MATERNITY NCLEX® M PRACTISE QUESTIONS WITH CORRECT ANSWERS AND RATIONALES AND
MORE EXPLANATIONS 2026 ASSURED EXCEL!!
Question 1
The postpartum nurse is assessing a patient who delivered a full-term healthy infant 4 hours
ago. The patient's temperature is 100.2°F. Which nursing action would be most appropriate?
A. Draw blood cultures
B. Notify the physician
C. Initiate antibiotic therapy
D. Encourage PO fluids
CORRECT ANSWER
D. Encourage PO fluids
NCLEX Rationale
A temperature of 100.2°F (37.9°C) during the first 24 hours postpartum is usually a normal
finding due to:
• Dehydration
• Physical exertion during labor
• Mild postpartum fluid shifts
The nurse should encourage oral fluids to promote hydration and help reduce the temperature.
Why the Other Options Are Incorrect
A. Draw blood cultures
• Not indicated for a mild temperature elevation without signs of infection.
B. Notify the physician
• A fever greater than 100.4°F (38°C) or persistent fever would require further evaluation.
C. Initiate antibiotic therapy
, • Antibiotics are not started for a low-grade postpartum temperature without evidence of
infection.
Memory Trick
First 24 hours postpartum: Slight fever = Fluids first
NCLEX Exam Pearl
Postpartum infection should be suspected with:
• Fever ≥100.4°F (38°C)
• Foul-smelling lochia
• Uterine tenderness
• Chills
• Elevated heart rate
Question 2
The nurse is assessing a patient who delivered 48 hours ago via cesarean delivery. What
findings would be expected?
A. Uterus 3 cm above the umbilicus; lochia rubra
B. Uterus at the umbilicus; lochia serosa
C. Uterus 2 cm below the umbilicus; lochia rubra
D. Uterus 4 cm below the umbilicus; lochia alba
CORRECT ANSWER
C. Uterus 2 cm below the umbilicus; lochia rubra
NCLEX Rationale
, At 48 hours postpartum, the uterus should be descending approximately 1 cm per day after
delivery.
Expected findings:
• Fundus approximately 2 cm below the umbilicus
• Lochia may still be rubra (bright red) during the first 3 days
Why the Other Options Are Incorrect
A. 3 cm above umbilicus
• Suggests uterine atony or bladder distention.
B. Uterus at umbilicus; lochia serosa
• Fundus should have descended by this time.
D. 4 cm below umbilicus; lochia alba
• Lochia alba occurs later (after approximately day 10).
Memory Trick
Postpartum Fundus: "Down 1 cm Daily"
NCLEX Exam Pearl
Lochia progression:
Rubra
• Days 1–3
• Red/bloody
🩷 Serosa
• Days 4–10
• Pink/brown
Alba
MORE EXPLANATIONS 2026 ASSURED EXCEL!!
Question 1
The postpartum nurse is assessing a patient who delivered a full-term healthy infant 4 hours
ago. The patient's temperature is 100.2°F. Which nursing action would be most appropriate?
A. Draw blood cultures
B. Notify the physician
C. Initiate antibiotic therapy
D. Encourage PO fluids
CORRECT ANSWER
D. Encourage PO fluids
NCLEX Rationale
A temperature of 100.2°F (37.9°C) during the first 24 hours postpartum is usually a normal
finding due to:
• Dehydration
• Physical exertion during labor
• Mild postpartum fluid shifts
The nurse should encourage oral fluids to promote hydration and help reduce the temperature.
Why the Other Options Are Incorrect
A. Draw blood cultures
• Not indicated for a mild temperature elevation without signs of infection.
B. Notify the physician
• A fever greater than 100.4°F (38°C) or persistent fever would require further evaluation.
C. Initiate antibiotic therapy
, • Antibiotics are not started for a low-grade postpartum temperature without evidence of
infection.
Memory Trick
First 24 hours postpartum: Slight fever = Fluids first
NCLEX Exam Pearl
Postpartum infection should be suspected with:
• Fever ≥100.4°F (38°C)
• Foul-smelling lochia
• Uterine tenderness
• Chills
• Elevated heart rate
Question 2
The nurse is assessing a patient who delivered 48 hours ago via cesarean delivery. What
findings would be expected?
A. Uterus 3 cm above the umbilicus; lochia rubra
B. Uterus at the umbilicus; lochia serosa
C. Uterus 2 cm below the umbilicus; lochia rubra
D. Uterus 4 cm below the umbilicus; lochia alba
CORRECT ANSWER
C. Uterus 2 cm below the umbilicus; lochia rubra
NCLEX Rationale
, At 48 hours postpartum, the uterus should be descending approximately 1 cm per day after
delivery.
Expected findings:
• Fundus approximately 2 cm below the umbilicus
• Lochia may still be rubra (bright red) during the first 3 days
Why the Other Options Are Incorrect
A. 3 cm above umbilicus
• Suggests uterine atony or bladder distention.
B. Uterus at umbilicus; lochia serosa
• Fundus should have descended by this time.
D. 4 cm below umbilicus; lochia alba
• Lochia alba occurs later (after approximately day 10).
Memory Trick
Postpartum Fundus: "Down 1 cm Daily"
NCLEX Exam Pearl
Lochia progression:
Rubra
• Days 1–3
• Red/bloody
🩷 Serosa
• Days 4–10
• Pink/brown
Alba
