NUR 230 EXAM 2 OB PEDS 50 MOST TESTED QUESTIONS
WITH VERIFIED AND CORRECT ANSWERS WITH
RATIONALES GRADED A+
1. The nurse is teaching a client with type 1 diabetes mellitus who just
delivered a healthy baby. Which information should the nurse include in
the client’s teaching?
A. Feed the baby formula because insulin through breastfeeding may
cause low blood sugar.
B. Due to hormonal changes after delivery, the need for insulin may decrease.
C. Urine should be checked for ketones every time the client voids.
D. Change to oral hypoglycemic medications because they control blood
sugar better than insulin.
Correct Answer:
B. Due to hormonal changes after delivery, the need for insulin may decrease.
Rationale:
After delivery, the placenta is expelled, causing a rapid decrease in
placental hormones such as human placental lactogen, estrogen, and
progesterone. These hormones contribute to insulin resistance during
pregnancy. Once their levels decrease, insulin sensitivity improves, so a
client with type 1 diabetes may require significantly less insulin postpartum.
Blood glucose levels should be monitored closely because reduced insulin
requirements can increase the risk of hypoglycemia, especially during
breastfeeding.
2. The nurse is caring for several clients on the postpartum unit. Which
client should the nurse see first?
A. Primipara who delivered 3 hours ago and is having difficulty
getting the newborn to latch.
B. Multipara who saturated 2 perineal pads in 1 hour.
C. Multipara who delivered 16 hours ago and reports abdominal
cramping and sweating.
,D. Primipara requesting help repositioning her baby after a cesarean birth.
Correct Answer:
B. Multipara who saturated 2 perineal pads in 1 hour.
Rationale:
Saturating two perineal pads within 1 hour is an abnormal finding that may
indicate postpartum hemorrhage. Excessive blood loss can rapidly
become life-threatening and requires immediate assessment and
intervention. The nurse should assess the client's vital signs, fundal tone,
uterine position, and amount of lochia. The other clients have concerns
that are important but are not as urgent as possible hemorrhage.
3. The nurse receives change-of-shift report for clients who delivered
within the last 24 hours. Which client should the nurse assess first?
A. The client who reports discomfort in the perineal area from an episiotomy.
B. The client with an oral temperature of 100.3°F.
C. The client whose pulse increased from 76/min to 100/min.
D. The client who reports passing a dime-sized clot with the last void.
Correct Answer:
C. The client whose pulse increased from 76/min to 100/min.
Rationale:
A rising pulse during the postpartum period can be an early sign of
hemorrhage or infection. Tachycardia may occur before more obvious
signs of blood loss become apparent, so this client requires prompt
assessment. The nurse should assess vital signs, uterine tone, fundal
position, lochia, and overall condition. Mild perineal discomfort and
passage of a small clot may be expected postpartum. A mild
,temperature elevation during the first 24 hours may also occur because of
dehydration or the effects of labor.
4. The nurse is caring for a client who gave birth 18 hours ago. The client
reports nipple tenderness and states that the baby is not breastfeeding
well. Which response by the nurse is appropriate?
A. “Wait until the baby is crying before breastfeeding.”
B. “Try removing the infant’s clothing and placing the baby skin-to-skin
on your chest.”
C. “Apply a large amount of topical breast cream before every feeding.”
D. “Limit breastfeeding until your nipples are no longer tender.”
Correct Answer:
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on
your chest.”
Rationale:
Skin-to-skin contact promotes newborn bonding, rooting, and successful
breastfeeding. It helps calm the infant and encourages the baby to seek the
breast and latch effectively. Newborns show early hunger cues such as
rooting, hand-to-mouth movements, and increased alertness. Waiting until
the baby cries is not recommended because crying is a late hunger cue
and may make latching more difficult. Proper positioning and latch should
also be assessed to reduce nipple tenderness.
5. The nurse is caring for a client who is 1 hour postpartum. The nurse
observes moderate lochia rubra and several small clots on the perineal
pad. The fundus is firm, midline, and at the umbilicus. Which action
should the nurse implement?
, A. Increase the frequency of fundal massage.
B. Notify the primary care provider.
C. Document the findings and continue to monitor.
D. Encourage the client to empty the bladder immediately.
Correct Answer:
C. Document the findings and continue to monitor.
Rationale:
During the early postpartum period, lochia rubra is expected and consists
mainly of blood, decidual tissue, and mucus. Small clots may also occur
during the first several hours after delivery. The fundus being firm, midline,
and at the umbilicus indicates effective uterine contraction. Because the
findings are consistent with expected postpartum changes, the nurse
should document them and continue monitoring. Fundal massage or
catheterization would be indicated if the uterus were boggy or displaced.
6. The nurse is caring for a formula-feeding postpartum client who
reports painful, swollen breasts on the third postpartum day. Which
instruction should the nurse give?
