NUR 335 EXAM 3 2026/2027 – NURSING STUDY GUIDE, PRACTICE QUESTIONS &
COMPREHENSIVE EXAM REVIEW
Postpartum Period - correct answer ✔✔First 6 weeks after delivery, "Fourth Trimester".
- Rapid physical, social, and emotional adaptation.
Postpartum Assessment - correct answer ✔✔Providing comfort and restoring physiological functions
affected by childbirth.
- Assessing for early signs of potential complications. Promoting health and education.
- Physiological changes BUBBLE-HE.
Death and complications can happen for how long after birth? - correct answer ✔✔1 year.
Healthy People 2020 Prevention includes? - correct answer ✔✔Reducing the rate of maternal mortality,
maternal illness and complications due to pregnancy, and increase the proportion of breastfed infants.
Uterine Involution - correct answer ✔✔The return of the uterus to its normal size and former condition
after delivery. Fundal position, tone, and location.
Endometrial Healing - correct answer ✔✔Lochia, color, amount and odor.
Assessing uterine involution happens how often? - correct answer ✔✔- Q15 min during first hour.
- Q30 min in the second hour.
- Q4 hours for the next 24 hours.
- Every shift after that.
Location of the uterus post pregnancy is? - correct answer ✔✔- Immediately after birth it lies between
the umbilicus and the symphysis pubis.
- 12 hours after birth it is at umbilicus or 1 cm above.
- 24 hours after birth it is 1 cm below the umbilicus.
- Descends 1 cm/day for 14 days when it is no longer felt.
Position of the uterus is what? - correct answer ✔✔Midline. Full bladder can cause a shift, have the
patient void if needed.
Tone of the uterus should be what? - correct answer ✔✔Firm and contracted. Boggy uterus would need
fundal massage.
Nursing education postpartum? - correct answer ✔✔- Explain the process of involution.
- Massage the fundus if boggy.
- Uterus should descend 1 cm per day.
- Afterpains may occur as the uterus contracts.
What is the endometrium? - correct answer ✔✔Lining of the uterus. Undergoes exfoliation and
regeneration after birth.
,What is the bloody discharge after birth called? - correct answer ✔✔Lochia. Contains red blood cells,
sloughed off residual tissue, epithelial cells, and bacteria.
What color changes do lochia make? - correct answer ✔✔Red, pink, yellow.
What is the red discharge after birth called? - correct answer ✔✔Rubra, lasts 3-4 days.
What is the pink discharge after birth calleD? - correct answer ✔✔Serosa, lasts 4-10 days.
What is the yellow discharge after birth called? - correct answer ✔✔Alba, lasts 10-28 days.
How many pads are too many after birth? - correct answer ✔✔More than 1 pad per hour.
When should you report clots in discharge to the provider? - correct answer ✔✔A clot greater than the
size of an egg should be weighed and reported to the provider. 1gm in weight = 1mL of blood loss.
What nursing education should you provide about endometrial healing? - correct answer ✔✔- Normal
stages of lochia.
- Reducing the risk of infection, such as changing the peri-pad frequently, cleaning from front to back,
and using the peri-bottle to keep the are clean. Pat dry, do not wipe.
How much vaginal blood loss is normal? - correct answer ✔✔500 ml.
How much c-section blood loss is normal? - correct answer ✔✔1000 ml.
How can you encourage a woman to pee after giving birth? - correct answer ✔✔Peppermint in the hat
to stimulate.
What is the normal WBC count for a woman after child birth? Lasting 7 days. - correct answer
✔✔30,000.
What is the hormone that causes uterine contraction? - correct answer ✔✔Oxytocin.
What is one way you can stimulate the production of oxytocin? - correct answer ✔✔Nipple stimulation.
When the uterus feels boggy, how do you encourage the uterus to contract? - correct answer ✔✔Fundal
massage.
How do you know the amount of blood being lost? - correct answer ✔✔Weigh the chux or pads.
What does uterine involution mean? - correct answer ✔✔Changing of a pregnant uterus to a non-
pregnant uterus.
What kind of changes occur to the vagina and perineum? - correct answer ✔✔Edema, mild stretching,
minor lacerations, major tears, and/or episiotomies.
What does a stage one laceration include? - correct answer ✔✔Tear of the perineal skin.
, What does a stage two laceration include? - correct answer ✔✔Tear of the perineal skin and muscle.
