MIDTERM Exam : NUR2513/ NUR 2513
(Latest 2025/ 2026) Maternal-Child
Nursing Exam | Questions and Verified
Answers| Graded A - Rasmussen
The perinatal nurse's assessment while caring for a woman in the immediate post
birth period reveals that the woman is experiencing profuse bleeding. What is the
most likely etiology for her bleeding?
a. Uterine atony
b. Uterine inversion
c. Vaginal hematoma
d. Vaginal laceration - ANSWER ANS: A
Uterine atony is marked hypotonia of the uterus. It is the leading cause of
postpartum hemorrhage. Uterine inversion may lead to hemorrhage but it is not the
most likely source of this woman's bleeding. Furthermore if the woman were
experiencing a uterine inversion it would be evidenced by the presence of a large
red rounded mass protruding from the introitus. A vaginal hematoma may be
associated with hemorrhage. However the most likely clinical finding would be
pain not the presence of profuse bleeding. A vaginal laceration may cause
hemorrhage but it is more likely that profuse bleeding would result from uterine
atony. A vaginal laceration should be suspected if vaginal bleeding continues in the
presence of a firm contracted uterine fundus.
Which is a primary nursing responsibility when caring for a woman experiencing
an obstetrical hemorrhage associated with uterine atony?
a. Establish venous access.
b. Perform fundal massage.
c. Prepare the woman for surgical intervention.
d. Catheterize the bladder. - ANSWER ANS: B
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although establishing venous access may be a necessary
,intervention the initial intervention would be fundal massage. The woman may
need surgical intervention to treat her postpartum hemorrhage but the initial
nursing intervention would be to assess the uterus. After uterine massage the nurse
may want to catheterize the patient to eliminate any bladder distension that may be
preventing the uterus from contracting properly.
Which is the most likely cause of late postpartum hemorrhage (PPH)?
a. Subinvolution of the placental site
b. Defective vascularity of the decidua
c. Cervical lacerations
d. Coagulation disorders - ANSWER ANS: A
Late PPH may be the result of subinvolution of the uterus pelvic infection or
retained placental fragments. Late PPH is not typically a result of defective
vascularity of the decidua cervical lacerations or coagulation disorders.
What woman is at greatest risk for early postpartum hemorrhage (PPH)?
a. A primiparous woman being prepared for an emergency Caesarean birth for fetal
distress
b. A woman with severe pre-eclampsia on magnesium sulphate whose labour is
being induced
c. A multiparous woman with an 8-hour labour
d. A primigravida in spontaneous labour with preterm twins - ANSWER
ANS: B
Magnesium sulphate administration during labour poses a risk for PPH.
Magnesium acts as a smooth muscle relaxant thereby contributing to uterine
relaxation and atony. Although many causes and risk factors are associated with
PPH the primiparous woman being prepared for an emergency Caesarian birth the
multiparous woman with 8-hour labour and the primigravida in spontaneous labour
are not at risk for early PPH.
,What is the initial priority nursing intervention when a nurse observes profuse
postpartum bleeding?
a. Call the woman's primary health care provider.
b. Administer the standing order for an oxytocic.
c. Palpate the uterus and massage it if it is boggy.
d. Assess maternal blood pressure (BP) and pulse for signs of hypovolemic shock.
- ANSWER ANS: C
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although calling the health care provider administering an oxytocic
and assessing maternal BP are appropriate interventions the primary intervention
should be to assess the uterus. Uterine atony is the leading cause of postpartum
hemorrhage.
What is the most objective and least invasive assessment of adequate organ
perfusion and oxygenation when caring for a postpartum woman experiencing
hemorrhagic shock?
a. Absence of cyanosis in the buccal mucosa
b. Cool dry skin
c. Diminished restlessness
d. Urinary output of at least 30 mL/hr - ANSWER ANS: D
Hemorrhage may result in hemorrhagic shock. Shock is an emergency situation in
which the perfusion of body organs may become severely compromised and death
may occur. The presence of adequate urinary output indicates adequate tissue
perfusion. The assessment of the buccal mucosa for cyanosis can be subjective in
nature. The presence of cool pale clammy skin would be an indicative finding
associated with hemorrhagic shock. Hemorrhagic shock is associated with lethargy
not restlessness.
Which is one of the first symptoms of puerperal infection to assess for in the
postpartum woman?
, a. Fatigue continuing for longer than 1 week
b. Pain with voiding
c. Profuse vaginal bleeding with ambulation
d. Temperature of 38.6° C - ANSWER ANS: D
Postpartum or puerperal infection is any clinical infection of the genital canal that
occurs within 28 days after miscarriage induced abortion or childbirth. A
temperature greater than 38° C warrants further investigation for a puerperal
infection. Fatigue would be a late finding associated with infection. Pain with
voiding may indicate a urinary tract infection but it is not typically one of the
earlier symptoms of infection. Profuse lochia may be associated with endometritis
but it is not the first symptom associated with infection.
The perinatal nurse assisting with establishing lactation is aware that which action
can minimize acute mastitis?
a. Washing the nipples and breasts with mild soap and water once a day
b. Using proper breastfeeding techniques
c. Wearing a nipple shield for the first few days of breastfeeding
d. Wearing a supportive bra 24 hours a day - ANSWER ANS:
B
Almost all instances of acute mastitis can be avoided by using proper breastfeeding
technique to prevent cracked nipples. Washing the nipples and breasts daily is no
longer indicated. In fact this can cause tissue dryness and irritation which can lead
to tissue breakdown and infection. Wearing a nipple shield does not prevent
mastitis. Wearing a supportive bra 24 hours a day may contribute to mastitis
especially if an underwire bra is worn because it may put pressure on the upper
outer area of the breast contributing to blocked ducts and mastitis.
