1. Eve is 2 days postpartum. During palpation, where would you normally
expect to find her fundus?
a. at the level of the umbilicus
b. 2 fingers below umbilicus
c. 5 fingers below umbilicus
d. non-palpable at this time: b. 2 fingers below umbilicus
2. Keisha delivered her third child about 24 hours ago. She begins to c/o severe
uterine cramping while breastfeeding. She is experiencing:
a. exfoliation of dead tissue
b. involution of uterus
c. shedding of the endometrium
d. after pains: d. after pains
3. Three days after delivering her child, Gretchen calls the 24 hour hotline. She
is crying and states that her breasts suddenly became "bigger" and "really
hurt." She is experiencing:
a. colostrum production
b. a breast tumor
c. engorgement
d. overproduction of milk: c. engorgement
4. Tiffany delivered via cesarean 2 days ago. She is frustrated by constant
perspiration and urination. This is likely the result of:
a. changes in urine pH and a possible UTI
b. drinking too much fluid in the early postpartum period
c. the body's removal of fluids accumulated during pregnancy
d. receiving excessive amounts of IV fluids during labor: c. the body's removal
of fluids accumulated during pregnancy
5. While assessing Sierra, a 32yo mother of 3, you notice uterine bleeding and
find that her uterus is displayed upward and to the right. This is probably cause
by:
,a. retained placental fragments
b. rupture of the uterus
c. distention of the bladder
d. cervical bruising: c. distention of the bladder
,6. Olga, a 38yo patient whom you administered the rubella vaccine, states that
at her age she plans to get pregnant right away. You tell her she should:
a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine
b. get pregnant ASAP because of her age
c. avoid getting pregnant for at least a year after receiving the MMR vaccine
d. abstain from sex for 2 weeks after delivery: a. avoid pregnancy for at least 8
weeks after receiving the MMR vaccine
7. Joan is a 17yo and just delivered a healthy baby boy 6 hours ago. She talks
on her cell phone whenever you are in the room and refuses to touch or hold
her baby, even when he cries. You overhear Joan tell someone that the baby
is "ugly like his father." Joan is most likely experiencing:
a. exhaustion
b. mal-attachment
c. normal attachment
d. postpartum depression: b. mal-attachment
8. Recommended advice for breastfeeding mothers include:
a. avoid the use of a sports bra
b. wash the nipples with soap and water after each feeding
c. apply a warm compress to ease nipple pain
d. "conditioning" the nipples by gently rubbing them with moist tea bags: c.
apply a warm compress to ease nipple pain
9. Samantha read in the discharge booklet that postpartum patients are at
risk for thrombophlebitis, and she asks you how she can prevent this from
happening. You instruct her to:
a. remain on strict bedrest
b. ambulate frequently
c. cross her legs while sitting
d. avoid elevating her legs: b. ambulate frequently
10. Suzanne delivered vaginally 8 hours ago. She has uterine cramping and
rates her pain a "9" but refuses pain medication. What is your best response
regarding her pain?
a. tell her she should take the ibuprofen as prescribed by her MD
b. encourage her to fight the pain because it will make her stronger
c. ask her to use the call button if she changes her mind about taking pain
, medication
d. offer her a non-drug option such as a hot pack or massage: d. offer her a
non-drug option such as a hot pack or massage
11. Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She
reports she is "bleeding a lot" and her perineal pad, changed 45 minutes ago,
is fully saturated. Palpation reveals a boggy uterus. Your first intervention is:
a. start IV fluids
b. place a catheter
c. massage her uterus until firm
d. call the MD: c. massage her uterus until firm
12. Mei experienced premature rupture of membranes during her pregnancy
and her internal fetal monitors placed during labor. She later delivered by
cesarean. 12 hours after delivery, her HR is 104 and her lochia smells foul.
You suspect:
a. endometriosis
b. mastitis
c. uterine cancer
d. endometritis: d. endometritis
13. You are preparing to discharge Maria after delivering a healthy boy. You
believe Maria understands the discharge teaching instructions when she
states:
a. it is acceptable to have bleeding nipples after breastfeeding for the first few
days
b. I should not worry if I have a large mass under my breasts
c. I will call my nurse-midwife if I saturate a pad in one hour
d. suicidal thoughts are okay because the baby blues are normal: c. I will call
my nurse-midwife if I saturate a pad in one hour
14. An infant born to a mother who abused drugs during pregnancy exhibited
withdrawal signs in the nursery that included fever and poor state control.
