ATI RN
Postpartum Care NCLEX Questions Questions
Question 1 of 5
A nurse is taking care of a G2P2 woman with a third-degree perineal tear during the fourth stage of labor. The nurse should include which intervention in the plan of care during her 12-hour shift?
Correct Answer: D
Rationale: Correct Answer: D Rationale: 1. Ice pack application reduces swelling and provides comfort to the perineal tear. 2. Ice packs help to decrease pain and promote healing in the perineal area. 3. Ice packs are a non-invasive and non-pharmacological method of pain relief. 4. Ice packs can be safely used without interfering with the wound healing process. Summary of Incorrect Choices: A: Assessing vital signs every 4 hours is important but not specific to managing perineal tear pain. B: Keeping the patient NPO is not necessary for perineal tear management unless indicated for other reasons. C: Catheterization prior to ambulation is not directly related to perineal tear care and may not be necessary during the fourth stage of labor.
Question 2 of 5
Which nursing care goal is the highest priority for a woman who had a vaginal delivery 3 hours earlier?
Correct Answer: C
Rationale: The correct answer is C because monitoring lochia flow is crucial post-vaginal delivery to assess for excessive bleeding, which could indicate postpartum hemorrhage. This goal takes precedence over other options as it pertains to the client's immediate health and well-being. A: Wearing a bra does not address any urgent postpartum concerns. B: Eating meals is important but does not take priority over assessing for hemorrhage. D: Ambulation is beneficial but not as critical as monitoring lochia flow for potential complications.
Question 3 of 5
The nurse is preparing a postpartum patient for discharge. Which patient teaching is most important for the nurse to provide?
Correct Answer: B
Rationale: The correct answer is B: The signs and symptoms of secondary hemorrhage. This is crucial because it can be life-threatening and requires immediate medical attention. Secondary hemorrhage is excessive bleeding that occurs after the first 24 hours postpartum. It is important for the nurse to educate the patient on recognizing the signs such as increased bleeding, lightheadedness, dizziness, and low blood pressure. Choices A, C, and D are important topics for patient education but do not pose the same level of urgency and immediate risk as secondary hemorrhage.
Question 4 of 5
The nurse is performing a uterus assessment on a patient who is 20 hours postpartum. The nurse finds the fundus of the uterus to be soft and boggy. In addition, the uterus is displaced to the left and moderate bleeding is noted. If the uterus does respond to uterine massage, which actions does the nurse implement?
Correct Answer: D
Rationale: The correct answer is D: Place an emergency call to the HCP. In this scenario, the findings of a soft, boggy fundus, left displacement, and moderate bleeding indicate uterine atony, a common cause of postpartum hemorrhage. If uterine massage doesn't improve the situation, immediate intervention is crucial. Calling the healthcare provider allows for rapid assessment and potential interventions like administering uterotonics or other necessary treatments to address the postpartum hemorrhage promptly. Choices A (assisting the patient to void) and C (administering oxytocin) are important interventions but not the priority in this critical situation. Choice B (reassessing) can delay necessary interventions for managing postpartum hemorrhage.
Question 5 of 5
The nurse is aware that some parenting skills are acquired through the process of intentional learning. Which activity does the nurse associate with intentional learning?
Correct Answer: B
Rationale: The correct answer is B: The couple attends hospital classes addressing newborn and infant care. This is associated with intentional learning as it involves actively seeking out structured education on parenting skills. Attending classes allows the couple to acquire knowledge and skills related to newborn and infant care in a deliberate and purposeful manner. Incorrect choices: A: Observing other individuals who are mothers and fathers may provide some insights, but it is more passive and may not involve structured learning. C: Discussing how they were parented is reflective but may not necessarily involve acquiring new parenting skills through intentional learning. D: Watching media containing parenting roles is passive and may not provide the same level of structured education as attending classes specifically addressing newborn and infant care.