Women's Health NP || Most Recent Exam 2026|2027
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| University of South Alabama
Which finding in a postpartum patient requires the most immediate
follow-up?
A. Mild uterine cramping during breastfeeding
B. Lochia rubra during the first few postpartum days
C. Foul-smelling lochia accompanied by fever
D. Mild breast fullness before feeding
Answer: C. Foul-smelling lochia accompanied by fever
Rationale: Foul-smelling lochia with fever suggests postpartum uterine
infection, such as endometritis. Mild cramping, lochia rubra early after
delivery, and breast fullness can be normal postpartum findings.
Which postpartum finding is most consistent with uterine atony?
A. Firm midline fundus with scant lochia
B. Boggy uterus with heavy vaginal bleeding
C. Fundus descending appropriately each day
D. Lochia changing from rubra to serosa
Answer: B. Boggy uterus with heavy vaginal bleeding
Rationale: Uterine atony is the most common cause of primary
postpartum hemorrhage. The uterus fails to contract effectively and is
,typically soft or boggy, accompanied by excessive bleeding. Fundal
massage and uterotonic therapy are commonly used interventions.
A postpartum patient has a boggy uterus and heavy bleeding. What is
the nurse practitioner's priority initial intervention?
A. Encourage ambulation
B. Perform fundal massage
C. Apply an ice pack to the perineum
D. Encourage oral fluids only
Answer: B. Perform fundal massage
Rationale: Fundal massage stimulates uterine contraction and is an
immediate intervention for uterine atony. If bleeding persists,
uterotonic medications and additional evaluation are required.
Which medication is commonly used as a first-line uterotonic for
postpartum uterine atony?
A. Oxytocin
B. Terbutaline
C. Magnesium sulfate
D. Methylergonovine only
Answer: A. Oxytocin
Rationale: Oxytocin promotes uterine contraction and is commonly
used to prevent and treat postpartum hemorrhage caused by uterine
atony. The other medications have different primary indications or
important contraindications.
Which description correctly identifies lochia rubra?
,A. White or yellow-white discharge occurring late postpartum
B. Predominantly blood-containing discharge during the early
postpartum period
C. Green, purulent vaginal discharge
D. Clear mucus occurring only after breastfeeding
Answer: B. Predominantly blood-containing discharge during the early
postpartum period
Rationale: Lochia rubra is the initial postpartum discharge and
contains substantial blood along with decidual tissue and mucus. It is
normally followed by lochia serosa and then lochia alba.
A postpartum patient has lochia that becomes foul smelling and is
associated with uterine tenderness. What condition should be
suspected?
A. Normal uterine involution
B. Endometritis
C. Physiologic diuresis
D. Lactogenesis
Answer: B. Endometritis
Rationale: Postpartum endometritis commonly presents with fever,
uterine tenderness, and malodorous lochia. Prompt evaluation and
antimicrobial treatment are indicated.
Which postpartum finding is generally considered physiologic?
A. Saturating a pad in less than an hour
B. Foul-smelling lochia
, C. Mild afterpains during breastfeeding
D. Persistent severe unilateral calf pain
Answer: C. Mild afterpains during breastfeeding
Rationale: Breastfeeding stimulates oxytocin release, which can increase
uterine contractions and cause afterpains. Heavy bleeding, malodorous
discharge, and unilateral calf symptoms require evaluation.
A postpartum patient has unilateral calf swelling, warmth, tenderness,
and redness. What is the priority concern?
A. Normal postpartum edema
B. Deep venous thrombosis
C. Mastitis
D. Urinary retention
Answer: B. Deep venous thrombosis
Rationale: Unilateral swelling, warmth, redness, and tenderness are
concerning for venous thrombosis. The patient should not have the
affected leg massaged because of the potential for thromboembolism.
Which symptom in a postpartum patient is particularly concerning for
pulmonary embolism?
A. Mild uterine cramping
B. Sudden shortness of breath and chest pain
C. Breast fullness
D. Mild urinary frequency
Answer: B. Sudden shortness of breath and chest pain