NUR 230
EXAM 2
OB/Peds
50 Actual Questions w/Correct Answers
Galen College of Nursing
What you Will Get:
• 50 verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept
reinforcement.
,1. The nurse is teaching a client with type 1 diabetes mellitus who just delivered
a healthy baby. Which information should the nurse include in the client’s
teaching?
A. Feed the baby formula because insulin through breastfeeding may cause low
blood sugar
B. Due to hormonal changes after delivery, the need for insulin may decrease
C. Urine should be checked for ketones every time the client voids
D. Change to oral hypoglycemic medications because they control blood sugar
better than insulin
Correct Answer:
B. Due to hormonal changes after delivery, the need for insulin may decrease
Expert Rationale:
After delivery, placental hormones rapidly decrease, which lowers insulin
resistance. Clients with type 1 diabetes may need less insulin postpartum and
should be monitored closely for hypoglycemia.
2. The nurse is caring for several clients on the postpartum unit. Which client
should the nurse see first?
A. Primipara who delivered 3 hours ago and is having difficulty getting the
newborn to latch
B. Multipara who saturated 2 perineal pads in 1 hour
C. Multipara who delivered 16 hours ago and reports abdominal cramping and
sweating
D. Primipara requesting help repositioning her baby after a cesarean birth
Correct Answer:
B. Multipara who saturated 2 perineal pads in 1 hour
Expert Rationale:
,Saturating 2 pads in 1 hour may indicate postpartum hemorrhage and requires
immediate assessment. Breastfeeding difficulty, afterpains, sweating, and
positioning concerns are important but are not the priority over possible
hemorrhage.
3. The nurse receives change-of-shift report for clients who delivered within the
last 24 hours. Which client should the nurse assess first?
A. The client who reports discomfort in the perineal area from an episiotomy
B. The client with an oral temperature of 100.3°F
C. The client whose pulse increased from 76/min to 100/min
D. The client who reports passing a dime-sized clot with the last void
Correct Answer:
C. The client whose pulse increased from 76/min to 100/min
Expert Rationale:
A rising pulse in the postpartum period can be an early sign of hemorrhage or
infection. A mild temperature elevation during the first 24 hours can be related to
dehydration. Perineal discomfort and small clots can be expected findings.
4. The nurse is caring for a client who gave birth 18 hours ago. The client reports
nipple tenderness and states that the baby is not breastfeeding well. Which
response by the nurse is appropriate?
A. “Wait until the baby is crying before breastfeeding.”
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on your
chest.”
C. “Apply a large amount of topical breast cream before every feeding.”
D. “Limit breastfeeding until your nipples are no longer tender.”
Correct Answer:
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on your
chest.”
,Expert Rationale:
Skin-to-skin contact promotes newborn rooting, latch, bonding, and breastfeeding
success. Waiting until the infant cries can make latching more difficult because
crying is a late hunger cue.
5. The nurse is caring for a client who is 1 hour postpartum. The nurse observes
moderate lochia rubra and several small clots on the perineal pad. The fundus is
firm, midline, and at the umbilicus. Which action should the nurse implement?
A. Increase the frequency of fundal massage
B. Notify the primary care provider
C. Document the findings and continue to monitor
D. Encourage the client to empty the bladder immediately
Correct Answer:
C. Document the findings and continue to monitor
Expert Rationale:
Moderate lochia rubra with small clots can be expected during the first hours
postpartum if the fundus is firm, midline, and at the expected level. No
intervention is needed other than documentation and continued monitoring.
6. The nurse is caring for a formula-feeding postpartum client who reports
painful, swollen breasts on the third postpartum day. Which instruction should
the nurse give?
A. Stimulate the nipples manually
B. Refrain from expelling milk
C. Gently massage the breasts before feeding
D. Pump every 2 hours to empty the breasts
Correct Answer:
B. Refrain from expelling milk
, Expert Rationale:
For a formula-feeding client, expressing milk stimulates further milk production
and can worsen engorgement. Supportive measures include a supportive bra, cold
compresses, and avoiding breast stimulation.
7. The nurse is assessing a client who is 24 hours postpartum. Which finding is
most important for the nurse to follow up?
A. White blood cell count of 8,500/mm³
B. Voided 2,125 mL of clear yellow urine in the last 24 hours
C. Perineal pad saturated with blood
D. Fundus firm at the midline
Correct Answer:
C. Perineal pad saturated with blood
Expert Rationale:
A saturated perineal pad may indicate excessive bleeding and requires immediate
assessment for postpartum hemorrhage. Diuresis is common postpartum, and the
listed WBC is not concerning.
8. The nurse is caring for a client who delivered vaginally 4 hours ago. The
fundus is right of midline and becomes firm only with massage. What is the
priority action?
A. Insert an indwelling urinary catheter
B. Perform a straight catheterization and massage the fundus until firm
C. Place the client’s hands in warm water
D. Notify the provider before taking further action
Correct Answer:
B. Perform a straight catheterization and massage the fundus until firm
EXAM 2
OB/Peds
50 Actual Questions w/Correct Answers
Galen College of Nursing
What you Will Get:
• 50 verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept
reinforcement.
