NURS 306 Quiz 9 V2 | NURS 306 OB |
Actual Q&A with Rationale (NURS306 Quiz
9) | West Coast University
1. A nurse is assessing a postpartum client 4 hours after delivery. The fundus is firm, but the
client is experiencing a steady trickle of bright red blood. Which complication should the
nurse suspect?
A. Uterine atony
B. Laceration of the genital tract
C. Retained placental fragments
D. Hematoma formation
Answer: B
Rationale: A firm fundus with a steady trickle of bright red blood is a classic sign of a
laceration in the birth canal. Uterine atony would typically present with a boggy or soft
fundus. The nurse must notify the provider immediately as surgical repair may be required
to stop the bleeding.
2. Which of the following medications is contraindicated for a client experiencing postpartum
hemorrhage who has a history of asthma?
A. Misoprostol (Cytotec)
B. Oxytocin (Pitocin)
,C. Methylergonovine (Methergine)
D. Carboprost tromethamine (Hemabate)
Answer: D
Rationale: Hemabate is a prostaglandin that can cause significant bronchoconstriction,
making it dangerous for patients with asthma. Oxytocin is the first-line treatment for PPH
and has no respiratory contraindications. Methergine is avoided in patients with
hypertension, not asthma.
3. A postpartum nurse is caring for a client who is 2 days postpartum and reports feeling
‘tearful, let down, and irritable.’ What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Answer: B
Rationale: Postpartum blues typically occurs within the first few days after birth and
resolves spontaneously within about 10 days. It is characterized by mood swings, crying,
and anxiety due to hormonal shifts and exhaustion. Postpartum depression is more severe,
lasts longer, and requires clinical intervention.
, 4. A nurse is providing discharge instructions to a mother who is breastfeeding. Which
statement by the mother indicates an understanding of mastitis prevention?
A. I will wear a tight-fitting underwire bra to support my breasts.
B. I will limit breastfeeding to 5 minutes on each side.
C. I will skip a feeding if my nipples become sore.
D. I will ensure my baby latches onto both the nipple and the areola.
Answer: D
Rationale: A proper latch is essential to prevent nipple trauma and ensure the breast is
emptied completely, which reduces the risk of mastitis. Underwire bras and skipping
feedings can lead to milk stasis and clogged ducts. Frequent, effective emptying of the
breast is the primary preventative measure for infection.
5. A newborn is being assessed at 1 minute of life. Heart rate is 110 bpm, the cry is vigorous,
there is some flexion of extremities, the baby grimaces when stimulated, and the body is pink
with blue extremities. What is the APGAR score?
A. 7
B. 10
C. 9
D. 8
Answer: D
Actual Q&A with Rationale (NURS306 Quiz
9) | West Coast University
1. A nurse is assessing a postpartum client 4 hours after delivery. The fundus is firm, but the
client is experiencing a steady trickle of bright red blood. Which complication should the
nurse suspect?
A. Uterine atony
B. Laceration of the genital tract
C. Retained placental fragments
D. Hematoma formation
Answer: B
Rationale: A firm fundus with a steady trickle of bright red blood is a classic sign of a
laceration in the birth canal. Uterine atony would typically present with a boggy or soft
fundus. The nurse must notify the provider immediately as surgical repair may be required
to stop the bleeding.
2. Which of the following medications is contraindicated for a client experiencing postpartum
hemorrhage who has a history of asthma?
A. Misoprostol (Cytotec)
B. Oxytocin (Pitocin)
,C. Methylergonovine (Methergine)
D. Carboprost tromethamine (Hemabate)
Answer: D
Rationale: Hemabate is a prostaglandin that can cause significant bronchoconstriction,
making it dangerous for patients with asthma. Oxytocin is the first-line treatment for PPH
and has no respiratory contraindications. Methergine is avoided in patients with
hypertension, not asthma.
3. A postpartum nurse is caring for a client who is 2 days postpartum and reports feeling
‘tearful, let down, and irritable.’ What is the most likely diagnosis?
A. Postpartum psychosis
B. Postpartum blues
C. Postpartum depression
D. Bipolar disorder
Answer: B
Rationale: Postpartum blues typically occurs within the first few days after birth and
resolves spontaneously within about 10 days. It is characterized by mood swings, crying,
and anxiety due to hormonal shifts and exhaustion. Postpartum depression is more severe,
lasts longer, and requires clinical intervention.
, 4. A nurse is providing discharge instructions to a mother who is breastfeeding. Which
statement by the mother indicates an understanding of mastitis prevention?
A. I will wear a tight-fitting underwire bra to support my breasts.
B. I will limit breastfeeding to 5 minutes on each side.
C. I will skip a feeding if my nipples become sore.
D. I will ensure my baby latches onto both the nipple and the areola.
Answer: D
Rationale: A proper latch is essential to prevent nipple trauma and ensure the breast is
emptied completely, which reduces the risk of mastitis. Underwire bras and skipping
feedings can lead to milk stasis and clogged ducts. Frequent, effective emptying of the
breast is the primary preventative measure for infection.
5. A newborn is being assessed at 1 minute of life. Heart rate is 110 bpm, the cry is vigorous,
there is some flexion of extremities, the baby grimaces when stimulated, and the body is pink
with blue extremities. What is the APGAR score?
A. 7
B. 10
C. 9
D. 8
Answer: D
