OB Postpartum NCLEX Questions &
answers 2025/2026 passed
B) Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
Rationale: Every 15 minutes during the first hour and then every 30 minutes for the next two
hours. - ANS ✔✔A postpartum nurse is preparing to care for a woman who has just delivered a
healthy newborn infant. In the immediate postpartum period the nurse plans to take the
woman's vital signs:
A) Every 30 minutes during the first hour and then every hour for the next two hours.
B) Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
C) Every hour for the first 2 hours and then every 4 hours
D) Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours.
D) Increase hydration by encouraging oral fluids
Rationale: The mother's temperature may be taken every 4 hours while she is awake.
Temperatures up to 100.4 (38 C) in the first 24 hours after birth are often related to the
dehydrating effects of labor. The most appropriate action is to increase hydration by
encouraging oral fluids, which should bring the temperature to a normal reading. Although the
nurse would document the findings, the most appropriate action would be to increase the
hydration. - ANS ✔✔A postpartum nurse is taking the vital signs of a woman who delivered a
healthy newborn infant 4 hours ago. The nurse notes that the mother's temperature is 100.2*F.
Which of the following actions would be most appropriate?
A) Retake the temperature in 15 minutes
B) Notify the physician
C) Document the findings
D) Increase hydration by encouraging oral fluids
,B) Instruct the mother to request help when getting out of bed
Rationale: Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings
of faintness or dizziness are signs that should caution the nurse to be aware of the client's
safety. The nurse should advise the mother to get help the first few times the mother gets out
of bed. Obtaining an H/H requires a physicians order. - ANS ✔✔The nurse is assessing a client
who is 6 hours PP after delivering a full-term healthy infant. The client complains to the nurse of
feelings of faintness and dizziness. Which of the following nursing actions would be most
appropriate?
A) Obtain hemoglobin and hematocrit levels
B) Instruct the mother to request help when getting out of bed
C) Elevate the mother's legs
D) Inform the nursery room nurse to avoid bringing the newborn infant to the mother until the
feelings of lightheadedness and dizziness have subsided
C) Ask the mother to urinate and empty her bladder
Rationale: Before starting the fundal assessment, the nurse should ask the mother to empty her
bladder so that an accurate assessment can be done. When the nurse is performing fundal
assessment, the nurse asks the woman to lie flat on her back with the knees flexed. Massaging
the fundus is not appropriate unless the fundus is boggy and soft, and then it should be
massaged gently until firm. - ANS ✔✔A nurse is preparing to perform a fundal assessment on a
postpartum client. The initial nursing action in performing this assessment is which of the
following?
A) Ask the client to turn on her side
B) Ask the client to lie flat on her back with the knees and legs flat and straight
C) Ask the mother to urinate and empty her bladder
D) Massage the fundus gently before determining the level of the fundus.
, B) Indicates the presence of infection
Rationale: Lochia, the discharge present after birth, is red for the first 1 to 3 days and gradually
decreases in amount. Normal lochia has a fleshy odor. Foul smelling or purulent lochia usually
indicates infection, and these findings are not normal. Encouraging the woman to drink fluids or
increase ambulation is not an accurate nursing intervention - ANS ✔✔The nurse is assessing the
lochia on a 1 day PP patient. The nurse notes that the lochia is red and has a foul-smelling odor.
The nurse determines that this assessment finding is:
A) Normal
B) Indicates the presence of infection
C) Indicates the need for increasing oral fluids
D) Indicates the need for increasing ambulation
B) Notify the physician
Rationale: Normally, one may find a few small clots in the first 1 to 2 days after birth from
pooling of blood in the vagina. Clots larger than 1 cm are considered abnormal. The cause of
these clots, such as uterine atony or retained placental fragments, needs to be determined and
treated to prevent further blood loss. Although the findings would be documented, the most
appropriate action is to notify the physician. - ANS ✔✔When performing a PP assessment on a
client, the nurse notes the presence of clots in the lochia. The nurse examines the clots and
notes that they are larger than 1 cm. Which of the following nursing actions is most
appropriate?
