Challenge your knowledge about Antepartum NCLEX Questions. This will tackle topics nurses should know about Obsteric nursing.
9. The nurse is preparing to care for four assigned clients. Which client is at highest risk for hemorrhage?
a) A primiparous client who delivered 4 hours ago
b) A multiparous client who delivered 6 hours ago
c) A primiparous client who delivered 6 hours ago and had epidural anesthesia
d) A multiparous client who delivered a large baby after oxytocin (Pitocin) induction
10. A postpartum client is diagnosed with cystitis. The nurse should plan for which priority nursing action in the care of the client?
a) Providing sitz baths
b) Encouraging fluid intake
c) Placing ice on the perineum
d) Monitoring hemoglobin and hematocrit levels
11. Antepartum NCLEX Questions about the nurse who is monitoring a postpartum client who received epidural anesthesia for delivery for the presence of a vulvar hematoma. Which assessment finding would best indicate the presence of a hematoma?
a) Changes in vital signs
b) Signs of heavy bruising
c) Complaints of intense pain
d) Complaints of a tearing sensation
12. The nurse is developing a plan of care for a postpartum client with a small vulvar hematoma. The nurse should include which specific action during the first 12 hours after delivery?
a) Assess vital signs every 4 hours.
b) Measure fundal height every 4 hours.
c) Prepare an ice pack for application to the area.
d) Inform the health care provider of assessment findings.
13. On assessment of a postpartum client, the nurse notes that the uterus feels soft and boggy. The nurse should take which initial action?
a) Elevate the client’s legs.
b) Document the findings.
c) Massage the fundus until it is firm.
d) Push on the uterus to assist in expressing clots.
Antepartum NCLEX Questions
Answers and Rationale
- Rationale: The causes of postpartum hemorrhage include uterine atony; laceration of the vagina; hematoma development in the cervix, perineum, or labia; and retained placental fragments. Predisposing factors for hemorrhage include a previous history of postpartum hemorrhage, placenta previa, abruptio placentae, overdistention of the uterus from polyhydramnios, multiple gestation, a large neonate, infection, multiparity, dystocia or labor that is prolonged, operative delivery such as a cesarean or forceps delivery, and intrauterine manipulation. The multiparous client who delivered a large fetus after oxytocin induction has more risk factors associated with postpartum hemorrhage than the other clients. In addition, there are no specific data in the client descriptions in options A, B, and C that present the risk for hemorrhage.
- Test-Taking Strategy: Focus on the subject , the client at highest risk for hemorrhage. Read the client description in each option. Noting the words large and oxytocin in the correct option will direct you to this option.
- Antepartum NCLEX Questions Rationale: Cystitis is an infection of the bladder. The client should consume 3000 mL of fluids per day if not contraindicated. Sitz baths and ice would be appropriate interventions for perineal discomfort. Hemoglobin and hematocrit levels would be monitored with hemorrhage.
- Test-Taking Strategy: Focus on the subject , measures to treat cystitis, and note the strategic word priority. Remember that increased fluids are a priority intervention.
- Rationale: Because the client has had epidural anesthesia and is anesthetized, she cannot feel pain, pressure, or a tearing sensation. Changes in vital signs indicate hypovolemia in an anesthetized postpartum client with vulvar hematoma. Option 2 (heavy bruising) may be seen, but vital sign changes indicate hematoma caused by blood collection in the perineal tissues.
- Test-Taking Strategy: Note the strategic word best. Also note that the client received epidural anesthesia. With this in mind, eliminate options C and D. From the remaining options, use the ABCs—airway, breathing, and circulation—to direct you to the correct option.
- Rationale: A hematoma is a localized collection of blood into the tissues of the reproductive sac after delivery. Vulvar hematoma is the most common. Application of ice reduces swelling caused by hematoma formation in the vulvar area. Options A, B, and D are not interventions that are specific to the plan of care for a client with a small vulvar hematoma.
- Antepartum NCLEX Questions Test-Taking Strategy: Focus on the subject , a small vulvar hematoma. This focus will assist in directing you to the correct option.
- Rationale: If the uterus is not contracted firmly (i.e., it is soft and boggy), the initial intervention is to massage the fundus until it is firm and to express clots that may have accumulated in the uterus. Elevating the client’s legs would not assist in managing uterine atony. Documenting the findings is an appropriate action but is not the initial action. Pushing on an uncontracted uterus can invert the uterus and cause massive hemorrhage.
- Test-Taking Strategy: Note the strategic word initial in the question. Focus on the subject , that the uterus is soft and boggy. Recalling the therapeutic management for uterine atony will assist in directing you to the correct option.
After you reviewed your answers through its rationale, you can now proceed to the next set of questions:
Antepartum NCLEX Questions 14-20
Or go back to the first set of questions:
Antepartum NCLEX Questions (1-5)