Maternal Newborn Nursing Test Maternity Nursing: Postpartum 4 — Questions and Answers
Question 1: A postpartum client has a hemoglobin of 8.2 g/dL. Which symptom is she most likely to report?
- Severe headache and visual changes
- Fatigue and pallor on exertion (Correct answer)
- Fever and uterine tenderness
- Painful urination and urinary urgency
Correct answer: Fatigue and pallor on exertion
Anemia from postpartum blood loss manifests primarily as fatigue, pallor, and decreased activity tolerance.
Question 2: Which position should the nurse teach a client with a third-degree perineal laceration to use for most comfortable sitting?
- Sitting upright on a hard surface
- Clenching buttocks together before sitting and using a foam donut cushion (Correct answer)
- Lying flat to avoid any pressure
- Sitting with legs crossed to protect the perineum
Correct answer: Clenching buttocks together before sitting and using a foam donut cushion
Squeezing the buttocks together before sitting reduces direct pressure on the perineum, and a foam ring cushion further relieves discomfort.
Question 3: A client on postpartum day 1 is crying and states she feels overwhelmed and irritable. Her assessment is otherwise normal. How should the nurse interpret this?
- Probable postpartum depression requiring psychiatric referral
- Normal postpartum blues related to hormonal shifts (Correct answer)
- Early sign of postpartum psychosis
- Grief response requiring social work consult
Correct answer: Normal postpartum blues related to hormonal shifts
Postpartum blues affect up to 80% of new mothers within the first few days due to rapid estrogen and progesterone decline; they resolve within 2 weeks without treatment.
Question 4: A client is prescribed methylergonovine (Methergine) for postpartum uterine atony. Which vital sign is a contraindication to administering this medication?
- Heart rate of 58 bpm
- Blood pressure of 148/94 mmHg (Correct answer)
- Temperature of 37.8°C (100°F)
- Respiratory rate of 18 breaths/min
Correct answer: Blood pressure of 148/94 mmHg
Methylergonovine is a vasoconstrictor and is contraindicated in hypertension because it can dangerously elevate blood pressure.
Question 5: Which assessment best indicates that postpartum involution is progressing normally on day 3?
- Fundus palpable at the umbilicus
- Fundus 3 cm below the umbilicus (Correct answer)
- Fundus palpable at the symphysis pubis
- Fundus not palpable abdominally
Correct answer: Fundus 3 cm below the umbilicus
The uterus descends approximately 1 cm (one fingerbreadth) per day; by day 3 it should be approximately 3 cm below the umbilicus.
Question 6: A postpartum client who had a cesarean birth asks when she can expect her bowel function to return. What should the nurse tell her?
- Within 12 hours, because surgery stimulates bowel peristalsis
- Usually within 2–3 days, assisted by ambulation and passage of flatus (Correct answer)
- Not until she is fully off IV fluids
- Only after a Fleet enema is administered
Correct answer: Usually within 2–3 days, assisted by ambulation and passage of flatus
Post-cesarean ileus typically resolves within 2–3 days; early ambulation and adequate hydration help restore peristalsis.
Question 7: A nurse is preparing discharge teaching about resuming sexual intercourse postpartum. What is the standard recommendation?
- Wait at least 6 weeks or until cleared by the provider and lochia has ceased (Correct answer)
- Resume whenever the client feels physically comfortable, usually within 1 week
- Wait exactly 6 weeks regardless of healing status
- Avoid intercourse until the next menstrual period returns
Correct answer: Wait at least 6 weeks or until cleared by the provider and lochia has ceased
Most providers recommend waiting until lochia has stopped and perineal healing is complete, typically around 6 weeks and after provider clearance.
