Study 4 quizzes free—no account needed. 2 more quizzes to explore.

Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 15

Question 1 of 30

Case 1: A client is 6 hours postpartum following a vaginal delivery. She reports severe perineal pain and rectal pressure. The uterus is firm and lochia is minimal. What complication should the nurse suspect?

Select one answer.

Review all questions in this quiz

Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 15 Practice Questions

Review these Next-Gen NCLEX Postpartum Clinical Judgment – Quiz 15 nursing practice questions with answer choices and explanations.

Question 1

Case 1: A client is 6 hours postpartum following a vaginal delivery. She reports severe perineal pain and rectal pressure. The uterus is firm and lochia is minimal. What complication should the nurse suspect?

  1. Perineal hematoma
  2. Uterine atony
  3. Endometritis
  4. Placental abruption
View answer and explanation

Correct answer:

  1. Perineal hematoma

Explanation: Severe perineal pain and rectal pressure with a firm uterus suggests a perineal hematoma caused by bleeding into soft tissue.

Question 2

Case 1: Which assessment finding supports the suspected diagnosis?

  1. Bluish swelling in the perineal area
  2. Heavy vaginal bleeding
  3. Foul-smelling lochia
  4. High fever
View answer and explanation

Correct answer:

  1. Bluish swelling in the perineal area

Explanation: A tense bluish swelling in the perineal area is a classic sign of a hematoma.

Question 3

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

  1. Notify the provider immediately
  2. Encourage ambulation
  3. Massage the fundus
  4. Administer oxytocin
View answer and explanation

Correct answer:

  1. Notify the provider immediately

Explanation: Perineal hematomas may expand rapidly and require provider evaluation and possible surgical intervention.

Question 4

Case 1: Which vital sign change indicates worsening bleeding?

  1. Heart rate 118 bpm
  2. Respiratory rate 18
  3. BP 120/80
  4. Temperature 98°F
View answer and explanation

Correct answer:

  1. Heart rate 118 bpm

Explanation: Tachycardia may indicate internal bleeding and hypovolemia.

Question 5

Case 1: Which treatment does the nurse anticipate?

  1. Surgical evacuation of hematoma
  2. Antibiotics
  3. Insulin therapy
  4. Oxytocin infusion
View answer and explanation

Correct answer:

  1. Surgical evacuation of hematoma

Explanation: Large hematomas may require surgical evacuation and ligation of bleeding vessels.

Question 6

Case 1: Which nursing intervention helps reduce swelling before treatment?

  1. Apply ice packs
  2. Encourage walking
  3. Warm compress
  4. Breastfeeding
View answer and explanation

Correct answer:

  1. Apply ice packs

Explanation: Cold therapy reduces swelling and bleeding.

Question 7

Case 1: Which laboratory value should the nurse monitor?

  1. Hemoglobin and hematocrit
  2. Blood glucose
  3. Sodium level
  4. Potassium level
View answer and explanation

Correct answer:

  1. Hemoglobin and hematocrit

Explanation: Blood loss may cause decreased hemoglobin and hematocrit.

Question 8

Case 1: Which symptom suggests the hematoma is enlarging?

  1. Increasing pain and pressure
  2. Reduced lochia
  3. Mild fatigue
  4. Breast tenderness
View answer and explanation

Correct answer:

  1. Increasing pain and pressure

Explanation: Increasing pain and pressure indicate continued bleeding into tissues.

Question 9

Case 1: Which outcome indicates successful treatment?

  1. Pain relief and stable vital signs
  2. Persistent swelling
  3. Falling blood pressure
  4. Increasing heart rate
View answer and explanation

Correct answer:

  1. Pain relief and stable vital signs

Explanation: Resolution of pain and stable vitals indicate bleeding has stopped.

Question 10

Case 1: Which discharge teaching is appropriate?

  1. Report increasing pain or swelling
  2. Avoid reporting symptoms
  3. Limit fluid intake
  4. Remain on bed rest
View answer and explanation

Correct answer:

  1. Report increasing pain or swelling

Explanation: Increasing pain or swelling may indicate recurrence.

Question 11

Case 2: A client 4 days postpartum reports calf pain and swelling in the left leg. What complication should the nurse suspect?

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

Correct answer:

  1. Deep vein thrombosis

Explanation: Calf pain and swelling postpartum suggest deep vein thrombosis (DVT).

Question 12

Case 2: Which assessment finding supports the diagnosis?

  1. Warmth and redness of the calf
  2. Fever and chills
  3. Breast redness
  4. Uterine tenderness
View answer and explanation

Correct answer:

  1. Warmth and redness of the calf

Explanation: Localized warmth, redness, and swelling indicate possible DVT.

Question 13

Case 2: What is the nurse’s priority action?

  1. Notify the provider
  2. Massage the leg
  3. Encourage walking
  4. Apply heat
View answer and explanation

Correct answer:

  1. Notify the provider

Explanation: Massage or ambulation may dislodge the clot; provider must be notified immediately.

