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Worksheetsraul exam 3- 1st practice
Total questions: 100
Worksheet time: 53mins
A postpartum nurse is assessing a patient’s uterus. It is boggy and deviated to the right. What should the nurse do first?
Notify the healthcare provider
Massage the fundus
Document the finding
Apply ice to the abdomen
Which contraception method must be washed with soap and water after each use and replaced every 2 years?
Cervical cap
Diaphragm
Sponge
Female condom
What contraception method comes in different sizes, shapes, and flavors?
Condoms
IUD
Cervical ring
Spermicides
Which contraceptive is safe for breastfeeding mothers and reduces menstrual pain for 3–5 years?
Copper IUD
Levonorgestrel (Mirena) IUD
Nexplanon implant
Oral contraceptives
A woman over 35 who smokes should avoid which method of birth control?
IUD
Oral contraceptive pills
Condoms
Diaphragm
Which are female sterilization methods?
Vasectomy and IUD
Transcervical and salpingectomy
Hysterectomy and tubal ligation
Implant and ring
A woman takes her temperature each morning before getting out of bed to determine fertility. This method is known as:
Calendar method
Ovulation method
Withdrawal method
The nurse uses the acronym BUBBLE HE during postpartum assessment. What does “E” represent?
Endometrial tone
Emotions
Edema
Episiotomy
When assessing a postpartum woman’s breasts, which finding is normal?
Cracked nipples
Reddened and firm breasts
Soft breasts, nipples not cracked
Engorged and painful breasts
Before assessing the uterus, the nurse should instruct the patient to:
Drink water
Void
Eat a snack
Walk for 10 minutes
How should the uterus change postpartum?
Rise above the umbilicus daily
Descend one fingerbreadth per day
Remain midline for 10 days
Become soft after 24 hours
A postpartum woman complains of constipation. What should the nurse expect to administer?
Milk of Magnesia
Stool softener
Enema
Laxative suppository
What is the normal blood loss for a vaginal delivery?
100–200 mL
200–500 mL
500–1000 mL
>1000 mL
Which of the following findings indicates effective healing of an episiotomy incision?
A) Edema and redness
B) REEDA criteria within normal limits
C) Drainage and tenderness
During the “taking in” phase, the postpartum woman:
Is independent and confident
Focuses on infant needs
Is passive and dependent
Begins to assume new roles
Which behavior demonstrates the “taking hold” phase?
Passive attitude
Focus on self
Interest in infant’s cues and needs
Memory lapses
Why is magnesium sulfate administered during pregnancy?
To stimulate contractions
For pre-eclampsia seizure prevention
For fetal lung maturity
To lower blood pressure
What is the desired magnesium level for a mother receiving magnesium therapy?
1–3 mEq/L
6–8 mEq/L
9–12 mEq/L
2–4 mEq/L
The nurse observes a patient on magnesium with absent reflexes. What should the nurse do?
Administer calcium gluconate
Stop fluids
Increase the magnesium dose
Reassess in 1 hour
The nurse knows that a major risk of magnesium therapy is:
Seizures
Respiratory depression
Hypertension
Hyperactivity
What are the two most common causes of postpartum hemorrhage (PPH)?
A) Infection and trauma
B) Uterine atony and retained placenta
C) DIC and dehydration
D) Clotting disorder and laceration
A postpartum patient has a boggy fundus and excessive bleeding. Which medication should the nurse expect to give first?
Methergine
Pitocin (Oxytocin)
Hemabate
Cytotec
Which postpartum medication is contraindicated in a patient with hypertension?
Carboprost
Methergine
Cytotec
Pitocin
When should a mother with Rh-negative blood receive RhoGAM?
Within 72 hours after delivery if baby is Rh-positive
Only during labor
At 6 weeks postpartum
Before every pregnancy
Which are risk factors for postpartum infection?
Short labor, spontaneous delivery
Prolonged rupture of membranes, cesarean birth
Low BMI and breastfeeding
Early ambulation
Which is a sign of mastitis?
Pale cool breast
Red, hot, painful area on breast
Cracked nipples only
White discharge from nipple
The most common postpartum infection is:
Mastitis
Endometritis
UTI
Peritonitis
Which symptom differentiates postpartum depression from postpartum blues?
