,Arizona College NUR 335 Exam 3 | Maternal Health
Theory & Application (2026) Q&A
1. A nurse is assessing a postpartum client using the BUBBLE-LE framework. Which
components are included in this assessment?
A) Blood, Uterus, Baby, Breathing, Lab work, Ears
B) Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, Lower extremities
C) Baby, Uterus, Blood pressure, Breathing, Laboratory, Elimination
D) Breasts, Umbilicus, Bowel, Bladder, Lochia, Endometrium
Correct Answer: Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, Lower
extremities
Rationale: BUBBLE-LE is the standard postpartum assessment framework. It stands for
Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, and Lower Extremities. This
systematic approach ensures comprehensive evaluation of maternal recovery.
2. During a postpartum assessment, the nurse palpates the fundus and finds it is boggy and
displaced to the right. What is the nurse's priority action?
A) Document the finding as normal
B) Perform fundal massage and ask the client to void
C) Notify the healthcare provider immediately
D) Apply an ice pack to the abdomen
Correct Answer: Perform fundal massage and ask the client to void
,Rationale: A boggy fundus indicates uterine atony, which increases hemorrhage risk. A
fundus displaced to the right often indicates a distended bladder. The priority is to massage
the fundus and assist the client to void to allow the uterus to contract effectively.
3. What is the leading cause of early postpartum hemorrhage?
A) Retained placental fragments
B) Uterine atony
C) Genital tract lacerations
D) Coagulation disorders
Correct Answer: Uterine atony
Rationale: Uterine atony is the leading cause of early postpartum hemorrhage because
the uterine vessels are not compressed after delivery. Risk factors include prolonged labor,
macrosomia, and multifetal gestation. Prompt recognition and fundal massage are essential.
4. The main causes of postpartum hemorrhage are referred to as the "4 T's." What do they
stand for?
A) Tone, Tear, Tissue, Thrombin
B) Tone, Trauma, Tissue, Thrombin
C) Temperature, Tone, Trauma, Thrombin
D) Time, Tone, Trauma, Tissue
Correct Answer: Tone, Trauma, Tissue, Thrombin
Rationale: The 4 T's of postpartum hemorrhage are Tone (uterine atony), Trauma
(lacerations, hematomas), Tissue (retained placental fragments), and Thrombin
(coagulation disorders). This framework guides systematic assessment and intervention.
, 5. What is the best way to measure estimated blood loss (EBL) in a postpartum client?
A) Visual estimation
B) Counting the number of pads used
C) Weighing the pads
D) Measuring blood in a graduated container
Correct Answer: Weighing the pads
Rationale: Weighing pads is the most accurate method for measuring estimated blood
loss. One gram of weight equals approximately 1 mL of blood loss. Visual estimation and
pad counting are less accurate and may underestimate actual blood loss.
6. A patient reports soaking a pad in less than 1 hour with an egg-sized clot. What is the
priority nursing intervention?
A) Reassure the mother that this is normal
B) Perform fundal massage and notify the healthcare provider
C) Tell the mother to rest and continue monitoring
D) Administer oral iron supplements
Correct Answer: Perform fundal massage and notify the healthcare provider
Rationale: Soaking a pad in less than 1 hour with an egg-sized clot indicates postpartum
hemorrhage. The priority is to perform fundal massage to stimulate uterine contraction and
immediately notify the provider for further intervention.
7. A mother reports low platelets, oozing at the IV site, epistaxis, and hypovolemic shock.
What should the nurse do?
Theory & Application (2026) Q&A
1. A nurse is assessing a postpartum client using the BUBBLE-LE framework. Which
components are included in this assessment?
A) Blood, Uterus, Baby, Breathing, Lab work, Ears
B) Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, Lower extremities
C) Baby, Uterus, Blood pressure, Breathing, Laboratory, Elimination
D) Breasts, Umbilicus, Bowel, Bladder, Lochia, Endometrium
Correct Answer: Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, Lower
extremities
Rationale: BUBBLE-LE is the standard postpartum assessment framework. It stands for
Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy/perineum, and Lower Extremities. This
systematic approach ensures comprehensive evaluation of maternal recovery.
2. During a postpartum assessment, the nurse palpates the fundus and finds it is boggy and
displaced to the right. What is the nurse's priority action?
A) Document the finding as normal
B) Perform fundal massage and ask the client to void
C) Notify the healthcare provider immediately
D) Apply an ice pack to the abdomen
Correct Answer: Perform fundal massage and ask the client to void
,Rationale: A boggy fundus indicates uterine atony, which increases hemorrhage risk. A
fundus displaced to the right often indicates a distended bladder. The priority is to massage
the fundus and assist the client to void to allow the uterus to contract effectively.
3. What is the leading cause of early postpartum hemorrhage?
A) Retained placental fragments
B) Uterine atony
C) Genital tract lacerations
D) Coagulation disorders
Correct Answer: Uterine atony
Rationale: Uterine atony is the leading cause of early postpartum hemorrhage because
the uterine vessels are not compressed after delivery. Risk factors include prolonged labor,
macrosomia, and multifetal gestation. Prompt recognition and fundal massage are essential.
4. The main causes of postpartum hemorrhage are referred to as the "4 T's." What do they
stand for?
A) Tone, Tear, Tissue, Thrombin
B) Tone, Trauma, Tissue, Thrombin
C) Temperature, Tone, Trauma, Thrombin
D) Time, Tone, Trauma, Tissue
Correct Answer: Tone, Trauma, Tissue, Thrombin
Rationale: The 4 T's of postpartum hemorrhage are Tone (uterine atony), Trauma
(lacerations, hematomas), Tissue (retained placental fragments), and Thrombin
(coagulation disorders). This framework guides systematic assessment and intervention.
, 5. What is the best way to measure estimated blood loss (EBL) in a postpartum client?
A) Visual estimation
B) Counting the number of pads used
C) Weighing the pads
D) Measuring blood in a graduated container
Correct Answer: Weighing the pads
Rationale: Weighing pads is the most accurate method for measuring estimated blood
loss. One gram of weight equals approximately 1 mL of blood loss. Visual estimation and
pad counting are less accurate and may underestimate actual blood loss.
6. A patient reports soaking a pad in less than 1 hour with an egg-sized clot. What is the
priority nursing intervention?
A) Reassure the mother that this is normal
B) Perform fundal massage and notify the healthcare provider
C) Tell the mother to rest and continue monitoring
D) Administer oral iron supplements
Correct Answer: Perform fundal massage and notify the healthcare provider
Rationale: Soaking a pad in less than 1 hour with an egg-sized clot indicates postpartum
hemorrhage. The priority is to perform fundal massage to stimulate uterine contraction and
immediately notify the provider for further intervention.
7. A mother reports low platelets, oozing at the IV site, epistaxis, and hypovolemic shock.
What should the nurse do?
