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Maternal and Newborn Nursing · Maternity Nursing Practice Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A postpartum client saturates a perineal pad in 15 minutes and has a boggy uterus displaced to the right.

Which intervention should the nurse perform first?

A. Offer a high-fiber snack
B. Apply an ice pack to the perineum
C. Massage the fundus and assess bladder fullness
D. Remove the IV line
E. Encourage the client to sleep

Expert Explanatory Rationale

Correct Answer: C. Massage the fundus and assess bladder fullness

A boggy, displaced uterus with heavy bleeding suggests uterine atony, often worsened by a full bladder. Fundal massage and bladder assessment are immediate actions.

Question 2 of 15

Case excerpt

One hour after birth, a client reports chills and has a temperature of 37.7°C (99.9°F). The uterus is firm and bleeding is scant.

How should the nurse interpret this finding?

A. It may be a transient response after birth; continue assessment and monitoring
B. It proves retained placental fragments
C. It confirms postpartum endometritis
D. It indicates uterine inversion
E. It requires immediate broad-spectrum antibiotics

Expert Explanatory Rationale

Correct Answer: A. It may be a transient response after birth; continue assessment and monitoring

Shivering and a mildly elevated temperature can occur transiently after birth. Continue monitoring and assess for persistent fever or other infection signs.

Question 3 of 15

Case excerpt

A client who had a vaginal birth has a swollen, tense, painful perineal area and reports rectal pressure. Lochia is scant.

Which complication should the nurse suspect in this scenario: A client who had a vaginal birth has a swollen, tense, painful perineal area and reports?

A. Uterine atony
B. Perineal hematoma
C. Endometritis
D. Bladder distention only
E. Mastitis

Expert Explanatory Rationale

Correct Answer: B. Perineal hematoma

Severe perineal or rectal pressure with localized swelling and pain despite scant external bleeding suggests a concealed hematoma.

Question 4 of 15

Case excerpt

A postpartum client asks when menstruation may return while exclusively breastfeeding.

Which response is best?

A. Ovulation cannot occur before the first postpartum period
B. Breastfeeding prevents pregnancy in every circumstance
C. Periods permanently stop after breastfeeding
D. Menstruation always returns exactly six weeks after birth
E. The timing varies; breastfeeding may delay ovulation and menstruation, but pregnancy is still possible

Expert Explanatory Rationale

Correct Answer: E. The timing varies; breastfeeding may delay ovulation and menstruation, but pregnancy is still possible

Lactation can delay the return of ovulation and menstruation, but it is not universally contraceptive; discuss appropriate contraception.

Question 5 of 15

Case excerpt

A client on postpartum day 3 reports unilateral calf pain and swelling. The affected leg is warm.

What should the nurse do?

A. Apply vigorous heat and encourage running
B. Massage the calf firmly
C. Notify the provider promptly and avoid massaging the leg
D. Ignore the finding if there is no fever
E. Perform repeated ankle pumping before assessment

Expert Explanatory Rationale

Correct Answer: C. Notify the provider promptly and avoid massaging the leg

Unilateral warmth, swelling, and pain raise concern for deep-vein thrombosis. Prompt evaluation is needed; do not massage the leg.

Question 6 of 15

Case excerpt

A postpartum client has a firm fundus but continues to have a steady trickle of bright-red blood.

Which cause should the nurse consider?

A. Genital tract laceration
B. Breast engorgement
C. Bladder fullness as the only cause
D. Normal lochia alba
E. Uterine atony

Expert Explanatory Rationale

Correct Answer: A. Genital tract laceration

Persistent bleeding with a firm, contracted uterus suggests trauma such as a cervical or vaginal laceration.

Question 7 of 15

Case excerpt

A breastfeeding parent has a painful, reddened wedge-shaped area of one breast and fever.

Which condition is most likely?

A. Uterine infection
B. Galactocele without inflammation
C. Normal milk let-down
D. Mastitis
E. Engorgement alone

Expert Explanatory Rationale

Correct Answer: D. Mastitis

Localized breast erythema, pain, and fever are consistent with mastitis; clinical evaluation and continued effective milk removal are commonly recommended.

Question 8 of 15

Case excerpt

A client after cesarean birth reports increasing abdominal pain, distention, and inability to pass flatus.

Which assessment is most useful?

A. Fundal height alone
B. Bowel sounds, abdominal findings, and return of gastrointestinal function
C. Visual acuity
D. Breast symmetry
E. Patellar reflexes only

Expert Explanatory Rationale

Correct Answer: B. Bowel sounds, abdominal findings, and return of gastrointestinal function

Pain and distention after abdominal surgery warrant assessment for delayed bowel function or ileus.

Question 9 of 15

Case excerpt

A postpartum client says, 'I cry easily, but I still enjoy my baby and can care for myself.' Symptoms began on day 3 after birth.

