NSG 340 Exam 3 | Obstetric and Maternity Nursing | Grand Canyon
,University | Q & A | 2026/2027 Edition (PDF)
1. A nurse is assessing a client who is 6 hours postpartum after a vaginal delivery. The client's fundus is
firm, midline, and at the umbilicus. The nurse notes moderate lochia rubra with a few small clots. Which
action should the nurse take?
A) Massage the fundus vigorously
B) Notify the healthcare provider immediately
C) Document the findings and continue to monitor
D) Administer oxytocin
Correct Answer: Document the findings and continue to monitor
Rationale: A firm fundus at the umbilicus with moderate lochia rubra is an expected finding in the
immediate postpartum period. Small clots are common and do not require intervention unless they are
large or associated with heavy bleeding. The nurse should document and continue routine monitoring.
2. A postpartum client reports that her lochia has a foul odor. The nurse assesses the client's
temperature and finds it to be 100.8°F (38.2°C). Which condition should the nurse suspect?
A) Normal postpartum finding
B) Endometritis
C) Mastitis
D) Urinary tract infection
Correct Answer: Endometritis
Rationale: Foul-smelling lochia combined with fever is a classic sign of endometritis, a postpartum
uterine infection. Endometritis is the most common postpartum infection and requires prompt antibiotic
treatment. Mastitis typically presents with breast pain and redness, and a UTI would present with
urinary symptoms.
3. The nurse is providing education to a postpartum client about the signs of infection. Which statement
by the client indicates understanding?
A) "I should call my provider if I have a temperature over 100.4°F."
,B) "I should call my provider if I have a temperature over 101.0°F."
C) "I should only call my provider if I have pain with urination."
D) "I should only call my provider if I have foul-smelling lochia."
Correct Answer: "I should call my provider if I have a temperature over 100.4°F."
Rationale: A temperature of 100.4°F (38°C) or higher in the postpartum period may indicate an infection,
such as endometritis or a urinary tract infection. The client should report fever, foul-smelling lochia,
uterine tenderness, or pain with urination.
4. A nurse is assessing a postpartum client who is 2 days post-delivery. The client reports that she has
not had a bowel movement since delivery. What is the most appropriate response?
A) "This is normal; you may not have a bowel movement for several days."
B) "You should have had a bowel movement by now; I will notify the provider."
C) "You need to take a laxative immediately."
D) "You should not eat any solid food until you have a bowel movement."
Correct Answer: "This is normal; you may not have a bowel movement for several days."
Rationale: Bowel movements may be delayed for a few days after delivery due to decreased intestinal
motility, pain medications, and perineal discomfort. The nurse should reassure the client, encourage
fluid intake, and recommend stool softeners if needed.
5. A nurse is assessing a postpartum client who is 1 week post-delivery. The client reports that she is
feeling sad and anxious and has difficulty sleeping even when the baby is sleeping. What is the priority
nursing action?
A) Reassure the client that this is normal "baby blues"
B) Assess for signs of postpartum depression
C) Encourage the client to rest more
D) Refer the client to a support group
, Correct Answer: Assess for signs of postpartum depression
Rationale: While "baby blues" are common in the first 1-2 weeks postpartum, persistent sadness,
anxiety, and difficulty sleeping beyond 2 weeks may indicate postpartum depression. The nurse should
assess the client for additional signs of postpartum depression and refer for further evaluation if
needed.
6. A nurse is providing education to a postpartum client about the signs of postpartum depression.
Which of the following should the nurse include?
A) Feelings of sadness and anxiety that resolve within 2 weeks
B) Persistent feelings of sadness, anxiety, and difficulty bonding with the baby
C) Excessive energy and euphoria
D) Decreased appetite only
Correct Answer: Persistent feelings of sadness, anxiety, and difficulty bonding with the baby
Rationale: Postpartum depression is characterized by persistent feelings of sadness, anxiety,
hopelessness, and difficulty bonding with the baby. It lasts longer than 2 weeks and can affect the
mother's ability to function. It requires prompt evaluation and treatment.
7. A client who had a cesarean section 24 hours ago reports incisional pain rated 7 out of 10. Which
action should the nurse take first?
A) Administer the prescribed analgesic
B) Assess the incision site for redness, warmth, or drainage
C) Notify the healthcare provider
D) Apply a warm compress to the incision
Correct Answer: Assess the incision site for redness, warmth, or drainage
Rationale: Before administering an analgesic, the nurse should first assess the incision site to rule out
complications such as infection or wound dehiscence. Redness, warmth, or drainage would indicate a
potential infection that requires further intervention.
