NUR 3300 Exam 4 – Nursing Practice II – (2026)
Practice Exam
William Paterson University – 200 Questions with
Correct Answers & Detailed Rationales
Exam 4 Overview
Exam 4 covers the following topics:
• Postpartum Complications
• Newborn Nutrition and Assessment
• The Childbearing Family
• Maternal Health and Perinatal Care
• High-Risk Pregnancy and Obstetric Emergencies
• Neonatal Transition and Adaptation
• Postpartum Adaptations and Family Dynamics
SECTION 1: Postpartum Complications (Questions 1-
40)
,1. A postpartum client is experiencing heavy, bright
red vaginal bleeding, a firm fundus, and tachycardia.
The nurse suspects which complication?
A) Uterine atony
B) Retained placental fragments
C) Laceration of the birth canal
D) Coagulopathy
Answer: A
Rationale: Uterine atony is the most common cause of
postpartum hemorrhage. It presents with a boggy, non-
contracted uterus, heavy bleeding, and signs of
hypovolemia. The fundus is typically firm in lacerations and
with retained fragments.
2. The nurse is assessing a patient 2 hours after vaginal
delivery. The fundus is boggy and displaced to the
right. The patient's perineal pad is saturated with
bright red blood. What is the priority nursing action?
A) Call the healthcare provider immediately
B) Massage the fundus and assist the patient to void
C) Administer oxytocin as prescribed
D) Assess vital signs
,Answer: B
Rationale: A boggy, displaced fundus indicates uterine
atony, often caused by a full bladder displacing the uterus.
The priority is to massage the fundus to promote
contraction and assist the patient to void to empty the
bladder.
3. A postpartum patient with a history of preeclampsia
develops a severe headache, visual disturbances, and
right upper quadrant pain. Which complication should
the nurse suspect?
A) Postpartum preeclampsia
B) HELLP syndrome
C) Stroke
D) Pituitary infarction
Answer: B
Rationale: HELLP syndrome (Hemolysis, Elevated Liver
enzymes, Low Platelets) is a severe complication of
preeclampsia. Symptoms include headache, visual
disturbances, right upper quadrant pain (liver
involvement), nausea, and malaise.
, 4. The nurse is assessing a postpartum patient who had an
emergency cesarean section 24 hours ago. The patient
reports sudden onset ofshortness of breath, chest pain,
and anxiety. Vital signs: HR 120, RR 32, SpO2 88%. What
is the priority nursing action?
A) Administer oxygen andnotify therapid response team
B) Reassure the patient and encourage deepbreathing
C) Administer pain medication
D) Assess thesurgical incision
Answer: A
Rationale: Sudden onset of dyspnea, chest pain, andhypoxia
in a postpartum patient is concerningfor pulmonary
embolism (PE) or amniotic fluid embolism. The priority is to
administer oxygen and activatethe rapid response team.
5. Apostpartum patient is exhibiting excessive thirst,
polyuria, and complaints offeeling faint. Laboratory
results show hypernatremia and elevated serum
osmolality. Which condition is most likely?
A) Syndromeof Inappropriate Antidiuretic Hormone (SIADH)
B) Diabetes insipidus
C) Preeclampsia
D) Postpartum thyroiditis
Practice Exam
William Paterson University – 200 Questions with
Correct Answers & Detailed Rationales
Exam 4 Overview
Exam 4 covers the following topics:
• Postpartum Complications
• Newborn Nutrition and Assessment
• The Childbearing Family
• Maternal Health and Perinatal Care
• High-Risk Pregnancy and Obstetric Emergencies
• Neonatal Transition and Adaptation
• Postpartum Adaptations and Family Dynamics
SECTION 1: Postpartum Complications (Questions 1-
40)
,1. A postpartum client is experiencing heavy, bright
red vaginal bleeding, a firm fundus, and tachycardia.
The nurse suspects which complication?
A) Uterine atony
B) Retained placental fragments
C) Laceration of the birth canal
D) Coagulopathy
Answer: A
Rationale: Uterine atony is the most common cause of
postpartum hemorrhage. It presents with a boggy, non-
contracted uterus, heavy bleeding, and signs of
hypovolemia. The fundus is typically firm in lacerations and
with retained fragments.
2. The nurse is assessing a patient 2 hours after vaginal
delivery. The fundus is boggy and displaced to the
right. The patient's perineal pad is saturated with
bright red blood. What is the priority nursing action?
A) Call the healthcare provider immediately
B) Massage the fundus and assist the patient to void
C) Administer oxytocin as prescribed
D) Assess vital signs
,Answer: B
Rationale: A boggy, displaced fundus indicates uterine
atony, often caused by a full bladder displacing the uterus.
The priority is to massage the fundus to promote
contraction and assist the patient to void to empty the
bladder.
3. A postpartum patient with a history of preeclampsia
develops a severe headache, visual disturbances, and
right upper quadrant pain. Which complication should
the nurse suspect?
A) Postpartum preeclampsia
B) HELLP syndrome
C) Stroke
D) Pituitary infarction
Answer: B
Rationale: HELLP syndrome (Hemolysis, Elevated Liver
enzymes, Low Platelets) is a severe complication of
preeclampsia. Symptoms include headache, visual
disturbances, right upper quadrant pain (liver
involvement), nausea, and malaise.
, 4. The nurse is assessing a postpartum patient who had an
emergency cesarean section 24 hours ago. The patient
reports sudden onset ofshortness of breath, chest pain,
and anxiety. Vital signs: HR 120, RR 32, SpO2 88%. What
is the priority nursing action?
A) Administer oxygen andnotify therapid response team
B) Reassure the patient and encourage deepbreathing
C) Administer pain medication
D) Assess thesurgical incision
Answer: A
Rationale: Sudden onset of dyspnea, chest pain, andhypoxia
in a postpartum patient is concerningfor pulmonary
embolism (PE) or amniotic fluid embolism. The priority is to
administer oxygen and activatethe rapid response team.
5. Apostpartum patient is exhibiting excessive thirst,
polyuria, and complaints offeeling faint. Laboratory
results show hypernatremia and elevated serum
osmolality. Which condition is most likely?
A) Syndromeof Inappropriate Antidiuretic Hormone (SIADH)
B) Diabetes insipidus
C) Preeclampsia
D) Postpartum thyroiditis
