OB POSTPARTUM NCLEX
2026 NEWEST EXAM
CURRENTLY TESTING
COMPLETE EXAM
QUESTIONS WITH DETAILED
VERIFIED ANSWERS(100%
COORECT ANSWERS) A+
STUDY MATERIAL
Which of the following circumstances is most likely to cause uterine atony and lead to PP
hemorrhage?
A) Hypertension
B) Cervical and vaginal tears
C) Urine retention
D) Endometritis
C) Urine retention
Rationale: Urine retention causes a distended bladder to displace the uterus above the umbilicus and to
the side, which prevents the uterus from contracting. The uterus needs to remain contracted if bleeding
is to stay within normal limits. Cervical and vaginal tears can cause PP hemorrhage but are less common
occurrences in the PP period
Which type of lochia should the nurse expect to find in a client 2 days PP?
A) Foul-smelling
B) Lochia serosa
C) Lochia alba
D) Lochia rubra
D) Lochia rubra
,After expulsion of the placenta in a client who has six living children, an infusion of lactated ringer's
solution with 10 units of pitocin is ordered. The nurse understands that this is indicated for this client
because:
A) She had a precipitate birth
B) This was an extramural birth
C) Retained placental fragments must be expelled
D) Multigravidas are at increased risk for uterine atony
D) Multigravidas are at increased risk for uterine atony
Rationale: Multiple full-term pregnancies and deliveries result in overstretched uterine muscles that do
not contract efficiently and bleeding may ensue.
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding
woman who is one day postpartum. An expected finding would be:
A) Soft, non-tender; colostrum is present
B) Leakage of milk at let down
C) Swollen, warm, and tender upon palpation
D) A few blisters and a bruise on each areola
A) Soft, non-tender; colostrum is present
Rationale: Breasts are essentially unchanged for the first two to three days after birth. Colostrum is
present and may leak from the nipples.
Following the birth of her baby, a woman expresses concern about the weight she gained during
pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the
expected pattern of weight loss, should begin by telling this woman that:
A) Return to pre pregnant weight is usually achieved by the end of the postpartum period
B) Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3 pound weight loss
C) The expected weight loss immediately after birth averages about 11 to 13 pounds
D) Lactation will inhibit weight loss since caloric intake must increase to support milk production
C) The expected weight loss immediately after birth averages about 11 to 13 pounds
Rationale: Prepregnant weight is usually achieved by 2 to 3 months after birth, not within the 6-week
postpartum period. Weight loss from diuresis, diaphoresis, and bleeding is about 9 pounds. Weight loss
continues during breast
Which of the following findings would be a source of concern if noted during the assessment of a
woman who is 12 hours postpartum?
A) Postural hypotension
B) Temperature of 100.4°F
C) Bradycardia — pulse rate of 55 BPM
D) Pain in left calf with dorsiflexion of left foot
, D) Pain in left calf with dorsiflexion of left foot
Rationale: Responses 1 and 3 are expected related to circulatory changes after birth. A temperature of
100.4°F in the first 24 hours is most likely indicative of dehydration which is easily corrected by
increasing oral fluid intake. The findings in response 4 indicate a positive Homan sign and are suggestive
of thrombophlebitis and should be investigated further.
The nurse examines a woman one hour after birth. The woman's fundus is boggy, midline, and 1 cm
below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action
would be to:
A) Place her on a bedpan to empty her bladder
B) Massage her fundus
C) Call the physician
D) Administer Methergine 0.2 mg IM which has been ordered prn
B) Massage her fundus
Rationale: A boggy or soft fundus indicates that uterine atony is present. This is confirmed by the
profuse lochia and passage of clots. The first action would be to massage the fundus until firm, followed
by 3 and 4, especially if the fundus does not become or remain firm with massage. There is no indication
of a distended bladder since the fundus is midline and below the umbilicus.
When performing a postpartum check, the nurse should:
A) Assist the woman into a lateral position with upper leg flexed forward to facilitate the examination
of her perineum
B) Assist the woman into a supine position with her arms above her head and her legs extended for
the examination of her abdomen
C) Instruct the woman to avoid urinating just before the examination since a full bladder will facilitate
fundal palpation
D) Wash hands and put on sterile gloves before beginning the check
A) Assist the woman into a lateral position with upper leg flexed forward to facilitate the examination of
her perineum
Rationale: While the supine position is best for examining the abdomen, the woman should keep her
arms at her sides and slightly flex her knees in order to relax abdominal muscles and facilitate palpation
of the fundus. The bladder should be emptied before the check. A full bladder alters the position of the
fundus and makes the findings inaccurate. Although hands are washed before starting the check, clean
(not sterile) gloves are put on just before the perineum and pad are assessed
Perineal care is an important infection control measure. When evaluating a postpartum woman's
perineal care technique, the nurse would recognize the need for further instruction if the woman:
A) Uses soap and warm water to wash the vulva and perineum
B) Washes from symphysis pubis back to episiotomy
C) Changes her perineal pad every 2 - 3 hours
D) Uses the peribottle to rinse upward into her vagina
2026 NEWEST EXAM
CURRENTLY TESTING
COMPLETE EXAM
QUESTIONS WITH DETAILED
VERIFIED ANSWERS(100%
COORECT ANSWERS) A+
STUDY MATERIAL
Which of the following circumstances is most likely to cause uterine atony and lead to PP
hemorrhage?
