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KAPLAN POSTPARTUM NURSING ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for the Kaplan Postpartum Nursing Assessment with a focused study resource
covering essential concepts in postpartum and maternal nursing care. It supports
review of postpartum assessment, normal physiological changes, maternal
complications, newborn care considerations, patient education, and appropriate
nursing interventions. Use the material to reinforce key knowledge, strengthen clinical
judgment, and identify areas that may require additional review. This resource is best
suited for nursing students and NCLEX candidates preparing for postpartum nursing
assessments.
MULTIPLE CHOICE.
SECTION 1: PHYSIOLOGICAL CHANGES & ASSESSMENT (Questions 1-15)
1. The nurse is assessing a client who is 12 hours postpartum. The client's
fundus is firm at the umbilicus and midline. Which action should the
nurse take?
a) Notify the healthcare provider immediately
b) Document the finding as normal
c) Massage the fundus vigorously
d) Administer prescribed oxytocin
Answer: b) Document the finding as normal
Rationale: At 12 hours postpartum, the fundus should be firm and located at
the level of the umbilicus (approximately 1 cm below the umbilicus per day
after delivery). This is a normal finding. Massage is only needed if the fundus is
boggy. Documentation is appropriate.
2. A client who is 24 hours postpartum has a fundus that is firm, located 2
cm above the umbilicus, and displaced to the right. The client reports
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increased vaginal bleeding. Which action should the nurse take first?
a) Administer prescribed oxytocin
b) Assist the client to void
c) Notify the healthcare provider
d) Massage the fundus
Answer: b) Assist the client to void
Rationale: A fundus that is displaced to the right and above the umbilicus
often indicates a full bladder, which can displace the uterus and cause
increased bleeding. The nurse should first assist the client to void and then
reassess. If the fundus remains displaced, massage and medication may be
needed.
3. A client who is 4 hours postpartum has a boggy fundus that is displaced
to the left. The client's perineal pad is saturated with bright red blood.
Which action should the nurse take first?
a) Administer prescribed oxytocin
b) Assist the client to void
c) Massage the fundus until firm
d) Notify the healthcare provider
Answer: c) Massage the fundus until firm
Rationale: A boggy fundus with heavy bleeding indicates uterine atony. The
priority is to massage the fundus to stimulate contraction until it becomes
firm. After the fundus is firm, the nurse can administer oxytocin, assist with
voiding, and notify the provider.
4. A client is 6 hours postpartum. The nurse assesses the client's
perineum and notes a large, firm, bluish mass near the vaginal opening.
The client reports severe pain. This finding is most consistent with:
a) A normal postpartum finding
b) A hematoma
c) An episiotomy infection
d) Hemorrhoids
Answer: b) A hematoma
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Rationale: A large, firm, bluish mass near the vaginal opening with severe
pain is characteristic of a perineal hematoma. This is a complication that
requires immediate intervention. The nurse should notify the provider, apply
ice, and prepare for possible surgical evacuation.
5. A client is 24 hours postpartum. The nurse assesses the client's lochia.
Which finding should be reported to the provider?
a) Moderate lochia rubra with small clots
b) Scant lochia serosa
c) Heavy lochia rubra with large clots
d) Foul-smelling lochia with purulent drainage
Answer: d) Foul-smelling lochia with purulent drainage
Rationale: Foul-smelling lochia with purulent drainage indicates infection
(endometritis). This finding should be reported to the provider immediately.
Heavy lochia with large clots may indicate hemorrhage, but foul-smelling
discharge is a specific sign of infection.
6. The nurse is assessing a client's breast. The client reports engorgement
and discomfort. The nurse notes that the breasts are firm, tender, and
warm to the touch. Which intervention should the nurse recommend?
a) Apply cold packs to the breasts
b) Apply warm packs to the breasts
c) Wear a tight-fitting bra
d) Avoid breastfeeding
Answer: a) Apply cold packs to the breasts
Rationale: For breast engorgement, cold packs help reduce swelling and
discomfort. Warm packs may be used before feeding to stimulate let-down,
but cold packs are recommended after feeding to reduce edema. The client
should continue breastfeeding to relieve engorgement.
7. A client is 2 weeks postpartum and reports bright red vaginal bleeding.
The nurse should suspect:
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a) Normal lochia rubra
b) Late postpartum hemorrhage
c) Infection
d) Retained placental fragments
Answer: d) Retained placental fragments
Rationale: Bright red bleeding after the first week postpartum may indicate
retained placental fragments or late postpartum hemorrhage. Normal lochia
rubra should transition to lochia serosa by day 3-4 and lochia alba by day 10-
14.
8. A client reports that her breasts are painful, and the nurse notes
redness and warmth on one breast. The client has a fever of 101.2°F.
Which intervention should the nurse anticipate?
a) Antibiotic therapy
b) Cold compresses only
c) Discontinuing breastfeeding
d) Applying heat only
Answer: a) Antibiotic therapy
Rationale: The client has signs of mastitis (breast pain, redness, warmth,
fever). Mastitis typically requires antibiotic therapy. The client should continue
breastfeeding or pumping to empty the breast and prevent progression to
abscess.
9. A client is 3 days postpartum and reports that she has not had a bowel
movement since delivery. Which intervention should the nurse
recommend?
a) Administer a suppository
b) Increase fluid intake and dietary fiber
c) Administer an enema
d) Notify the provider
Answer: b) Increase fluid intake and dietary fiber
Rationale: Constipation is common in the postpartum period due to
hormonal changes, decreased peristalsis, and pain with bowel movements.
