Obstetric Nurse Test Obstetric Nurse Postpartum Complications 2 — Questions and Answers
Question 1: A postpartum patient reports a sudden, severe headache rated 9/10 on day 3 after delivery. Her BP is 158/104 mmHg. Which condition should the nurse suspect first?
- Tension headache from sleep deprivation
- Postpartum preeclampsia (Correct answer)
- Spinal headache from epidural
- Migraine exacerbation
Correct answer: Postpartum preeclampsia
Severe headache with BP ≥150/100 mmHg after delivery indicates postpartum preeclampsia, which can occur up to 6 weeks postpartum.
Question 2: Which uterine position finding on postpartum assessment most likely indicates urinary retention?
- Fundus firm at the umbilicus on day 1
- Fundus deviated to the right and above expected level (Correct answer)
- Fundus 2 cm below the umbilicus on day 2
- Fundus midline and firm at day 1
Correct answer: Fundus deviated to the right and above expected level
A full bladder displaces the uterus upward and to one side, preventing normal involution and increasing hemorrhage risk.
Question 3: A patient 5 days postpartum presents with fever 38.9°C, unilateral breast erythema, warmth, and flu-like body aches. The MOST appropriate initial nursing intervention is:
- Advise the patient to stop breastfeeding immediately
- Encourage continued breastfeeding and notify the provider for antibiotic evaluation (Correct answer)
- Apply ice packs and administer acetaminophen only
- Obtain a milk culture before any other action
Correct answer: Encourage continued breastfeeding and notify the provider for antibiotic evaluation
Lactation mastitis is treated with antibiotics (typically dicloxacillin), and continued breastfeeding or pumping prevents abscess formation.
Question 4: A postpartum patient's CBC shows hemoglobin 7.2 g/dL on day 1. She is asymptomatic at rest but feels dizzy when ambulating. Which intervention is the priority?
- Administer iron supplements and recheck in 1 week
- Prepare for blood transfusion as ordered and monitor vital signs closely (Correct answer)
- Encourage increased fluid intake to dilute the blood
- Reassure the patient that this is a normal postpartum finding
Correct answer: Prepare for blood transfusion as ordered and monitor vital signs closely
Symptomatic anemia with hemoglobin below 7–8 g/dL typically warrants transfusion evaluation and close hemodynamic monitoring.
Question 5: Which finding best distinguishes wound dehiscence from normal postpartum surgical incision healing in a cesarean patient?
- Mild bruising along the incision edges
- Separation of wound edges with or without exposed tissue (Correct answer)
- Slight crusting along the staple line
- Mild itching at the incision site on day 5
Correct answer: Separation of wound edges with or without exposed tissue
Dehiscence is identified by separation of the wound edges, which may expose subcutaneous tissue and requires prompt wound care and medical evaluation.
Question 6: A postpartum patient on day 2 reports calf pain and swelling in her left leg. The nurse should FIRST:
- Massage the calf to relieve muscle tension
- Elevate the leg and notify the provider immediately (Correct answer)
- Apply a warm compress and encourage ambulation
- Reassure her that leg cramps are common postpartum
Correct answer: Elevate the leg and notify the provider immediately
Unilateral calf pain and swelling suggest deep vein thrombosis; massaging the leg is contraindicated as it may dislodge a clot.
Question 7: Which risk factor most significantly increases a postpartum patient's likelihood of developing endometritis?
- Breastfeeding within the first hour after birth
- Cesarean delivery after prolonged labor and multiple vaginal exams (Correct answer)
- Epidural analgesia during labor
- Gestational diabetes controlled with diet alone
Correct answer: Cesarean delivery after prolonged labor and multiple vaginal exams
Cesarean delivery is the single greatest risk factor for endometritis; risk increases further with prolonged labor, PROM, and multiple cervical exams.
Obstetric Nurse Test Obstetric Nurse Postpartum Complications 2
A postpartum patient reports a sudden, severe headache rated 9/10 on day 3 after delivery.
Her BP is 158/104 mmHg.
Which condition should the nurse suspect first?