Mood swings resolving in 2 weeks
Inability to care for self or infant
Crying spells
Fatigue
A postpartum patient who delivered 2 hours ago reports dizziness and soaking one pad in 30 minutes. What should the nurse do?
Encourage fluids
Notify the healthcare provider
Document and recheck later
Reassure as normal
A breastfeeding mother reports nipple pain and cracks. What is the likely cause?
Allergic reaction
Improper latch
Engorgement
Vitamin C deficiency
A postpartum mother has a temperature of 101°F, chills, and severe pelvic pain. The nurse suspects:
Mastitis
Endometritis
Preeclampsia
Cystitis
Which statement from a breastfeeding mother indicates understanding of mastitis care?
I’ll stop breastfeeding until it heals.
I’ll continue breastfeeding and apply warm compresses.
I should avoid fluids to prevent swelling.
I’ll wear a tight bra for support.
What is the normal lochia finding 1 hour postpartum after vaginal birth if the fundus is firm and midline?
Heavy bleeding with large clots
Small clots with lochia rubra, moderate flow
Serosa drainage
No bleeding
A nurse assesses the perineum using the acronym REEDA. What does “A” stand for?
Abrasion
Approximation
Appearance
Abscess
A patient receiving Methergine after delivery should be monitored closely for:
Bradycardia
Hypertension
Hypotension
A postpartum patient receiving Carboprost (Hemabate) should not have a history of:
Diabetes
Asthma
Hypertension
Migraine
The nurse is caring for a patient on magnesium sulfate. Which assessment finding requires immediate intervention?
Urine output 40 mL/hr
Respiratory rate 10/min
Diminished reflexes +1
BP 110/70 mm Hg
Which postpartum patient requires further teaching about perineal care?
I’ll use a peri bottle after voiding.
I’ll change pads every few hours.
I’ll wipe back to front to avoid pain.
I’ll take sitz baths twice daily.
A nurse observes a firm, midline fundus with continuous heavy bleeding. What should the nurse suspect?
Uterine atony
Vaginal or cervical laceration
Retained placenta
DIC
Which intervention promotes normal bowel elimination postpartum?
Decreasing fluid intake
Stool softeners and fluids
Suppressing urge to defecate
Ice packs to abdomen
Which finding requires immediate postpartum follow-up?
Small clots on peripad
Foul-smelling lochia
Fundus firm and midline
Normal perineal soreness
A postpartum woman reports calf pain and redness. The nurse suspects:
Varicose veins
Deep-vein thrombosis
Dehydration
A nurse is teaching discharge instructions using POSTBIRTH. Which symptom indicates an emergency?
Feeling tired
Bleeding through one pad/hour
Constipation
Lightheadedness when standing
Which statement by a postpartum patient indicates understanding of activity recommendations?
I’ll start jogging 1 week after delivery.
I should do about 150 minutes of exercise per week.
I can start weightlifting once my bleeding starts.
I should avoid walking for 6 weeks.
When can most postpartum patients safely resume sexual intercourse?
As soon as bleeding stops
4 to 6 weeks postpartum
After 10 days
When perineal stitches dissolve
Which teaching should be included for non-breastfeeding mothers?
Apply warm compresses
Wear supportive bra and use ice packs
Pump breasts twice daily
Take hot showers
A postpartum woman with cracked nipples asks how to relieve the pain. The nurse should recommend:
Lanolin cream
Baby powder
Alcohol wipes
Deodorant
Which newborn finding indicates effective latch during breastfeeding?
Clicking sounds
Audible swallowing
Dimpling of cheeks
No visible milk
A nurse assesses the postpartum uterus and finds it boggy with clots expelled after massage. The next action is to:
A patient with pre-eclampsia is receiving magnesium sulfate. Which finding shows the medication is effective?
Deep tendon reflexes +4
Absence of seizures
Urine output < 30 mL/hr
RR 8/min
Which nursing action helps prevent postpartum infection?
Encourage early ambulation
Emphasize hand hygiene and perineal care
Restrict fluids
Delay breastfeeding
Which factor increases the risk for postpartum infection?
Scheduled cesarean section
Short rupture of membranes
Vaginal delivery under 4 hours
Early ambulation
What complication is associated with the use of vacuum extraction during birth?
Fetal scalp hematoma
Maternal hematoma
Neonatal jaundice
Uterine rupture
Which finding suggests a maternal hematoma after forceps delivery?
Perineal bruising with severe unrelieved pain
Mild tenderness with drainage
Firm midline uterus
Scant lochia
A postpartum patient asks when her milk will “come in.” The nurse should reply:
In about 3 to 5 days.
Immediately after delivery.
Within the first 6 hours.
At 3 weeks.
Which postpartum phase is characterized by the mother’s eagerness to learn and focus on infant care?
(a)
The nurse knows the most accurate method to measure postpartum blood loss is:
Counting pads
Estimating visually
Quantitative blood loss by weighing pads
Asking the patient
Which postpartum medication combination provides best pain control?
Tylenol and Aleve
Percocet and Motrin
Tramadol and aspirin
Morphine and Tylenol
A postpartum woman on magnesium has urine output of 20 mL/hr, RR 12/min, and absent reflexes. The nurse should:
Stop magnesium infusion and notify provider
Increase infusion rate
Document as expected
Encourage oral fluids
Which statement indicates the mother understands RhoGAM administration?
It’s only given during pregnancy.
I’ll get it within 72 hours if my baby’s blood type is positive.
I’ll receive it before delivery regardless of blood type.
I’ll take it by mouth at home.
Which postpartum finding indicates uterine atony?
Firm, midline fundus
Boggy fundus with heavy bleeding
Fundus below the umbilicus
Scant lochia rubra
What is the nurse’s priority action if the uterus is boggy?
Notify provider
Massage the fundus until firm
Apply ice to abdomen
Start oxytocin infusion
Which of the following best defines postpartum hemorrhage?
Loss > 500 mL after vaginal birth or > 1000 mL after cesarean
Bleeding for more than 2 weeks
Hemoglobin < 8 g/dL
Which medication is first-line for postpartum hemorrhage?
Methergine
Pitocin (Oxytocin)
Hemabate
Cytotec
A postpartum patient with hypertension should NOT receive which medication?
Pitocin
Methergine
Cytotec
Carboprost
A patient who had forceps delivery reports severe perineal pain unrelieved by opioids. The nurse suspects:
Hematoma
Infection
Laceration
Constipation
What education should the nurse provide for postpartum blues?
It resolves within 2 weeks without medical treatment
It requires antidepressants
It means you cannot care for your baby
It is a psychiatric emergency
Which finding differentiates postpartum depression from postpartum blues?
Crying spells
Hopelessness and inability to care for infant
Fatigue
Appetite changes
A woman with a history of intimate-partner violence is at high risk for:
Postpartum infection
Postpartum depression
Mastitis
Pre-eclampsia
A postpartum nurse documents a firm fundus at the umbilicus with heavy bleeding. What should the nurse suspect?
Cervical laceration
Retained placenta
Uterine atony
Which maternal statement indicates correct formula-feeding technique?
I’ll re-use any leftover milk later.
I’ll feed every 2–3 hours.
I’ll warm bottles in the microwave.
I’ll prop the bottle for convenience.
The nurse teaches a mother to use a peri bottle postpartum to:
Reduce bleeding
Cleanse the perineum without touching
Relieve cramps
Encourage urination
A postpartum patient with red, painful breast area and flu-like symptoms likely has:
Engorgement
Mastitis
Fibrocystic disease
Plugged duct
When teaching about mastitis prevention, the nurse should include:
Avoid breastfeeding on the affected side
Ensure proper latch and frequent feeding
Wear tight bras continuously
Limit fluid intake
Which of the following is a normal postpartum uterine finding at 24 hours?
Firm fundus one fingerbreadth below the umbilicus
Fundus at the umbilicus and boggy
Fundus deviated right
Fundus two above the umbilicus
A postpartum patient asks why she received a RhoGAM injection. The nurse responds:
It protects future Rh-positive babies from complications.
It prevents postpartum infection.
It helps your uterus contract.
It prevents depression.
Which of the following findings requires immediate intervention after delivery?
Fundus firm and midline
Bright-red trickle with firm uterus
Scant lochia serosa
Mild perineal swelling
Which lab result is consistent with magnesium toxicity?
Serum magnesium 2 mEq/L
Serum magnesium 9 mEq/L
Deep tendon reflex +3
Urine output > 60 mL/hr
What is the antidote for magnesium toxicity?
Calcium gluconate
Protamine sulfate
Vitamin K
Narcan
A nurse performing a postpartum assessment uses BUBBLE HE. What does the “H” stand for?
A) Headache and hydration
B) Homan’s sign or hemorrhoids
C) Heart rate
D) Healing
A postpartum woman reports fever, fatigue, and uterine tenderness. The nurse should suspect:
Endometritis
Mastitis
Cystitis
DIC
Which statement shows understanding of fluid needs while breastfeeding?
I should drink at least 2–3 liters of water daily.
I’ll avoid fluids to prevent swelling.
I’ll drink only when thirsty.
Caffeine helps milk supply.
Which nutritional change should a breastfeeding mother make?
Decrease calories
Increase intake by 500 calories per day
Limit dairy
Increase protein by 10 g/day only
Which nursing action is appropriate for hemorrhoids developed during labor?
Apply ice
Encourage warm sitz baths
Administer stool softeners only
Avoid fluids
A mother is 3 days postpartum and tearful but caring for her baby appropriately. The nurse recognizes this as:
Postpartum psychosis
Postpartum blues
Postpartum depression
Inadequate bonding
Which statement shows understanding of postpartum sexual activity?
We’ll resume sex in 4–6 weeks.
We can have intercourse when bleeding stops.
Birth control isn’t needed if I’m breastfeeding.
Lubrication will not be affected.
Which of the following defines quantitative blood loss (QBL)?
Visually estimating pad saturation
Weighing sponges and pads
Counting soaked pads
Recording time between pad changes
A postpartum patient with tachycardia, pallor, and dizziness should be assessed for:
Infection
Postpartum hemorrhage
Hypertension
Pain
Which teaching point is correct for preventing postpartum infection?
Change pads every 8 hours
Perform hand hygiene before and after perineal care
Avoid bathing for 2 weeks
Limit protein intake
What is the nurse’s priority for a patient experiencing heavy lochia and a firm uterus?
Check for bladder distention
Notify the provider
Massage fundus
Document as normal
A mother on magnesium sulfate complains of shortness of breath and lethargy. The nurse should:
Stop magnesium infusion and call provider
Continue therapy and monitor
Lower the bed and give oxygen only
Administer Pitocin
A nurse assessing mother–infant bonding finds the mother looking at the infant and smiling. This indicates:
Passive behavior
Attachment
Anxiety
Postpartum blues
Which of the following indicates positive newborn adaptation immediately after birth?
Apnea lasting 30 seconds
Strong cry and pink color
Nasal flaring
Grunting
The nurse assisting with delivery knows the priority for the newborn is:
Clear airway
Apply eye ointment
Identify infant
Measure length
After ensuring airway patency in a newborn, the next action is to:
Dry the infant and cover the head
Apply ID bracelet
Suction the mouth again
Give vitamin K
A nurse caring for a newborn of a rubella-positive mother isolates the baby because:
The newborn may shed the virus
The baby has encephalitis
The mother is immune
The nurse is non-immune
The nurse identifies a postpartum patient at greatest risk for hemorrhage as one with:
Cesarean birth and uterine atony
Multiparity with firm fundus
Vacuum delivery with normal lochia
Induced labor with small infant
Which is an appropriate postpartum pain management strategy?
Percocet and Motrin as ordered
Ibuprofen alone every 8 hours
No medications while breastfeeding
Use heat packs only
A patient reports passing clots larger than an orange. The nurse should suspect:
Retained placenta
Dehydration
Bladder distention
DIC
A nurse is performing discharge teaching. Which statement indicates the patient understands when to call her provider?
If I soak a pad in 30 minutes, I’ll call right away.
If my bleeding is light pink.
If my lochia has no odor.
If my milk comes in on day 3.
