NARM Postpartum Care

Question 1

What is the expected rate of uterine fundal descent during normal postpartum involution?

Accepted Answer

Descends approximately 1 cm (one fingerbreadth) per day

Answer

Returns to pre-pregnancy size within 2 weeks with no measurable daily change

Answer

Remains at the umbilicus for the first 5 days postpartum

Answer

Rises above the umbilicus on day 2 before beginning to descend

Question 2

Which description best characterizes normal lochia rubra?

Accepted Answer

Dark red discharge containing decidual tissue that may include small clots, lasting 1–4 days

Answer

Pink-brown watery discharge beginning immediately after delivery and lasting 3 weeks

Answer

Yellow-white creamy discharge present from birth through 6 weeks

Answer

Bright red discharge with large clots and an offensive odor throughout the first week

Question 3

Which intervention is most effective in preventing postpartum hemorrhage?

Accepted Answer

Active management of the third stage of labor including uterotonics and controlled cord traction

Answer

Routine episiotomy to reduce perineal trauma

Answer

Immediate cord clamping within 30 seconds of delivery

Answer

Keeping the mother in a supine position for 2 hours after birth

Question 4

After repair of a second-degree perineal laceration, which perineal care instruction is most appropriate?

Accepted Answer

Use warm sitz baths, keep the perineum clean, and pat dry after voiding

Answer

Keep the area completely dry and avoid all water contact for 2 weeks

Answer

Apply ice packs continuously for 48 hours and avoid sitz baths for the first week

Answer

Change sterile dressings twice daily and apply antibiotic ointment to the suture line

Question 5

During the first hour after an uncomplicated vaginal birth, how frequently should the midwife assess maternal vital signs?

Accepted Answer

Every 15 minutes

Answer

Every 5 minutes continuously

Answer

Every 30 minutes

Answer

Once at 60 minutes if the mother appears stable

Question 6

Which statement best distinguishes postpartum blues from postpartum depression?

Accepted Answer

Postpartum blues typically resolves spontaneously within 10–14 days without treatment

Answer

Postpartum blues requires initiation of antidepressant therapy

Answer

Postpartum depression always begins within 24 hours of delivery

Answer

Both conditions require psychiatric hospitalization and medication management

Question 7

What is the expected timeframe for a postpartum woman to achieve her first spontaneous void after an uncomplicated vaginal delivery?

Accepted Answer

Within 6–8 hours of delivery

Answer

Within 1 hour of delivery

Answer

Within 24–48 hours of delivery

Answer

Within 3–5 days as perineal swelling resolves