing early attachment.
Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle
New Jersey. Pearson Education Inc. Page 573

Chapter 24: Postpartal Family: Needs and Care
1. The postpartum nurse is planning discharge teaching for the new postpartum mother.
Which of the following is the best way to teach information to this client?
A. Provide all information while discharging the patient.
B. Provide written discharge material only.
C. No teaching is required, as this is not the clients first postpartum experience.
D. Deliver information a little at a time and repeat it until discharge.
Correct Answer: D
Rationale:
A. Providing all information at one time is not the best way to teach information.
B. Providing only written instruction is not the best way to teach information.
C. Discharge teaching is always done, regardless of how many children the client has had in the past.
D. Information should be delivered a little at a time and repeated to make sure that the parents
understand what the nurse has discussed with them.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle
New Jersey. Pearson Education Inc. Page 609

2. The nurse instructs the postpartum client that she can resume light housekeeping after
the:
A. Second week at home.
B. First week at home.
C. Six-week postpartum checkup.
D. Second day at home.
Correct Answer: A
Rationale:
A. The postpartum client can resume light housekeeping after the second week at home.
B. Within the first week is too early to resume even light housekeeping activity.
C. Its not necessary to wait until after the six-week postpartum checkup to resume light housekeeping.
D. The second day is too early to resume even light housekeeping activity.
Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle
New Jersey. Pearson Education Inc. Page 602

Chapter 25 : The Postpartal Family at Risk
1. The charge nurse is analyzing a postpartum clients risk for hemorrhage. Which client has
the greatest risk for postpartum hemorrhage?
A. The client who went overdue and delivered vaginally
B. The client who delivered by a scheduled cesarean delivery
C. The client who had oxytocin augmentation of labor
D. The client who delivered vaginally at 36 weeks
Correct Answer: C
Rationale:
A. The client who was overdue is not at as great a risk for postpartum hemorrhage.
B. The client who delivered by cesarean is not at as great a risk for postpartum hemorrhage.
C. Uterine atony is a cause of postpartal hemorrhage. A contributing factor that can cause uterine atony is
oxytocin augmentation of labor.
D. The client who delivered vaginally at 36 weeks is not at as great a risk for postpartum hemorrhage.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 615

2. A client had a cesarean birth 3 days ago. She has tenderness, localized heat, and redness of
the left leg. She is afebrile. As a result of these symptoms, the nurse recognizes that the
client will most likely be:
A. Encouraged to ambulate freely.
B. Given aspirin 650 mg by mouth.
C. Given Methergine IM.
D. Placed on bedrest.
Correct Answer: D
Rationale:
A. Encouraging the client to ambulate freely would increase the inflammation.
B. Aspirin 650 mg by mouth has anticoagulant properties, but usually is not necessary unless complications
occur.
C. Methergine is given only for postpartum hemorrhage, and would only cause vasoconstriction of an already
inflamed vessel.
D. The client will likely be placed on bedrest because these symptoms indicate the presence of superficial
thrombophlebitis. The treatment involves bedrest, elevation of the affected limb, analgesics, and use of
elastic support hose.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 631


3. The postpartum client is concerned about mastitis because she experienced it with her last
baby. Preventive measures the nurse could teach include:
A. Wearing a tight-fitting bra.
B. Limiting feedings to q.i.d.
C. Frequent breastfeeding.
D. Forcing fluids.
Correct Answer: C
Rationale:
A. Although wearing a supportive bra is recommended, a tight-fitting bra would mechanically suppress
lactation
B. Limiting feedings to q.i.d. would suppress lactation.
C. Frequent breastfeeding is important because complete emptying of the breasts prevents engorgement and
stasis.
D. Forcing fluids is not necessary.

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 627

4. The nurse understands that the classic symptom for a postpartum client with endometritis
is:
A. Foul-smelling lochia.
B. Sawtooth temperature spikes.
C. Profuse vaginal discharge.
D. Uterine tenderness.
Correct Answer: A
Rationale:
A. Foul-smelling lochia is cited as the classic sign of endometriosis.
B. Sawtooth temperature spikes are a sign of endometritis but not the classic symptom.
C. Scant or profuse vaginal discharge is a sign endometritis but not the classic symptom.
D. Uterine tenderness is a symptom of endometritis but is not the classic symptom

Source: London M., Ladewig P.,Ball J., and Bindler R., (2007) Maternal and child nursing care 2
nd
edition. Upper Sadle New
Jersey. Pearson Education Inc. Page 523