,NSG3332/NSG 3332 Exam 3 | Maternal-Infant
Nursing Care | South College | Q & A | 2026/2027
Edition (PDF)
1. Four hours after a vaginal birth, the nurse palpates a soft uterus above the
umbilicus with heavier-than-expected lochia. What is the priority action?
A) Apply an ice pack to the perineum.
B) Assist the patient to ambulate.
C) Obtain a newborn blood glucose.
D) Massage the uterine fundus.
Correct Answer: Massage the uterine fundus.
Rationale: A boggy uterus indicates inadequate uterine contraction and suggests uterine
atony, the most common cause of early postpartum hemorrhage. Fundal massage
stimulates myometrial contraction and should be performed promptly while the nurse
continues evaluating bleeding, bladder status, vital signs, and the need for uterotonic
therapy.
2. A postpartum uterus is firm but displaced to the right and higher than expected.
Which problem is most likely?
A) Retained placenta
B) Bladder distention
C) Endometritis
D) Uterine inversion
Correct Answer: Bladder distention
Rationale: A full bladder can push the uterus upward and laterally, commonly toward the
right. Bladder distention also interferes with effective uterine contraction and can increase
postpartum bleeding. Assisting the patient to void often restores the uterus to a firm,
midline position.
3. Which sequence represents the expected progression of postpartum lochia?
A) Alba, serosa, rubra
B) Serosa, alba, rubra
C) Rubra, serosa, alba
D) Rubra, alba, serosa
Correct Answer: Rubra, serosa, alba
Rationale: Lochia rubra is initially red and bloody, followed by pink-brown lochia serosa,
and finally whitish or yellowish lochia alba. Reappearance of heavy rubra after it has
, diminished may warrant assessment for excessive activity, subinvolution, retained tissue, or
hemorrhage.
4. A patient 5 days postpartum reports foul-smelling lochia, uterine tenderness, chills,
and fever. Which complication should the nurse suspect?
A) Mastitis
B) Deep-vein thrombosis
C) Normal involution
D) Endometritis
Correct Answer: Endometritis
Rationale: Postpartum endometritis is infection of the uterine lining and typically presents
with fever, uterine or lower abdominal tenderness, malodorous lochia, chills, and malaise.
Risk factors include cesarean birth, prolonged labor, prolonged rupture of membranes,
and multiple vaginal examinations.
5. During postpartum assessment, which finding most strongly suggests subinvolution?
A) Firm fundus descending appropriately each day
B) Uterus larger than expected with prolonged lochia rubra
C) Lochia changing from serosa to alba
D) Mild uterine cramping during breastfeeding
Correct Answer: Uterus larger than expected with prolonged lochia rubra
Rationale: Subinvolution is delayed return of the uterus to its prepregnancy size. A fundus
that remains elevated or enlarged and persistent or recurrent lochia rubra are
characteristic. Retained placental fragments and infection are common contributors.
6. Which postpartum finding requires the most immediate intervention?
A) Saturating a perineal pad in 15 minutes
B) Mild afterpains during breastfeeding
C) Lochia rubra on postpartum day 1
D) Fatigue after nighttime feeding
Correct Answer: Saturating a perineal pad in 15 minutes
Rationale: Rapid pad saturation suggests significant postpartum hemorrhage. Because
blood loss can progress quickly to hypovolemic shock, maternal circulation, uterine tone,
and bleeding source must be addressed immediately.
7. A patient with postpartum hemorrhage has a boggy uterus despite fundal massage.
Which medication is commonly administered first to increase uterine tone?
A) Oxytocin
B) Terbutaline
Nursing Care | South College | Q & A | 2026/2027
Edition (PDF)
1. Four hours after a vaginal birth, the nurse palpates a soft uterus above the
umbilicus with heavier-than-expected lochia. What is the priority action?
A) Apply an ice pack to the perineum.
B) Assist the patient to ambulate.
C) Obtain a newborn blood glucose.
D) Massage the uterine fundus.
Correct Answer: Massage the uterine fundus.
Rationale: A boggy uterus indicates inadequate uterine contraction and suggests uterine
atony, the most common cause of early postpartum hemorrhage. Fundal massage
stimulates myometrial contraction and should be performed promptly while the nurse
continues evaluating bleeding, bladder status, vital signs, and the need for uterotonic
therapy.
2. A postpartum uterus is firm but displaced to the right and higher than expected.
Which problem is most likely?
A) Retained placenta
B) Bladder distention
C) Endometritis
D) Uterine inversion
Correct Answer: Bladder distention
Rationale: A full bladder can push the uterus upward and laterally, commonly toward the
right. Bladder distention also interferes with effective uterine contraction and can increase
postpartum bleeding. Assisting the patient to void often restores the uterus to a firm,
midline position.
3. Which sequence represents the expected progression of postpartum lochia?
A) Alba, serosa, rubra
B) Serosa, alba, rubra
C) Rubra, serosa, alba
D) Rubra, alba, serosa
Correct Answer: Rubra, serosa, alba
Rationale: Lochia rubra is initially red and bloody, followed by pink-brown lochia serosa,
and finally whitish or yellowish lochia alba. Reappearance of heavy rubra after it has
, diminished may warrant assessment for excessive activity, subinvolution, retained tissue, or
hemorrhage.
4. A patient 5 days postpartum reports foul-smelling lochia, uterine tenderness, chills,
and fever. Which complication should the nurse suspect?
A) Mastitis
B) Deep-vein thrombosis
C) Normal involution
D) Endometritis
Correct Answer: Endometritis
Rationale: Postpartum endometritis is infection of the uterine lining and typically presents
with fever, uterine or lower abdominal tenderness, malodorous lochia, chills, and malaise.
Risk factors include cesarean birth, prolonged labor, prolonged rupture of membranes,
and multiple vaginal examinations.
5. During postpartum assessment, which finding most strongly suggests subinvolution?
A) Firm fundus descending appropriately each day
B) Uterus larger than expected with prolonged lochia rubra
C) Lochia changing from serosa to alba
D) Mild uterine cramping during breastfeeding
Correct Answer: Uterus larger than expected with prolonged lochia rubra
Rationale: Subinvolution is delayed return of the uterus to its prepregnancy size. A fundus
that remains elevated or enlarged and persistent or recurrent lochia rubra are
characteristic. Retained placental fragments and infection are common contributors.
6. Which postpartum finding requires the most immediate intervention?
A) Saturating a perineal pad in 15 minutes
B) Mild afterpains during breastfeeding
C) Lochia rubra on postpartum day 1
D) Fatigue after nighttime feeding
Correct Answer: Saturating a perineal pad in 15 minutes
Rationale: Rapid pad saturation suggests significant postpartum hemorrhage. Because
blood loss can progress quickly to hypovolemic shock, maternal circulation, uterine tone,
and bleeding source must be addressed immediately.
7. A patient with postpartum hemorrhage has a boggy uterus despite fundal massage.
Which medication is commonly administered first to increase uterine tone?
A) Oxytocin
B) Terbutaline
