,NUR202 Maternal Newborn Nursing Exam 3
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A postpartum client who delivered a 4,500-gram infant 30 minutes ago suddenly experiences
a gush of blood. The fundus is boggy, midline, and at the level of the umbilicus. Which is the
priority nursing action?
A. Administer methylergonovine IM
B. Massage the uterine fundus firmly
C. Notify the healthcare provider
D. Insert an indwelling urinary catheter
Correct Answer: B. Massage the uterine fundus firmly
Rationale: A boggy uterus indicates uterine atony, which is the most common cause of
postpartum hemorrhage. The initial priority is to massage the fundus to stimulate contraction
and expel clots. Methylergonovine is contraindicated in hypertension and should be given after
fundal massage if bleeding continues.
2. A nurse is assessing a postpartum client who delivered 2 hours ago. The client reports sudden
severe perineal pain. The nurse notes a large, swollen, discolored area on the perineum. Which
complication is most likely?
,A. Perineal laceration
B. Episiotomy dehiscence
C. Perineal hematoma
D. Vulvar varicosities
Correct Answer: C. Perineal hematoma
Rationale: A perineal hematoma presents with sudden, severe perineal pain and a large,
swollen, discolored mass. It requires immediate evaluation and possible surgical evacuation.
3. A postpartum client has a temperature of 101.8°F on postpartum day 3, uterine tenderness,
and foul-smelling lochia. Which condition is most likely?
A. Mastitis
B. Endometritis
C. Urinary tract infection
D. Atelectasis
, Correct Answer: B. Endometritis
Rationale: Endometritis (postpartum uterine infection) presents with fever, uterine tenderness,
and foul-smelling lochia. It is a common postpartum infection that requires antibiotic therapy.
4. A nurse is reviewing risk factors for postpartum hemorrhage. Which factor places a client at
the highest risk?
A. Precipitous labor
B. Uterine overdistention
C. Multiparity
D. Prolonged second stage of labor
Correct Answer: B. Uterine overdistention
Rationale: Uterine overdistention (from multiple gestation, polyhydramnios, or macrosomia)
prevents effective uterine contraction after delivery, leading to uterine atony and postpartum
hemorrhage.
5. A postpartum client who had a cesarean delivery reports unilateral calf pain, warmth, and
redness. Which action should the nurse take first?
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A postpartum client who delivered a 4,500-gram infant 30 minutes ago suddenly experiences
a gush of blood. The fundus is boggy, midline, and at the level of the umbilicus. Which is the
priority nursing action?
A. Administer methylergonovine IM
B. Massage the uterine fundus firmly
C. Notify the healthcare provider
D. Insert an indwelling urinary catheter
Correct Answer: B. Massage the uterine fundus firmly
Rationale: A boggy uterus indicates uterine atony, which is the most common cause of
postpartum hemorrhage. The initial priority is to massage the fundus to stimulate contraction
and expel clots. Methylergonovine is contraindicated in hypertension and should be given after
fundal massage if bleeding continues.
2. A nurse is assessing a postpartum client who delivered 2 hours ago. The client reports sudden
severe perineal pain. The nurse notes a large, swollen, discolored area on the perineum. Which
complication is most likely?
,A. Perineal laceration
B. Episiotomy dehiscence
C. Perineal hematoma
D. Vulvar varicosities
Correct Answer: C. Perineal hematoma
Rationale: A perineal hematoma presents with sudden, severe perineal pain and a large,
swollen, discolored mass. It requires immediate evaluation and possible surgical evacuation.
3. A postpartum client has a temperature of 101.8°F on postpartum day 3, uterine tenderness,
and foul-smelling lochia. Which condition is most likely?
A. Mastitis
B. Endometritis
C. Urinary tract infection
D. Atelectasis
, Correct Answer: B. Endometritis
Rationale: Endometritis (postpartum uterine infection) presents with fever, uterine tenderness,
and foul-smelling lochia. It is a common postpartum infection that requires antibiotic therapy.
4. A nurse is reviewing risk factors for postpartum hemorrhage. Which factor places a client at
the highest risk?
A. Precipitous labor
B. Uterine overdistention
C. Multiparity
D. Prolonged second stage of labor
Correct Answer: B. Uterine overdistention
Rationale: Uterine overdistention (from multiple gestation, polyhydramnios, or macrosomia)
prevents effective uterine contraction after delivery, leading to uterine atony and postpartum
hemorrhage.
5. A postpartum client who had a cesarean delivery reports unilateral calf pain, warmth, and
redness. Which action should the nurse take first?