Question 14

Case 2: Which diagnostic test confirms DVT?

  1. Venous ultrasound
  2. Chest X-ray
  3. Urinalysis
  4. EKG
View answer and explanation

Correct answer:

  1. Venous ultrasound

Explanation: Ultrasound is the primary diagnostic test for DVT.

Question 15

Case 2: Which medication will likely be prescribed?

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

Correct answer:

  1. Heparin

Explanation: Anticoagulants such as heparin prevent clot growth.

Question 16

Case 2: Which complication is most life-threatening?

  1. Pulmonary embolism
  2. Mastitis
  3. Hemorrhage
  4. Endometritis
View answer and explanation

Correct answer:

  1. Pulmonary embolism

Explanation: DVT may lead to pulmonary embolism if the clot dislodges.

Question 17

Case 2: Which symptom indicates pulmonary embolism?

  1. Sudden shortness of breath
  2. Mild fatigue
  3. Breast pain
  4. Abdominal cramps
View answer and explanation

Correct answer:

  1. Sudden shortness of breath

Explanation: Sudden dyspnea and chest pain are hallmark symptoms.

Question 18

Case 2: Which prevention strategy is most effective?

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

Correct answer:

  1. Early ambulation

Explanation: Early ambulation promotes circulation and prevents clot formation.

Question 19

Case 2: Which vital sign change may occur with pulmonary embolism?

  1. Tachypnea
  2. Low respiratory rate
  3. Low heart rate
  4. Normal oxygen levels
View answer and explanation

Correct answer:

  1. Tachypnea

Explanation: Rapid breathing occurs due to impaired oxygen exchange.

Question 20

Case 2: Which outcome indicates improvement?

  1. Reduced swelling and pain
  2. Increasing redness
  3. Persistent swelling
  4. New chest pain
View answer and explanation

Correct answer:

  1. Reduced swelling and pain

Explanation: Decreasing symptoms indicate effective treatment.

Question 21

Case 3: A client 3 weeks postpartum reports persistent sadness, fatigue, and difficulty caring for her infant. What condition should the nurse suspect?

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

Correct answer:

  1. Postpartum depression

Explanation: Symptoms lasting beyond two weeks suggest postpartum depression.

Question 22

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

  1. Ask about thoughts of harming herself or the baby
  2. Assess fundal height
  3. Measure lochia
  4. Check breast tenderness
View answer and explanation

Correct answer:

  1. Ask about thoughts of harming herself or the baby

Explanation: Safety assessment is the priority when postpartum depression is suspected.

Question 23

Case 3: Which risk factor increases the likelihood of postpartum depression?

  1. History of depression
  2. Multiparity
  3. Short labor
  4. Breastfeeding
View answer and explanation

Correct answer:

  1. History of depression

Explanation: A history of depression is a strong risk factor.

Question 24

Case 3: Which symptom suggests postpartum psychosis instead?

  1. Hallucinations
  2. Fatigue
  3. Mood swings
  4. Crying
View answer and explanation

Correct answer:

  1. Hallucinations

Explanation: Psychosis involves hallucinations or delusions and requires emergency care.

Question 25

Case 3: Which treatment might be prescribed?

  1. Antidepressant medication
  2. Insulin therapy
  3. Oxytocin infusion
  4. Magnesium sulfate
View answer and explanation

Correct answer:

  1. Antidepressant medication

Explanation: Antidepressants and counseling are common treatments.

Question 26

Case 3: Which nursing intervention supports recovery?

  1. Encourage support from family
  2. Limit social interaction
  3. Encourage isolation
  4. Reduce communication
View answer and explanation

Correct answer:

  1. Encourage support from family

Explanation: Strong social support improves outcomes.

Question 27

Case 3: Which statement by the client indicates worsening depression?

  1. I feel hopeless and overwhelmed.
  2. I am tired today.
  3. I want to rest.
  4. I feel sore.
View answer and explanation

Correct answer:

  1. I feel hopeless and overwhelmed.

Explanation: Feelings of hopelessness indicate significant depression.

Question 28

Case 3: Which referral is most appropriate?

  1. Mental health professional
  2. Dietitian
  3. Respiratory therapist
  4. Physical therapist
View answer and explanation

Correct answer:

  1. Mental health professional

Explanation: Mental health support is essential for postpartum depression.

Question 29

Case 3: Which outcome indicates improvement?

  1. Client expresses interest in caring for the baby
  2. Persistent hopelessness
  3. Withdrawal from family
  4. Refusal to communicate
View answer and explanation

Correct answer:

  1. Client expresses interest in caring for the baby

Explanation: Improved bonding and engagement indicate recovery.

Question 30

Case 3: Which discharge teaching is essential?

  1. Report worsening mood or suicidal thoughts immediately
  2. Avoid discussing emotions
  3. Stop seeking support
  4. Ignore mood changes
View answer and explanation

Correct answer:

  1. Report worsening mood or suicidal thoughts immediately

Explanation: Prompt reporting of worsening symptoms helps prevent harm.