Answer to Question 1
ANS: D
A perineal hematoma can cause excessive pain and the sensation of needing to defecate. The nurse assesses for this condition by gently palpating the perineal area through sterile gloves while observing for the degree of sensitivity to this touch. If a hematoma is suspected, the provider needs to be notified immediately so that the bleeding can be identified and halted.
Answer to Question 2
ANS: B
Soft surfaces and pillows such as donut rings should not be used by the woman with hemorrhoids, as they separate the buttocks when the woman sits down and decrease venous flow, which increases pain. The woman should be instructed to sit on hard surfaces and tighten the buttocks prior to sitting. The other responses do not give accurate information.