What does a stage three laceration include? - correct answer ✔✔Tear of the perineal skin, muscle, and
anal sphincter.
What does a stage four laceration include? - correct answer ✔✔Tear of the perineal skin, muscle, anal
sphincter, and rectal mucosa.
What is a midline episiotomy? - correct answer ✔✔Cut right down the middle.
What is a mediolateral episiotomy? - correct answer ✔✔Cut to the side at a 45 degree angle.
What does REEDA stand for? - correct answer ✔✔Redness, edema, ecchymosis, drainage, and
approximation.
What position is best to view and episiotomy? - correct answer ✔✔Side lying. Provide privacy and
explain what you're doing, and examine from behind.
What are comfort measures that can be used for an episiotomy? - correct answer ✔✔Ice packs, sits
bath, side lying, topical anesthetics, analgesia, and tucks pads.
How long does it take for breast milk to come in? - correct answer ✔✔2-3 days.
What is colostrum and why is it important? - correct answer ✔✔The first secretion from the mammary
glands after giving birth, rich in antibodies. (IgA)
What is human milk composed of? (Contents) - correct answer ✔✔Proteins, carbohydrates, and fats are
synthesized in the breasts' alveolar glands.
How does breast milk protect the baby from infection? (Contents) - correct answer ✔✔Antibodies,
enzymes, and immune factors.
How does breast milk inhibit bacteria growth inside the baby? (Prevent disease) - correct answer
✔✔Stimulates the growth of healthy bacteria in the intestinal system.
Ways to decrease pain associated with breast engorgement in women not breast feeding? - correct
answer ✔✔Wear a supportive and well fitting bra, avoid expressing milk, and apply ice.
What happens to stroke volume and cardiac output after the birth of the baby? - correct answer
✔✔Stroke volume and cardiac output increases as blood that was shunted to the placenta is now
returning to the maternal system.
What happens to blood volume after the birth of the baby? - correct answer ✔✔Blood volume initially
decreases due to blood loss. Blood volume then increases due to shifts from the extracellular to the
vascular space.
Why is pulmonary edema a risk after delivery? - correct answer ✔✔Pulmonary edema may be due to
large amounts of IV fluids, and medications.
COMPREHENSIVE EXAM REVIEW
Postpartum Period - correct answer ✔✔First 6 weeks after delivery, "Fourth Trimester".
- Rapid physical, social, and emotional adaptation.
Postpartum Assessment - correct answer ✔✔Providing comfort and restoring physiological functions
affected by childbirth.
- Assessing for early signs of potential complications. Promoting health and education.
- Physiological changes BUBBLE-HE.
Death and complications can happen for how long after birth? - correct answer ✔✔1 year.
Healthy People 2020 Prevention includes? - correct answer ✔✔Reducing the rate of maternal mortality,
maternal illness and complications due to pregnancy, and increase the proportion of breastfed infants.
Uterine Involution - correct answer ✔✔The return of the uterus to its normal size and former condition
after delivery. Fundal position, tone, and location.
Endometrial Healing - correct answer ✔✔Lochia, color, amount and odor.
Assessing uterine involution happens how often? - correct answer ✔✔- Q15 min during first hour.
- Q30 min in the second hour.
- Q4 hours for the next 24 hours.
- Every shift after that.
Location of the uterus post pregnancy is? - correct answer ✔✔- Immediately after birth it lies between
the umbilicus and the symphysis pubis.
- 12 hours after birth it is at umbilicus or 1 cm above.
- 24 hours after birth it is 1 cm below the umbilicus.
- Descends 1 cm/day for 14 days when it is no longer felt.
Position of the uterus is what? - correct answer ✔✔Midline. Full bladder can cause a shift, have the
patient void if needed.
Tone of the uterus should be what? - correct answer ✔✔Firm and contracted. Boggy uterus would need
fundal massage.
Nursing education postpartum? - correct answer ✔✔- Explain the process of involution.
- Massage the fundus if boggy.
- Uterus should descend 1 cm per day.
- Afterpains may occur as the uterus contracts.
What is the endometrium? - correct answer ✔✔Lining of the uterus. Undergoes exfoliation and
regeneration after birth.
,What is the bloody discharge after birth called? - correct answer ✔✔Lochia. Contains red blood cells,
sloughed off residual tissue, epithelial cells, and bacteria.
