Maternal Newborn Nursing Test Maternity Nursing: Postpartum 5 — Questions and Answers
Question 1: A postpartum client is breastfeeding and asks about contraception. Which method is safest to recommend at 6 weeks postpartum?
- Combined oral contraceptive pills
- Progestin-only mini-pill (Correct answer)
- Monthly contraceptive injection (Depo-Provera given in first 3 days)
- Estrogen patch
Correct answer: Progestin-only mini-pill
Progestin-only contraceptives do not suppress milk supply and are the preferred hormonal contraceptive option for breastfeeding mothers.
Question 2: A postpartum client reports she cannot urinate 6 hours after a vaginal delivery. Which nursing action is the priority?
- Encourage oral fluids and reassess in 2 hours
- Assess for bladder distension and offer measures to stimulate voiding (Correct answer)
- Perform straight catheterization immediately
- Document the finding and notify the provider
Correct answer: Assess for bladder distension and offer measures to stimulate voiding
Before catheterization, the nurse should assess the degree of distension and try non-invasive measures such as running water, privacy, and warm perineal rinse.
Question 3: Which laboratory value requires the most urgent follow-up in a postpartum client on day 1?
- Hemoglobin 11.2 g/dL
- WBC 16,000/mm³
- Platelet count 48,000/mm³ (Correct answer)
- Hematocrit 32%
Correct answer: Platelet count 48,000/mm³
A platelet count of 48,000/mm³ is critically low and increases risk for life-threatening hemorrhage, requiring immediate provider notification.
Question 4: A postpartum client who is 2 days post-cesarean suddenly reports chest pain and dyspnea. Which action should the nurse take first?
- Administer supplemental oxygen and notify the provider (Correct answer)
- Reassure the client that this is normal post-surgical pain
- Perform fundal assessment to rule out hemorrhage
- Obtain a 12-lead ECG and prepare for cardioversion
Correct answer: Administer supplemental oxygen and notify the provider
Chest pain and dyspnea in a postpartum client suggest pulmonary embolism; oxygen and immediate provider notification are the priority interventions.
Question 5: A client with mastitis is prescribed antibiotics. Which instruction should the nurse include?
- Stop breastfeeding until the infection clears
- Continue breastfeeding or pumping to prevent milk stasis (Correct answer)
- Apply cold compresses only to reduce inflammation
- Wean the infant immediately to rest the breast
Correct answer: Continue breastfeeding or pumping to prevent milk stasis
Continued breastfeeding or pumping is recommended during mastitis because stopping can worsen engorgement, promote abscess formation, and prolong infection.
Question 6: A nurse is performing the Edinburgh Postnatal Depression Scale (EPDS) screening. At what score should the nurse initiate immediate follow-up?
- Score of 5 or higher
- Score of 10 or higher
- Score of 13 or higher (Correct answer)
- Any score above zero
Correct answer: Score of 13 or higher
An EPDS score of 13 or higher indicates probable postpartum depression and requires immediate referral and further mental health evaluation.
Question 7: A postpartum client delivered a macrosomic infant and is at highest risk for which complication?
- Postpartum thyroiditis
- Uterine atony and postpartum hemorrhage (Correct answer)
- Endometritis from prolonged labor
- Deep vein thrombosis from bedrest
Correct answer: Uterine atony and postpartum hemorrhage
Overdistension of the uterus from a large baby impairs myometrial contraction, significantly increasing the risk of uterine atony and hemorrhage.
Maternal Newborn Nursing Test Maternity Nursing: Postpartum 5
A postpartum client is breastfeeding and asks about contraception.
Which method is safest to recommend at 6 weeks postpartum?