A perinatal nurse is caring for a woman who delivered by cesarean section 1 hour ago. The nurse's assessment reveals the client is experiencing profuse lochial bleeding. What is the most likely cause for this bleeding?

Uterine inversion

Vaginal laceration

Uterine atony

Vaginal hematoma

Answer and Explanation

The Correct Answer is C

A. Uterine inversion is a rare, life-threatening emergency in which the uterus turns inside out. It presents with sudden, severe abdominal pain, hemorrhage, shock, and the inability to palpate the uterine fundus abdominally. Although bleeding can be heavy, it is uncommon and not the most likely cause of profuse lochial bleeding 1 hour after a cesarean section.
B. Vaginal lacerations cause persistent bleeding despite a firm, well-contracted uterus and are more commonly associated with operative or traumatic vaginal deliveries. Since this client delivered by cesarean section, vaginal lacerations are less likely to be the source of heavy lochial bleeding.
C. Uterine atony is the most common cause of early postpartum hemorrhage, occurring within the first 24 hours after delivery. It results from failure of the uterus to contract and compress blood vessels at the placental site, leading to excessive lochial bleeding. Risk factors include prolonged labor, overdistended uterus, infection, and cesarean delivery.
D. Vaginal hematomas result from concealed bleeding into soft tissues and typically present with severe perineal or rectal pain, pressure, and signs of hypovolemia with minimal visible bleeding, making this an unlikely cause of profuse lochial bleeding.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

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

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Magnetic resonance imaging (MRI) can provide detailed images of breast tissue and is useful for evaluating the extent of disease, but it cannot definitively diagnose breast cancer. It is typically used as a supplemental tool after an abnormal mammogram or ultrasound.

B. Ultrasound is helpful in distinguishing between solid and cystic masses and guiding biopsies, but it cannot confirm malignancy on its own.

C. Core needle biopsy is the definitive diagnostic test for breast cancer. It involves obtaining a tissue sample from the suspicious area, which is then examined histologically to confirm the presence of malignant cells. This step is necessary before treatment planning.

D. Mammogram is a screening tool that detects abnormalities such as masses or microcalcifications, but it cannot confirm cancer. Abnormal findings on a mammogram require further diagnostic testing, such as a biopsy, for confirmation.

A. Preterm labor occurs when the cervix remains closed. B. A woman with symptoms can wait several days before contacting the primary caregiver. C. The client can ambulate for 2 hours. D. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

Correct Answer is D

Explanation

A. Preterm labor does not occur when the cervix remains closed. It is characterized by regular uterine contractions accompanied by progressive cervical change, including effacement and dilation before 37 weeks of gestation. A closed cervix without dilation or effacement is not indicative of preterm labor, making this statement incorrect.

B. Waiting several days before contacting the provider is dangerous and inappropriate. Preterm labor can progress rapidly, potentially leading to preterm birth and neonatal complications. Clients should contact their healthcare provider immediately if they experience symptoms such as contractions, pelvic pressure, or changes in vaginal discharge.

C. Ambulating for 2 hours is not recommended in the context of suspected preterm labor. In fact, activity can sometimes exacerbate uterine contractions. Bed rest or reduced activity may be advised while the client awaits evaluation, depending on provider recommendations.

D. Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change. This means labor occurring before 37 weeks, regular contractions (typically four or more in 20 minutes or eight or more in 60 minutes), and measurable cervical changes such as effacement of 80% or dilation of 1 cm or more. This statement accurately reflects the clinical criteria used to identify preterm labor and is the most important information for the nurse to understand and communicate to the client.

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 perinatal nurse is caring for a woman who delivered by cesarean section 1 hour ago. The nurse's assessment reveals the client is experiencing profuse lochial bleeding. What is the most likely cause for this bleeding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 42 year-old had an abnormal mammogram and is now being referred for further testing. Which diagnostic test is used to confirm a suspected diagnosis of breast cancer?

Correct Answer is C

Explanation

The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is most important for the nurse to understand and share with the client?

Correct Answer is D

Explanation

A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because she has a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching?

The nurse is evaluating the new mother's knowledge about appropriate infant bottle feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place?

A nurse is assessing a client that delivered 1 hour ago. Which of the following findings is an early indication of hypovolemic shock?

A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding?

The nurse is performing an initial assessment of a client in labor. What is the appropriate terminology for the relationship of the fetal body parts to one another?

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)?