POSTPARTUM CHANGES AND CARE: OBSTETRICS
NURSING FUNDAMENTALS | FROM QUESTION TO
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 70%.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, What changes occur in the vagina postpartum? Answer: The vagina distends and gradually
returns to pre-pregnancy size, but muscle tone is never fully restored; rugae reappear and
mucosa thickens.
What happens to the cervix in the first few days postpartum? Answer: The cervix is soft,
edematous, and bruised initially, but shortens, closes, and becomes firm with a slit-like
appearance by 2-3 days postpartum.
What are common changes in the perineum after delivery? Answer: The perineum may be
erythematous and edematous, especially if lacerations or an episiotomy are present, with
possible hematomas or hemorrhoids.
How does breastfeeding affect hormone levels postpartum? Answer: Breastfeeding encourages
the release of oxytocin and decreases estrogen, which helps with breast milk production and
causes vaginal dryness.
What is the average time for the first ovulation postpartum for lactating women? Answer: The
average time for the first postpartum ovulation in lactating women is about 6 months.
What urinary changes can occur postpartum? Answer: Trauma to the perineum and decreased
bladder elasticity may cause urinary retention and increase the risk of urinary tract infections.
What cardiovascular changes occur after delivery? Answer: Blood volume decreases due to
blood loss and diuresis; normal blood loss is 300-500cc for vaginal birth and 500-1000cc for
cesarean birth.
What are the vital sign changes postpartum? Answer: Blood pressure may be unchanged or
slightly increased; pulse and cardiac output increase initially, then gradually decrease to non-
pregnant levels by 6-8 weeks.
What laboratory changes are expected in the postpartum period? Answer: Hemoglobin and
hematocrit levels drop for 3-4 days, then increase; WBC count may rise to 20-25,000 in the first
week.
What musculoskeletal changes occur postpartum? Answer: Musculoskeletal function typically
returns to normal by 6-8 weeks postpartum; however, feet may remain larger.
What vaccinations are recommended for postpartum women? Answer: MMR for non-immune
women, Rhogam for Rh-negative mothers with Rh-positive newborns, varicella vaccine if non-
immune, and Tdap during the last trimester.
What skin changes may occur postpartum? Answer: Striae may fade but remain; darkened
pigmented areas may persist, and some changes revert to normal within 6 weeks.
What are the goals during the immediate postpartum period? Answer: Goals include preventing
postpartum hemorrhage, assisting in recovery, providing comfort measures, education, and
promoting bonding.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
NURSING FUNDAMENTALS | FROM QUESTION TO
PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027.
Duration: 2 Hours.
Total Marks: 70%.
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, What changes occur in the vagina postpartum? Answer: The vagina distends and gradually
returns to pre-pregnancy size, but muscle tone is never fully restored; rugae reappear and
mucosa thickens.
What happens to the cervix in the first few days postpartum? Answer: The cervix is soft,
edematous, and bruised initially, but shortens, closes, and becomes firm with a slit-like
appearance by 2-3 days postpartum.
What are common changes in the perineum after delivery? Answer: The perineum may be
erythematous and edematous, especially if lacerations or an episiotomy are present, with
possible hematomas or hemorrhoids.
How does breastfeeding affect hormone levels postpartum? Answer: Breastfeeding encourages
the release of oxytocin and decreases estrogen, which helps with breast milk production and
causes vaginal dryness.
What is the average time for the first ovulation postpartum for lactating women? Answer: The
average time for the first postpartum ovulation in lactating women is about 6 months.
What urinary changes can occur postpartum? Answer: Trauma to the perineum and decreased
bladder elasticity may cause urinary retention and increase the risk of urinary tract infections.
What cardiovascular changes occur after delivery? Answer: Blood volume decreases due to
blood loss and diuresis; normal blood loss is 300-500cc for vaginal birth and 500-1000cc for
cesarean birth.
What are the vital sign changes postpartum? Answer: Blood pressure may be unchanged or
slightly increased; pulse and cardiac output increase initially, then gradually decrease to non-
pregnant levels by 6-8 weeks.
What laboratory changes are expected in the postpartum period? Answer: Hemoglobin and
hematocrit levels drop for 3-4 days, then increase; WBC count may rise to 20-25,000 in the first
week.
What musculoskeletal changes occur postpartum? Answer: Musculoskeletal function typically
returns to normal by 6-8 weeks postpartum; however, feet may remain larger.
What vaccinations are recommended for postpartum women? Answer: MMR for non-immune
women, Rhogam for Rh-negative mothers with Rh-positive newborns, varicella vaccine if non-
immune, and Tdap during the last trimester.
What skin changes may occur postpartum? Answer: Striae may fade but remain; darkened
pigmented areas may persist, and some changes revert to normal within 6 weeks.
What are the goals during the immediate postpartum period? Answer: Goals include preventing
postpartum hemorrhage, assisting in recovery, providing comfort measures, education, and
promoting bonding.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
