,NSG 3500 Exam 3 Nursing Practice – Maternal Health Questions And
Answers 2026/2027 Galen College
Q1. Which physiologic change normally occurs immediately after
delivery of the placenta?
A) The uterus becomes soft and enlarged.
B) The uterus contracts and becomes firm.
C) Maternal blood volume immediately returns to prepregnancy level.
D) Cardiac output immediately decreases below baseline.
Correct Answer: B) The uterus contracts and becomes firm
Rationale: Following placental delivery, uterine contraction compresses
maternal blood vessels at the placental site and helps control bleeding.
Q2. Which assessment finding indicates normal uterine involution
during the early postpartum period?
A) A firm fundus that gradually descends
B) A progressively rising fundus
C) A boggy fundus that remains deviated
D) A uterus that remains larger each day
Correct Answer: A) A firm fundus that gradually descends
Rationale: After birth, the uterus contracts and progressively decreases in
size as it returns toward the nonpregnant state.
Q3. On postpartum assessment, the fundus is boggy. Which nursing
action is most appropriate initially?
A) Place the patient in Trendelenburg position.
B) Massage the fundus while assessing bleeding.
C) Encourage the patient to ambulate immediately.
D) Apply a heating pad to the abdomen.
Correct Answer: B) Massage the fundus while assessing bleeding.
Rationale: A boggy uterus is poorly contracted and may cause excessive
bleeding. Fundal massage promotes contraction while the nurse evaluates
the amount of blood loss.
Q4. A postpartum patient's fundus is firm but displaced to the right
of midline. Which condition should the nurse suspect?
,A) A full bladder
B) Uterine inversion
C) Placental abruption
D) Normal involution
Correct Answer: A) A full bladder
Rationale: A distended bladder can displace the uterus from the midline
and interfere with effective uterine contraction.
Q5. Which postpartum finding should the nurse report promptly?
A) Fundus becoming smaller each day
B) Mild uterine cramping during breastfeeding
C) Fundus becoming softer and higher rather than descending
D) Mild fatigue
Correct Answer: C) Fundus becoming softer and higher rather than
descending
Rationale: A soft or rising fundus can indicate subinvolution or poor uterine
contraction and may be associated with excessive bleeding.
Q6. Which hormone contributes to postpartum uterine contraction
during breastfeeding?
A) Estrogen
B) Oxytocin
C) FSH
D) hCG
Correct Answer: B) Oxytocin
Rationale: Suckling stimulates oxytocin release, which causes uterine
contractions and promotes involution.
Q7. Which finding is expected in a postpartum patient during the
first few days?
A) Lochia rubra
B) Lochia alba only
C) Complete absence of vaginal discharge
D) Bright-red bleeding that becomes progressively heavier
Correct Answer: A) Lochia rubra
, Rationale: Lochia rubra is the normal dark or bright-red postpartum
discharge during the early days after birth and contains blood and decidual
tissue.
Q8. Which change in lochia is expected as postpartum healing
progresses?
A) Rubra → serosa → alba
B) Alba → rubra → serosa
C) Serosa → rubra → alba
D) Rubra → alba → serosa
Correct Answer: A) Rubra → serosa → alba
Rationale: Normal lochia changes from red and blood-tinged to pink/brown
and then yellow-white as the uterus heals.
Q9. Which lochia finding is most concerning several days after birth?
A) Small amounts of serosa
B) Lochia gradually becoming lighter
C) Return to persistent heavy bright-red bleeding
D) Decreasing amount of discharge
Correct Answer: C) Return to persistent heavy bright-red bleeding
Rationale: Persistent or renewed heavy bright-red bleeding can indicate
abnormal postpartum bleeding and requires evaluation.
Q10. Which postpartum change is expected as estrogen and
progesterone levels fall?
A) Increased breast tenderness only
B) Initiation of lactation
C) Immediate return to ovulation in every patient
D) Permanent suppression of prolactin
Correct Answer: B) Initiation of lactation
Rationale: The sharp decline in placental estrogen and progesterone after
delivery allows prolactin to stimulate milk production.
Q11. Which breast secretion is produced during the first days after
birth?
