NRS 240 MATERNITY POSTPARTUM (OB)
FINAL EXAM | QUESTIONS AND ANSWERS
| 2026 UPDATE | 100% CORRECT - LIU
SECTION 1: POSTPARTUM PHYSIOLOGICAL CHANGES (Uterine Involution, Lochia, Vital
Signs) — 10 Questions
Q1: A nurse is assessing a postpartum client on her second day after delivery. The fundus is
palpated at the level of the umbilicus and is firm. Which action by the nurse is most
appropriate?
A. Notify the provider immediately; the fundus is too high for day 2 postpartum.
B. Document the finding as expected and continue routine assessments.
C. Massage the fundus to promote further involution.
D. Insert a urinary catheter to relieve bladder distention.
Correct Answer: B
Rationale: On postpartum day 2, the fundus at the umbilicus is a normal finding; the uterus
descends approximately one fingerbreadth (1 cm) per day and should be at the symphysis
pubis by day 10.
Q2: A nurse is caring for a postpartum client who delivered vaginally 12 hours ago. The client
reports heavy vaginal bleeding with small clots. The nurse notes that the lochia is bright red
and moderate in amount. Which term describes this finding?
A. Lochia alba
B. Lochia serosa
C. Lochia rubra
D. Lochia scant
Correct Answer: C
Rationale: Lochia rubra is characterized by bright red color, moderate to heavy flow, and
small clots, typically lasting 3–4 days postpartum as it consists of blood, decidua, and
mucus.
Q3: A postpartum client is 6 hours post-vaginal delivery. Her vital signs are: BP 140/90
mmHg, HR 88 bpm, RR 16/min, T 99.1°F (37.3°C). Which assessment finding requires
immediate nursing intervention?
,A. Temperature of 99.1°F
B. Heart rate of 88 bpm
C. Blood pressure of 140/90 mmHg
D. Respiratory rate of 16/min
Correct Answer: C
Rationale: A blood pressure of 140/90 mmHg in the immediate postpartum period may
indicate postpartum hypertension or preeclampsia; the nurse should assess for headache,
visual changes, and edema and notify the provider.
Q4: A nurse is assessing lochia on a postpartum client on day 5. The client reports that the
flow has decreased and the color is now pinkish-brown. Which documentation is most
accurate?
A. Lochia rubra, moderate amount
B. Lochia serosa, scant to light amount
C. Lochia alba, yellow-white color
D. Lochia rubra, heavy amount with clots
Correct Answer: B
Rationale: Lochia serosa appears on days 3–10 as a pinkish-brown or serosanguineous
discharge that is scant to light in amount, containing serous exudate, erythrocytes, and
leukocytes.
Q5: A nurse palpates the fundus of a postpartum client 4 hours after cesarean birth and finds
it displaced to the right of the midline and boggy. What is the nurse's priority action?
A. Administer oxytocin per protocol
B. Assist the client to empty her bladder
C. Notify the provider of uterine atony
D. Increase the rate of IV fluids
Correct Answer: B
Rationale: A fundus displaced to the right indicates a full bladder, which prevents uterine
contraction and involution; emptying the bladder allows the uterus to contract and return to
the midline.
Q6: A postpartum client asks the nurse why she is experiencing increased urinary output
during the first few days after delivery. Which response by the nurse is most accurate?
, A. "The kidneys are compensating for blood loss during delivery."
B. "This is due to the diuresis of excess extracellular fluid and increased renal perfusion after
delivery."
C. "Your body is trying to eliminate the IV fluids you received during labor."
D. "This occurs because the uterus is no longer compressing the bladder."
Correct Answer: B
Rationale: Postpartum diuresis results from the elimination of excess extracellular fluid
accumulated during pregnancy, increased renal perfusion, and decreased pressure from the
gravid uterus on the renal system.
Q7: A nurse is assessing a postpartum client on day 3. The fundus is located 2 cm below the
umbilicus and is firm. The client is voiding spontaneously. Which conclusion by the nurse is
correct?
A. Uterine involution is progressing normally.
B. The fundus is too low for day 3 postpartum.
C. The client requires a urinary catheter.
D. Uterine atony is present.
Correct Answer: A
Rationale: The uterus descends approximately one fingerbreadth (1 cm) per day; on day 3,
the fundus at 2 cm below the umbilicus indicates normal involution, and a firm fundus
confirms adequate uterine contraction.
Q8: A nurse notes that a postpartum client has a pulse rate of 60 bpm on the first day after
delivery. The client is asymptomatic. Which action by the nurse is most appropriate?
A. Prepare for emergency cardiac intervention
B. Document the finding as expected postpartum bradycardia
C. Administer atropine per standing orders
D. Increase the client's activity level
Correct Answer: B
Rationale: Postpartum bradycardia (pulse 50–70 bpm) is a normal physiological adaptation
due to increased stroke volume and decreased cardiac workload after delivery; it typically
resolves within 6–10 days.
