OB/NB SU Exam 4 | Complete Questions with
Correct Answers and Detailed Rationales - Latest
Update 2026
Question 1
A nurse is caring for a client immediately after delivery. Which assessment finding requires
immediate intervention?
A. Firm uterus at the umbilicus
B. Moderate lochia rubra
C. Boggy uterus displaced to the right
D. Mild perineal edema
Correct Answer: C
Rationale:
A boggy uterus indicates uterine atony, a leading cause of postpartum hemorrhage. A uterus
displaced to the right often indicates a full bladder that prevents adequate uterine contraction.
Question 2
Which newborn finding is expected during the first 24 hours after birth?
A. Persistent central cyanosis
B. Heart rate of 130 bpm
C. Temperature of 35.5°C (95.9°F)
D. Respiratory rate of 80/min while sleeping
Correct Answer: B
Rationale:
A normal newborn heart rate ranges from 110–160 bpm. Persistent central cyanosis,
hypothermia, and sustained tachypnea require evaluation.
,Question 3
Which maternal hormone is primarily responsible for milk production?
A. Estrogen
B. Oxytocin
C. Progesterone
D. Prolactin
Correct Answer: D
Rationale:
Prolactin stimulates milk production, whereas oxytocin causes milk ejection (let-down reflex).
Question 4
Which finding indicates effective breastfeeding?
A. Infant loses 15% of birth weight
B. Audible swallowing is heard
C. Mother reports severe nipple pain
D. Infant nurses for 2 minutes every feeding
Correct Answer: B
Rationale:
Audible swallowing indicates successful milk transfer during breastfeeding.
Question 5
A postpartum client is saturating one perineal pad every 15 minutes. What is the nurse's priority
action?
A. Encourage oral fluids
B. Massage the uterine fundus
C. Apply ice packs
D. Ambulate the client
Correct Answer: B
,Rationale:
Heavy bleeding often results from uterine atony. Fundal massage promotes uterine contraction
and decreases hemorrhage.
Question 6
Which newborn assessment finding is most concerning?
A. Acrocyanosis
B. Vernix caseosa
C. Nasal flaring
D. Milia
Correct Answer: C
Rationale:
Nasal flaring is a sign of respiratory distress requiring immediate evaluation.
Question 7
A client at 34 weeks' gestation reports leaking clear fluid. Which action should the nurse
perform first?
A. Digital cervical examination
B. Assess fetal heart rate
C. Encourage ambulation
D. Administer oxytocin
Correct Answer: B
Rationale:
After suspected rupture of membranes, fetal heart rate assessment is the priority because cord
compression may occur.
Question 8
Which medication is routinely administered to newborns to prevent hemorrhagic disease?
A. Erythromycin
B. Vitamin K
, C. Hepatitis B immune globulin
D. Naloxone
Correct Answer: B
Rationale:
Vitamin K promotes clotting factor production because newborn intestines initially lack bacteria
that synthesize vitamin K.
Question 9
Which Apgar score component assesses neurologic function?
A. Pulse
B. Respiratory effort
C. Reflex irritability
D. Color
Correct Answer: C
Rationale:
Reflex irritability evaluates neurologic responsiveness.
Question 10
Which finding suggests postpartum endometritis?
A. Temperature 38.8°C (101.8°F)
B. Lochia alba
C. Firm uterus
D. Mild afterpains
Correct Answer: A
Rationale:
Fever, uterine tenderness, and foul-smelling lochia suggest postpartum infection.
Question 11
Which newborn reflex disappears first?
Correct Answers and Detailed Rationales - Latest
Update 2026
Question 1
A nurse is caring for a client immediately after delivery. Which assessment finding requires
immediate intervention?
A. Firm uterus at the umbilicus
B. Moderate lochia rubra
C. Boggy uterus displaced to the right
D. Mild perineal edema
Correct Answer: C
Rationale:
A boggy uterus indicates uterine atony, a leading cause of postpartum hemorrhage. A uterus
displaced to the right often indicates a full bladder that prevents adequate uterine contraction.
Question 2
Which newborn finding is expected during the first 24 hours after birth?
A. Persistent central cyanosis
B. Heart rate of 130 bpm
C. Temperature of 35.5°C (95.9°F)
D. Respiratory rate of 80/min while sleeping
Correct Answer: B
Rationale:
A normal newborn heart rate ranges from 110–160 bpm. Persistent central cyanosis,
hypothermia, and sustained tachypnea require evaluation.
,Question 3
Which maternal hormone is primarily responsible for milk production?
A. Estrogen
B. Oxytocin
C. Progesterone
D. Prolactin
Correct Answer: D
Rationale:
Prolactin stimulates milk production, whereas oxytocin causes milk ejection (let-down reflex).
Question 4
Which finding indicates effective breastfeeding?
A. Infant loses 15% of birth weight
B. Audible swallowing is heard
C. Mother reports severe nipple pain
D. Infant nurses for 2 minutes every feeding
Correct Answer: B
Rationale:
Audible swallowing indicates successful milk transfer during breastfeeding.
Question 5
A postpartum client is saturating one perineal pad every 15 minutes. What is the nurse's priority
action?
A. Encourage oral fluids
B. Massage the uterine fundus
C. Apply ice packs
D. Ambulate the client
Correct Answer: B
,Rationale:
Heavy bleeding often results from uterine atony. Fundal massage promotes uterine contraction
and decreases hemorrhage.
Question 6
Which newborn assessment finding is most concerning?
A. Acrocyanosis
B. Vernix caseosa
C. Nasal flaring
D. Milia
Correct Answer: C
Rationale:
Nasal flaring is a sign of respiratory distress requiring immediate evaluation.
Question 7
A client at 34 weeks' gestation reports leaking clear fluid. Which action should the nurse
perform first?
A. Digital cervical examination
B. Assess fetal heart rate
C. Encourage ambulation
D. Administer oxytocin
Correct Answer: B
Rationale:
After suspected rupture of membranes, fetal heart rate assessment is the priority because cord
compression may occur.
Question 8
Which medication is routinely administered to newborns to prevent hemorrhagic disease?
A. Erythromycin
B. Vitamin K
, C. Hepatitis B immune globulin
D. Naloxone
Correct Answer: B
Rationale:
Vitamin K promotes clotting factor production because newborn intestines initially lack bacteria
that synthesize vitamin K.
Question 9
Which Apgar score component assesses neurologic function?
A. Pulse
B. Respiratory effort
C. Reflex irritability
D. Color
Correct Answer: C
Rationale:
Reflex irritability evaluates neurologic responsiveness.
Question 10
Which finding suggests postpartum endometritis?
A. Temperature 38.8°C (101.8°F)
B. Lochia alba
C. Firm uterus
D. Mild afterpains
Correct Answer: A
Rationale:
Fever, uterine tenderness, and foul-smelling lochia suggest postpartum infection.
Question 11
Which newborn reflex disappears first?