A) Document the findings
B) Notify the physician
C) Reassess the client in 2 hours
D) Encourage increased intake of fluids
D) Eight peripads per day
answers 2025/2026 passed
B) Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
Rationale: Every 15 minutes during the first hour and then every 30 minutes for the next two
hours. - ANS ✔✔A postpartum nurse is preparing to care for a woman who has just delivered a
healthy newborn infant. In the immediate postpartum period the nurse plans to take the
woman's vital signs:
A) Every 30 minutes during the first hour and then every hour for the next two hours.
B) Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
C) Every hour for the first 2 hours and then every 4 hours
D) Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours.
D) Increase hydration by encouraging oral fluids
Rationale: The mother's temperature may be taken every 4 hours while she is awake.
Temperatures up to 100.4 (38 C) in the first 24 hours after birth are often related to the
dehydrating effects of labor. The most appropriate action is to increase hydration by
encouraging oral fluids, which should bring the temperature to a normal reading. Although the
nurse would document the findings, the most appropriate action would be to increase the
hydration. - ANS ✔✔A postpartum nurse is taking the vital signs of a woman who delivered a
healthy newborn infant 4 hours ago. The nurse notes that the mother's temperature is 100.2*F.
Which of the following actions would be most appropriate?
A) Retake the temperature in 15 minutes
B) Notify the physician
C) Document the findings
D) Increase hydration by encouraging oral fluids
,B) Instruct the mother to request help when getting out of bed
Rationale: Orthostatic hypotension may be evident during the first 8 hours after birth. Feelings
of faintness or dizziness are signs that should caution the nurse to be aware of the client's
safety. The nurse should advise the mother to get help the first few times the mother gets out
of bed. Obtaining an H/H requires a physicians order. - ANS ✔✔The nurse is assessing a client
who is 6 hours PP after delivering a full-term healthy infant. The client complains to the nurse of
feelings of faintness and dizziness. Which of the following nursing actions would be most
appropriate?
A) Obtain hemoglobin and hematocrit levels
B) Instruct the mother to request help when getting out of bed
C) Elevate the mother's legs
D) Inform the nursery room nurse to avoid bringing the newborn infant to the mother until the
feelings of lightheadedness and dizziness have subsided
C) Ask the mother to urinate and empty her bladder
Rationale: Before starting the fundal assessment, the nurse should ask the mother to empty her
bladder so that an accurate assessment can be done. When the nurse is performing fundal
assessment, the nurse asks the woman to lie flat on her back with the knees flexed. Massaging
the fundus is not appropriate unless the fundus is boggy and soft, and then it should be
massaged gently until firm. - ANS ✔✔A nurse is preparing to perform a fundal assessment on a
postpartum client. The initial nursing action in performing this assessment is which of the
following?
A) Ask the client to turn on her side
B) Ask the client to lie flat on her back with the knees and legs flat and straight
C) Ask the mother to urinate and empty her bladder
D) Massage the fundus gently before determining the level of the fundus.
, B) Indicates the presence of infection
Rationale: Lochia, the discharge present after birth, is red for the first 1 to 3 days and gradually
decreases in amount. Normal lochia has a fleshy odor. Foul smelling or purulent lochia usually
indicates infection, and these findings are not normal. Encouraging the woman to drink fluids or
increase ambulation is not an accurate nursing intervention - ANS ✔✔The nurse is assessing the
lochia on a 1 day PP patient. The nurse notes that the lochia is red and has a foul-smelling odor.
The nurse determines that this assessment finding is:
A) Normal
B) Indicates the presence of infection
C) Indicates the need for increasing oral fluids
D) Indicates the need for increasing ambulation
B) Notify the physician
Rationale: Normally, one may find a few small clots in the first 1 to 2 days after birth from
pooling of blood in the vagina. Clots larger than 1 cm are considered abnormal. The cause of
these clots, such as uterine atony or retained placental fragments, needs to be determined and
treated to prevent further blood loss. Although the findings would be documented, the most
appropriate action is to notify the physician. - ANS ✔✔When performing a PP assessment on a
client, the nurse notes the presence of clots in the lochia. The nurse examines the clots and
notes that they are larger than 1 cm. Which of the following nursing actions is most
appropriate?
A) Document the findings
B) Notify the physician
C) Reassess the client in 2 hours
D) Encourage increased intake of fluids
D) Eight peripads per day
