Maternity and Pediatric Nursing 4th Edition Exam
Questions Updated 2025/2026 WITH CORRECT/ACCURATE
ANSWERS
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the
client's fundus, expecting it to be at which location?
A) Two fingerbreadths above the umbilicus
B) At the level of the umbilicus
C) Two fingerbreadths below the umbilicus
D) Four fingerbreadths below the umbilicus
Ans: C
During the first few days after birth, the uterus typically descends downward from the level of the
umbilicus at a rate of 1 cm (1 fingerbreadth) per day so that by day 2, it is about 2 fingerbreadths below
the umbilicus.
When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to
be:
A) Greater than after a vaginal delivery
B) About the same as after a vaginal delivery
C) Less than after a vaginal delivery
D) Saturated with clots and mucus
,Ans: C
Women who have had cesarean births tend to have less flow because the uterine debris is removed
manually along with delivery of the placenta.
A client who is breastfeeding her newborn tells the nurse, I notice that when I feed him, I feel fairly
strong contraction-like pain. Labor is over. Why am I having contractions now? Which response by the
nurse would be most appropriate?
A) Your uterus is still shrinking in size; that's why you're feeling this pain.
B) Let me check your vaginal discharge just to make sure everything is fine.
C) Your body is responding to the events of labor, just like after a tough workout.
D) The baby's sucking releases a hormone that causes the uterus to contract
Ans: D
The woman is describing afterpains, which are usually stronger during breast-feeding because oxytocin
released by the sucking reflex strengthens uterine contractions. Afterpains are associated with uterine
involution, but the woman's description strongly correlates with the hormonal events of breast-feeding.
All women experience afterpains, but they are more acute in multiparous women secondary to repeated
stretching of the uterine muscles.
The nurse interprets which of the following as evidence that a client is in the
taking-in phase?
A) Client states, He has my eyes and nose.
B) Client shows interest in caring for the newborn.
C) Client performs self-care independently.
D) Client confidently cares for the newborn
Ans: A
During the taking-in phase, new mothers when interacting with their newborns spend time claiming the
newborn and touching him or her, commonly identifying specific features in the newborn such as "he
has my nose" or "his fingers are long like his father's." Independence in self-care and interest in caring
, for the newborn are typical of the taking-hold phase. Confidence in caring for the newborn is
demonstrated during the letting-go phase.
A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history,
which of the following would the nurse identify as being least significant to this condition?
A) Early ambulation
B) Prolonged labor
C) Large fetus
D) Pulse rate of 60 beats/minute
Ans: A
Factors that inhibit involution include prolonged labor and difficult birth, incomplete expulsion of
amniotic membranes and placenta, uterine infection, overdistention of uterine muscles (such as by
multiple gestation, hydramnios, or large singleton fetus), full bladder (which displaces the uterus and
interferes with contractions), anesthesia(which relaxes uterine muscles), and close childbirth spacing.
Factors that facilitate uterine involution include complete expulsion of amniotic membranes and
placenta at birth, complication-free labor and birth process, breast-feeding, and early ambulation.
A woman who gave birth 24 hours ago tells the nurse, I've been urinating so much over the past several
hours. Which response by the nurse would be most appropriate?
A) You must have an infection, so let me get a urine specimen.
B) Your body is undergoing many changes that cause your bladder to fill quickly.
C) Your uterus is not contracting as quickly as it should.
D) The anesthesia that you received is wearing off and your bladder is working
again.
Ans: B
Postpartum diuresis occurs as a result of several mechanisms: the large amounts of IV fluids given during
labor, a decreasing antidiuretic effect of oxytocin as its level declines, the buildup and retention of extra
fluids during pregnancy, and a decreasing production of aldosterone—the hormone that decreases
sodium retention and increases urine production. All these factors contribute to rapid filling of the
bladder within 12 hours of birth. Diuresis begins within 12 hours after childbirth and continues
Questions Updated 2025/2026 WITH CORRECT/ACCURATE
ANSWERS
A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the
client's fundus, expecting it to be at which location?
