Study 4 quizzes free—no account needed. 1 more quizzes to explore.

Next-Gen NCLEX Postpartum Clinical Judgment

Question 1 of 20

Case 1: A client is 1 hour postpartum after a vaginal delivery. The nurse notes that the uterus is soft and boggy, located above the umbilicus. What is the nurse’s priority action?

Select one answer.

Review all questions in this quiz

Next-Gen NCLEX Postpartum Clinical Judgment Practice Questions

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

Question 1

Case 1: A client is 1 hour postpartum after a vaginal delivery. The nurse notes that the uterus is soft and boggy, 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 oral fluids
View answer and explanation

Correct answer:

  1. Massage the fundus

Explanation: A boggy uterus indicates uterine atony. The nurse should immediately perform fundal massage to stimulate uterine contraction and reduce bleeding.

Question 2

Case 1: After fundal massage, the uterus becomes firm but the client continues to bleed heavily. What is the nurse’s next action?

  1. Administer prescribed oxytocin
  2. Discontinue IV fluids
  3. Encourage breastfeeding
  4. Place the client in Trendelenburg position
View answer and explanation

Correct answer:

  1. Administer prescribed oxytocin

Explanation: If bleeding continues after fundal massage, uterotonic medications such as oxytocin are administered to promote uterine contraction.

Question 3

Case 1: Which finding indicates the client is developing hypovolemic shock?

  1. Heart rate 130 bpm and BP 88/56 mmHg
  2. Heart rate 85 bpm
  3. Blood pressure 120/80 mmHg
  4. Respirations 18 per minute
View answer and explanation

Correct answer:

  1. Heart rate 130 bpm and BP 88/56 mmHg

Explanation: Tachycardia and hypotension indicate significant blood loss and possible hypovolemic shock.

Question 4

Case 1: Which intervention should the nurse anticipate next?

  1. Blood transfusion preparation
  2. Discharge teaching
  3. Breastfeeding education
  4. Ambulation assistance
View answer and explanation

Correct answer:

  1. Blood transfusion preparation

Explanation: Severe postpartum hemorrhage may require blood transfusion to restore circulating volume.

Question 5

Case 1: Which risk factor in this client increases the risk for uterine atony?

  1. Multiparity
  2. Primigravida status
  3. Short labor
  4. Small fetus
View answer and explanation

Correct answer:

  1. Multiparity

Explanation: Multiparity is a risk factor because repeated pregnancies weaken uterine muscle tone.

Question 6

Case 2: A client is 3 days postpartum and reports fever, uterine tenderness, and foul-smelling lochia. What condition does the nurse suspect?

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

Correct answer:

  1. Endometritis

Explanation: Fever, uterine tenderness, and foul-smelling lochia are classic signs of endometritis.

Question 7

Case 2: Which risk factor most commonly contributes to this condition?

  1. Prolonged rupture of membranes
  2. Early ambulation
  3. Short labor
  4. Small infant
View answer and explanation

Correct answer:

  1. Prolonged rupture of membranes

Explanation: Prolonged rupture of membranes increases the risk of uterine infection.

Question 8

Case 2: Which treatment does the nurse anticipate?

  1. Broad-spectrum antibiotics
  2. Antidepressants
  3. Insulin therapy
  4. Anticoagulants
View answer and explanation

Correct answer:

  1. Broad-spectrum antibiotics

Explanation: Endometritis is treated with intravenous broad-spectrum antibiotics.

Question 9

Case 2: Which additional symptom supports this diagnosis?

  1. Chills and malaise
  2. Calf pain
  3. Shortness of breath
  4. Chest pain
View answer and explanation

Correct answer:

  1. Chills and malaise

Explanation: Infection commonly produces systemic symptoms such as chills and malaise.

Question 10

Case 2: Which nursing action helps prevent this infection in postpartum clients?

  1. Frequent perineal hygiene
  2. Limiting ambulation
  3. Restricting fluids
  4. Avoiding breastfeeding
View answer and explanation

Correct answer:

  1. Frequent perineal hygiene

Explanation: Perineal hygiene reduces bacterial contamination and infection risk.

Question 11

Case 3: A postpartum client reports sudden chest pain and shortness of breath. What complication should the nurse suspect?

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

Correct answer:

  1. Pulmonary embolism

Explanation: Chest pain and dyspnea postpartum may indicate pulmonary embolism.

Question 12

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

  1. Activate emergency response
  2. Check lochia
  3. Assess the fundus
  4. Encourage deep breathing
View answer and explanation

Correct answer:

  1. Activate emergency response

Explanation: Pulmonary embolism is life-threatening and requires immediate emergency response.

Question 13

Case 3: Which risk factor increases the likelihood of this complication?

  1. Prolonged immobility
  2. Early ambulation
  3. Normal BMI
  4. Short labor
View answer and explanation

Correct answer:

  1. Prolonged immobility

Explanation: Immobility increases the risk of deep vein thrombosis and pulmonary embolism.

Question 14

Case 3: Which symptom may indicate deep vein thrombosis before embolism occurs?

  1. Calf pain and swelling
  2. Fever
  3. Breast tenderness
  4. Lochia rubra
View answer and explanation

Correct answer:

  1. Calf pain and swelling

Explanation: DVT commonly presents with calf pain and swelling.

Question 15

Case 3: Which nursing intervention helps prevent this complication?

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

Correct answer:

  1. Early ambulation

Explanation: Early ambulation improves circulation and prevents clot formation.

Question 16

Case 3: Which vital sign change is most concerning?

  1. Respiratory rate 32/min
  2. Heart rate 80 bpm
  3. BP 120/70
  4. Temperature 98°F
View answer and explanation

Correct answer:

  1. Respiratory rate 32/min

Explanation: Tachypnea may indicate respiratory distress from embolism.

Question 17

Case 3: Which diagnostic test confirms pulmonary embolism?

  1. CT pulmonary angiography
  2. Ultrasound
  3. Urinalysis
  4. Chest X-ray
View answer and explanation

Correct answer:

  1. CT pulmonary angiography

Explanation: CT pulmonary angiography is commonly used to diagnose pulmonary embolism.

Question 18

Case 3: Which medication is commonly administered to treat this condition?

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

Correct answer:

  1. Heparin

Explanation: Anticoagulants such as heparin are used to treat pulmonary embolism.

Question 19

Case 3: Which assessment finding indicates improvement?

  1. Improved oxygen saturation
  2. Increased chest pain
  3. Increased respiratory distress
  4. Falling blood pressure
View answer and explanation

Correct answer:

  1. Improved oxygen saturation

Explanation: Improved oxygen saturation indicates better oxygenation.

Question 20

Case 3: Which teaching should the nurse provide before discharge to prevent recurrence?

  1. Walk frequently and avoid prolonged immobility
  2. Limit fluid intake
  3. Avoid physical activity
  4. Remain on bed rest
View answer and explanation

Correct answer:

  1. Walk frequently and avoid prolonged immobility

Explanation: Frequent ambulation reduces risk of future thromboembolism.