NCLEX RN Postpartum Nursing
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A nurse assesses a client 2 hours after a vaginal birth. Which finding
requires immediate intervention?
A. Moderate lochia rubra
B. Fundus firm and midline
C. Boggy uterus with heavy vaginal bleeding
D. Mild perineal discomfort
Answer: Boggy uterus with heavy vaginal bleeding
Rationale: A boggy uterus indicates uterine atony, the most common cause of
early postpartum hemorrhage. Immediate fundal massage and further
interventions are required.
2. Which postpartum finding is expected during the first 24 hours after
delivery?
A. Lochia alba
B. Lochia rubra
C. Foul-smelling lochia
D. Absent uterine contractions
Answer: Lochia rubra
Rationale: Lochia rubra is the normal dark-red vaginal discharge occurring
during the first several days after birth.
3. A postpartum client's fundus is boggy and displaced to the right. What
should the nurse do first?
,A. Administer oxytocin
B. Encourage breastfeeding
C. Assist the client to empty her bladder
D. Place the client in Trendelenburg position
Answer: Assist the client to empty her bladder
Rationale: A full bladder can displace the uterus and interfere with uterine
contraction, increasing bleeding.
4. Which assessment finding is most concerning 12 hours after delivery?
A. Pulse 82/min
B. Temperature 37.2°C (99°F)
C. Saturating one perineal pad in 15 minutes
D. Mild uterine cramping
Answer: Saturating one perineal pad in 15 minutes
Rationale: Rapidly saturating a pad indicates excessive postpartum bleeding
and possible postpartum hemorrhage.
5. Which medication is commonly administered to promote uterine
contraction after postpartum hemorrhage?
A. Terbutaline
B. Oxytocin
C. Magnesium sulfate
D. Betamethasone
Answer: Oxytocin
Rationale: Oxytocin stimulates uterine contractions and is commonly used to
prevent or treat uterine atony and postpartum hemorrhage.
6. Which finding indicates that a postpartum client's uterus is involuting
normally?
A. Fundus rises progressively after birth
B. Fundus becomes smaller and descends approximately 1 cm daily
C. Fundus remains above the umbilicus for 1 week
D. Uterus becomes increasingly tender
,Answer: Fundus becomes smaller and descends approximately 1 cm daily
Rationale: Normal uterine involution causes the fundus to descend
approximately one fingerbreadth or 1 cm per day.
7. A postpartum client reports severe perineal pain that is not relieved by
prescribed analgesics. The nurse notes a tense, swollen area. Which
complication should the nurse suspect?
A. Hemorrhoids
B. Perineal hematoma
C. Normal lochia
D. Endometritis
Answer: Perineal hematoma
Rationale: Severe, disproportionate perineal pain with localized swelling
suggests a hematoma caused by concealed bleeding.
8. Which intervention is appropriate for a client with a first-degree perineal
laceration?
A. Apply an ice pack during the first 24 hours
B. Avoid sitting for 1 week
C. Restrict oral fluids
D. Apply heat continuously during the first 24 hours
Answer: Apply an ice pack during the first 24 hours
Rationale: Cold therapy decreases edema and discomfort during the initial
postpartum period.
9. Which lochia finding should the nurse report?
A. Dark red lochia on postpartum day 1
B. Pinkish-brown lochia on postpartum day 5
C. Whitish-yellow lochia several weeks after birth
D. Foul-smelling lochia with fever
Answer: Foul-smelling lochia with fever
Rationale: Foul-smelling lochia accompanied by fever suggests postpartum
uterine infection, such as endometritis.
, 10.A client asks why she experiences abdominal cramping while
breastfeeding. What is the best response?
A. “Breastfeeding causes bladder spasms.”
B. “Oxytocin released during breastfeeding causes the uterus to contract.”
C. “Your uterus is becoming infected.”
D. “This occurs because your milk supply is increasing.”
Answer: Oxytocin released during breastfeeding causes the uterus to
contract.
Rationale: Nipple stimulation promotes oxytocin release, which causes
uterine contractions and supports involution.
11.Which postpartum assessment is the priority immediately after a vaginal
birth?
A. Hair and skin condition
B. Fundal tone and vaginal bleeding
C. Appetite
D. Bowel sounds
Answer: Fundal tone and vaginal bleeding
Rationale: Assessment for uterine tone and excessive bleeding is essential
because postpartum hemorrhage can rapidly become life-threatening.
12.Which intervention helps prevent postpartum venous
thromboembolism?
A. Prolonged bed rest
B. Early ambulation
C. Limiting fluids
D. Massaging the calves vigorously
Answer: Early ambulation
Rationale: Early ambulation promotes venous circulation and reduces venous
stasis and thromboembolism risk.
13.A postpartum client has unilateral calf pain, warmth, and swelling. What
should the nurse do?
