ATI RN
Complication Postpartum Questions
Question 1 of 5
What would a steady trickle of bright red blood from the vagina in the presence of a firm fundus suggest to the nurse?
Correct Answer: A
Rationale: The correct answer is A: Uterine atony. A steady trickle of bright red blood with a firm fundus suggests uterine atony, which is the inability of the uterus to contract effectively after childbirth. This can lead to postpartum hemorrhage. Other choices are incorrect as they do not align with the clinical presentation. B: Lacerations of the genital tract would present with more active bleeding and not a steady trickle. C: Perineal hematoma involves bleeding in the perineal area, not from the vagina. D: Infection of the uterus would typically present with other symptoms like fever and foul-smelling discharge.
Question 2 of 5
The nurse works in a labor and delivery facility with new protocols for estimating postpartum blood loss. Which method for estimating blood loss is implemented in the delivery room?
Correct Answer: B
Rationale: The correct answer is B because collecting blood in calibrated, under-buttocks drapes for vaginal birth allows for a more accurate estimation of postpartum blood loss. This method provides a quantitative measurement, unlike the subjective method in option A. Option C does not provide a direct measurement of blood loss and may not be accurate. Option D relies on the health care provider's estimate, which may not always be precise or consistent. By using calibrated drapes, the nurse can easily measure and monitor blood loss, ensuring better patient care and outcomes.
Question 3 of 5
The nurse in a labor and delivery department carefully assesses postpartum patients for signs of complications related to hemorrhage. Which factor makes it most difficult to identify the risk of hemorrhage through vital sign evaluation?
Correct Answer: C
Rationale: The correct answer is C because changes in blood pressure may not be an immediate sign of hemorrhage. Hemorrhage can occur rapidly and cause a drop in blood pressure, but it may not be the first sign observed. Vital signs such as blood pressure can fluctuate for various reasons, making it challenging to solely rely on them to identify hemorrhage risk. Elevated blood pressure from prenatal conditions (A) and increased respirations due to labor activity (B) are more likely to be expected and can be explained by those specific factors. Heart rate increasing with the intensity of labor (D) is a common physiological response and may not necessarily indicate hemorrhage.
Question 4 of 5
The nurse is assisting the primary care provider with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension. Which medical prescription does the nurse anticipate for this patient?
Correct Answer: C
Rationale: The correct answer is C: Carboprost-tromethamine. In the given scenario, the patient is multiparous, had a precipitous birth, and has a history of hypertension. Carboprost-tromethamine is typically administered in the third stage of labor to manage postpartum hemorrhage, which is a potential complication in this case due to the patient's history of hypertension. Methylergonovine (choice A) is contraindicated in patients with hypertension due to its vasoconstrictive effects. Fresh frozen plasma (choice B) is not typically indicated for postpartum hemorrhage. Magnesium sulfate (choice D) is commonly used for pre-eclampsia/eclampsia but not specifically for postpartum hemorrhage in this scenario.
Question 5 of 5
The nurse is providing care for a patient who is 8 hours postpartum after a vaginal delivery. The patient reports severe perineal pain unaffected by pain medication. The nurse notices a 4 cm area of discoloration on the labia that is tender to the touch. Which action does the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Contact the primary care provider for further evaluation. The patient's symptoms of severe perineal pain, discoloration on the labia, and tenderness indicate a potential complication such as hematoma or infection. Contacting the primary care provider is essential for prompt assessment and appropriate intervention to prevent further complications. Continuing to apply ice (A) may not address the underlying issue and could potentially worsen the condition. Monitoring vital signs (B) is important but may not provide direct insight into the specific problem. Relieving pressure by placing the patient in a side-lying position (D) is not the priority in this situation and may not address the underlying cause of the symptoms.