,1. The nurse is teaching a client with type 1 diabetes mellitus who just delivered
a healthy baby. Which information should the nurse include in the client’s
teaching?
A. Feed the baby formula because insulin through breastfeeding may cause low
blood sugar
B. Due to hormonal changes after delivery, the need for insulin may decrease
C. Urine should be checked for ketones every time the client voids
D. Change to oral hypoglycemic medications because they control blood sugar
better than insulin
Correct Answer:
B. Due to hormonal changes after delivery, the need for insulin may decrease
Expert Rationale:
After delivery, placental hormones rapidly decrease, which lowers insulin
resistance. Clients with type 1 diabetes may need less insulin postpartum and
should be monitored closely for hypoglycemia.
2. The nurse is caring for several clients on the postpartum unit. Which client
should the nurse see first?
A. Primipara who delivered 3 hours ago and is having difficulty getting the
newborn to latch
B. Multipara who saturated 2 perineal pads in 1 hour
C. Multipara who delivered 16 hours ago and reports abdominal cramping and
sweating
D. Primipara requesting help repositioning her baby after a cesarean birth
Correct Answer:
B. Multipara who saturated 2 perineal pads in 1 hour
Expert Rationale:
,Saturating 2 pads in 1 hour may indicate postpartum hemorrhage and requires
immediate assessment. Breastfeeding difficulty, afterpains, sweating, and
positioning concerns are important but are not the priority over possible
hemorrhage.
3. The nurse receives change-of-shift report for clients who delivered within the
last 24 hours. Which client should the nurse assess first?
A. The client who reports discomfort in the perineal area from an episiotomy
B. The client with an oral temperature of 100.3°F
C. The client whose pulse increased from 76/min to 100/min
D. The client who reports passing a dime-sized clot with the last void
Correct Answer:
C. The client whose pulse increased from 76/min to 100/min
Expert Rationale:
A rising pulse in the postpartum period can be an early sign of hemorrhage or
infection. A mild temperature elevation during the first 24 hours can be related to
dehydration. Perineal discomfort and small clots can be expected findings.
4. The nurse is caring for a client who gave birth 18 hours ago. The client reports
nipple tenderness and states that the baby is not breastfeeding well. Which
response by the nurse is appropriate?
A. “Wait until the baby is crying before breastfeeding.”
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on your
chest.”
C. “Apply a large amount of topical breast cream before every feeding.”
D. “Limit breastfeeding until your nipples are no longer tender.”
Correct Answer:
B. “Try removing the infant’s clothing and placing the baby skin-to-skin on your
chest.”
,Expert Rationale:
Skin-to-skin contact promotes newborn rooting, latch, bonding, and breastfeeding
success. Waiting until the infant cries can make latching more difficult because
crying is a late hunger cue.
5. The nurse is caring for a client who is 1 hour postpartum. The nurse observes
moderate lochia rubra and several small clots on the perineal pad. The fundus is
firm, midline, and at the umbilicus. Which action should the nurse implement?
A. Increase the frequency of fundal massage
B. Notify the primary care provider
C. Document the findings and continue to monitor
D. Encourage the client to empty the bladder immediately
Correct Answer:
C. Document the findings and continue to monitor
Expert Rationale:
Moderate lochia rubra with small clots can be expected during the first hours
postpartum if the fundus is firm, midline, and at the expected level. No
intervention is needed other than documentation and continued monitoring.
6. The nurse is caring for a formula-feeding postpartum client who reports
painful, swollen breasts on the third postpartum day. Which instruction should
the nurse give?
A. Stimulate the nipples manually
B. Refrain from expelling milk
C. Gently massage the breasts before feeding
D. Pump every 2 hours to empty the breasts
Correct Answer:
B. Refrain from expelling milk
, Expert Rationale:
For a formula-feeding client, expressing milk stimulates further milk production
and can worsen engorgement. Supportive measures include a supportive bra, cold
compresses, and avoiding breast stimulation.
7. The nurse is assessing a client who is 24 hours postpartum. Which finding is
most important for the nurse to follow up?
A. White blood cell count of 8,500/mm³
B. Voided 2,125 mL of clear yellow urine in the last 24 hours
C. Perineal pad saturated with blood
D. Fundus firm at the midline
Correct Answer:
C. Perineal pad saturated with blood
Expert Rationale:
A saturated perineal pad may indicate excessive bleeding and requires immediate
assessment for postpartum hemorrhage. Diuresis is common postpartum, and the
listed WBC is not concerning.
8. The nurse is caring for a client who delivered vaginally 4 hours ago. The
fundus is right of midline and becomes firm only with massage. What is the
priority action?
A. Insert an indwelling urinary catheter
B. Perform a straight catheterization and massage the fundus until firm
C. Place the client’s hands in warm water
D. Notify the provider before taking further action
Correct Answer:
B. Perform a straight catheterization and massage the fundus until firm
