Galen College NSG 3500 Exam 3 (pdf) | 2026/2027 | Maternal Health
Q&A | Maternal Health Nursing
1. After a vaginal birth, how often should the nurse perform vital signs and
fundal assessments immediately postpartum?
A) Every 15 minutes for the first hour
B) Every 30 minutes for the first 2 hours
C) Every hour for the first 4 hours
D) Every 2 hours for the first 8 hours
Correct Answer: Every 15 minutes for the first hour
Rationale: In the immediate postpartum period, vital signs and fundal checks
should be performed every 15 minutes for the first hour to facilitate early
detection of hemorrhage or uterine atony. After the first hour, assessments
may be spaced to every 30 minutes, then hourly.
2. A postpartum patient reports cramping during breastfeeding. The nurse
should interpret this as:
A) A sign of infection
B) A sign of uterine atony
C) A good sign — the uterus is contracting
D) A sign of retained placental fragments
Correct Answer: A good sign — the uterus is contracting
Rationale: Afterpains (cramping) during breastfeeding are caused by the
release of oxytocin, which stimulates uterine contractions. This is a positive
sign indicating that the uterus is involuting and decreasing the risk of
hemorrhage. The pain is more common in multiparous women.
,3. A patient who had a cesarean section is 2 hours postpartum. The nurse
should perform assessments:
A) Less frequently than after a vaginal birth
B) More frequently than after a vaginal birth
C) At the same frequency as a vaginal birth
D) Only when the patient reports symptoms
Correct Answer: More frequently than after a vaginal birth
Rationale: Patients who have had a cesarean section are at higher risk for
complications such as bleeding, infection, and thromboembolism. More
frequent assessments are necessary to detect these complications early.
4. Immediately after delivery, the nurse palpates the fundus. Where should
the fundus be located?
A) At the level of the umbilicus
B) Midway between the pubic bone and umbilicus
C) Below the symphysis pubis
D) 2 cm above the umbilicus
Correct Answer: Midway between the pubic bone and umbilicus
Rationale: Immediately after delivery, the fundus is located midway between
the pubic bone and the umbilicus. It then rises to the level of the umbilicus
within 1-2 hours after delivery.
5. One to two hours after delivery, the fundus should be located at:
A) The level of the umbilicus
B) 1 cm above the umbilicus
,C) 1 cm below the umbilicus
D) Midway between the pubic bone and umbilicus
Correct Answer: The level of the umbilicus
Rationale: During the first 1-2 hours postpartum, the fundus should rise to
the level of the umbilicus due to the contraction of the uterus and the
absence of bladder distention.
6. A nurse assesses the fundus 12 hours after delivery. The expected fundal
height is:
A) 1 cm above the umbilicus
B) At the level of the umbilicus
C) 1 cm below the umbilicus
D) 2 cm below the umbilicus
Correct Answer: 1 cm above the umbilicus
Rationale: At 12 hours postpartum, the fundus is expected to be
approximately 1 cm above the umbilicus (U+1). The fundus gradually
descends approximately 1 cm per day.
7. Twenty-four hours after birth, the fundus should be located:
A) 1 cm above the umbilicus
B) At the level of the umbilicus
C) 1 cm below the umbilicus
D) 2 cm below the umbilicus
, Correct Answer: 1 cm below the umbilicus
Rationale: At 24 hours postpartum, the fundus should be approximately 1 cm
below the umbilicus (U-1). By 10-14 days postpartum, the fundus should no
longer be palpable abdominally.
8. The nurse palpates a boggy fundus. This finding indicates:
A) Normal uterine involution
B) Uterine atony
C) A full bladder
D) Retained placental fragments
Correct Answer: Uterine atony
Rationale: A boggy uterus is a sign of uterine atony (lack of muscle tone),
which can lead to postpartum hemorrhage. The priority intervention is to
massage the fundus until it becomes firm.
9. The nurse assesses that the fundus is deviated to the right side. The nurse
should first:
A) Notify the healthcare provider
B) Administer oxytocin
C) Assist the patient to void
D) Massage the fundus firmly
Correct Answer: Assist the patient to void
Q&A | Maternal Health Nursing
1. After a vaginal birth, how often should the nurse perform vital signs and
fundal assessments immediately postpartum?
