46. You checked a postpartum client frequently for bleeding after delivery. What’s considered excessive bleeding?*1 pointA. One perineal pad soaked through in 30 minutes or lessB. One perineal pad soaked through per hourC. One perineal pad soaked through in 15 minutes or lessD. One perineal pad soaked through in 2 hours47. The intrapartum period starts:*1 pointA. At conceptionB. At the onset of contractionsC. During the second trimesterD. After delivery of the neonate and placenta48. A pregnant woman has begun her third stage of labor. The third stage of labor lasts from:*1 pointA. delivery of the fetus to delivery of the placentaB. the onset of contractions to full dilation of the cervixC. delivery of the placenta to 2 hours after deliveryD. dilation of the cervix to delivery of the fetus49. When Mrs. Richard experiences a sudden increase in the amount of “bloody show”, you assess her:*1 pointA. hemorrhageB. rupture of membranesC. premature separation of the placentaD. increased cervical dilatation50. Mrs. Richard begins to hyperventilate during her labor process. Which of the following is the most common symptom of hyperventilation during labor?*1 pointA. headacheB. shortness of breathC. tremors of extremitiesD. tingling of face, fingers and feet

71.  Nursing care during the second stage of labor include:*1 pointA. coach breathing, encourage to bear down with each contractionB. careful evaluation of prenatal historyC. shave the perineumD. administer enema to the patient72.  The nurse is caring for a client on her 2nd postpartum day. The nurse should expect the client's lochia to be:*1 pointA. red and moderateB. brown and scantyC. continuous with red clotsD. thin and white73.  The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus?*1 pointA. 1 fingerbreadth above the umbilicusB. at the level of the umbilicusC. 1 fingerbreadth below the umbilicusD. below the symphysis pubis74. The nurse is helping to prepare a client for discharge following childbirth. During teaching a session, the nurse instructs the client to do Kegel exercise. What is the purpose of this exercise?*1 pointA. to tone the abdominal musclesB. to strengthen the perineal musclesC. to prevent urine retention .D. to relieve lower back pain75. Which of the following characteristics best describes that lochia is normal?*1 pointA. lochia amount increases with strenuous exerciseB. lochia is absent during the first 1-3 weeks after a cesarean birth.C. lochia contains no large clotsD. lochia is white for the first 1-3 days postpartum

21. Aware of the signs of an impending postpartum hemorrhage secondary to laceration of the cervix, the nurse assesses a postpartum client for a firm uterus and:*1 pointA. a decrease in pulse rateB. persistent muscular twitchingC. an increase in blood pressureD. continuous trickling of blood22. A new mother’s episiotomy is edematous, red and painful 8 hours after delivery. Which of the following interventions should you plan initially?*1 pointA. teach the client on how to immerse the buttocks and perineum in warm waterB. call the physician for additional pain medicationC. apply an ice bag to the perineumD. suggest a warm shower with water directly at the perineum23. Which of the following physiological responses is typical for the early postpartum period?*1 pointA. Rapid diuresis of 2,000 to 3,000 mlB. Increased motility of the GI systemC. Rapid decreased in blood pressureD. A feeling of urinary urgency and dysuria24. As a primigravida progresses with her labor, she begins to bear down with her contractions. You tell her that pushing in the absence of contractions before the cervix is fully dilated will lead to:*1 pointA. more rapid dilationB. cord prolapsedC. more rapid effacementD. development of cervical edema25. Complete flexion of the fetal head is advantageous for vaginal delivery because:*1 pointA. the fetus presents the smallest anteroposterior diameter of his skullB. the occipitomental diameter will be presented for deliveryC. the fetus presents the largest anteroposterior diameter of his skullD. the long axis of the fetus is parallel to the mother’s spine26. A postpartum nurse is providing instructions to a client after delivery of a healthy newborn infant. The nurse instructs the client that she should expect normal bowel elimination to return:*1 pointA. 3 days postpartumB. 7 days postpartumC. On the day of deliveryD. Within 2 weeks postpartum27. Mr. Young’s wife has requested her PRN medicines for pain. Of the following actions, which has the highest priority in relation to administering the medications?*1 pointA. providing privacy during the injectionB. assessing maternal vital signs and fetal heart rateC. assessing uterine contractions and the progress of laborD. informing her that she may become drowsy and/or nauseated28. The nurse encourages a multigravida to empty her bladder every 2 to 3 hours while she is in labor because:*1 pointA. a full bladder impedes the descent of the fetusB. a full bladder may rupture during laborC. a bruised bladder may predispose to pyelonephritisD. urine specimens are needed for glucose and albumin29. Which of the following fetal heart rates would be expected in the fetus of a laboring woman who is full -term?    *1 pointA. 80-100 beats per minuteB. 100-120 beats per minuteC. 120-160 beats per minuteD. 160-180 beats per minute30. Best time to get FHT:*1 pointA. at the beginning of uterine contractionB. just after a uterine contractionC. 10 minutes after a uterine contractionD. at the beginning and at the end of contraction

