A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-lb, 7-ounce boy after augmentation of labor with Pitocin.
She puts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of afterbirth hemorrhage in this woman is:

Retained placental fragments.

Unrepaired vaginal lacerations.

Uterine atony

Puerperal infection

Answer and Explanation

The Correct Answer is C

Uterine atony.

This is when the uterus does not contract enough to stop the bleeding from the placental site after delivery. It is the most common cause of postpartum hemorrhage, accounting for up to 80% of cases. Uterine atony can be caused by factors such as prolonged or augmented labor, large baby, multiple pregnancies, infection, or retained placenta.

The woman in question has some risk factors for uterine atony, such as a large baby and augmentation of labor with Pitocin.

The other choices are wrong because:

A . Retained placental fragments: This is when parts of the placenta remain attached to the uterine wall and prevent it from contracting properly. It is the second most common cause of postpartum hemorrhage.

However, there is no indication in the question that the woman had any difficulty with the delivery of the placenta or that it was incomplete

B. Unrepaired vaginal lacerations: This is when there are tears or cuts in the vagina or cervix that cause bleeding. It is a less common cause of postpartum hemorrhage.

However, there is no indication in the question that the woman had any trauma during delivery or that she was examined for lacerations

D. Puerperal infection: This is when there is an infection in the uterus or other parts of the reproductive tract after delivery.

It can cause fever, pain, and bleeding. It is a rare cause of postpartum hemorrhage.

However, there is no indication in the question that the woman had any signs or symptoms of infection, such as fever, chills, or foul-smelling discharge.

Normal ranges for blood loss after delivery are less than 500 mL for vaginal birth and less than 1000 mL for C-section.

Any amount above these thresholds can be considered postpartum hemorrhage and requires prompt evaluation and treatment.

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Correct Answer is D

Explanation

Ulcerative colitis is a chronic inflammatory bowel disease that causes diarrhea, pain, and bleeding in the colon. Stress and certain foods can trigger or worsen the symptoms, so it is important to teach the mother how to help her son cope with stress and avoid triggers.

Choice A is wrong because ulcerative colitis is not an infectious disease that can spread to others.

Choice B is wrong because ulcerative colitis causes diarrhea, not constipation. Nutritional guidance is important, but not the main focus of teaching.

Choice C is wrong because the daily use of enemas is not part of the treatment plan for ulcerative colitis. Enemas can irritate the colon and cause more inflammation.

A. Cough B. Osteoporosis C. Slowed growth D. Cushing’s syndrome

Correct Answer is C

Explanation

Children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for this increased risk because some studies have shown a growth delay in children treated with moderate to high doses of inhaled steroids. This appears to occur only during the first year of treatment and may be reversible.

Choice A is wrong because cough is not a side effect of inhaled steroids, but a symptom of asthma itself.

Choice B is wrong because osteoporosis is not a common side effect of inhaled steroids in children, but a possible risk for adults who use high doses of inhaled steroids or oral steroids.

Choice D is wrong because Cushing’s syndrome is not a side effect of inhaled steroids, but a rare complication of oral steroids.

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A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-lb, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of afterbirth hemorrhage in this woman is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What should the nurse stress in a teaching plan for the mother of an 11-year-old diagnosed with ulcerative colitis?

Correct Answer is D

Explanation

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for increased risk of:

Correct Answer is C

Explanation

The nurse is caring for a child with suspected diabetes insipidus. Which clinical manifestation would be observable?

A nurse is conducting discharge and teaches parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if the conditions occur. (Select all that apply.)

As relates to rubella and Rh issues, nurses should be aware that:.

When caring for an infant with an upper respiratory tract infection and elevated temperature, which appropriate nursing intervention should the nurse implement?

A newborn is jaundiced and receivesphototherapy via ultraviolet bank lights. An appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy by this method would be to:

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is:.

The nurse administers vitamin K to the newborn for which reason?

A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-lb, 7-ounce boy after augmentation of labor with Pitocin.
She puts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of afterbirth hemorrhage in this woman is: