MATERNITY TEST 2 CHAPTERS 28 AND
29 | COMPREHENSIVE OB NURSING
PRACTICE QUESTIONS AND STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,Lochia Rubra Reddish or red-brown vaginal discharge that occurs immediately after childbirth
and the first 1-2 days after that is composed mostly of blood.
Lochia Serosa Thinner Pale pinkish to brownish discharge lasting 1 week postpartum
Lochia Alba After the seventh day the drainage is slightly Whitish/yellowish and can last 10-14
days may last 2 weeks and remain normal.
Changes in the cervix, vagina, and perineum after The cervix appears edematous with bruising. The external cervical opening has a
pregnancy ragged slitlike appearance instead of a round shape due to it dilating and thinning
before delivery.
The vaginal walls are thin and dry with an absence of rugae. Vaginal mucus
production returns with the return of estrogen production. Rugae reappear
around 4 weeks after delivery.
bruising and edema of the perineum is common. The episiotomy if present should
be free of erythema with the edges well approximated and without discharge. It
should heal in 2-3 weeks.
1st degree Laceration Laceration extends through the skin and structures superficial to muscles.
2nd degree Laceration Laceration extends through muscles of perineal body.
3rd Degree Laceration Laceration continues through the sphincter muscle.
4th Degree Laceration Laceration also involves the anterior rectal wall.
Nursing Interventions for lacerations For 3rd and 4th degree lacerations assess bowel habits, the initial stool after
delivery may be uncomfortable, measures to promote soft stools should be
implemented, promote increased fluid intake, dietary fiber, walking, and NO
enemas or suppositories.
, Hypovolemic shock signs and symptoms woman has persistent significant bleeding (perineal pad soaked within 15 minutes)
the bleeding may not be accompanied by a change in vital signs or maternal
color or behavior, woman states she feels weak, lightheaded, "funny", or "sick to
her stomach", or she "sees stars." Woman begin to act anxious or exhibits air
hunger, skin turns grey or ashen, skin feels cool and clammy, pulse rate increases,
and blood pressure declines.
Changes in the breasts after pregnancy Estrogen stimulates the growth of milk ducts to prepare for lactation.
Colostrum is the first secretion produced by the breast
Prolactin is the hormone that stimulates milk production in the mammary alveolar
cells.
Oxytocin causes contraction of the mammary ducts which induces milk ejection
caused by infant sucking "Let down reflex"
Changes in the cardiovascular system after pregnancy blood volume is reduced to pre-pregnancy levels by 2-4 weeks after delivery.
Diuresis, diaphoresis, and blood loss during delivery account for fluid loss. 300-
500 mL of blood is lost during a vaginal birth and 600-800 mL of blood is lost in a
c-section birth. Cardiac output declines rapidly and the patient is at risk for
thrombus formation due to high levels of platelets in the early postpartum period.
Changes in the urinary system after pregnancy Decreased urge to void, altered voiding reflex, bladder distention, increased risk
of infection, bladder tone is restored 5-7 days after birth, and daily urine output
up to 30 mL/day
Changes in the neurologic system after pregnancy Eclampsia/seizures, carpal tunnel syndrome, headaches, restless leg syndrome,
lower extremity neuropathy, strokes, and sleep apnea
Changes in the GI system after pregnancy Appetite returns to normal, gastric motility decreases leading to constipation,
normal bowel elimination should return in 2-3 days, decreased abdominal tone
and tenderness may make the patient reluctant to strain for a BM.
Changes in the endocrine system after pregnancy Estrogen and progesterone levels drop markedly following expulsion of the
placenta and reach their lowest levels 1 week into the postpartum period.
Decreased estrogen levels are associated with breast engorgement and with the
diuresis of extra extracellular fluid.
Decreased estrogen levels after pregnancy Associated with breast engorgement, diuresis of excess extracellular fluid, and
levels in non-lactating women rise by 2 weeks PP.
Changes in the musculoskeletal system •Abdominal muscle tone and joint stabilization occur during the 6-8 week period
after delivery
•Some pelvic joints may never return to their pre-pregnant position
•Discomfort may be felt in the joints immediately after delivery due to secretion of
relaxin. May be a permanent increase in shoe size
29 | COMPREHENSIVE OB NURSING
PRACTICE QUESTIONS AND STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,Lochia Rubra Reddish or red-brown vaginal discharge that occurs immediately after childbirth
and the first 1-2 days after that is composed mostly of blood.
Lochia Serosa Thinner Pale pinkish to brownish discharge lasting 1 week postpartum
Lochia Alba After the seventh day the drainage is slightly Whitish/yellowish and can last 10-14
days may last 2 weeks and remain normal.
Changes in the cervix, vagina, and perineum after The cervix appears edematous with bruising. The external cervical opening has a
pregnancy ragged slitlike appearance instead of a round shape due to it dilating and thinning
before delivery.
The vaginal walls are thin and dry with an absence of rugae. Vaginal mucus
production returns with the return of estrogen production. Rugae reappear
around 4 weeks after delivery.
bruising and edema of the perineum is common. The episiotomy if present should
be free of erythema with the edges well approximated and without discharge. It
should heal in 2-3 weeks.
1st degree Laceration Laceration extends through the skin and structures superficial to muscles.
2nd degree Laceration Laceration extends through muscles of perineal body.
3rd Degree Laceration Laceration continues through the sphincter muscle.
4th Degree Laceration Laceration also involves the anterior rectal wall.
Nursing Interventions for lacerations For 3rd and 4th degree lacerations assess bowel habits, the initial stool after
delivery may be uncomfortable, measures to promote soft stools should be
implemented, promote increased fluid intake, dietary fiber, walking, and NO
enemas or suppositories.
, Hypovolemic shock signs and symptoms woman has persistent significant bleeding (perineal pad soaked within 15 minutes)
the bleeding may not be accompanied by a change in vital signs or maternal
color or behavior, woman states she feels weak, lightheaded, "funny", or "sick to
her stomach", or she "sees stars." Woman begin to act anxious or exhibits air
hunger, skin turns grey or ashen, skin feels cool and clammy, pulse rate increases,
and blood pressure declines.
Changes in the breasts after pregnancy Estrogen stimulates the growth of milk ducts to prepare for lactation.
Colostrum is the first secretion produced by the breast
Prolactin is the hormone that stimulates milk production in the mammary alveolar
cells.
Oxytocin causes contraction of the mammary ducts which induces milk ejection
caused by infant sucking "Let down reflex"
Changes in the cardiovascular system after pregnancy blood volume is reduced to pre-pregnancy levels by 2-4 weeks after delivery.
Diuresis, diaphoresis, and blood loss during delivery account for fluid loss. 300-
500 mL of blood is lost during a vaginal birth and 600-800 mL of blood is lost in a
c-section birth. Cardiac output declines rapidly and the patient is at risk for
thrombus formation due to high levels of platelets in the early postpartum period.
Changes in the urinary system after pregnancy Decreased urge to void, altered voiding reflex, bladder distention, increased risk
of infection, bladder tone is restored 5-7 days after birth, and daily urine output
up to 30 mL/day
Changes in the neurologic system after pregnancy Eclampsia/seizures, carpal tunnel syndrome, headaches, restless leg syndrome,
lower extremity neuropathy, strokes, and sleep apnea
Changes in the GI system after pregnancy Appetite returns to normal, gastric motility decreases leading to constipation,
normal bowel elimination should return in 2-3 days, decreased abdominal tone
and tenderness may make the patient reluctant to strain for a BM.
Changes in the endocrine system after pregnancy Estrogen and progesterone levels drop markedly following expulsion of the
placenta and reach their lowest levels 1 week into the postpartum period.
Decreased estrogen levels are associated with breast engorgement and with the
diuresis of extra extracellular fluid.
Decreased estrogen levels after pregnancy Associated with breast engorgement, diuresis of excess extracellular fluid, and
levels in non-lactating women rise by 2 weeks PP.
Changes in the musculoskeletal system •Abdominal muscle tone and joint stabilization occur during the 6-8 week period
after delivery
•Some pelvic joints may never return to their pre-pregnant position
•Discomfort may be felt in the joints immediately after delivery due to secretion of
relaxin. May be a permanent increase in shoe size