3. The client asks the nurse about regaining her pre-pregnant weight. The nurse explains that the physiologic changes that results to weight loss during the first six weeks postpartum is due to the following EXCEPT:*1 pointA. Uterine bleedingB. Lochial dischargeC. Increase urine outputD. Increase perspiration4. The nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4 hours ago. The nurse notes that the mother’s temperature is 37. 8 ˚C. Which of the following actions would be most appropriate?*1 pointA. Retake the temperature in 15 minutesB. Document the findingsC. Notify the physicianD. Increased hydration by encouraging oral fluids5. A fully dilated woman was rushed in the delivery unit. As the head is being delivered, which action should the nurse do next?*1 pointA. Place a slight pressure on the fundusB. Deliver the posterior shoulder of the neonateC. Check the neonate’s neck for umbilical cordD. Suction the mouth of the neonate6. Glessy determines that a client is in the second stage of labor and may start pushing. What marks the beginning of the second stage and what marks the end?*1 pointA. Cervical dilation of 7 to 8 cm; complete cervical dilationB. Complete cervical dilation; delivery of the neonateC. Cervical dilation of 7 to 8cm; delivery of the placentaD. Complete cervical dilation; delivery of the placenta7. Nurse Glessy is aware that the following would be an inappropriate indication of placental detachment?*1 pointA. Abrupt lengthening of the cordB. Increase in the number of contractionsC. Relaxation of the uterusD. Increased vaginal bleeding8. Karen didn’t recognize for over an hour that she was in labor. A sign of true labor is:*1 pointA. Sudden increase energy from epinephrine releaseB. “Nagging” but constant pain in the lower backC. Urinary urgency from increased bladder pressureD. “Show” or release of the cervical mucus plug9. Karen asks you which fetal position and presentation are ideal. Your best answer would be:*1 pointA. Right Occipitoanterior with full flexionB. Left transverse anterior in moderate flexionC. Right occipitoposterior with no flexionD. Left sacroanterior with full flexion10.  During the assessment of a client in labor the cervix is determined to be 4cm dilated. The nurse understands that this client is in the stage of labor known as:*1 pointA. FirstB. SecondC. ThirdD. Fourth

A client who is pregnant at 39 weeks gestation spontaneously ruptured her membranes while ambulating to the bathroom. After the client returns to bed, which of the following should be the nurse's initial action?A. Assess the color of the amniotic fluidB. Perform a vaginal examination to assess the cervix for dilationC. Inform the client she is now on strict bed rest until further noticeD. Assess the fetal heart tones

The nurse is aware that a client at 40 weeks’ gestation is experiencing true labor if:*1 pointA. cervical dilatation has occurredB. the pains become more noticeableC. her membranes have rupturedD. the fetal heart rate baseline decreases