Safe Maternity & Pediatric Nursing Care (Latest Edition) Test
Bank by Palmer & Coats — Complete Chapters 1–38 with Clear,
Exam-Focused Questions & Answers to Build Confidence in
Nursing Practice Graded A+ Guaranteed Pass!!!!!!!!!!
Question
After the nurse assesses a woman's uterus and finds it soft and boggy with no improvement
after massage, which is the priority intervention?
A) Notifying the provider
B) Assessing the bladder
C) Inserting a catheter
D) Having the woman breastfeed
Expert Rationale: A soft, boggy uterus (uterine atony) is the most common cause of
postpartum hemorrhage. If massage does not firm the uterus, the bladder should be
assessed because a distended bladder can displace the uterus and prevent contraction.
Breastfeeding stimulates oxytocin release but will not address a full bladder. Notifying the
provider and catheterization may follow if bladder distention is confirmed.
Question
The nurse caring for a patient during the first hour after delivery needs to notify the provider
when which condition is assessed?
A) Several small blood clots on the peripad
B) Saturation of two peripads over the hour
C) Passing a large clot the size of a fist
D) Yellow-white drainage from the nipples
Expert Rationale: Passing a large clot the size of a fist (or larger) indicates excessive
bleeding and possible hemorrhage. Several small clots are normal; saturating two peripads
in an hour is also concerning but a large clot is a more immediate indicator of hemorrhage.
Yellow-white drainage is colostrum, which is normal.
Question
The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic.
Which assessment finding is incorrect to document as part of this examination?
,A) Breasts firm and tender; patient reports sore nipples
B) Fundus 2 cm below umbilicus, firm
C) Lochia pink, small amount of drainage
D) Pulse strong and regular at rate of 84 beats per minute
Expert Rationale: BUBBLE LE stands for Breasts, Uterus, Bladder, Bowels, Lochia,
Episiotomy/Incision, and Extremities. Pulse is not part of the BUBBLE LE assessment; it is
part of vital signs. Vital signs are assessed separately from the focal postpartum
assessment.
Question
While performing a BUBBLE LE postpartum assessment, the nurse notes a raised area just
above the symphysis pubis. Which is the nurse's priority action?
A) Completing the assessment and documenting the findings
B) Notifying the provider and obtaining orders
C) Assisting the patient to the bathroom
D) Massaging the uterus until it becomes firm
Expert Rationale: A raised area above the symphysis pubis indicates a distended bladder.
A full bladder can displace the uterus and prevent it from contracting, leading to
hemorrhage. The priority is to assist the patient to void. If the patient cannot void,
catheterization may be needed.
Question
The nursing instructor observes a student providing care to an adolescent postpartum
patient. Which statement made by the student indicates the need for further teaching?
A) "Let me show you a way to hold the baby when you're giving him a bath."
B) "Do you want your little friend to stay while you breastfeed?"
C) "You're going to be a great mother because you really want to learn."
D) "Do you have any questions or need help with anything?"
Expert Rationale: Adolescents are minors and should not be treated as adults. Referring to
a peer as a "little friend" is condescending and does not respect the adolescent's
autonomy. The nurse should ask the adolescent if she wants her friend to stay, using
respectful language and allowing her to make the decision.
,Question
A new adolescent mother asks the nurse how to bathe her baby. Which is the nurse's best
approach to teach her this procedure?
A) Have the new mother bathe the baby while the nurse talks her through the process
B) Explain the procedure using pictures and diagrams
C) Give the new mother a brochure and tell her to ask if she has any questions
D) Let the new mother watch the nurse bathe the baby and then give a return
demonstration tomorrow
Expert Rationale: The best approach to teaching adolescent mothers is to allow them to
watch the procedure first, then have them perform a return demonstration. This builds
confidence and ensures comprehension. Step-by-step guidance during the actual bath is
also effective, but watching first is less anxiety-provoking.
Question
What is the nurse's role when caring for a mother who is relinquishing her infant for
adoption?
A) Discouraging her from holding or seeing her infant
B) Encouraging her to see the infant and take pictures
C) Avoiding discussion about the baby or her labor unless she brings it up
D) Respecting the mother's choices regarding the baby
Expert Rationale: The nurse should respect the mother's choices regarding her infant and
support her decisions. For mothers relinquishing for adoption, the nurse should offer the
opportunity to see, hold, and take pictures of the infant, allowing her to grieve and process
the experience. The decision is hers.
