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Postpartum Assessment and Complications – Quiz 10

Question 1 of 25

Your patient delivered 30 minutes ago. She was a G7P6 at 39 weeks gestation. Upon assessment you note a boggy fundus three fingers above the umbilicus, large clots in the lochia, maternal HR 132 bpm, and BP 90/60. What is your initial action?

Select one answer.

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Postpartum Assessment and Complications – Quiz 10 Practice Questions

Review these Postpartum Assessment and Complications – Quiz 10 nursing practice questions with answer choices and explanations.

Question 1

Your patient delivered 30 minutes ago. She was a G7P6 at 39 weeks gestation. Upon assessment you note a boggy fundus three fingers above the umbilicus, large clots in the lochia, maternal HR 132 bpm, and BP 90/60. What is your initial action?

  1. Call the physician to report a suspected laceration
  2. Prepare the client for dilation and curettage
  3. Obtain type and crossmatch and administer blood products
  4. Massage the fundus
View answer and explanation

Correct answer:

  1. Massage the fundus

Explanation: A boggy uterus with heavy bleeding shortly after delivery suggests uterine atony. The first nursing intervention is fundal massage to stimulate uterine contraction and reduce bleeding.

Question 2

A client who is 7 days postpartum and breastfeeding reports redness and pain in her right breast and has a fever of 101.2°F. What diagnosis does the nurse suspect?

  1. Endometritis
  2. Mastitis
  3. Hematoma
  4. Incisional infection
View answer and explanation

Correct answer:

  1. Mastitis

Explanation: Mastitis is an infection of breast tissue common in breastfeeding mothers and presents with redness, warmth, pain, and fever.

Question 3

A nurse is caring for a postpartum client who has a standing order for methylergonovine (Methergine). Which client should not receive this medication?

  1. Client with a temperature of 100.5°F
  2. Client with a hematocrit of 32%
  3. Client who has preeclampsia and hypertension
  4. Client with a WBC count of 24,000
View answer and explanation

Correct answer:

  1. Client who has preeclampsia and hypertension

Explanation: Methergine causes vasoconstriction and raises blood pressure, making it contraindicated in clients with hypertension or preeclampsia.

Question 4

A client delivered after premature rupture of membranes lasting 36 hours. Which findings are most concerning to the nurse?

  1. Positive group B streptococcus vaginal culture at 36 weeks
  2. Voiding every two hours with blood in the urine
  3. Temperature that spikes up and down
  4. Continuous abdominal pain
View answer and explanation

Correct answer:

  1. Positive group B streptococcus vaginal culture at 36 weeks

Explanation: Prolonged rupture of membranes increases infection risk. A positive GBS status increases the risk of neonatal and maternal infection.

Question 5

A nurse is caring for a client who is 4 hours postpartum following a vaginal birth. The client has saturated a perineal pad within 10 minutes. What should the nurse do first?

  1. Assess the client's blood pressure
  2. Assess the bladder for distention
  3. Massage the client's fundus
  4. Prepare to administer a prescribed oxytocic
View answer and explanation

Correct answer:

  1. Massage the client's fundus

Explanation: Heavy postpartum bleeding is usually caused by uterine atony, so the nurse should massage the fundus first to stimulate contraction.

Question 6

Which symptoms should a postpartum client report to the provider after discharge?

  1. Fundus cannot be felt two weeks after delivery
  2. Flu-like symptoms such as fever and chills
  3. Depression preventing care for herself or the baby
  4. Lochia with a foul odor
View answer and explanation

Correct answer:

  1. Flu-like symptoms such as fever and chills

Explanation: Flu-like symptoms may indicate infection and should be reported immediately after discharge.

Question 7

A nurse is assessing a multiparous client who is 8 hours postpartum. Which finding suggests the client needs to urinate?

  1. Moderate lochia rubra
  2. Fundus three fingerbreadths above the umbilicus
  3. Moderate swelling of the labia
  4. Blood pressure 130/84 mmHg
View answer and explanation

Correct answer:

  1. Fundus three fingerbreadths above the umbilicus

Explanation: A distended bladder can push the uterus upward, causing the fundus to be higher than expected.

Question 8

A postpartum client complains of dizziness and rectal discomfort five hours after delivery. The fundus is firm and lochia is moderate. What complication should the nurse suspect?

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

Correct answer:

  1. Perineal hematoma

Explanation: Perineal hematoma often presents with rectal pressure, pain, dizziness, and a firm uterus with normal lochia.

Question 9

A client who is 4 hours postpartum is soaking more than one pad per hour. The fundus is firm but there is a steady trickle of bright red blood. What action should the nurse take?

  1. Continue massaging the fundus
  2. Administer Pitocin infusion
  3. Notify the physician or care provider
  4. Insert a straight catheter
View answer and explanation

Correct answer:

  1. Notify the physician or care provider

Explanation: A firm uterus with continued bleeding suggests a laceration of the birth canal requiring provider evaluation.

Question 10

A client who is 3 weeks postpartum reports feeling sad, lacking energy, and crying frequently. What is the nurse's priority action?