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A nurse assesses a client 2 hours after a vaginal birth. Which finding
requires immediate intervention?
A. Moderate lochia rubra
B. Fundus firm and midline
C. Boggy uterus with heavy vaginal bleeding
D. Mild perineal discomfort
Answer: Boggy uterus with heavy vaginal bleeding
Rationale: A boggy uterus indicates uterine atony, the most common cause of
early postpartum hemorrhage. Immediate fundal massage and further
interventions are required.
2. Which postpartum finding is expected during the first 24 hours after
delivery?
A. Lochia alba
B. Lochia rubra
C. Foul-smelling lochia
D. Absent uterine contractions
Answer: Lochia rubra
Rationale: Lochia rubra is the normal dark-red vaginal discharge occurring
during the first several days after birth.
3. A postpartum client's fundus is boggy and displaced to the right. What
should the nurse do first?
,A. Administer oxytocin
B. Encourage breastfeeding
C. Assist the client to empty her bladder
D. Place the client in Trendelenburg position
Answer: Assist the client to empty her bladder
Rationale: A full bladder can displace the uterus and interfere with uterine
contraction, increasing bleeding.
4. Which assessment finding is most concerning 12 hours after delivery?
A. Pulse 82/min
B. Temperature 37.2°C (99°F)
C. Saturating one perineal pad in 15 minutes
D. Mild uterine cramping
Answer: Saturating one perineal pad in 15 minutes
Rationale: Rapidly saturating a pad indicates excessive postpartum bleeding
and possible postpartum hemorrhage.
5. Which medication is commonly administered to promote uterine
contraction after postpartum hemorrhage?
A. Terbutaline
B. Oxytocin
C. Magnesium sulfate
D. Betamethasone
Answer: Oxytocin
Rationale: Oxytocin stimulates uterine contractions and is commonly used to
prevent or treat uterine atony and postpartum hemorrhage.
6. Which finding indicates that a postpartum client's uterus is involuting
normally?
A. Fundus rises progressively after birth
B. Fundus becomes smaller and descends approximately 1 cm daily
C. Fundus remains above the umbilicus for 1 week
D. Uterus becomes increasingly tender
,Answer: Fundus becomes smaller and descends approximately 1 cm daily
Rationale: Normal uterine involution causes the fundus to descend
approximately one fingerbreadth or 1 cm per day.
7. A postpartum client reports severe perineal pain that is not relieved by
prescribed analgesics. The nurse notes a tense, swollen area. Which
complication should the nurse suspect?
A. Hemorrhoids
B. Perineal hematoma
C. Normal lochia
D. Endometritis
Answer: Perineal hematoma
Rationale: Severe, disproportionate perineal pain with localized swelling
suggests a hematoma caused by concealed bleeding.
8. Which intervention is appropriate for a client with a first-degree perineal
laceration?
A. Apply an ice pack during the first 24 hours
B. Avoid sitting for 1 week
C. Restrict oral fluids
D. Apply heat continuously during the first 24 hours
Answer: Apply an ice pack during the first 24 hours
Rationale: Cold therapy decreases edema and discomfort during the initial
postpartum period.
9. Which lochia finding should the nurse report?
A. Dark red lochia on postpartum day 1
B. Pinkish-brown lochia on postpartum day 5
C. Whitish-yellow lochia several weeks after birth
D. Foul-smelling lochia with fever
Answer: Foul-smelling lochia with fever
Rationale: Foul-smelling lochia accompanied by fever suggests postpartum
uterine infection, such as endometritis.
, 10.A client asks why she experiences abdominal cramping while
breastfeeding. What is the best response?
A. “Breastfeeding causes bladder spasms.”
B. “Oxytocin released during breastfeeding causes the uterus to contract.”
C. “Your uterus is becoming infected.”
D. “This occurs because your milk supply is increasing.”
Answer: Oxytocin released during breastfeeding causes the uterus to
contract.
Rationale: Nipple stimulation promotes oxytocin release, which causes
uterine contractions and supports involution.
11.Which postpartum assessment is the priority immediately after a vaginal
birth?
A. Hair and skin condition
B. Fundal tone and vaginal bleeding
C. Appetite
D. Bowel sounds
Answer: Fundal tone and vaginal bleeding
Rationale: Assessment for uterine tone and excessive bleeding is essential
because postpartum hemorrhage can rapidly become life-threatening.
12.Which intervention helps prevent postpartum venous
thromboembolism?
A. Prolonged bed rest
B. Early ambulation
C. Limiting fluids
D. Massaging the calves vigorously
Answer: Early ambulation
Rationale: Early ambulation promotes venous circulation and reduces venous
stasis and thromboembolism risk.
13.A postpartum client has unilateral calf pain, warmth, and swelling. What
should the nurse do?
