The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

Hypotension

Cold, clammy skin

Tachycardia

Decreased urinary output

Answer and Explanation

The Correct Answer is C

Tachycardia. Tachycardia is a sign of hypovolemic shock from postpartum hemorrhage, which occurs when the blood volume is reduced and the heart rate increases to compensate for the low cardiac output and tissue perfusion. Tachycardia is usually the first sign of hypovolemic shock, as it can occur even before a significant drop in blood pressure or other symptoms.

Choice A. Hypotension is incorrect because it is a late sign of hypovolemic shock, which occurs when the compensatory mechanisms fail to maintain adequate blood pressure and organ perfusion.

Choice B. Cold, clammy skin is incorrect because it is a sign of peripheral vasoconstriction, which occurs as a compensatory mechanism to divert blood flow to the vital organs. However, it is not specific to hypovolemic shock and can occur in other types of shock as well.

Choice D. Decreased urinary output is incorrect because it is a sign of renal impairment, which occurs as a result of reduced blood flow to the kidneys. However, it is not specific to hypovolemic shock and can occur in other types of shock or renal disorders as well.

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Correct Answer is C

Explanation

Notify the physician of a possible pulmonary embolism. This is because the client's symptoms suggest that she has a pulmonary embolism, which is a blockage of a blood vessel in the lungs often caused by blood clots that travel from the legs. Pulmonary embolism is a life-threateningcondition that requires immediate medical attention. The client may also have chest pain, coughing up blood, dizziness, or fainting.

Choice A is wrong because postpartum mucous membrane congestion does not cause fever, cough, or shortness of breath.

Choice B is wrong because an upper respiratory infection does not cause edema and redness along the saphenous vein.

Choice D is wrong because an antipyretic remedy does not treat the underlying cause of the fever and may mask the severity of the condition.

A. The ductus arteriosus expands to allow more blood to enter the lungs B. The foramen ovale closes, preventing blood exchange from right to left in the heart C. The umbilical vein that carried oxygenated blood in utero becomes the ascending aorta entering the right atrium D. The ductus venosus shunts oxygenated aortic blood to the lungs.

Correct Answer is B

Explanation

The foramen ovale closes, preventing blood exchange from right to left in the heart. This is because the foramen ovale is a fetal shunt that allows blood to bypass the lungs and flow from the right atrium to the left atrium. After birth, when the baby starts to breathe air, the lungs expand and the pulmonary resistance decreases. This causes an increase in blood flow and pressure in the left atrium, which pushes the foramen ovale closed. This prevents blood from mixing between the right and left sides of the heart and allows oxygenated blood to circulate to the body¹².

Choice A is not correct because the ductus arteriosus does not expand to allow more blood to enter the lungs. The ductus arteriosus is another fetal shunt that

connects the pulmonary artery to the aorta. It allows blood to bypass the lungs and flow from the right ventricle to the aorta. After birth, when the baby starts to breathe air, the oxygen concentration in the blood increases and causes the ductus arteriosus to constrict and close. This increases blood flow to the lungs and decreases blood flow to the aorta.

Choice C is not correct because the umbilical vein that carried oxygenated blood in utero does not become the ascending aorta entering the right atrium. The umbilical vein is a fetal vessel that carries oxygenated blood from the placenta to the fetus. It connects to either the portal vein or the ductus venosus, which then drains into the inferior vena cava. After birth, when the umbilical cord is clamped and cut, the umbilical vein collapses and becomes a fibrous cord called ligamentum teres hepatis.

Choice D is not correct because the ductus venosus does not shunt oxygenated aortic blood to the lungs. The ductus venosus is another fetal vessel that connects the umbilical vein to the inferior vena cava. It allows some of the oxygenated blood from the placenta to bypass the liver and enter directly into the systemic circulation. After birth, when the umbilical cord is clamped and cut, the ductus venosus closes and becomes a fibrous cord called ligamentum venosum.

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The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

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Naxlex Comprehensive Predictor Exams

The 1-day postpartum patient shows a temperature elevation, cough, and slight shortness of breath on exertion. Based on these symptoms, the nurse should:

Correct Answer is C

Explanation

When a newborn takes its first breath, what physical changes occur in the heart to increase oxygenation of the body?

Correct Answer is B

Explanation

Which finding would alert the nurse to suspect that a newborn is experiencing respiratory distress?

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The first sign of hypovolemic shock from postpartum hemorrhage is likely to be:

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