  1. Assist the family to identify coping skills
  2. Ask the client if she has considered harming her newborn
  3. Anticipate an antidepressant prescription
  4. Reinforce postpartum discharge teaching
View answer and explanation

Correct answer:

  1. Ask the client if she has considered harming her newborn

Explanation: When postpartum depression is suspected, the nurse must assess for safety first, including thoughts of harming the baby or herself.

Question 11

Which finding during postpartum assessment indicates normal uterine involution?

  1. Fundus firm and midline at the umbilicus
  2. Fundus soft and above the umbilicus
  3. Fundus deviated to the right
  4. Fundus difficult to palpate
View answer and explanation

Correct answer:

  1. Fundus firm and midline at the umbilicus

Explanation: A firm, midline fundus at the level of the umbilicus shortly after delivery indicates normal uterine contraction.

Question 12

Which lochia stage occurs during the first few days after delivery and appears bright red?

  1. Lochia rubra
  2. Lochia serosa
  3. Lochia alba
  4. Lochia sanguinea
View answer and explanation

Correct answer:

  1. Lochia rubra

Explanation: Lochia rubra occurs in the first few days postpartum and consists mainly of blood and tissue debris.

Question 13

Which postpartum hormone causes uterine contractions and helps reduce bleeding?

  1. Oxytocin
  2. Progesterone
  3. Estrogen
  4. Prolactin
View answer and explanation

Correct answer:

  1. Oxytocin

Explanation: Oxytocin stimulates uterine contractions that help prevent postpartum hemorrhage.

Question 14

Which sign indicates a postpartum infection of the uterus?

  1. Foul-smelling lochia
  2. Clear vaginal discharge
  3. Mild uterine cramping
  4. Slight fatigue
View answer and explanation

Correct answer:

  1. Foul-smelling lochia

Explanation: Foul-smelling lochia is a common sign of endometritis.

Question 15

Which condition causes severe swelling and pain in the perineum after delivery?

  1. Perineal hematoma
  2. Endometritis
  3. Mastitis
  4. Lochia serosa
View answer and explanation

Correct answer:

  1. Perineal hematoma

Explanation: A hematoma forms when blood accumulates in tissues after delivery trauma.

Question 16

Which medication is commonly used to control postpartum bleeding?

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

Correct answer:

  1. Oxytocin

Explanation: Oxytocin stimulates uterine contractions to reduce postpartum bleeding.

Question 17

Which maternal action helps prevent deep vein thrombosis after delivery?

  1. Early ambulation
  2. Fluid restriction
  3. Bed rest
  4. Cold compresses
View answer and explanation

Correct answer:

  1. Early ambulation

Explanation: Early ambulation improves circulation and reduces clot formation risk.

Question 18

Which postpartum emotional condition typically resolves within two weeks after birth?

  1. Postpartum blues
  2. Postpartum psychosis
  3. Major depression
  4. Bipolar disorder
View answer and explanation

Correct answer:

  1. Postpartum blues

Explanation: Postpartum blues involve mild mood swings and usually resolve within two weeks.

Question 19

Which postpartum sign suggests urinary retention?

  1. Fundus deviated to one side
  2. Moderate lochia rubra
  3. Firm uterus
  4. Normal blood pressure
View answer and explanation

Correct answer:

  1. Fundus deviated to one side

Explanation: A distended bladder may displace the uterus laterally.

Question 20

Which postpartum intervention helps reduce perineal swelling?

  1. Ice packs
  2. Warm baths
  3. Massage
  4. Exercise
View answer and explanation

Correct answer:

  1. Ice packs

Explanation: Ice packs reduce inflammation and swelling in the perineal area.

Question 21

Which complication causes excessive bleeding due to retained placental fragments?

  1. Retained placenta
  2. Placenta previa
  3. Eclampsia
  4. Hyperemesis gravidarum
View answer and explanation

Correct answer:

  1. Retained placenta

Explanation: Retained placental fragments prevent uterine contraction and cause bleeding.

Question 22

Which postpartum exercise strengthens pelvic floor muscles?

  1. Kegel exercises
  2. Push-ups
  3. Sit-ups
  4. Jogging
View answer and explanation

Correct answer:

  1. Kegel exercises

Explanation: Kegel exercises strengthen pelvic muscles weakened during childbirth.

Question 23

Which condition occurs when a breastfeeding mother develops painful cracked nipples?

  1. Poor infant latch
  2. Mastitis
  3. Endometritis
  4. Lochia alba
View answer and explanation

Correct answer:

  1. Poor infant latch

Explanation: Improper latch is the most common cause of nipple trauma.

Question 24

Which postpartum finding indicates normal healing of the uterus?

  1. Fundus descending about one fingerbreadth per day
  2. Fundus remaining above the umbilicus
  3. Soft uterus
  4. Continuous bright red bleeding
View answer and explanation

Correct answer:

  1. Fundus descending about one fingerbreadth per day

Explanation: The uterus normally descends approximately one fingerbreadth daily during involution.

Question 25

Which maternal symptom suggests postpartum psychosis?

  1. Hallucinations or delusions
  2. Mild fatigue
  3. Slight mood swings
  4. Occasional crying
View answer and explanation

Correct answer:

  1. Hallucinations or delusions

Explanation: Postpartum psychosis includes hallucinations, delusions, and severe behavioral changes.