NSG 3500 Maternal Exam 3 Review | 50 Questions and Answers with Rationales | 2026/2027 Updated | 100% Correct -

NSG 3500 Maternal Exam 3 Review | 50
Questions and Answers with Rationales |
2026/2027 Updated | 100% Correct -
NSG 3500 Maternal Exam 3 Review



Table of Contents

Section Topic Questions


I Postpartum Hemorrhage & Uterine Atony 1–12


II Postpartum Assessment & Involution 13–22


III Fetal Monitoring & Intrapartum Complications 23–34


IV High-Risk Conditions & Medications 35–44


V Postpartum Complications: Infection, Hematoma, Thromboembolism 45–50


— Complete Answer Key —


— High-Yield Review —



Section I: Postpartum Hemorrhage & Uterine Atony

Questions 1–12

Question 1
A postpartum nurse is caring for a client who is 12 hours post-delivery and reports heavy, bright

,red bleeding with large clots. The nurse notes the uterus is boggy and displaced to the right.
What is the priority nursing action?

A) Massage the uterine fundus firmly
B) Encourage the client to void
C) Administer prescribed oxytocin
D) Notify the healthcare provider immediately

Correct Answer: B) Encourage the client to void

Rationale: A boggy uterus displaced to the right suggests a full bladder is preventing
uterine contraction. The priority is to empty the bladder first—by encouraging voiding or
catheterizing if needed—then massage the fundus. After the bladder is empty, fundal massage
(A) and oxytocin (C) can be effective. Notification (D) follows if measures fail.



Question 2
What is the most common cause of postpartum hemorrhage?

A) Uterine atony
B) Retained placental fragments
C) Coagulation disorders
D) Cervical lacerations

Correct Answer: A) Uterine atony

Rationale: Uterine atony (failure of the uterus to contract after delivery) is the most
common cause of postpartum hemorrhage, accounting for approximately 70–80% of cases.
Retained placental fragments (B), coagulation disorders (C), and lacerations (D) are other causes
but less common.



Question 3
A client is 2 hours postpartum with a firm, midline fundus but heavy, bright red bleeding with
steady trickle. What is the most likely cause?

A) Uterine atony
B) Cervical or vaginal laceration
C) Retained placental fragments
D) Bladder distention

Correct Answer: B) Cervical or vaginal laceration

, Rationale: If the fundus is firm and midline (not atonic) but bleeding remains heavy, a
laceration of the birth canal is the most probable cause. Uterine atony (A) presents with a boggy
uterus. Retained placental fragments (C) typically cause subinvolution and late bleeding.
Bladder distention (D) displaces the fundus and causes atony.



Question 4
What medication is contraindicated in a postpartum client with hypertension who is
experiencing hemorrhage?

A) Oxytocin
B) Methylergonovine (Methergine)
C) Carboprost (Hemabate)
D) Misoprostol (Cytotec)

Correct Answer: B) Methylergonovine (Methergine)

Rationale: Methylergonovine causes vasoconstriction and can elevate blood pressure, so
it is contraindicated in hypertensive or preeclamptic clients. Oxytocin (A) is generally safe.
Carboprost (C) is contraindicated in asthma. Misoprostol (D) is generally safe.



Question 5
What medication is contraindicated in a postpartum client with asthma who is experiencing
hemorrhage?

A) Oxytocin
B) Methylergonovine
C) Carboprost (Hemabate)
D) Misoprostol

Correct Answer: C) Carboprost (Hemabate)

Rationale: Carboprost is a prostaglandin that can cause bronchospasm and is
contraindicated in clients with asthma. Methylergonovine (B) is contraindicated in hypertension.
Oxytocin (A) and misoprostol (D) are generally safe in asthma.



Question 6
When does early postpartum hemorrhage occur?