Postpartum Maternal Nursing Care

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1. 1

   Which uterine fundus finding is expected shortly after an uncomplicated birth?

   

   A Firm, midline, and near the level of the umbilicus B Boggy, displaced laterally, and above the umbilicus C Nonpalpable and located deep within the pelvis
2. 2

   Which sequence correctly describes the normal progression of postpartum lochia?

   

   A Alba, rubra, then serosa B Serosa, alba, then rubra C Rubra, serosa, then alba
3. 3

   One hour after birth, a patient has heavy vaginal bleeding and a boggy uterus. What should the nurse do first?

   A Massage the uterine fundus while initiating the hemorrhage response B Place the patient in a warm bath C Delay intervention until the quantified blood loss is complete
4. 4

   Which finding meets the commonly used clinical definition of postpartum hemorrhage?

   A Any blood loss greater than 500 mL after vaginal birth, without considering symptoms B Cumulative blood loss of at least 1000 mL or bleeding with hypovolemia within 24 hours of birth C Blood loss greater than 1500 mL only after cesarean birth
5. 5

   Which uterotonic medication should generally be avoided in a postpartum patient with severe hypertension?

   A Oxytocin B Misoprostol C Methylergonovine
6. 6

   A patient with bacterial mastitis asks whether breastfeeding should continue. What is the best response?

   A Stop emptying both breasts until all symptoms resolve B Continue breastfeeding or expressing milk unless specifically contraindicated C Breastfeed only from the unaffected breast and never express the affected side
7. 7

   Which cluster of findings is most consistent with postpartum endometritis?

   A Bradycardia, clear lochia, and a painless firm uterus B Breast fullness, milk leakage, and mild afterpains C Fever, uterine tenderness, and foul-smelling lochia
8. 8

   A patient six days postpartum reports a severe headache, visual spots, and epigastric pain. What is the priority instruction?

   A Seek immediate emergency evaluation B Rest at home and reassess the symptoms the next day C Increase caffeine intake and avoid checking blood pressure
9. 9

   Which assessment combination most strongly suggests magnesium sulfate toxicity?

   

   A Hyperactive reflexes and a respiratory rate of 22 breaths per minute B Absent deep tendon reflexes and a respiratory rate of 10 breaths per minute C Mild flushing and a urinary output of 60 mL per hour
10. 10

    Which medication should be readily available as the antidote for severe magnesium sulfate toxicity?

    A Naloxone B Protamine sulfate C Calcium gluconate
11. 11

    Which postpartum assessment finding is most suggestive of a lower-extremity deep vein thrombosis?

    

    A Unilateral calf swelling, warmth, and tenderness B Equal mild ankle swelling that improves with elevation C Bilateral cool feet without pain or discoloration
12. 12

    When is postpartum Rh(D) immune globulin indicated?

    A For an Rh-positive patient whose newborn is Rh-negative B For an unsensitized Rh-negative patient whose newborn is Rh-positive C For any patient with an ABO blood type different from the newborn
13. 13

    Which teaching is appropriate after a nonimmune patient receives the rubella vaccine postpartum?

    A Avoid breastfeeding for seven days B Return for the same vaccine every week for one month C Avoid becoming pregnant for at least 28 days
14. 14

    Which cesarean incision finding requires the most urgent follow-up?

    

    A Separation of the wound edges with purulent drainage B Mild bruising near an intact incision during the first day C Slight tenderness that improves with prescribed analgesia
15. 15

    Which feature is most characteristic of postpartum blues rather than postpartum depression?

    A Severe functional impairment lasting longer than one month B Tearfulness and mood changes that improve within about two weeks C Persistent hopelessness with thoughts of self-harm
16. 16

    Which postpartum mental health symptom requires emergency intervention?

    A Brief tearfulness during the first week while maintaining daily function B Fatigue that improves after sleep and family assistance C Hallucinations or delusions involving the patient or newborn