The perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:
Retained placenta fragments.
Vaginal hematoma.
Uterine atony.
Uterine inversion.
The Correct Answer is C
Choice A rationale
Retained placental fragments lead to delayed, not immediate, postpartum hemorrhage as they prevent complete uterine contraction over time.
Choice B rationale
Vaginal hematomas cause concealed, localized bleeding with minimal external blood loss, differing from profuse hemorrhage presentations.
Choice C rationale
Uterine atony, the most common cause, occurs when the uterus fails to contract effectively, leading to uncontrolled and excessive bleeding.
Choice D rationale
Uterine inversion, though serious, is rare and typically accompanied by visible uterine prolapse, not commonly causing profuse bleeding in the immediate postbirth period.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Placing the infant prone increases the risk of sudden infant death syndrome (SIDS), particularly for neonates. Supine positioning reduces this risk and is supported by evidence-based guidelines for infant care.
Choice B rationale
Tightly swaddling and dimming lights mimic the in utero environment, reducing overstimulation and promoting self-regulation. This is especially vital for neonates with neonatal abstinence syndrome (NAS), who are sensitive to external stimuli.
Choice C rationale
Providing excessive stimulation can exacerbate stress responses in neonates with NAS. This may manifest as increased crying, irritability, and tachycardia, worsening their fragile physiological state.
Choice D rationale
Feeding half-strength formula is not advised as it may cause inadequate caloric intake and impaired weight gain. Normal feeding practices, with proper intervals, are crucial to supporting healthy growth and development.
Correct Answer is D
Explanation
Choice A rationale
While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.
Choice B rationale
Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.
Choice C rationale
A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.
Choice D rationale
Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.
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