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Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 14

Question 1 of 30

Case 1: A client is 2 hours postpartum following a vaginal delivery. The nurse notes heavy bleeding and multiple large clots. The uterus is firm but located at the umbilicus. What complication should the nurse suspect?

Select one answer.

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Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 14 Practice Questions

Review these Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 14 nursing practice questions with answer choices and explanations.

Question 1

Case 1: A client is 2 hours postpartum following a vaginal delivery. The nurse notes heavy bleeding and multiple large clots. The uterus is firm but located at the umbilicus. What complication should the nurse suspect?

  1. Retained placental fragments
  2. Uterine atony
  3. Perineal hematoma
  4. Endometritis
View answer and explanation

Correct answer:

  1. Retained placental fragments

Explanation: Heavy bleeding with a firm uterus suggests retained placental fragments rather than uterine atony.

Question 2

Case 1: Which assessment finding supports the suspected diagnosis?

  1. Continuous bleeding despite a firm uterus
  2. Boggy uterus
  3. Breast tenderness
  4. Calf pain
View answer and explanation

Correct answer:

  1. Continuous bleeding despite a firm uterus

Explanation: Persistent bleeding with a firm uterus is typical of retained placental tissue.

Question 3

Case 1: What is the nurse’s priority action?

  1. Notify the provider
  2. Encourage ambulation
  3. Administer analgesics
  4. Provide breastfeeding education
View answer and explanation

Correct answer:

  1. Notify the provider

Explanation: Retained placental fragments require provider evaluation and possible surgical removal.

Question 4

Case 1: Which treatment does the nurse anticipate?

  1. Dilation and curettage
  2. Antibiotics
  3. Insulin therapy
  4. Antidepressants
View answer and explanation

Correct answer:

  1. Dilation and curettage

Explanation: Dilation and curettage (D&C) may be performed to remove retained placental fragments.

Question 5

Case 1: Which vital sign change is most concerning?

  1. Heart rate 120 bpm
  2. Respirations 18
  3. Temperature 98°F
  4. BP 118/70
View answer and explanation

Correct answer:

  1. Heart rate 120 bpm

Explanation: Tachycardia may indicate blood loss and developing shock.

Question 6

Case 1: Which intervention helps monitor blood loss accurately?

  1. Weighing perineal pads
  2. Measuring abdominal circumference
  3. Monitoring urine color
  4. Assessing breast fullness
View answer and explanation

Correct answer:

  1. Weighing perineal pads

Explanation: Weighing pads provides a more accurate estimate of blood loss.

Question 7

Case 1: Which laboratory test is most important to monitor?

  1. Hemoglobin and hematocrit
  2. Blood glucose
  3. Liver enzymes
  4. Thyroid levels
View answer and explanation

Correct answer:

  1. Hemoglobin and hematocrit

Explanation: Hemoglobin and hematocrit levels help assess severity of blood loss.

Question 8

Case 1: Which medication might be administered to control bleeding?

  1. Oxytocin
  2. Insulin
  3. Magnesium sulfate
  4. Acetaminophen
View answer and explanation

Correct answer:

  1. Oxytocin

Explanation: Oxytocin stimulates uterine contractions to reduce bleeding.

Question 9

Case 1: Which client statement indicates understanding of postpartum care?

  1. I should report heavy bleeding immediately.
  2. Bleeding heavily is normal after delivery.
  3. Large clots are expected.
  4. Bleeding will increase over time.
View answer and explanation

Correct answer:

  1. I should report heavy bleeding immediately.

Explanation: Heavy bleeding postpartum is abnormal and should be reported.

Question 10

Case 1: Which outcome indicates successful treatment?

  1. Decreased bleeding and stable vital signs
  2. Increased heart rate
  3. Persistent bleeding
  4. Low blood pressure
View answer and explanation

Correct answer:

  1. Decreased bleeding and stable vital signs

Explanation: Stabilized vital signs and reduced bleeding indicate improvement.

Question 11

Case 2: A client who is 5 days postpartum reports breast pain, redness, and fever of 101°F. What condition does the nurse suspect?

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

Correct answer:

  1. Mastitis

Explanation: Mastitis commonly occurs in breastfeeding mothers and presents with breast redness, pain, and fever.

Question 12

Case 2: Which risk factor increases the likelihood of this condition?

  1. Incomplete emptying of the breast
  2. Frequent breastfeeding
  3. Adequate hydration
  4. Early ambulation
View answer and explanation

Correct answer:

  1. Incomplete emptying of the breast

Explanation: Milk stasis from incomplete breast emptying promotes bacterial growth.

Question 13

Case 2: Which nursing intervention is most appropriate?

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

Correct answer:

  1. Encourage continued breastfeeding

Explanation: Breastfeeding helps empty the breast and relieve milk stasis.

Question 14

Case 2: Which medication will the provider likely prescribe?

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

Correct answer:

  1. Antibiotics

Explanation: Mastitis is typically treated with antibiotics.

Question 15

Case 2: Which additional symptom supports this diagnosis?