A postpartum client has heavy bleeding and a boggy uterus. Which actions should the nurse take? (Select all that apply)

A. Massage the fundus
B. Call for assistance and follow the hemorrhage protocol
C. Delay intervention until the next vital-sign check
D. Quantify blood loss
E. Assess bladder fullness

Expert Explanatory Rationale

Correct Answer: A. Massage the fundus; B. Call for assistance and follow the hemorrhage protocol; D. Quantify blood loss; E. Assess bladder fullness

Fundal massage, bladder assessment, blood-loss quantification, and escalation are key actions for suspected uterine atony.

Question 10 of 15

Case excerpt

A client who gave birth 5 days ago reports hopelessness, inability to sleep even when the baby sleeps, and difficulty bonding.

A postpartum client reports unilateral calf pain, warmth, and swelling. Which nursing actions are appropriate? (Select all that apply)

A. Assess for respiratory symptoms
B. Document the findings and time of onset
C. Avoid massaging the affected leg
D. Notify the provider promptly
E. Encourage vigorous walking before evaluation

Expert Explanatory Rationale

Correct Answer: A. Assess for respiratory symptoms; B. Document the findings and time of onset; C. Avoid massaging the affected leg; D. Notify the provider promptly

These findings may indicate deep-vein thrombosis. Prompt evaluation is needed; avoid massage and assess for symptoms of pulmonary embolism.

Question 11 of 15

Case excerpt

A client is Rh-negative and receives Rh(D) immune globulin after delivery.

A breastfeeding client has fever and a painful red area on one breast. Which teaching points are appropriate? (Select all that apply)

A. Follow the prescribed treatment plan
B. Stop all breastfeeding permanently without clinical advice
C. Continue effective milk removal if advised
D. Seek clinical assessment for possible mastitis
E. Use supportive measures for comfort

Expert Explanatory Rationale

Correct Answer: A. Follow the prescribed treatment plan; C. Continue effective milk removal if advised; D. Seek clinical assessment for possible mastitis; E. Use supportive measures for comfort

Mastitis needs clinical assessment. Continued milk removal and prescribed treatment are commonly part of management.

Question 12 of 15

Case excerpt

A postpartum client asks how to care for a clean perineal repair.

A postpartum client reports persistent hopelessness and difficulty bonding. Which nursing actions are appropriate? (Select all that apply)

A. Listen without judgment
B. Arrange prompt clinical evaluation
C. Assess for thoughts of self-harm or harm to the infant
D. Assess available support and immediate safety
E. Assume symptoms are normal postpartum blues

Expert Explanatory Rationale

Correct Answer: A. Listen without judgment; B. Arrange prompt clinical evaluation; C. Assess for thoughts of self-harm or harm to the infant; D. Assess available support and immediate safety

Significant depressive symptoms require safety assessment, prompt evaluation, nonjudgmental support, and review of available help.

Question 13 of 15

Case excerpt

A client with a cesarean incision reports that the wound edges have separated and a loop of tissue is visible.

A client is recovering from cesarean birth. Which findings should be reported promptly? (Select all that apply)

A. Fever with worsening abdominal pain
B. Wound edges separating
C. Mild incisional soreness that improves with prescribed analgesia
D. Shortness of breath or chest pain
E. Increasing incision redness or drainage

Expert Explanatory Rationale

Correct Answer: A. Fever with worsening abdominal pain; B. Wound edges separating; D. Shortness of breath or chest pain; E. Increasing incision redness or drainage

Possible infection, wound separation, and cardiopulmonary symptoms require prompt evaluation.

Question 14 of 15

Case excerpt

Medication or fluid administration calculation in a maternal, newborn, or child-health setting.

A postpartum client is prescribed 1,000 mL of IV fluid over 5 hours. What rate should the nurse program in mL/hr? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 200

1,000 mL ÷ 5 hours = 200 mL/hr.

Question 15 of 15

Case excerpt

The nurse is coordinating a time-sensitive maternal, newborn, or child-health response.

A postpartum client reports dizziness when first getting out of bed. Place the nursing actions in the safest order.

A. Stop the attempt to ambulate and assist the client to a safe position
B. Assess blood pressure, pulse, bleeding, and symptoms
C. Call for help if symptoms persist or instability is present
D. Implement the prescribed response to the assessment findings
E. Reassess stability before another assisted ambulation attempt

Expert Explanatory Rationale

Correct Answer: A. Stop the attempt to ambulate and assist the client to a safe position; B. Assess blood pressure, pulse, bleeding, and symptoms; C. Call for help if symptoms persist or instability is present; D. Implement the prescribed response to the assessment findings; E. Reassess stability before another assisted ambulation attempt

Prevent a fall first, assess for causes such as blood loss or orthostatic changes, escalate, intervene, and reassess.

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