A) Every 15 minutes for the first hour
B) Every 30 minutes for the first 2 hours
C) Every hour for the first 4 hours
D) Every 2 hours for the first 8 hours
Correct Answer: Every 15 minutes for the first hour
Rationale: In the immediate postpartum period, vital signs and fundal checks
should be performed every 15 minutes for the first hour to facilitate early
detection of hemorrhage or uterine atony. After the first hour, assessments
may be spaced to every 30 minutes, then hourly.
2. A postpartum patient reports cramping during breastfeeding. The nurse
should interpret this as:
A) A sign of infection
B) A sign of uterine atony
C) A good sign — the uterus is contracting
D) A sign of retained placental fragments
Correct Answer: A good sign — the uterus is contracting
Rationale: Afterpains (cramping) during breastfeeding are caused by the
release of oxytocin, which stimulates uterine contractions. This is a positive
sign indicating that the uterus is involuting and decreasing the risk of
hemorrhage. The pain is more common in multiparous women.
,3. A patient who had a cesarean section is 2 hours postpartum. The nurse
should perform assessments:
A) Less frequently than after a vaginal birth
B) More frequently than after a vaginal birth
C) At the same frequency as a vaginal birth
D) Only when the patient reports symptoms
Correct Answer: More frequently than after a vaginal birth
Rationale: Patients who have had a cesarean section are at higher risk for
complications such as bleeding, infection, and thromboembolism. More
frequent assessments are necessary to detect these complications early.
4. Immediately after delivery, the nurse palpates the fundus. Where should
the fundus be located?
A) At the level of the umbilicus
B) Midway between the pubic bone and umbilicus
C) Below the symphysis pubis
D) 2 cm above the umbilicus
Correct Answer: Midway between the pubic bone and umbilicus
Rationale: Immediately after delivery, the fundus is located midway between
the pubic bone and the umbilicus. It then rises to the level of the umbilicus
within 1-2 hours after delivery.
5. One to two hours after delivery, the fundus should be located at:
A) The level of the umbilicus
B) 1 cm above the umbilicus
,C) 1 cm below the umbilicus
D) Midway between the pubic bone and umbilicus
Correct Answer: The level of the umbilicus
Rationale: During the first 1-2 hours postpartum, the fundus should rise to
the level of the umbilicus due to the contraction of the uterus and the
absence of bladder distention.
6. A nurse assesses the fundus 12 hours after delivery. The expected fundal
height is:
A) 1 cm above the umbilicus
B) At the level of the umbilicus
C) 1 cm below the umbilicus
D) 2 cm below the umbilicus
Correct Answer: 1 cm above the umbilicus
Rationale: At 12 hours postpartum, the fundus is expected to be
approximately 1 cm above the umbilicus (U+1). The fundus gradually
descends approximately 1 cm per day.
7. Twenty-four hours after birth, the fundus should be located:
A) 1 cm above the umbilicus
B) At the level of the umbilicus
C) 1 cm below the umbilicus
D) 2 cm below the umbilicus
, Correct Answer: 1 cm below the umbilicus
Rationale: At 24 hours postpartum, the fundus should be approximately 1 cm
below the umbilicus (U-1). By 10-14 days postpartum, the fundus should no
longer be palpable abdominally.
8. The nurse palpates a boggy fundus. This finding indicates:
A) Normal uterine involution
B) Uterine atony
C) A full bladder
D) Retained placental fragments
Correct Answer: Uterine atony
Rationale: A boggy uterus is a sign of uterine atony (lack of muscle tone),
which can lead to postpartum hemorrhage. The priority intervention is to
massage the fundus until it becomes firm.
9. The nurse assesses that the fundus is deviated to the right side. The nurse
should first:
A) Notify the healthcare provider
B) Administer oxytocin
C) Assist the patient to void
D) Massage the fundus firmly
Correct Answer: Assist the patient to void