A) Hypertension
B) Cervical and vaginal tears
C) Urine retention
D) Endometritis
C) Urine retention
Rationale: Urine retention causes a distended bladder to displace the uterus above the umbilicus and to
the side, which prevents the uterus from contracting. The uterus needs to remain contracted if bleeding
is to stay within normal limits. Cervical and vaginal tears can cause PP hemorrhage but are less common
occurrences in the PP period
Which type of lochia should the nurse expect to find in a client 2 days PP?
A) Foul-smelling
B) Lochia serosa
C) Lochia alba
D) Lochia rubra
D) Lochia rubra
,After expulsion of the placenta in a client who has six living children, an infusion of lactated ringer's
solution with 10 units of pitocin is ordered. The nurse understands that this is indicated for this client
because:
A) She had a precipitate birth
B) This was an extramural birth
C) Retained placental fragments must be expelled
D) Multigravidas are at increased risk for uterine atony
D) Multigravidas are at increased risk for uterine atony
Rationale: Multiple full-term pregnancies and deliveries result in overstretched uterine muscles that do
not contract efficiently and bleeding may ensue.
As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding
woman who is one day postpartum. An expected finding would be:
A) Soft, non-tender; colostrum is present
B) Leakage of milk at let down
C) Swollen, warm, and tender upon palpation
D) A few blisters and a bruise on each areola
A) Soft, non-tender; colostrum is present
Rationale: Breasts are essentially unchanged for the first two to three days after birth. Colostrum is
present and may leak from the nipples.
Following the birth of her baby, a woman expresses concern about the weight she gained during
pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the
expected pattern of weight loss, should begin by telling this woman that:
A) Return to pre pregnant weight is usually achieved by the end of the postpartum period
B) Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3 pound weight loss
C) The expected weight loss immediately after birth averages about 11 to 13 pounds
D) Lactation will inhibit weight loss since caloric intake must increase to support milk production
C) The expected weight loss immediately after birth averages about 11 to 13 pounds
Rationale: Prepregnant weight is usually achieved by 2 to 3 months after birth, not within the 6-week
postpartum period. Weight loss from diuresis, diaphoresis, and bleeding is about 9 pounds. Weight loss
continues during breast
Which of the following findings would be a source of concern if noted during the assessment of a
woman who is 12 hours postpartum?
A) Postural hypotension
B) Temperature of 100.4°F
C) Bradycardia — pulse rate of 55 BPM
D) Pain in left calf with dorsiflexion of left foot
, D) Pain in left calf with dorsiflexion of left foot
Rationale: Responses 1 and 3 are expected related to circulatory changes after birth. A temperature of
100.4°F in the first 24 hours is most likely indicative of dehydration which is easily corrected by
increasing oral fluid intake. The findings in response 4 indicate a positive Homan sign and are suggestive
of thrombophlebitis and should be investigated further.
The nurse examines a woman one hour after birth. The woman's fundus is boggy, midline, and 1 cm
below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action
would be to:
A) Place her on a bedpan to empty her bladder
B) Massage her fundus
C) Call the physician
D) Administer Methergine 0.2 mg IM which has been ordered prn
B) Massage her fundus
Rationale: A boggy or soft fundus indicates that uterine atony is present. This is confirmed by the
profuse lochia and passage of clots. The first action would be to massage the fundus until firm, followed
by 3 and 4, especially if the fundus does not become or remain firm with massage. There is no indication
of a distended bladder since the fundus is midline and below the umbilicus.
When performing a postpartum check, the nurse should:
A) Assist the woman into a lateral position with upper leg flexed forward to facilitate the examination
of her perineum
B) Assist the woman into a supine position with her arms above her head and her legs extended for
the examination of her abdomen
C) Instruct the woman to avoid urinating just before the examination since a full bladder will facilitate
fundal palpation
D) Wash hands and put on sterile gloves before beginning the check
A) Assist the woman into a lateral position with upper leg flexed forward to facilitate the examination of
her perineum
Rationale: While the supine position is best for examining the abdomen, the woman should keep her
arms at her sides and slightly flex her knees in order to relax abdominal muscles and facilitate palpation
of the fundus. The bladder should be emptied before the check. A full bladder alters the position of the
fundus and makes the findings inaccurate. Although hands are washed before starting the check, clean
(not sterile) gloves are put on just before the perineum and pad are assessed
Perineal care is an important infection control measure. When evaluating a postpartum woman's
perineal care technique, the nurse would recognize the need for further instruction if the woman:
A) Uses soap and warm water to wash the vulva and perineum
B) Washes from symphysis pubis back to episiotomy
C) Changes her perineal pad every 2 - 3 hours
D) Uses the peribottle to rinse upward into her vagina