A. Stimulate the nipples manually.
B. Refrain from expressing milk.
C. Gently massage the breasts before feeding.
D. Pump every 2 hours to empty the breasts.
Correct Answer:
B. Refrain from expressing milk.
Rationale:
WITH VERIFIED AND CORRECT ANSWERS WITH
RATIONALES GRADED A+
1. The nurse is teaching a client with type 1 diabetes mellitus who just
delivered a healthy baby. Which information should the nurse include in
the client’s teaching?
A. Feed the baby formula because insulin through breastfeeding may
cause low blood sugar.
B. Due to hormonal changes after delivery, the need for insulin may decrease.
C. Urine should be checked for ketones every time the client voids.
D. Change to oral hypoglycemic medications because they control blood
sugar better than insulin.
Correct Answer:
B. Due to hormonal changes after delivery, the need for insulin may decrease.
Rationale:
After delivery, the placenta is expelled, causing a rapid decrease in
placental hormones such as human placental lactogen, estrogen, and
progesterone. These hormones contribute to insulin resistance during
pregnancy. Once their levels decrease, insulin sensitivity improves, so a
client with type 1 diabetes may require significantly less insulin postpartum.
Blood glucose levels should be monitored closely because reduced insulin
requirements can increase the risk of hypoglycemia, especially during
breastfeeding.
2. The nurse is caring for several clients on the postpartum unit. Which
client should the nurse see first?
A. Primipara who delivered 3 hours ago and is having difficulty
getting the newborn to latch.
B. Multipara who saturated 2 perineal pads in 1 hour.
C. Multipara who delivered 16 hours ago and reports abdominal
cramping and sweating.
,D. Primipara requesting help repositioning her baby after a cesarean birth.
Correct Answer:
B. Multipara who saturated 2 perineal pads in 1 hour.
Rationale:
Saturating two perineal pads within 1 hour is an abnormal finding that may
indicate postpartum hemorrhage. Excessive blood loss can rapidly
become life-threatening and requires immediate assessment and
intervention. The nurse should assess the client's vital signs, fundal tone,
uterine position, and amount of lochia. The other clients have concerns
that are important but are not as urgent as possible hemorrhage.
3. The nurse receives change-of-shift report for clients who delivered
within the last 24 hours. Which client should the nurse assess first?
A. The client who reports discomfort in the perineal area from an episiotomy.
B. The client with an oral temperature of 100.3°F.
C. The client whose pulse increased from 76/min to 100/min.
D. The client who reports passing a dime-sized clot with the last void.
Correct Answer:
C. The client whose pulse increased from 76/min to 100/min.
Rationale:
A rising pulse during the postpartum period can be an early sign of
hemorrhage or infection. Tachycardia may occur before more obvious
signs of blood loss become apparent, so this client requires prompt
assessment. The nurse should assess vital signs, uterine tone, fundal
position, lochia, and overall condition. Mild perineal discomfort and
passage of a small clot may be expected postpartum. A mild
,temperature elevation during the first 24 hours may also occur because of
dehydration or the effects of labor.
4. The nurse is caring for a client who gave birth 18 hours ago. The client
reports nipple tenderness and states that the baby is not breastfeeding
well. Which response by the nurse is appropriate?
A. “Wait until the baby is crying before breastfeeding.”
B. “Try removing the infant’s clothing and placing the baby skin-to-skin
on your chest.”
C. “Apply a large amount of topical breast cream before every feeding.”
D. “Limit breastfeeding until your nipples are no longer tender.”
Correct Answer:
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on
your chest.”
Rationale:
Skin-to-skin contact promotes newborn bonding, rooting, and successful
breastfeeding. It helps calm the infant and encourages the baby to seek the
breast and latch effectively. Newborns show early hunger cues such as
rooting, hand-to-mouth movements, and increased alertness. Waiting until
the baby cries is not recommended because crying is a late hunger cue
and may make latching more difficult. Proper positioning and latch should
also be assessed to reduce nipple tenderness.
5. The nurse is caring for a client who is 1 hour postpartum. The nurse
observes moderate lochia rubra and several small clots on the perineal
pad. The fundus is firm, midline, and at the umbilicus. Which action
should the nurse implement?
, A. Increase the frequency of fundal massage.
B. Notify the primary care provider.
C. Document the findings and continue to monitor.
D. Encourage the client to empty the bladder immediately.
Correct Answer:
C. Document the findings and continue to monitor.
Rationale:
During the early postpartum period, lochia rubra is expected and consists
mainly of blood, decidual tissue, and mucus. Small clots may also occur
during the first several hours after delivery. The fundus being firm, midline,
and at the umbilicus indicates effective uterine contraction. Because the
findings are consistent with expected postpartum changes, the nurse
should document them and continue monitoring. Fundal massage or
catheterization would be indicated if the uterus were boggy or displaced.
6. The nurse is caring for a formula-feeding postpartum client who
reports painful, swollen breasts on the third postpartum day. Which
instruction should the nurse give?
A. Stimulate the nipples manually.
B. Refrain from expressing milk.
C. Gently massage the breasts before feeding.
D. Pump every 2 hours to empty the breasts.
Correct Answer:
B. Refrain from expressing milk.
Rationale:
