DOH Nursing Obstetric & Maternity Nursing 2

Question 1

Which intervention is priority when a postpartum patient has a boggy, displaced uterus and heavy vaginal bleeding?

Accepted Answer

Fundal massage and bladder emptying (catheterization if needed)

Answer

A boggy, displaced uterus suggests uterine atony complicated by bladder distension (a full bladder displaces the uterus and prevents contraction). Priority is bimanual fundal massage to stimulate contractions and catheterization to empty the bladder, allowing the uterus to contract.

Question 2

What is the normal blood loss considered acceptable during a vaginal delivery?

Accepted Answer

Up to 500 mL

Answer

Postpartum hemorrhage is traditionally defined as blood loss >500 mL after vaginal delivery or >1,000 mL after cesarean section. Modern guidelines use a functional definition (signs of hemodynamic compromise), but 500 mL remains the classic threshold for vaginal delivery.

Question 3

Which assessment finding in a neonate at 10 minutes of life requires immediate resuscitation?

Accepted Answer

Apgar score of 3 with persistent central cyanosis and poor muscle tone

Answer

An APGAR score of 3 indicates severe neonatal depression (central cyanosis, bradycardia, absent or weak breathing, limp tone). Immediate resuscitation with positive pressure ventilation and further interventions per NRP guidelines are required. Score of 7+ is reassuring.

Question 4

A breastfeeding mother asks why her colostrum is yellow-orange in color. What should the nurse explain?

Accepted Answer

Colostrum is rich in immunoglobulins, protein, and beta-carotene, which gives it its color and provides passive immunity

Answer

Colostrum (produced in the first 2–4 days) is thick, yellow-orange, and rich in secretory IgA, lactoferrin, leukocytes, growth factors, and protein. It provides passive immunity, laxative effect (meconium passage), and perfect early nutrition. Its color comes from beta-carotene.

Question 5

What is the recommended timing for cord clamping in a vigorous term newborn according to current guidelines?

Accepted Answer

Delayed cord clamping at 1–3 minutes after birth

Answer

WHO and ACOG recommend delayed umbilical cord clamping (DCC) for at least 1 minute (preferably 1–3 minutes) in vigorous term and preterm newborns. DCC improves iron stores, reduces anemia, and provides additional blood volume from the placenta.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Obstetric & Maternity Nursing 2