After stabilization and discharge, the caretaker called to report a return of
withdrawal symptoms. This pattern is consistent with maternal abuse of:
a. alcohol
b. cocaine
c. methadone: b. cocaine
expect to find her fundus?
a. at the level of the umbilicus
b. 2 fingers below umbilicus
c. 5 fingers below umbilicus
d. non-palpable at this time: b. 2 fingers below umbilicus
2. Keisha delivered her third child about 24 hours ago. She begins to c/o severe
uterine cramping while breastfeeding. She is experiencing:
a. exfoliation of dead tissue
b. involution of uterus
c. shedding of the endometrium
d. after pains: d. after pains
3. Three days after delivering her child, Gretchen calls the 24 hour hotline. She
is crying and states that her breasts suddenly became "bigger" and "really
hurt." She is experiencing:
a. colostrum production
b. a breast tumor
c. engorgement
d. overproduction of milk: c. engorgement
4. Tiffany delivered via cesarean 2 days ago. She is frustrated by constant
perspiration and urination. This is likely the result of:
a. changes in urine pH and a possible UTI
b. drinking too much fluid in the early postpartum period
c. the body's removal of fluids accumulated during pregnancy
d. receiving excessive amounts of IV fluids during labor: c. the body's removal
of fluids accumulated during pregnancy
5. While assessing Sierra, a 32yo mother of 3, you notice uterine bleeding and
find that her uterus is displayed upward and to the right. This is probably cause
by:
,a. retained placental fragments
b. rupture of the uterus
c. distention of the bladder
d. cervical bruising: c. distention of the bladder
,6. Olga, a 38yo patient whom you administered the rubella vaccine, states that
at her age she plans to get pregnant right away. You tell her she should:
a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine
b. get pregnant ASAP because of her age
c. avoid getting pregnant for at least a year after receiving the MMR vaccine
d. abstain from sex for 2 weeks after delivery: a. avoid pregnancy for at least 8
weeks after receiving the MMR vaccine
7. Joan is a 17yo and just delivered a healthy baby boy 6 hours ago. She talks
on her cell phone whenever you are in the room and refuses to touch or hold
her baby, even when he cries. You overhear Joan tell someone that the baby
is "ugly like his father." Joan is most likely experiencing:
a. exhaustion
b. mal-attachment
c. normal attachment
d. postpartum depression: b. mal-attachment
8. Recommended advice for breastfeeding mothers include:
a. avoid the use of a sports bra
b. wash the nipples with soap and water after each feeding
c. apply a warm compress to ease nipple pain
d. "conditioning" the nipples by gently rubbing them with moist tea bags: c.
apply a warm compress to ease nipple pain
9. Samantha read in the discharge booklet that postpartum patients are at
risk for thrombophlebitis, and she asks you how she can prevent this from
happening. You instruct her to:
a. remain on strict bedrest
b. ambulate frequently
c. cross her legs while sitting
d. avoid elevating her legs: b. ambulate frequently
10. Suzanne delivered vaginally 8 hours ago. She has uterine cramping and
rates her pain a "9" but refuses pain medication. What is your best response
regarding her pain?
a. tell her she should take the ibuprofen as prescribed by her MD
b. encourage her to fight the pain because it will make her stronger
c. ask her to use the call button if she changes her mind about taking pain
, medication
d. offer her a non-drug option such as a hot pack or massage: d. offer her a
non-drug option such as a hot pack or massage
11. Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She
reports she is "bleeding a lot" and her perineal pad, changed 45 minutes ago,
is fully saturated. Palpation reveals a boggy uterus. Your first intervention is:
a. start IV fluids
b. place a catheter
c. massage her uterus until firm
d. call the MD: c. massage her uterus until firm
12. Mei experienced premature rupture of membranes during her pregnancy
and her internal fetal monitors placed during labor. She later delivered by
cesarean. 12 hours after delivery, her HR is 104 and her lochia smells foul.
You suspect:
a. endometriosis
b. mastitis
c. uterine cancer
d. endometritis: d. endometritis
13. You are preparing to discharge Maria after delivering a healthy boy. You
believe Maria understands the discharge teaching instructions when she
states:
a. it is acceptable to have bleeding nipples after breastfeeding for the first few
days
b. I should not worry if I have a large mass under my breasts
c. I will call my nurse-midwife if I saturate a pad in one hour
d. suicidal thoughts are okay because the baby blues are normal: c. I will call
my nurse-midwife if I saturate a pad in one hour
14. An infant born to a mother who abused drugs during pregnancy exhibited
withdrawal signs in the nursery that included fever and poor state control.
After stabilization and discharge, the caretaker called to report a return of
withdrawal symptoms. This pattern is consistent with maternal abuse of:
a. alcohol
b. cocaine
c. methadone: b. cocaine
