Childbearing Family Q&A | Maternal-Child Nursing
1. A nurse is assessing a patient who is 12 hours postpartum. At which
location would the nurse expect to find the uterine fundus?
A) At the level of the umbilicus
B) One centimeter below the umbilicus
C) One centimeter above the umbilicus
D) Two centimeters below the umbilicus
Correct Answer: One centimeter above the umbilicus
Rationale: At the end of the third stage of labor, the fundus is approximately
2 cm below the umbilicus. Within 12 hours after delivery, the fundus may
rise to approximately 1 cm above the umbilicus. The fundus then descends
about 1-2 cm every 24 hours.
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2. A postpartum patient is experiencing uterine cramping during
breastfeeding. Which term best describes this phenomenon?
A) Subinvolution
B) Afterpains
C) Uterine atony
D) Endometritis
Correct Answer: Afterpains
Rationale: Afterpains are cramping pains that occur as the uterus contracts
during the postpartum period. These are more noticeable during
,breastfeeding due to the release of oxytocin, which stimulates uterine
contractions. Afterpains typically resolve within 3-7 days.
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3. A nurse is assessing the lochia of a patient who is 5 days postpartum. The
discharge is pinkish-brown in color. Which term correctly describes this
finding?
A) Lochia rubra
B) Lochia serosa
C) Lochia alba
D) Lochia purulenta
Correct Answer: Lochia serosa
Rationale: Lochia serosa occurs from approximately days 3-4 to day 10
postpartum and is pinkish-brown in color. It contains old blood, serum,
leukocytes, and tissue debris. Lochia rubra is bright red, and lochia alba is
yellow-white.
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4. A postpartum patient's uterine fundus is boggy and displaced to the right.
Which nursing action is the priority?
A) Document the findings as normal
B) Administer prescribed oxytocin
C) Assist the patient to void
D) Notify the healthcare provider immediately
,Correct Answer: Assist the patient to void
Rationale: A boggy uterus that is displaced to the right often indicates a full
bladder, which can displace the uterus and prevent adequate contraction.
The nurse should first assist the patient to void, which often allows the
uterus to return to midline and become firm.
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5. Which of the following is a potential cause of subinvolution?
A) Multiparity
B) Breastfeeding
C) Retained placental fragments
D) Early ambulation
Correct Answer: Retained placental fragments
Rationale: Subinvolution is the failure of the uterus to return to its
nonpregnant state and is characterized by late postpartum bleeding.
Common causes include retained placental fragments and infection.
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6. A nurse is assessing a patient's lochia on postpartum day 2. The nurse
notes bright red bleeding with small clots. Which finding would be of greatest
concern?
A) Moderate lochia rubra
B) Heavy bleeding that saturates a perineal pad in 15 minutes
C) Scant lochia rubra
, D) Lochia with a fleshy odor
Correct Answer: Heavy bleeding that saturates a perineal pad in 15 minutes
Rationale: Heavy bleeding that saturates a pad in 15 minutes or less
indicates excessive bleeding and possible postpartum hemorrhage. While
moderate lochia rubra with small clots can be normal in the early postpartum
period, the volume of bleeding is the key concern.
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7. A nurse is caring for a postpartum patient who is 2 hours post-delivery.
How often should the nurse assess the fundus and lochia?
A) Every 15 minutes for the first hour, then every 30 minutes for the next
hour
B) Every hour for the first 8 hours
C) Every 4 hours for the first 24 hours
D) Once per shift
Correct Answer: Every 15 minutes for the first hour, then every 30 minutes
for the next hour
Rationale: For the first hour after delivery, the fundus should be assessed
every 15 minutes. For the next hour, it should be assessed every 30 minutes.
After the first 2 hours, assessments are typically every 4 hours for the first
24 hours, then once per shift thereafter.
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