ATI RN
Postpartum Care Nursing Questions Questions
Question 1 of 5
A nurse is providing postpartum care to a G4P4 woman who gave birth vaginally 48 hours ago to a 9 pound 10 ounce boy with only a pudendal block for anesthesia. The physician has written orders for the woman to have a sitz bath three times a day. Which information is most closely correlated with the order?
Correct Answer: B
Rationale: The correct answer is B: The woman has an episiotomy. The rationale is that a sitz bath is commonly recommended postpartum for women who have had an episiotomy to promote healing and reduce discomfort. An episiotomy is a surgical incision made in the perineum during childbirth to widen the vaginal opening. In this case, the woman had a vaginal birth and received a pudendal block for anesthesia, which are not directly correlated with the sitz bath order. Being multiparous (choice A) does not necessarily indicate the need for a sitz bath. Therefore, the most closely correlated information with the sitz bath order is the presence of an episiotomy.
Question 2 of 5
The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient's uterus?
Correct Answer: C
Rationale: The correct answer is C: Ask the patient to void. It is important to ask the patient to void before assessing the uterus to ensure that the bladder is empty, which allows for a more accurate assessment of the uterus size and position. This helps prevent displacement of the uterus due to a full bladder, leading to a more accurate assessment of postpartum hemorrhage risk. Placing the patient on the left side (A) is done after assessing the uterus to facilitate uterine involution. Assessing the passage of lochia (B) is important but not a priority before assessing the uterus. Administering oxytocin (D) may be indicated but should be based on assessment findings rather than being the first action.
Question 3 of 5
Prior to discharge from the birthing center, the nurse informs the patient that she will receive vaccines for rubella, hepatitis B, pertussis, and influenza. For which reason does the nurse explain the need for the vaccinations?
Correct Answer: B
Rationale: Step 1: Vaccinating the mother before discharge is important to protect the neonate. Step 2: Maternal vaccines provide passive immunity to the newborn through transplacental transfer of antibodies. Step 3: This protection is crucial as newborns have immature immune systems and are vulnerable to infections. Step 4: Rubella, hepatitis B, pertussis, and influenza are serious illnesses that can be prevented through maternal immunization. Step 5: Therefore, the correct answer is B as it aligns with the concept of maternal vaccination for the benefit of the neonate. Summary: A: Incorrect. Discharge is not based on the mother's vaccination status but on the overall health of both mother and neonate. C: Incorrect. Pregnancy does not suppress the immune system to the extent that maternal vaccination is contraindicated. D: Incorrect. Vaccination is recommended based on the timing of administration, not solely on the mother's medical care status.
Question 4 of 5
In an attempt to improve the effectiveness of postpartum teaching, the nurse uses the AWHONN acronym POST BIRTH. Which teaching points require the patient to call for 911 assistance? Select all that apply.
Correct Answer: C
Rationale: The correct answer is C: Thoughts of hurting self or baby. This teaching point requires the patient to call for 911 assistance because it indicates a serious mental health emergency, such as postpartum depression or psychosis, which can lead to harm. It is crucial for immediate intervention by trained professionals. A: Bleeding that soaks a pad per hour is concerning but does not necessarily require immediate 911 assistance unless accompanied by other severe symptoms like dizziness or fainting. B: A bad headache with vision changes may indicate severe conditions like preeclampsia, which requires urgent medical attention but not necessarily a 911 call unless the symptoms worsen rapidly. D: Signs an incision is not healing, while important to monitor, does not typically warrant a 911 call unless there are signs of infection or severe complications. In summary, only choice C requires immediate 911 assistance due to the severe nature of mental health emergencies.
Question 5 of 5
The postpartum nurse is planning a home visit to a mother who delivered her baby 1 week ago. Which finding indicates to the nurse a possible problem with mother–infant bonding?
Correct Answer: C
Rationale: The correct answer is C because when a mother primarily focuses on her physical recovery and concerns during a home visit, it may indicate a possible problem with mother-infant bonding. This is because bonding involves emotional connection, interaction, and care between the mother and baby, which goes beyond physical recovery. A: The mother being pleased to have the nurse visit her home and baby is a positive sign of engagement and interest in the baby's well-being. B: The baby's grandmother being present and involved with mother/baby care can actually enhance bonding by providing support and assistance. D: The baby's father being on 'paternity leave' and involved with the baby is another positive sign of family support and involvement in bonding.