  1. Flu-like symptoms
  2. Shortness of breath
  3. Calf pain
  4. Chest pain
View answer and explanation

Correct answer:

  1. Flu-like symptoms

Explanation: Mastitis often causes systemic flu-like symptoms.

Question 16

Case 2: Which nursing teaching is important for prevention?

  1. Ensure proper infant latch
  2. Limit breastfeeding
  3. Avoid breast stimulation
  4. Restrict fluids
View answer and explanation

Correct answer:

  1. Ensure proper infant latch

Explanation: A proper latch prevents nipple trauma and milk stasis.

Question 17

Case 2: Which assessment should the nurse perform next?

  1. Inspect the breast for redness and swelling
  2. Check fundal height
  3. Measure lochia
  4. Assess calf circumference
View answer and explanation

Correct answer:

  1. Inspect the breast for redness and swelling

Explanation: Inspection of the breast confirms signs of mastitis.

Question 18

Case 2: Which complication can occur if mastitis is untreated?

  1. Breast abscess
  2. Pulmonary embolism
  3. Uterine rupture
  4. Placental abruption
View answer and explanation

Correct answer:

  1. Breast abscess

Explanation: Untreated mastitis may progress to a breast abscess.

Question 19

Case 2: Which outcome indicates improvement?

  1. Reduced breast pain and fever
  2. Increasing redness
  3. Persistent fever
  4. Increasing swelling
View answer and explanation

Correct answer:

  1. Reduced breast pain and fever

Explanation: Resolution of symptoms indicates treatment effectiveness.

Question 20

Case 2: Which teaching should the nurse include before discharge?

  1. Alternate breastfeeding positions
  2. Stop breastfeeding if pain occurs
  3. Limit fluids
  4. Avoid breast stimulation
View answer and explanation

Correct answer:

  1. Alternate breastfeeding positions

Explanation: Changing positions helps fully empty all areas of the breast.

Question 21

Case 3: A client who is 2 days postpartum reports severe headache, blurred vision, and blood pressure of 168/102 mmHg. What complication does the nurse suspect?

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

Correct answer:

  1. Postpartum preeclampsia

Explanation: Severe hypertension with neurological symptoms indicates postpartum preeclampsia.

Question 22

Case 3: What is the nurse’s priority action?

  1. Notify the provider immediately
  2. Encourage ambulation
  3. Provide breastfeeding education
  4. Administer pain medication
View answer and explanation

Correct answer:

  1. Notify the provider immediately

Explanation: Postpartum preeclampsia is a medical emergency requiring immediate evaluation.

Question 23

Case 3: Which medication will the nurse anticipate administering?

  1. Magnesium sulfate
  2. Insulin
  3. Oxytocin
  4. Ibuprofen
View answer and explanation

Correct answer:

  1. Magnesium sulfate

Explanation: Magnesium sulfate is used to prevent seizures in preeclampsia.

Question 24

Case 3: Which assessment finding indicates worsening condition?

  1. Seizure activity
  2. Reduced headache
  3. Stable BP
  4. Normal reflexes
View answer and explanation

Correct answer:

  1. Seizure activity

Explanation: Seizures indicate progression to eclampsia.

Question 25

Case 3: Which laboratory value supports this diagnosis?

  1. Proteinuria
  2. Low glucose
  3. Low calcium
  4. Low potassium
View answer and explanation

Correct answer:

  1. Proteinuria

Explanation: Proteinuria is a hallmark of preeclampsia.

Question 26

Case 3: Which nursing intervention helps prevent seizures?

  1. Reduce environmental stimulation
  2. Encourage ambulation
  3. Increase fluid intake
  4. Encourage exercise
View answer and explanation

Correct answer:

  1. Reduce environmental stimulation

Explanation: Reducing stimulation helps prevent seizure triggers.

Question 27

Case 3: Which reflex finding is expected in severe preeclampsia?

  1. Hyperreflexia
  2. Absent reflexes
  3. Normal reflexes
  4. Weak reflexes
View answer and explanation

Correct answer:

  1. Hyperreflexia

Explanation: Hyperreflexia occurs due to central nervous system irritability.

Question 28

Case 3: Which vital sign indicates improvement?

  1. BP 130/82
  2. BP 170/110
  3. BP 168/102
  4. BP 175/108
View answer and explanation

Correct answer:

  1. BP 130/82

Explanation: Lower blood pressure indicates stabilization.

Question 29

Case 3: Which teaching is important for this client?

  1. Report headaches or visual disturbances immediately
  2. Avoid reporting symptoms
  3. Increase physical exercise
  4. Stop monitoring blood pressure
View answer and explanation

Correct answer:

  1. Report headaches or visual disturbances immediately

Explanation: Neurological symptoms can indicate worsening preeclampsia.

Question 30

Case 3: Which outcome indicates effective management?

  1. Stable blood pressure and absence of seizures
  2. Increasing BP
  3. Seizure activity
  4. Worsening headache
View answer and explanation

Correct answer:

  1. Stable blood pressure and absence of seizures

Explanation: Stable vital signs and no seizures indicate improvement.