FINAL EXAM | QUESTIONS AND ANSWERS
| 2026 UPDATE | 100% CORRECT - LIU
SECTION 1: POSTPARTUM PHYSIOLOGICAL CHANGES (Uterine Involution, Lochia, Vital
Signs) — 10 Questions
Q1: A nurse is assessing a postpartum client on her second day after delivery. The fundus is
palpated at the level of the umbilicus and is firm. Which action by the nurse is most
appropriate?
A. Notify the provider immediately; the fundus is too high for day 2 postpartum.
B. Document the finding as expected and continue routine assessments.
C. Massage the fundus to promote further involution.
D. Insert a urinary catheter to relieve bladder distention.
Correct Answer: B
Rationale: On postpartum day 2, the fundus at the umbilicus is a normal finding; the uterus
descends approximately one fingerbreadth (1 cm) per day and should be at the symphysis
pubis by day 10.
Q2: A nurse is caring for a postpartum client who delivered vaginally 12 hours ago. The client
reports heavy vaginal bleeding with small clots. The nurse notes that the lochia is bright red
and moderate in amount. Which term describes this finding?
A. Lochia alba
B. Lochia serosa
C. Lochia rubra
D. Lochia scant
Correct Answer: C
Rationale: Lochia rubra is characterized by bright red color, moderate to heavy flow, and
small clots, typically lasting 3–4 days postpartum as it consists of blood, decidua, and
mucus.
Q3: A postpartum client is 6 hours post-vaginal delivery. Her vital signs are: BP 140/90
mmHg, HR 88 bpm, RR 16/min, T 99.1°F (37.3°C). Which assessment finding requires
immediate nursing intervention?
,A. Temperature of 99.1°F
B. Heart rate of 88 bpm
C. Blood pressure of 140/90 mmHg
D. Respiratory rate of 16/min
Correct Answer: C
Rationale: A blood pressure of 140/90 mmHg in the immediate postpartum period may
indicate postpartum hypertension or preeclampsia; the nurse should assess for headache,
visual changes, and edema and notify the provider.
Q4: A nurse is assessing lochia on a postpartum client on day 5. The client reports that the
flow has decreased and the color is now pinkish-brown. Which documentation is most
accurate?
A. Lochia rubra, moderate amount
B. Lochia serosa, scant to light amount
C. Lochia alba, yellow-white color
D. Lochia rubra, heavy amount with clots
Correct Answer: B
Rationale: Lochia serosa appears on days 3–10 as a pinkish-brown or serosanguineous
discharge that is scant to light in amount, containing serous exudate, erythrocytes, and
leukocytes.
Q5: A nurse palpates the fundus of a postpartum client 4 hours after cesarean birth and finds
it displaced to the right of the midline and boggy. What is the nurse's priority action?
A. Administer oxytocin per protocol
B. Assist the client to empty her bladder
C. Notify the provider of uterine atony
D. Increase the rate of IV fluids
Correct Answer: B
Rationale: A fundus displaced to the right indicates a full bladder, which prevents uterine
contraction and involution; emptying the bladder allows the uterus to contract and return to
the midline.
Q6: A postpartum client asks the nurse why she is experiencing increased urinary output
during the first few days after delivery. Which response by the nurse is most accurate?
, A. "The kidneys are compensating for blood loss during delivery."
B. "This is due to the diuresis of excess extracellular fluid and increased renal perfusion after
delivery."
C. "Your body is trying to eliminate the IV fluids you received during labor."
D. "This occurs because the uterus is no longer compressing the bladder."
Correct Answer: B
Rationale: Postpartum diuresis results from the elimination of excess extracellular fluid
accumulated during pregnancy, increased renal perfusion, and decreased pressure from the
gravid uterus on the renal system.
Q7: A nurse is assessing a postpartum client on day 3. The fundus is located 2 cm below the
umbilicus and is firm. The client is voiding spontaneously. Which conclusion by the nurse is
correct?
A. Uterine involution is progressing normally.
B. The fundus is too low for day 3 postpartum.
C. The client requires a urinary catheter.
D. Uterine atony is present.
Correct Answer: A
Rationale: The uterus descends approximately one fingerbreadth (1 cm) per day; on day 3,
the fundus at 2 cm below the umbilicus indicates normal involution, and a firm fundus
confirms adequate uterine contraction.
Q8: A nurse notes that a postpartum client has a pulse rate of 60 bpm on the first day after
delivery. The client is asymptomatic. Which action by the nurse is most appropriate?
A. Prepare for emergency cardiac intervention
B. Document the finding as expected postpartum bradycardia
C. Administer atropine per standing orders
D. Increase the client's activity level
Correct Answer: B
Rationale: Postpartum bradycardia (pulse 50–70 bpm) is a normal physiological adaptation
due to increased stroke volume and decreased cardiac workload after delivery; it typically
resolves within 6–10 days.
