Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 3 — Questions and Answers
Question 1: A breastfeeding mother at 48 hours postpartum reports breast engorgement. Which intervention is most appropriate?
- Apply ice packs continuously and supplement with formula
- Encourage frequent feeding and warm compresses before nursing (Correct answer)
- Recommend pumping only and avoiding direct breastfeeding
- Administer oral estrogen to suppress lactation
Correct answer: Encourage frequent feeding and warm compresses before nursing
Frequent nursing and warm compresses before feeding help relieve engorgement by promoting milk let-down and flow.
Question 2: Which postpartum vital sign finding requires the most immediate nursing action?
- Temperature 37.8°C on day 2 postpartum
- Heart rate 58 bpm on day 1 postpartum
- Blood pressure 162/110 mmHg on day 2 postpartum (Correct answer)
- Respiratory rate 18 breaths/min on day 1 postpartum
Correct answer: Blood pressure 162/110 mmHg on day 2 postpartum
A blood pressure of 162/110 mmHg meets the threshold for severe hypertension and requires immediate intervention to prevent eclampsia or stroke.
Question 3: A postpartum patient who delivered via cesarean section reports sharp, shooting chest pain and shortness of breath on day 3. What is the nurse's priority concern?
- Pleurisy from surgical inflammation
- Pulmonary embolism (Correct answer)
- Intercostal muscle strain from coughing
- Anxiety related to postpartum adjustment
Correct answer: Pulmonary embolism
Chest pain and dyspnea in the early postpartum period, especially post-cesarean, raise high concern for pulmonary embolism due to increased clotting risk.
Question 4: A patient on day 5 postpartum develops a fever of 38.5°C, unilateral breast redness, and warmth. What condition should the nurse suspect?
- Engorgement
- Mastitis (Correct answer)
- Breast abscess
- Galactocele
Correct answer: Mastitis
Fever combined with unilateral breast redness and warmth after day 3 postpartum is classic for mastitis, typically caused by Staphylococcus aureus.
Question 5: Which finding during postpartum assessment of a patient's extremities warrants immediate notification of the provider?
- Mild bilateral ankle edema
- Unilateral calf redness, warmth, and tenderness (Correct answer)
- Trace pedal pitting edema
- Varicose veins noted on both legs
Correct answer: Unilateral calf redness, warmth, and tenderness
Unilateral calf redness, warmth, and tenderness are classic signs of deep vein thrombosis, a serious postpartum complication requiring immediate evaluation.
Question 6: What is the recommended timing for administering Rh immune globulin (RhoGAM) to an Rh-negative mother after delivery of an Rh-positive infant?
- Within 24 hours of delivery
- Within 72 hours of delivery (Correct answer)
- Within 1 week of delivery
- Within 30 days of delivery
Correct answer: Within 72 hours of delivery
Rh immune globulin must be administered within 72 hours of delivery to prevent Rh sensitization in Rh-negative mothers.
Question 7: A postpartum nurse is assessing a patient's bladder 6 hours after vaginal delivery. The patient states she has not voided. Which action should the nurse take first?
- Insert a straight catheter immediately
- Encourage voiding by running water and applying warmth to the suprapubic area (Correct answer)
- Restrict oral fluids to reduce bladder filling
- Notify the provider of urinary retention
Correct answer: Encourage voiding by running water and applying warmth to the suprapubic area
Non-invasive measures such as running water and warmth should be attempted first to stimulate spontaneous voiding before catheterization.
Obstetric Nurse Test Obstetric Nurse Postpartum Maternal Care 3
A breastfeeding mother at 48 hours postpartum reports breast engorgement.
Which intervention is most appropriate?