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NUR 230 Exam 3 Childbearing Child Caring
Family Nursing 2026/2027 Comprehensive
Questions with Verified Answers and Detailed
Rationales Grade A - Galen
1. Which rationale would lead the nurse to advise a postpartum client to
breastfeed regularly to lower the risk of postpartum hemorrhage?
A) Lactose production
B) Progesterone production
C) Estrogen production
D) Oxytocin production
Correct Answer: D) Oxytocin production
Rationale:
1. Breastfeeding stimulates the release of oxytocin from the posterior pituitary.
2. Oxytocin causes uterine contractions, which compress blood vessels and
prevent hemorrhage.
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3. This is the physiological basis for breastfeeding to reduce postpartum
bleeding risk.
2. If a client chooses not to breastfeed, which condition should the nurse
assess for?
A) Engorgement
B) Low estrogen levels
C) Sore nipples
D) Postpartum Depression
Correct Answer: A) Engorgement
Rationale:
1. Engorgement occurs when milk production begins regardless of feeding
method.
2. Non-breastfeeding mothers are at risk for painful breast engorgement.
3. Management includes ice packs, supportive bra, and avoiding breast
stimulation.
3. Which condition is likely and should be further evaluated in a client
who gave birth to triplets, whose abdomen is overdistended, and whose
abdominal muscle walls are separated?
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A) Subinvolution
B) Diastasis recti abdominis
C) Persistent rubra lochia
D) Postpartum hemostasis
Correct Answer: B) Diastasis recti abdominis
Rationale:
1. Diastasis recti is separation of the rectus abdominis muscles.
2. Multiple gestation and overdistended abdomen are risk factors.
3. This condition requires further evaluation and possible physical therapy.
4. Which rationale explains the nursing intervention of placing one hand
below the umbilicus and the other on the symphysis, then applying
downward pressure toward the vagina? (Select all that apply.)
A) To assess laceration repair for redness
B) To determine whether the fundus is firm
C) To help the client void spontaneously
D) To assist the client in expelling clots
E) To assess for the presence of hemorrhoids
Correct Answer: B) To determine whether the fundus is firm and D) To
assist the client in expelling clots
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Rationale:
1. The lower hand supports the uterus to prevent inversion.
2. The upper hand palpates the fundus to assess firmness.
3. Downward pressure can help expel clots if the uterus is boggy.
5. When should the client expect to have her first bowel movement after
delivery?
A) Day 1
B) Day 3
C) Day 5
D) Day 4
Correct Answer: B) Day 3
Rationale:
1. Bowel function returns approximately 2-3 days postpartum.
2. Progesterone, anesthesia, and decreased muscle tone contribute to sluggish
bowel.
3. Stool softeners are often prescribed to prevent constipation.
6. Which physiologic change causes a postpartum increase in circulating
blood volume?
NUR 230 Exam 3 Childbearing Child Caring
Family Nursing 2026/2027 Comprehensive
Questions with Verified Answers and Detailed
Rationales Grade A - Galen
1. Which rationale would lead the nurse to advise a postpartum client to
breastfeed regularly to lower the risk of postpartum hemorrhage?
A) Lactose production
B) Progesterone production
C) Estrogen production
D) Oxytocin production
Correct Answer: D) Oxytocin production
Rationale:
1. Breastfeeding stimulates the release of oxytocin from the posterior pituitary.
2. Oxytocin causes uterine contractions, which compress blood vessels and
prevent hemorrhage.
,2|Page
3. This is the physiological basis for breastfeeding to reduce postpartum
bleeding risk.
2. If a client chooses not to breastfeed, which condition should the nurse
assess for?
A) Engorgement
B) Low estrogen levels
C) Sore nipples
D) Postpartum Depression
Correct Answer: A) Engorgement
Rationale:
1. Engorgement occurs when milk production begins regardless of feeding
method.
2. Non-breastfeeding mothers are at risk for painful breast engorgement.
3. Management includes ice packs, supportive bra, and avoiding breast
stimulation.
3. Which condition is likely and should be further evaluated in a client
who gave birth to triplets, whose abdomen is overdistended, and whose
abdominal muscle walls are separated?
,3|Page
A) Subinvolution
B) Diastasis recti abdominis
C) Persistent rubra lochia
D) Postpartum hemostasis
Correct Answer: B) Diastasis recti abdominis
Rationale:
1. Diastasis recti is separation of the rectus abdominis muscles.
2. Multiple gestation and overdistended abdomen are risk factors.
3. This condition requires further evaluation and possible physical therapy.
4. Which rationale explains the nursing intervention of placing one hand
below the umbilicus and the other on the symphysis, then applying
downward pressure toward the vagina? (Select all that apply.)
A) To assess laceration repair for redness
B) To determine whether the fundus is firm
C) To help the client void spontaneously
D) To assist the client in expelling clots
E) To assess for the presence of hemorrhoids
Correct Answer: B) To determine whether the fundus is firm and D) To
assist the client in expelling clots
, 4|Page
Rationale:
1. The lower hand supports the uterus to prevent inversion.
2. The upper hand palpates the fundus to assess firmness.
3. Downward pressure can help expel clots if the uterus is boggy.
5. When should the client expect to have her first bowel movement after
delivery?
A) Day 1
B) Day 3
C) Day 5
D) Day 4
Correct Answer: B) Day 3
Rationale:
1. Bowel function returns approximately 2-3 days postpartum.
2. Progesterone, anesthesia, and decreased muscle tone contribute to sluggish
bowel.
3. Stool softeners are often prescribed to prevent constipation.
6. Which physiologic change causes a postpartum increase in circulating
blood volume?