,University | Q & A | 2026/2027 Edition (PDF)
1. A nurse is assessing a client who is 6 hours postpartum after a vaginal delivery. The client's fundus is
firm, midline, and at the umbilicus. The nurse notes moderate lochia rubra with a few small clots. Which
action should the nurse take?
A) Massage the fundus vigorously
B) Notify the healthcare provider immediately
C) Document the findings and continue to monitor
D) Administer oxytocin
Correct Answer: Document the findings and continue to monitor
Rationale: A firm fundus at the umbilicus with moderate lochia rubra is an expected finding in the
immediate postpartum period. Small clots are common and do not require intervention unless they are
large or associated with heavy bleeding. The nurse should document and continue routine monitoring.
2. A postpartum client reports that her lochia has a foul odor. The nurse assesses the client's
temperature and finds it to be 100.8°F (38.2°C). Which condition should the nurse suspect?
A) Normal postpartum finding
B) Endometritis
C) Mastitis
D) Urinary tract infection
Correct Answer: Endometritis
Rationale: Foul-smelling lochia combined with fever is a classic sign of endometritis, a postpartum
uterine infection. Endometritis is the most common postpartum infection and requires prompt antibiotic
treatment. Mastitis typically presents with breast pain and redness, and a UTI would present with
urinary symptoms.
3. The nurse is providing education to a postpartum client about the signs of infection. Which statement
by the client indicates understanding?
A) "I should call my provider if I have a temperature over 100.4°F."
,B) "I should call my provider if I have a temperature over 101.0°F."
C) "I should only call my provider if I have pain with urination."
D) "I should only call my provider if I have foul-smelling lochia."
Correct Answer: "I should call my provider if I have a temperature over 100.4°F."
Rationale: A temperature of 100.4°F (38°C) or higher in the postpartum period may indicate an infection,
such as endometritis or a urinary tract infection. The client should report fever, foul-smelling lochia,
uterine tenderness, or pain with urination.
4. A nurse is assessing a postpartum client who is 2 days post-delivery. The client reports that she has
not had a bowel movement since delivery. What is the most appropriate response?
A) "This is normal; you may not have a bowel movement for several days."
B) "You should have had a bowel movement by now; I will notify the provider."
C) "You need to take a laxative immediately."
D) "You should not eat any solid food until you have a bowel movement."
Correct Answer: "This is normal; you may not have a bowel movement for several days."
Rationale: Bowel movements may be delayed for a few days after delivery due to decreased intestinal
motility, pain medications, and perineal discomfort. The nurse should reassure the client, encourage
fluid intake, and recommend stool softeners if needed.
5. A nurse is assessing a postpartum client who is 1 week post-delivery. The client reports that she is
feeling sad and anxious and has difficulty sleeping even when the baby is sleeping. What is the priority
nursing action?
A) Reassure the client that this is normal "baby blues"
B) Assess for signs of postpartum depression
C) Encourage the client to rest more
D) Refer the client to a support group
, Correct Answer: Assess for signs of postpartum depression
Rationale: While "baby blues" are common in the first 1-2 weeks postpartum, persistent sadness,
anxiety, and difficulty sleeping beyond 2 weeks may indicate postpartum depression. The nurse should
assess the client for additional signs of postpartum depression and refer for further evaluation if
needed.
6. A nurse is providing education to a postpartum client about the signs of postpartum depression.
Which of the following should the nurse include?
A) Feelings of sadness and anxiety that resolve within 2 weeks
B) Persistent feelings of sadness, anxiety, and difficulty bonding with the baby
C) Excessive energy and euphoria
D) Decreased appetite only
Correct Answer: Persistent feelings of sadness, anxiety, and difficulty bonding with the baby
Rationale: Postpartum depression is characterized by persistent feelings of sadness, anxiety,
hopelessness, and difficulty bonding with the baby. It lasts longer than 2 weeks and can affect the
mother's ability to function. It requires prompt evaluation and treatment.
7. A client who had a cesarean section 24 hours ago reports incisional pain rated 7 out of 10. Which
action should the nurse take first?
A) Administer the prescribed analgesic
B) Assess the incision site for redness, warmth, or drainage
C) Notify the healthcare provider
D) Apply a warm compress to the incision
Correct Answer: Assess the incision site for redness, warmth, or drainage
Rationale: Before administering an analgesic, the nurse should first assess the incision site to rule out
complications such as infection or wound dehiscence. Redness, warmth, or drainage would indicate a
potential infection that requires further intervention.