What color changes do lochia make? - correct answer ✔✔Red, pink, yellow.
What is the red discharge after birth called? - correct answer ✔✔Rubra, lasts 3-4 days.
What is the pink discharge after birth calleD? - correct answer ✔✔Serosa, lasts 4-10 days.
What is the yellow discharge after birth called? - correct answer ✔✔Alba, lasts 10-28 days.
How many pads are too many after birth? - correct answer ✔✔More than 1 pad per hour.
When should you report clots in discharge to the provider? - correct answer ✔✔A clot greater than the
size of an egg should be weighed and reported to the provider. 1gm in weight = 1mL of blood loss.
What nursing education should you provide about endometrial healing? - correct answer ✔✔- Normal
stages of lochia.
- Reducing the risk of infection, such as changing the peri-pad frequently, cleaning from front to back,
and using the peri-bottle to keep the are clean. Pat dry, do not wipe.
How much vaginal blood loss is normal? - correct answer ✔✔500 ml.
How much c-section blood loss is normal? - correct answer ✔✔1000 ml.
How can you encourage a woman to pee after giving birth? - correct answer ✔✔Peppermint in the hat
to stimulate.
What is the normal WBC count for a woman after child birth? Lasting 7 days. - correct answer
✔✔30,000.
What is the hormone that causes uterine contraction? - correct answer ✔✔Oxytocin.
What is one way you can stimulate the production of oxytocin? - correct answer ✔✔Nipple stimulation.
When the uterus feels boggy, how do you encourage the uterus to contract? - correct answer ✔✔Fundal
massage.
How do you know the amount of blood being lost? - correct answer ✔✔Weigh the chux or pads.
What does uterine involution mean? - correct answer ✔✔Changing of a pregnant uterus to a non-
pregnant uterus.
What kind of changes occur to the vagina and perineum? - correct answer ✔✔Edema, mild stretching,
minor lacerations, major tears, and/or episiotomies.
What does a stage one laceration include? - correct answer ✔✔Tear of the perineal skin.
, What does a stage two laceration include? - correct answer ✔✔Tear of the perineal skin and muscle.
What does a stage three laceration include? - correct answer ✔✔Tear of the perineal skin, muscle, and
anal sphincter.
What does a stage four laceration include? - correct answer ✔✔Tear of the perineal skin, muscle, anal
sphincter, and rectal mucosa.
What is a midline episiotomy? - correct answer ✔✔Cut right down the middle.
What is a mediolateral episiotomy? - correct answer ✔✔Cut to the side at a 45 degree angle.
What does REEDA stand for? - correct answer ✔✔Redness, edema, ecchymosis, drainage, and
approximation.
What position is best to view and episiotomy? - correct answer ✔✔Side lying. Provide privacy and
explain what you're doing, and examine from behind.
What are comfort measures that can be used for an episiotomy? - correct answer ✔✔Ice packs, sits
bath, side lying, topical anesthetics, analgesia, and tucks pads.
How long does it take for breast milk to come in? - correct answer ✔✔2-3 days.
What is colostrum and why is it important? - correct answer ✔✔The first secretion from the mammary
glands after giving birth, rich in antibodies. (IgA)
What is human milk composed of? (Contents) - correct answer ✔✔Proteins, carbohydrates, and fats are
synthesized in the breasts' alveolar glands.
How does breast milk protect the baby from infection? (Contents) - correct answer ✔✔Antibodies,
enzymes, and immune factors.
How does breast milk inhibit bacteria growth inside the baby? (Prevent disease) - correct answer
✔✔Stimulates the growth of healthy bacteria in the intestinal system.
Ways to decrease pain associated with breast engorgement in women not breast feeding? - correct
answer ✔✔Wear a supportive and well fitting bra, avoid expressing milk, and apply ice.
What happens to stroke volume and cardiac output after the birth of the baby? - correct answer
✔✔Stroke volume and cardiac output increases as blood that was shunted to the placenta is now
returning to the maternal system.
What happens to blood volume after the birth of the baby? - correct answer ✔✔Blood volume initially
decreases due to blood loss. Blood volume then increases due to shifts from the extracellular to the
vascular space.
Why is pulmonary edema a risk after delivery? - correct answer ✔✔Pulmonary edema may be due to
large amounts of IV fluids, and medications.
