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NCLEX Postpartum Clinical Judgment – Quiz 12

Question 1 of 30

A nurse is assessing a client 1 hour postpartum. The uterus is boggy and located above the umbilicus. What is the nurse’s priority action?

Select one answer.

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NCLEX Postpartum Clinical Judgment – Quiz 12 Practice Questions

Review these NCLEX Postpartum Clinical Judgment – Quiz 12 nursing practice questions with answer choices and explanations.

Question 1

A nurse is assessing a client 1 hour postpartum. The uterus is boggy and located above the umbilicus. What is the nurse’s priority action?

  1. Notify the provider
  2. Massage the fundus
  3. Administer pain medication
  4. Encourage breastfeeding
View answer and explanation

Correct answer:

  1. Massage the fundus

Explanation: A boggy uterus indicates uterine atony. The priority intervention is fundal massage to stimulate uterine contraction and prevent hemorrhage.

Question 2

A postpartum client reports soaking two pads in 30 minutes. What is the nurse’s first action?

  1. Assess the fundus
  2. Call the physician
  3. Administer oxytocin
  4. Check hemoglobin levels
View answer and explanation

Correct answer:

  1. Assess the fundus

Explanation: The nurse should first assess the fundus to determine whether bleeding is caused by uterine atony.

Question 3

A postpartum client reports severe perineal pain and pressure. The fundus is firm and lochia is minimal. What complication does the nurse suspect?

  1. Perineal hematoma
  2. Endometritis
  3. Uterine atony
  4. Postpartum depression
View answer and explanation

Correct answer:

  1. Perineal hematoma

Explanation: A firm uterus with severe perineal pain and pressure suggests a perineal hematoma.

Question 4

A nurse notes that a postpartum client's uterus is firm but displaced to the right. What should the nurse do next?

  1. Encourage the client to void
  2. Administer oxytocin
  3. Massage the uterus
  4. Call the provider
View answer and explanation

Correct answer:

  1. Encourage the client to void

Explanation: A deviated uterus commonly indicates bladder distention. The client should empty her bladder.

Question 5

Which postpartum client should the nurse assess first?

  1. Client with a temperature of 100.2°F
  2. Client soaking one pad every hour
  3. Client reporting mild cramping
  4. Client feeling fatigued
View answer and explanation

Correct answer:

  1. Client soaking one pad every hour

Explanation: Excessive bleeding is a priority and may indicate postpartum hemorrhage.

Question 6

A postpartum client reports chills and a fever of 102°F. What condition should the nurse suspect?

  1. Endometritis
  2. Postpartum blues
  3. Perineal hematoma
  4. Normal postpartum recovery
View answer and explanation

Correct answer:

  1. Endometritis

Explanation: Fever and chills postpartum are classic signs of uterine infection (endometritis).

Question 7

A breastfeeding client reports breast redness, pain, and fever. What is the priority nursing intervention?

  1. Encourage continued breastfeeding
  2. Stop breastfeeding
  3. Restrict fluids
  4. Apply tight bandages
View answer and explanation

Correct answer:

  1. Encourage continued breastfeeding

Explanation: Continued breastfeeding helps drain the breast and resolve mastitis.

Question 8

A postpartum client suddenly reports chest pain and shortness of breath. What is the nurse's priority action?

  1. Call the rapid response team
  2. Check fundal height
  3. Provide pain medication
  4. Encourage deep breathing
View answer and explanation

Correct answer:

  1. Call the rapid response team

Explanation: Chest pain and dyspnea may indicate pulmonary embolism, which requires immediate emergency response.

Question 9

A nurse is caring for four postpartum clients. Which client should be seen first?

  1. Client with foul-smelling lochia
  2. Client with headache
  3. Client requesting pain medication
  4. Client reporting fatigue
View answer and explanation

Correct answer:

  1. Client with foul-smelling lochia

Explanation: Foul-smelling lochia indicates infection and requires prompt evaluation.

Question 10

Which postpartum finding requires immediate nursing intervention?

  1. Boggy uterus
  2. Moderate lochia rubra
  3. Mild uterine cramping
  4. Temperature 99°F
View answer and explanation

Correct answer:

  1. Boggy uterus

Explanation: A boggy uterus indicates uterine atony and possible hemorrhage.

Question 11

A postpartum client reports sadness and crying for the past three days. What is the nurse's best response?

  1. Explain that postpartum blues are common
  2. Start antidepressant therapy
  3. Call psychiatric services
  4. Recommend hospital admission
View answer and explanation

Correct answer:

  1. Explain that postpartum blues are common

Explanation: Postpartum blues are common during the first two weeks after birth.

Question 12

A postpartum client states she has thoughts of harming her infant. What should the nurse do first?

  1. Ensure immediate safety of mother and infant
  2. Provide education
  3. Reassure the client
  4. Schedule counseling
View answer and explanation

Correct answer:

  1. Ensure immediate safety of mother and infant

Explanation: Safety of both mother and infant is the immediate priority.

Question 13

A postpartum client reports severe headache and visual disturbances. What complication should the nurse suspect?

  1. Postpartum preeclampsia
  2. Mastitis
  3. Postpartum blues
  4. Endometritis
View answer and explanation

Correct answer:

  1. Postpartum preeclampsia

Explanation: Severe headache and visual disturbances may indicate postpartum preeclampsia.

Question 14

Which client is at greatest risk for postpartum hemorrhage?