A) Mature milk only
B) Colostrum
Answers 2026/2027 Galen College
Q1. Which physiologic change normally occurs immediately after
delivery of the placenta?
A) The uterus becomes soft and enlarged.
B) The uterus contracts and becomes firm.
C) Maternal blood volume immediately returns to prepregnancy level.
D) Cardiac output immediately decreases below baseline.
Correct Answer: B) The uterus contracts and becomes firm
Rationale: Following placental delivery, uterine contraction compresses
maternal blood vessels at the placental site and helps control bleeding.
Q2. Which assessment finding indicates normal uterine involution
during the early postpartum period?
A) A firm fundus that gradually descends
B) A progressively rising fundus
C) A boggy fundus that remains deviated
D) A uterus that remains larger each day
Correct Answer: A) A firm fundus that gradually descends
Rationale: After birth, the uterus contracts and progressively decreases in
size as it returns toward the nonpregnant state.
Q3. On postpartum assessment, the fundus is boggy. Which nursing
action is most appropriate initially?
A) Place the patient in Trendelenburg position.
B) Massage the fundus while assessing bleeding.
C) Encourage the patient to ambulate immediately.
D) Apply a heating pad to the abdomen.
Correct Answer: B) Massage the fundus while assessing bleeding.
Rationale: A boggy uterus is poorly contracted and may cause excessive
bleeding. Fundal massage promotes contraction while the nurse evaluates
the amount of blood loss.
Q4. A postpartum patient's fundus is firm but displaced to the right
of midline. Which condition should the nurse suspect?
,A) A full bladder
B) Uterine inversion
C) Placental abruption
D) Normal involution
Correct Answer: A) A full bladder
Rationale: A distended bladder can displace the uterus from the midline
and interfere with effective uterine contraction.
Q5. Which postpartum finding should the nurse report promptly?
A) Fundus becoming smaller each day
B) Mild uterine cramping during breastfeeding
C) Fundus becoming softer and higher rather than descending
D) Mild fatigue
Correct Answer: C) Fundus becoming softer and higher rather than
descending
Rationale: A soft or rising fundus can indicate subinvolution or poor uterine
contraction and may be associated with excessive bleeding.
Q6. Which hormone contributes to postpartum uterine contraction
during breastfeeding?
A) Estrogen
B) Oxytocin
C) FSH
D) hCG
Correct Answer: B) Oxytocin
Rationale: Suckling stimulates oxytocin release, which causes uterine
contractions and promotes involution.
Q7. Which finding is expected in a postpartum patient during the
first few days?
A) Lochia rubra
B) Lochia alba only
C) Complete absence of vaginal discharge
D) Bright-red bleeding that becomes progressively heavier
Correct Answer: A) Lochia rubra
, Rationale: Lochia rubra is the normal dark or bright-red postpartum
discharge during the early days after birth and contains blood and decidual
tissue.
Q8. Which change in lochia is expected as postpartum healing
progresses?
A) Rubra → serosa → alba
B) Alba → rubra → serosa
C) Serosa → rubra → alba
D) Rubra → alba → serosa
Correct Answer: A) Rubra → serosa → alba
Rationale: Normal lochia changes from red and blood-tinged to pink/brown
and then yellow-white as the uterus heals.
Q9. Which lochia finding is most concerning several days after birth?
A) Small amounts of serosa
B) Lochia gradually becoming lighter
C) Return to persistent heavy bright-red bleeding
D) Decreasing amount of discharge
Correct Answer: C) Return to persistent heavy bright-red bleeding
Rationale: Persistent or renewed heavy bright-red bleeding can indicate
abnormal postpartum bleeding and requires evaluation.
Q10. Which postpartum change is expected as estrogen and
progesterone levels fall?
A) Increased breast tenderness only
B) Initiation of lactation
C) Immediate return to ovulation in every patient
D) Permanent suppression of prolactin
Correct Answer: B) Initiation of lactation
Rationale: The sharp decline in placental estrogen and progesterone after
delivery allows prolactin to stimulate milk production.
Q11. Which breast secretion is produced during the first days after
birth?
A) Mature milk only
B) Colostrum