A) Two fingerbreadths above the umbilicus
B) At the level of the umbilicus
C) Two fingerbreadths below the umbilicus
D) Four fingerbreadths below the umbilicus
Ans: C
During the first few days after birth, the uterus typically descends downward from the level of the
umbilicus at a rate of 1 cm (1 fingerbreadth) per day so that by day 2, it is about 2 fingerbreadths below
the umbilicus.
When caring for a mother who has had a cesarean birth, the nurse would expect the client's lochia to
be:
A) Greater than after a vaginal delivery
B) About the same as after a vaginal delivery
C) Less than after a vaginal delivery
D) Saturated with clots and mucus
,Ans: C
Women who have had cesarean births tend to have less flow because the uterine debris is removed
manually along with delivery of the placenta.
A client who is breastfeeding her newborn tells the nurse, I notice that when I feed him, I feel fairly
strong contraction-like pain. Labor is over. Why am I having contractions now? Which response by the
nurse would be most appropriate?
A) Your uterus is still shrinking in size; that's why you're feeling this pain.
B) Let me check your vaginal discharge just to make sure everything is fine.
C) Your body is responding to the events of labor, just like after a tough workout.
D) The baby's sucking releases a hormone that causes the uterus to contract
Ans: D
The woman is describing afterpains, which are usually stronger during breast-feeding because oxytocin
released by the sucking reflex strengthens uterine contractions. Afterpains are associated with uterine
involution, but the woman's description strongly correlates with the hormonal events of breast-feeding.
All women experience afterpains, but they are more acute in multiparous women secondary to repeated
stretching of the uterine muscles.
The nurse interprets which of the following as evidence that a client is in the
taking-in phase?
A) Client states, He has my eyes and nose.
B) Client shows interest in caring for the newborn.
C) Client performs self-care independently.
D) Client confidently cares for the newborn
Ans: A
During the taking-in phase, new mothers when interacting with their newborns spend time claiming the
newborn and touching him or her, commonly identifying specific features in the newborn such as "he
has my nose" or "his fingers are long like his father's." Independence in self-care and interest in caring
, for the newborn are typical of the taking-hold phase. Confidence in caring for the newborn is
demonstrated during the letting-go phase.
A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history,
which of the following would the nurse identify as being least significant to this condition?
A) Early ambulation
B) Prolonged labor
C) Large fetus
D) Pulse rate of 60 beats/minute
Ans: A
Factors that inhibit involution include prolonged labor and difficult birth, incomplete expulsion of
amniotic membranes and placenta, uterine infection, overdistention of uterine muscles (such as by
multiple gestation, hydramnios, or large singleton fetus), full bladder (which displaces the uterus and
interferes with contractions), anesthesia(which relaxes uterine muscles), and close childbirth spacing.
Factors that facilitate uterine involution include complete expulsion of amniotic membranes and
placenta at birth, complication-free labor and birth process, breast-feeding, and early ambulation.
A woman who gave birth 24 hours ago tells the nurse, I've been urinating so much over the past several
hours. Which response by the nurse would be most appropriate?
A) You must have an infection, so let me get a urine specimen.
B) Your body is undergoing many changes that cause your bladder to fill quickly.
C) Your uterus is not contracting as quickly as it should.
D) The anesthesia that you received is wearing off and your bladder is working
again.
Ans: B
Postpartum diuresis occurs as a result of several mechanisms: the large amounts of IV fluids given during
labor, a decreasing antidiuretic effect of oxytocin as its level declines, the buildup and retention of extra
fluids during pregnancy, and a decreasing production of aldosterone—the hormone that decreases
sodium retention and increases urine production. All these factors contribute to rapid filling of the
bladder within 12 hours of birth. Diuresis begins within 12 hours after childbirth and continues