  1. Multiparous client with uterine overdistention
  2. Primigravida client
  3. Client with small fetus
  4. Client with short labor
View answer and explanation

Correct answer:

  1. Multiparous client with uterine overdistention

Explanation: Multiparity and uterine overdistention increase risk of uterine atony.

Question 15

Which nursing intervention helps reduce risk of postpartum hemorrhage?

  1. Frequent fundal assessment
  2. Restrict fluids
  3. Bed rest
  4. Limit breastfeeding
View answer and explanation

Correct answer:

  1. Frequent fundal assessment

Explanation: Regular fundal assessment allows early detection of uterine atony.

Question 16

A postpartum client complains of calf pain and swelling. What should the nurse suspect?

  1. Deep vein thrombosis
  2. Endometritis
  3. Mastitis
  4. Hematoma
View answer and explanation

Correct answer:

  1. Deep vein thrombosis

Explanation: Calf pain and swelling suggest deep vein thrombosis.

Question 17

Which postpartum finding indicates normal recovery?

  1. Lochia changing from rubra to serosa
  2. Large clots in lochia
  3. Foul-smelling discharge
  4. Persistent bright red bleeding
View answer and explanation

Correct answer:

  1. Lochia changing from rubra to serosa

Explanation: Normal lochia progression is rubra → serosa → alba.

Question 18

A postpartum client reports difficulty urinating. What is the nurse's priority intervention?

  1. Assist the client to the bathroom
  2. Administer antibiotics
  3. Call the provider
  4. Start IV fluids
View answer and explanation

Correct answer:

  1. Assist the client to the bathroom

Explanation: Early assistance to void helps prevent bladder distention and uterine displacement.

Question 19

Which postpartum symptom suggests anemia?

  1. Fatigue and dizziness
  2. Mild cramping
  3. Pink lochia
  4. Breast tenderness
View answer and explanation

Correct answer:

  1. Fatigue and dizziness

Explanation: Fatigue and dizziness may indicate anemia due to blood loss.

Question 20

Which postpartum teaching helps prevent infection?

  1. Perform perineal hygiene frequently
  2. Avoid bathing
  3. Limit fluids
  4. Avoid urination
View answer and explanation

Correct answer:

  1. Perform perineal hygiene frequently

Explanation: Proper hygiene reduces risk of infection.

Question 21

Which postpartum symptom requires immediate evaluation?

  1. Heavy bleeding with clots
  2. Mild fatigue
  3. Breast fullness
  4. Mild cramping
View answer and explanation

Correct answer:

  1. Heavy bleeding with clots

Explanation: Heavy bleeding indicates possible hemorrhage.

Question 22

A postpartum nurse notes that the uterus is soft and bleeding continues after massage. What medication is typically administered?

  1. Oxytocin
  2. Insulin
  3. Heparin
  4. Morphine
View answer and explanation

Correct answer:

  1. Oxytocin

Explanation: Oxytocin stimulates uterine contraction to control bleeding.

Question 23

Which postpartum sign suggests infection of an episiotomy site?

  1. Redness and purulent drainage
  2. Mild swelling
  3. Slight discomfort
  4. Pink tissue
View answer and explanation

Correct answer:

  1. Redness and purulent drainage

Explanation: Purulent drainage and redness indicate infection.

Question 24

Which client requires priority follow-up after discharge?

  1. Client reporting suicidal thoughts
  2. Client reporting fatigue
  3. Client reporting mild cramps
  4. Client reporting mild sadness
View answer and explanation

Correct answer:

  1. Client reporting suicidal thoughts

Explanation: Suicidal thoughts require immediate intervention.

Question 25

Which postpartum intervention promotes uterine contraction naturally?

  1. Breastfeeding
  2. Bed rest
  3. Fluid restriction
  4. Cold compress
View answer and explanation

Correct answer:

  1. Breastfeeding

Explanation: Breastfeeding stimulates oxytocin release.

Question 26

A postpartum client complains of severe headache and high blood pressure. What condition is suspected?

  1. Postpartum preeclampsia
  2. Postpartum blues
  3. Mastitis
  4. Endometritis
View answer and explanation

Correct answer:

  1. Postpartum preeclampsia

Explanation: Severe headache and hypertension suggest postpartum preeclampsia.

Question 27

Which postpartum complication can cause sudden collapse and cardiovascular failure?

  1. Amniotic fluid embolism
  2. Mastitis
  3. Lochia rubra
  4. Hematoma
View answer and explanation

Correct answer:

  1. Amniotic fluid embolism

Explanation: Amniotic fluid embolism is a rare but fatal postpartum complication.

Question 28

Which postpartum assessment finding is most concerning?

  1. Fundus soft and difficult to locate
  2. Fundus firm at umbilicus
  3. Moderate lochia rubra
  4. Mild cramping
View answer and explanation

Correct answer:

  1. Fundus soft and difficult to locate

Explanation: A soft uterus indicates uterine atony.

Question 29

Which postpartum teaching helps prevent blood clots?

  1. Early ambulation
  2. Bed rest
  3. Fluid restriction
  4. Avoid walking
View answer and explanation

Correct answer:

  1. Early ambulation

Explanation: Early ambulation improves circulation and prevents clot formation.

Question 30

Which postpartum condition involves hallucinations and confusion?

  1. Postpartum psychosis
  2. Postpartum blues
  3. Fatigue
  4. Endometritis
View answer and explanation

Correct answer:

  1. Postpartum psychosis

Explanation: Postpartum psychosis is a psychiatric emergency involving hallucinations and confusion.