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1. What is an important measure to reduce the size of the bladder and keep it away from the surgical field during cesarean birth?
- Administer an oxytocic to contract the bladder.
- Restrict fluids in the woman for 4 hours before surgery.
- Insert a urinary catheter to drain the bladder and decrease its size.
- Give a diuretic to reduce the bladder to its smallest size.
2. The nurse administers ranitidine (Zantac) as ordered prior to a planned cesarean birth to:
- Promote uterine contractions.
- Decrease gastric secretions.
- Delay uterine contractions.
- Neutralize urine acidity.
3. The nurse instructs Mrs. Smith on deep breathing exercises as part of the preoperative teaching plan. The rationale for this exercise is to:
- Stimulate the diaphragm to contract.
- Promote involution on a traumatized uterus.
- Prevent stasis of mucus in the lungs.
- Prevent pulmonary edema.
4. What is the most important responsibility of the healthcare team before surgery starts?
- Assessing the woman’s hygiene.
- Inserting a urinary catheter.
- Decreasing the stomach secretions.
- Securing an informed consent and ensuring that it is obtained.
5. The nurse administers Ringer’s solution intravenously for what purpose?
- To avoid urinary tract infection.
- To ensure that the woman is fully hydrated.
- To reduce bladder size.
- To decrease urine specific gravity.
6. The surgeon plans to perform a low segment incision rather than a classic incision. This type of incision is more advantageous because:
- The procedure is faster with the incision being made simultaneously through the abdomen and uterus.
- The procedure is made with a vertical incision to decrease the chances of reopening.
- It is made horizontally and high on the woman’s abdomen.
- The likelihood of a postpartal uterine infection is decreased.
7. If oxytocin is ordered postoperatively for the client who has had a cesarean birth, the most important nursing intervention would be to:
- Monitor the woman’s blood pressure.
- Prevent infection at the incision site.
- Implement measures to promote comfort.
- Assess for increased lochia discharge.
8. Which of the following interventions would be most helpful to assist a woman to void after a cesarean birth?
- Withholding prescribed analgesic.
- Letting the woman void every 4 hours.
- Running water from the tap within woman’s hearing distance.
- Pouring cold water over her perineal area.
9. A woman has undergone a cesarean birth is to be discharged. The nurse would instruct the woman to notify her health care provider if she develops which of the following?
- Drainage at her incision line.
- No bowel movement for 2 days.
- Decrease in lochia.
- Pain on the incision site.
10. Which of the following is a complication of pain that occurs postoperatively?
Answers and Rationale
1. Answer: C. Insert a urinary catheter to drain the bladder and decrease its size.
- C: Inserting a urinary catheter would drain the urine from the bladder and decrease its size.
- A: Oxytocin would contract the uterus and not the bladder.
- B: Fluids will be restricted but this could not decrease the size of the bladder especially if the bladder is already full.
- D: The woman may have difficulty in voiding even if a diuretic is administered.
2. Answer: B. Decrease gastric secretions.
- B: Zantac decreases gastric secretions to decrease the risk for esophageal reflux and aspiration.
- A: Uterine contractions are promoted by oxytocic agents.
- C: Uterine contractions are delayed by uterine relaxants such as magnesium sulfate.
- D: Zantac could not neutralize urine acidity.
3. Answer: C. Prevent stasis of mucus in the lungs.
- C: Periodic deep breathing exercises fully aerate the lungs to prevent stasis of mucus.
- A: The uterus should be stimulated to contract and not the diaphragm.
- B: Involution is promoted by breastfeeding the infant.
- D: Pulmonary edema cannot be prevented by deep breathing exercises.
4. Answer: D. Securing an informed consent and ensuring that it is obtained.
- D: Informed consent is the most important responsibility because the patient must provide consent for the surgeons to operate on his body before they can start the procedure.
- A: The woman’s hygiene must be checked thoroughly, yet it is not on the top of the list of responsibilities for healthcare providers before surgery.
- B: The urinary catheter is inserted to reduce bladder size and keep the bladder away from the surgical field.
- C: Decreasing stomach secretions is not a primary responsibility yet a part of preoperative measures.
5. Answer: B. To ensure that the woman is fully hydrated.
- B: Intravenous fluid helps hydrating the woman and avoids hypotension or extreme blood loss.
- A: UTI can be prevented by drinking a large amount of water every day.
- C: Bladder size can be reduced by inserting a catheter.
- D: Urine specific gravity can be decreased by drinking large amount of matter.
6. Answer: D. The likelihood of a postpartal uterine infection is decreased.
- D: Uterine infection is less likely in a low segment incision because the incision is made horizontally across the uterus.
- A: The incision is not done simultaneously through the abdomen and uterus.
- B: A classic incision is made vertically.
- C: Low segment incision is made horizontally just below the symphysis pubis.
7. Answer: A. Monitor the woman’s blood pressure.
- A: Oxytocin can increase blood pressure so it must be monitored conscientiously.
- B: Oxytocin causes the uterus to contract and it does not predispose the woman to infection.
- C: Measures for comfort can be implemented, however it is not a priority i=during oxytocin administration.
- D: Lochia discharge might increase if oxytocin is administered because it evacuates the remaining contents inside the uterus.
8. Answer: C. Running water from the tap within woman’s hearing distance.
- C: Urinary elimination can be stimulated when the woman hears running water so she can void.
- A: Prescribed analgesic should not be withheld because it might cause discomfort to the woman.
- B: The woman should void every 2 hours.
- D: Warm water can be used to stimulate urination.
9. Answer: A. Drainage at her incision line.
- A: Drainage at the incision line might lead to infection at the site.
- B: Having no bowel movement 2 or 3 days postoperatively is normal.
- C: Lochia normally decreases until it stops flowing.
- D: Pain on the incision site is normal after surgery.
10. Answer: B. Pneumonia
- B: Pain may interfere with the woman’s mobility and the ability to deep breathe so pneumonia might become a complication.
- A: Constipation is not a complication; it may develop if the woman’s diet is inappropriate.
- C: Hypotension must be prevented postoperatively.
- D: Fever is a complication of infection.