Question
A postpartum patient who plans to relinquish her baby for adoption says, "I'm having
second thoughts. Maybe I should keep the baby." Which is the nurse's best response?
A) "If you aren't sure, you should keep the baby until you make up your mind."
B) "You've made a promise to the adopting parents, and it's too late to change your mind."
C) "It is such a difficult decision to make. You must feel pulled in two directions."
D) "I can hear the indecision in your voice. Would you like to talk about it?"
, Expert Rationale: The therapeutic response acknowledges the patient's indecision and
offers support to explore her feelings. Giving advice (A) or implying it is too late (B) is
nontherapeutic. Option C is empathetic but does not offer to explore further. Option D is
the most therapeutic.
Question
After a patient has been taught postpartum self-care, which statement by the mother
indicates the need for further teaching?
A) "I will make an appointment with my provider to have my episiotomy stitches removed
next week."
B) "I can take acetaminophen and use warm sitz baths to control discomfort at my
episiotomy site."
C) "I'll keep a squirt bottle filled with warm water in the bathroom to cleanse with each time
I urinate."
D) "I will wear my nursing bra at all times, even when I go to bed, as long as I continue to
nurse the baby."
Expert Rationale: Episiotomy stitches are absorbable and do not require removal. The
patient should be taught that the stitches will dissolve on their own. The other statements
are correct: acetaminophen and sitz baths are appropriate for pain; a squirt bottle is used
for perineal cleansing; wearing a nursing bra provides support.
Question
A postpartum patient is experiencing early postpartum hemorrhage. Which is the nurse's
priority intervention?
A) Notifying the provider
B) Performing fundal massage
C) Expressing clots from the boggy uterus
D) Weighing peripads and linens to determine blood loss
Expert Rationale: Early postpartum hemorrhage is most often caused by uterine atony.
The priority intervention is fundal massage to stimulate uterine contractions and reduce
bleeding. The provider should be notified, but the immediate action is to attempt to firm the
uterus.
Bank by Palmer & Coats — Complete Chapters 1–38 with Clear,
Exam-Focused Questions & Answers to Build Confidence in
Nursing Practice Graded A+ Guaranteed Pass!!!!!!!!!!
Question
After the nurse assesses a woman's uterus and finds it soft and boggy with no improvement
after massage, which is the priority intervention?
A) Notifying the provider
B) Assessing the bladder
C) Inserting a catheter
D) Having the woman breastfeed
Expert Rationale: A soft, boggy uterus (uterine atony) is the most common cause of
postpartum hemorrhage. If massage does not firm the uterus, the bladder should be
assessed because a distended bladder can displace the uterus and prevent contraction.
Breastfeeding stimulates oxytocin release but will not address a full bladder. Notifying the
provider and catheterization may follow if bladder distention is confirmed.
Question
The nurse caring for a patient during the first hour after delivery needs to notify the provider
when which condition is assessed?
A) Several small blood clots on the peripad
B) Saturation of two peripads over the hour
C) Passing a large clot the size of a fist
D) Yellow-white drainage from the nipples
Expert Rationale: Passing a large clot the size of a fist (or larger) indicates excessive
bleeding and possible hemorrhage. Several small clots are normal; saturating two peripads
in an hour is also concerning but a large clot is a more immediate indicator of hemorrhage.
Yellow-white drainage is colostrum, which is normal.
Question
The nurse performs a focal postpartum assessment using the BUBBLE LE mnemonic.
Which assessment finding is incorrect to document as part of this examination?
,A) Breasts firm and tender; patient reports sore nipples
B) Fundus 2 cm below umbilicus, firm
C) Lochia pink, small amount of drainage
D) Pulse strong and regular at rate of 84 beats per minute
Expert Rationale: BUBBLE LE stands for Breasts, Uterus, Bladder, Bowels, Lochia,
Episiotomy/Incision, and Extremities. Pulse is not part of the BUBBLE LE assessment; it is
part of vital signs. Vital signs are assessed separately from the focal postpartum
assessment.
Question
While performing a BUBBLE LE postpartum assessment, the nurse notes a raised area just
above the symphysis pubis. Which is the nurse's priority action?
