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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["C","D","E"]

Explanation

The parents should notify the physician if the infant has a temperature above 37.7° C (100° F), new frequent coughing, or turning blue or bluer

than normal. These are signs of infection, respiratory distress, or cyanosis, which could indicate complications after cardiac surgery.

Choice A is wrong because a respiratory rate of 36 breaths/minute at rest is within the normal range for an infant.

Choice B is wrong because an appetite slowly increasing is a positive sign of recovery and does not require immediate attention.

A. Inappropriate, because of child’s age B. A way to establish rapport C. Too distracting when cooperation is important D. Acceptable, if there is adequate time

Correct Answer is B

Explanation

A way to establish rapport. Doing a simple magic trick using gauze is a way to gain the child’s trust and attention, and to make the dressing change less stressful and more fun. This is appropriate for a 5-year-old child who is in the stage of initiative versus guilt according to Erikson’s theory of psychosocial development.

Choice A is wrong because 5-year-old children are curious and imaginative, and they enjoy magic tricks and fantasy play.

Choice C is wrong because a simple magic trick is not too distracting, but rather a way to engage the child and reduce anxiety.

Choice D is wrong because a simple magic trick is not inappropriate due to the child’s cognitive development. According to Piaget’s theory of cognitive development, 5-year-old children are in the preoperational stage, which means they can use symbols and language to represent objects and events.

A magic trick using gauze is a symbolic representation of something else, which the child can understand and appreciate.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

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

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.)

Correct Answer is ["C","D","E"]

Explanation

The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as:

Correct Answer is B

Explanation

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect?

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:

The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play?

A child is diagnosed with juvenile hypothyroidism. The nurse should expect to assess which symptoms are associated with hypothyroidism. (Select all that apply.).​​​​​​

Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?

Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply.):.

Magnesium sulfate is given to women with preeclampsia and eclampsia to:

A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:

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: