Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 2 — Questions and Answers
Question 1: A postpartum patient reports soaking more than one perineal pad per hour for two consecutive hours. What is the nurse's priority action?
- Document findings and reassess in 1 hour
- Notify the provider immediately (Correct answer)
- Encourage the patient to ambulate to reduce bleeding
- Apply ice pack to the perineum
Correct answer: Notify the provider immediately
Saturating more than one pad per hour for two hours indicates excessive postpartum hemorrhage requiring immediate provider notification.
Question 2: Which uterine finding is expected at 12 hours postpartum?
- Fundus 2 cm above the umbilicus, soft
- Fundus at the umbilicus, firm (Correct answer)
- Fundus 2 cm below the umbilicus, firm
- Fundus not palpable, soft
Correct answer: Fundus at the umbilicus, firm
At 12 hours postpartum, the fundus is typically at the level of the umbilicus and should be firm.
Question 3: A nurse assesses a postpartum patient who had a vaginal delivery and notes the lochia has changed from rubra to serosa on day 2. What should the nurse do?
- Notify the provider of abnormal progression
- Document as a normal finding (Correct answer)
- Encourage increased fluid intake
- Assess for signs of infection
Correct answer: Document as a normal finding
Lochia transitioning from rubra to serosa within the first few days is a normal postpartum finding and should be documented as such.
Question 4: Which medication is most appropriate to administer when a postpartum patient's uterus is boggy and fundal massage has not improved uterine tone?
- Ibuprofen 800 mg orally
- Oxytocin 10 units IM or IV infusion (Correct answer)
- Misoprostol 800 mcg sublingually
- Methylergonovine 0.2 mg IM
Correct answer: Oxytocin 10 units IM or IV infusion
Oxytocin is the first-line uterotonic agent for postpartum uterine atony after fundal massage fails.
Question 5: A postpartum patient with a third-degree perineal laceration asks the nurse about diet. Which recommendation is most appropriate?
- Restrict fiber to prevent loose stools
- Increase fiber and fluid intake to promote soft stools (Correct answer)
- Follow a liquid diet for the first week
- Avoid all dairy products
Correct answer: Increase fiber and fluid intake to promote soft stools
High fiber and fluid intake promotes soft, easy-to-pass stools, reducing strain on the repaired perineal laceration.
Question 6: When assessing a postpartum patient's REEDA score, what does the 'R' stand for?
- Redness (Correct answer)
- Rash
- Rupture
- Rigidity
Correct answer: Redness
REEDA is an acronym for Redness, Edema, Ecchymosis, Discharge, and Approximation used to assess perineal wound healing.
Question 7: A postpartum patient is prescribed sitz baths. Which instruction should the nurse provide?
- Use water as hot as tolerable for maximum benefit
- Soak for 20 minutes, 3–4 times daily (Correct answer)
- Add antiseptic solution to the water every time
- Avoid sitz baths if you have hemorrhoids
Correct answer: Soak for 20 minutes, 3–4 times daily
Sitz baths of warm water for 20 minutes, 3–4 times daily promote perineal healing and relieve discomfort.
Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 2
A postpartum patient reports soaking more than one perineal pad per hour for two consecutive hours.
What is the nurse's priority action?