A) Completing the assessment and documenting the findings
B) Notifying the provider and obtaining orders
C) Assisting the patient to the bathroom
D) Massaging the uterus until it becomes firm
Expert Rationale: A raised area above the symphysis pubis indicates a distended bladder.
A full bladder can displace the uterus and prevent it from contracting, leading to
hemorrhage. The priority is to assist the patient to void. If the patient cannot void,
catheterization may be needed.
Question
The nursing instructor observes a student providing care to an adolescent postpartum
patient. Which statement made by the student indicates the need for further teaching?
A) "Let me show you a way to hold the baby when you're giving him a bath."
B) "Do you want your little friend to stay while you breastfeed?"
C) "You're going to be a great mother because you really want to learn."
D) "Do you have any questions or need help with anything?"
Expert Rationale: Adolescents are minors and should not be treated as adults. Referring to
a peer as a "little friend" is condescending and does not respect the adolescent's
autonomy. The nurse should ask the adolescent if she wants her friend to stay, using
respectful language and allowing her to make the decision.
,Question
A new adolescent mother asks the nurse how to bathe her baby. Which is the nurse's best
approach to teach her this procedure?
A) Have the new mother bathe the baby while the nurse talks her through the process
B) Explain the procedure using pictures and diagrams
C) Give the new mother a brochure and tell her to ask if she has any questions
D) Let the new mother watch the nurse bathe the baby and then give a return
demonstration tomorrow
Expert Rationale: The best approach to teaching adolescent mothers is to allow them to
watch the procedure first, then have them perform a return demonstration. This builds
confidence and ensures comprehension. Step-by-step guidance during the actual bath is
also effective, but watching first is less anxiety-provoking.
Question
What is the nurse's role when caring for a mother who is relinquishing her infant for
adoption?
A) Discouraging her from holding or seeing her infant
B) Encouraging her to see the infant and take pictures
C) Avoiding discussion about the baby or her labor unless she brings it up
D) Respecting the mother's choices regarding the baby
Expert Rationale: The nurse should respect the mother's choices regarding her infant and
support her decisions. For mothers relinquishing for adoption, the nurse should offer the
opportunity to see, hold, and take pictures of the infant, allowing her to grieve and process
the experience. The decision is hers.
Question
A postpartum patient who plans to relinquish her baby for adoption says, "I'm having
second thoughts. Maybe I should keep the baby." Which is the nurse's best response?
A) "If you aren't sure, you should keep the baby until you make up your mind."
B) "You've made a promise to the adopting parents, and it's too late to change your mind."
C) "It is such a difficult decision to make. You must feel pulled in two directions."
D) "I can hear the indecision in your voice. Would you like to talk about it?"
, Expert Rationale: The therapeutic response acknowledges the patient's indecision and
offers support to explore her feelings. Giving advice (A) or implying it is too late (B) is
nontherapeutic. Option C is empathetic but does not offer to explore further. Option D is
the most therapeutic.
Question
After a patient has been taught postpartum self-care, which statement by the mother
indicates the need for further teaching?
A) "I will make an appointment with my provider to have my episiotomy stitches removed
next week."
B) "I can take acetaminophen and use warm sitz baths to control discomfort at my
episiotomy site."
C) "I'll keep a squirt bottle filled with warm water in the bathroom to cleanse with each time
I urinate."
D) "I will wear my nursing bra at all times, even when I go to bed, as long as I continue to
nurse the baby."
Expert Rationale: Episiotomy stitches are absorbable and do not require removal. The
patient should be taught that the stitches will dissolve on their own. The other statements
are correct: acetaminophen and sitz baths are appropriate for pain; a squirt bottle is used
for perineal cleansing; wearing a nursing bra provides support.
Question
A postpartum patient is experiencing early postpartum hemorrhage. Which is the nurse's
priority intervention?
A) Notifying the provider
B) Performing fundal massage
C) Expressing clots from the boggy uterus
D) Weighing peripads and linens to determine blood loss
Expert Rationale: Early postpartum hemorrhage is most often caused by uterine atony.
The priority intervention is fundal massage to stimulate uterine contractions and reduce
bleeding. The provider should be notified, but the immediate action is to attempt to firm the
uterus.
