NCLEX-RN® Review

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Chapter 34

NCLEX-RN® Review

This activity contains 10 questions.

The nurse assesses a postpartum client and palpates the fundus at 2 cm above the midline and deviated to the right. What is the appropriate nursing action?

	Encourage the client to breastfeed
	Assist the client to a prone position and place a small pillow under her abdomen
	Assist the client to empty her bladder
	Massage the fundus

A mother of a 12-hour-old infant says she is tired and would prefer to learn about diapering the baby some other time. The nurse recognizes this behavior is evidence of:

	Poor attachment.
	Ineffective coping.
	Maternal immaturity.
	Taking in phase.

A nurse is caring for several postpartum clients of different nationalities. Which of the following statements allow the nurse to provide culturally sensitive care? (Select all that apply)

	“Are there any foods that you think would be helpful for healing?”
	“Our visiting hours are from 11:00 AM until 8:00 PM. Fathers can stay the first night.”
	“It is wonderful that you will be breastfeeding your baby. Colostrum is so important for strengthening the baby’s immune system.”
	“The kitchen for family member use is right across the hall.”

A nurse is being cross trained to the maternity unit and uses the acronym “BUBBLE-HE” to recall the components of the postpartum assessment. Place the components of the assessment in the correct sequence.

A matching question presents 8 answer choices and 8 items. The answer choices are lettered A through H. The items are numbered 4.1 through 4.8. Screen readers will read the answer choices first. Then each item will be presented along with a select menu for choosing an answer choice. Using the pull-down menus, match each item in the left column to the corresponding item in the right column.

	7
	3
	8
	6
	5
	1
	4
	2

4.1 Uterus
4.2 Bowels
4.3 Lochia
4.4 Bladder
4.5 Episiotomy/laceration
4.6 Emotional status
4.7 Hemorrhoids/Homan’s sign
4.8 Breasts

A mother complains of excessive pain that is unrelieved by medication or comfort measures and continually asks the nurse numerous questions about her physical status. The nurse recognizes these to be symptoms of:

	Postpartum infection.
	Potential maladaptive parenting.
	Drug-seeking behaviors.
	Postpartum psychosis.

A nurse brings a baby out to a mother who is recovering from a cesarean section under general anesthesia. Which of the following attachment behaviors would be expected?

	The mother asks when general visiting hours begin.
	The mother touches the baby with her fingertips then palms.
	The mother looks steadily at the baby and begins to sob.
	The mother strokes the baby with the back of her hands.

A nurse is discussing involution with a postpartum client. Which of the following statements indicates an understanding of the effect of breastfeeding on the menstrual cycle.

	“My period started as soon as my baby was born.”
	“My period will most likely return in 6-8 weeks.”
	“My period will most likely return in 12-14 weeks.”
	“My period will not start as long as I am breastfeeding.”

A nurse is preparing several mothers for discharge. Which of the following mothers is at risk for a negative psychological outcome during the postpartum period?

	A primigravida with a large, overbearing family
	A primigravida who has recently immigrated
	An adolescent living in a home for adolescent mothers
	A multipara who lives with her in-laws

The nurse is receiving report on several newly admitted clients. Which of the following conditions places the client at greatest risk for bladder atony?

	Pregnancy-induced hypertension
	Multifetal gestation
	36-hour labor
	Preterm delivery

A mother is experiencing shaking chills during the hour following birth. What is the nurse’s initial action?

	Take a rectal temperature
	Notify the physician or nurse-midwife
	Cover the woman with warmed blankets
	Review the order sheet for antibiotic orders

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Some questions in this exercise may have more than one correct answer. To answer such questions correctly, you must select all the correct answers.

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