KAPLAN POSTPARTUM NURSING ASSESSMENT
2026/2027 COMPLETE (100) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for the Kaplan Postpartum Nursing Assessment with a focused study resource
covering essential concepts in postpartum and maternal nursing care. It supports
review of postpartum assessment, normal physiological changes, maternal
complications, newborn care considerations, patient education, and appropriate
nursing interventions. Use the material to reinforce key knowledge, strengthen clinical
judgment, and identify areas that may require additional review. This resource is best
suited for nursing students and NCLEX candidates preparing for postpartum nursing
assessments.
MULTIPLE CHOICE.
SECTION 1: PHYSIOLOGICAL CHANGES & ASSESSMENT (Questions 1-15)
1. The nurse is assessing a client who is 12 hours postpartum. The client's
fundus is firm at the umbilicus and midline. Which action should the
nurse take?
a) Notify the healthcare provider immediately
b) Document the finding as normal
c) Massage the fundus vigorously
d) Administer prescribed oxytocin
Answer: b) Document the finding as normal
Rationale: At 12 hours postpartum, the fundus should be firm and located at
the level of the umbilicus (approximately 1 cm below the umbilicus per day
after delivery). This is a normal finding. Massage is only needed if the fundus is
boggy. Documentation is appropriate.
2. A client who is 24 hours postpartum has a fundus that is firm, located 2
cm above the umbilicus, and displaced to the right. The client reports
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increased vaginal bleeding. Which action should the nurse take first?
a) Administer prescribed oxytocin
b) Assist the client to void
c) Notify the healthcare provider
d) Massage the fundus
Answer: b) Assist the client to void
Rationale: A fundus that is displaced to the right and above the umbilicus
often indicates a full bladder, which can displace the uterus and cause
increased bleeding. The nurse should first assist the client to void and then
reassess. If the fundus remains displaced, massage and medication may be
needed.
3. A client who is 4 hours postpartum has a boggy fundus that is displaced
to the left. The client's perineal pad is saturated with bright red blood.
Which action should the nurse take first?
a) Administer prescribed oxytocin
b) Assist the client to void
c) Massage the fundus until firm
d) Notify the healthcare provider
Answer: c) Massage the fundus until firm
Rationale: A boggy fundus with heavy bleeding indicates uterine atony. The
priority is to massage the fundus to stimulate contraction until it becomes
firm. After the fundus is firm, the nurse can administer oxytocin, assist with
voiding, and notify the provider.
4. A client is 6 hours postpartum. The nurse assesses the client's
perineum and notes a large, firm, bluish mass near the vaginal opening.
The client reports severe pain. This finding is most consistent with:
a) A normal postpartum finding
b) A hematoma
c) An episiotomy infection
d) Hemorrhoids
Answer: b) A hematoma
, Page 3 of 40
Rationale: A large, firm, bluish mass near the vaginal opening with severe
pain is characteristic of a perineal hematoma. This is a complication that
requires immediate intervention. The nurse should notify the provider, apply
ice, and prepare for possible surgical evacuation.
5. A client is 24 hours postpartum. The nurse assesses the client's lochia.
Which finding should be reported to the provider?
a) Moderate lochia rubra with small clots
b) Scant lochia serosa
c) Heavy lochia rubra with large clots
d) Foul-smelling lochia with purulent drainage
Answer: d) Foul-smelling lochia with purulent drainage
Rationale: Foul-smelling lochia with purulent drainage indicates infection
(endometritis). This finding should be reported to the provider immediately.
Heavy lochia with large clots may indicate hemorrhage, but foul-smelling
discharge is a specific sign of infection.
6. The nurse is assessing a client's breast. The client reports engorgement
and discomfort. The nurse notes that the breasts are firm, tender, and
warm to the touch. Which intervention should the nurse recommend?
a) Apply cold packs to the breasts
b) Apply warm packs to the breasts
c) Wear a tight-fitting bra
d) Avoid breastfeeding
Answer: a) Apply cold packs to the breasts
Rationale: For breast engorgement, cold packs help reduce swelling and
discomfort. Warm packs may be used before feeding to stimulate let-down,
but cold packs are recommended after feeding to reduce edema. The client
should continue breastfeeding to relieve engorgement.
7. A client is 2 weeks postpartum and reports bright red vaginal bleeding.
The nurse should suspect:
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a) Normal lochia rubra
b) Late postpartum hemorrhage
c) Infection
d) Retained placental fragments
Answer: d) Retained placental fragments
Rationale: Bright red bleeding after the first week postpartum may indicate
retained placental fragments or late postpartum hemorrhage. Normal lochia
rubra should transition to lochia serosa by day 3-4 and lochia alba by day 10-
14.
8. A client reports that her breasts are painful, and the nurse notes
redness and warmth on one breast. The client has a fever of 101.2°F.
Which intervention should the nurse anticipate?
a) Antibiotic therapy
b) Cold compresses only
c) Discontinuing breastfeeding
d) Applying heat only
Answer: a) Antibiotic therapy
Rationale: The client has signs of mastitis (breast pain, redness, warmth,
fever). Mastitis typically requires antibiotic therapy. The client should continue
breastfeeding or pumping to empty the breast and prevent progression to
abscess.
9. A client is 3 days postpartum and reports that she has not had a bowel
movement since delivery. Which intervention should the nurse
recommend?
a) Administer a suppository
b) Increase fluid intake and dietary fiber
c) Administer an enema
d) Notify the provider
Answer: b) Increase fluid intake and dietary fiber
Rationale: Constipation is common in the postpartum period due to
hormonal changes, decreased peristalsis, and pain with bowel movements.