Which statement is true with regard to postpartum hemorrhage (PPH)?
a. PPH is easy to recognize early after all the woman is bleeding.
b. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500
mL after Caesarean birth to define the condition as PPH.
c. If anything nurses and doctors tend to overestimate the amount of blood loss.
(Latest 2025/ 2026) Maternal-Child
Nursing Exam | Questions and Verified
Answers| Graded A - Rasmussen
The perinatal nurse's assessment while caring for a woman in the immediate post
birth period reveals that the woman is experiencing profuse bleeding. What is the
most likely etiology for her bleeding?
a. Uterine atony
b. Uterine inversion
c. Vaginal hematoma
d. Vaginal laceration - ANSWER ANS: A
Uterine atony is marked hypotonia of the uterus. It is the leading cause of
postpartum hemorrhage. Uterine inversion may lead to hemorrhage but it is not the
most likely source of this woman's bleeding. Furthermore if the woman were
experiencing a uterine inversion it would be evidenced by the presence of a large
red rounded mass protruding from the introitus. A vaginal hematoma may be
associated with hemorrhage. However the most likely clinical finding would be
pain not the presence of profuse bleeding. A vaginal laceration may cause
hemorrhage but it is more likely that profuse bleeding would result from uterine
atony. A vaginal laceration should be suspected if vaginal bleeding continues in the
presence of a firm contracted uterine fundus.
Which is a primary nursing responsibility when caring for a woman experiencing
an obstetrical hemorrhage associated with uterine atony?
a. Establish venous access.
b. Perform fundal massage.
c. Prepare the woman for surgical intervention.
d. Catheterize the bladder. - ANSWER ANS: B
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although establishing venous access may be a necessary
,intervention the initial intervention would be fundal massage. The woman may
need surgical intervention to treat her postpartum hemorrhage but the initial
nursing intervention would be to assess the uterus. After uterine massage the nurse
may want to catheterize the patient to eliminate any bladder distension that may be
preventing the uterus from contracting properly.
Which is the most likely cause of late postpartum hemorrhage (PPH)?
a. Subinvolution of the placental site
b. Defective vascularity of the decidua
c. Cervical lacerations
d. Coagulation disorders - ANSWER ANS: A
Late PPH may be the result of subinvolution of the uterus pelvic infection or
retained placental fragments. Late PPH is not typically a result of defective
vascularity of the decidua cervical lacerations or coagulation disorders.
What woman is at greatest risk for early postpartum hemorrhage (PPH)?
a. A primiparous woman being prepared for an emergency Caesarean birth for fetal
distress
b. A woman with severe pre-eclampsia on magnesium sulphate whose labour is
being induced
c. A multiparous woman with an 8-hour labour
d. A primigravida in spontaneous labour with preterm twins - ANSWER
ANS: B
Magnesium sulphate administration during labour poses a risk for PPH.
Magnesium acts as a smooth muscle relaxant thereby contributing to uterine
relaxation and atony. Although many causes and risk factors are associated with
PPH the primiparous woman being prepared for an emergency Caesarian birth the
multiparous woman with 8-hour labour and the primigravida in spontaneous labour
are not at risk for early PPH.
,What is the initial priority nursing intervention when a nurse observes profuse
postpartum bleeding?
a. Call the woman's primary health care provider.
b. Administer the standing order for an oxytocic.
c. Palpate the uterus and massage it if it is boggy.
d. Assess maternal blood pressure (BP) and pulse for signs of hypovolemic shock.
- ANSWER ANS: C
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although calling the health care provider administering an oxytocic
and assessing maternal BP are appropriate interventions the primary intervention
should be to assess the uterus. Uterine atony is the leading cause of postpartum
hemorrhage.
What is the most objective and least invasive assessment of adequate organ
perfusion and oxygenation when caring for a postpartum woman experiencing
hemorrhagic shock?
a. Absence of cyanosis in the buccal mucosa
b. Cool dry skin
c. Diminished restlessness
d. Urinary output of at least 30 mL/hr - ANSWER ANS: D
Hemorrhage may result in hemorrhagic shock. Shock is an emergency situation in
which the perfusion of body organs may become severely compromised and death
may occur. The presence of adequate urinary output indicates adequate tissue
perfusion. The assessment of the buccal mucosa for cyanosis can be subjective in
nature. The presence of cool pale clammy skin would be an indicative finding
associated with hemorrhagic shock. Hemorrhagic shock is associated with lethargy
not restlessness.
Which is one of the first symptoms of puerperal infection to assess for in the
postpartum woman?
, a. Fatigue continuing for longer than 1 week
b. Pain with voiding
c. Profuse vaginal bleeding with ambulation
d. Temperature of 38.6° C - ANSWER ANS: D
Postpartum or puerperal infection is any clinical infection of the genital canal that
occurs within 28 days after miscarriage induced abortion or childbirth. A
temperature greater than 38° C warrants further investigation for a puerperal
infection. Fatigue would be a late finding associated with infection. Pain with
voiding may indicate a urinary tract infection but it is not typically one of the
earlier symptoms of infection. Profuse lochia may be associated with endometritis
but it is not the first symptom associated with infection.
The perinatal nurse assisting with establishing lactation is aware that which action
can minimize acute mastitis?
a. Washing the nipples and breasts with mild soap and water once a day
b. Using proper breastfeeding techniques
c. Wearing a nipple shield for the first few days of breastfeeding
d. Wearing a supportive bra 24 hours a day - ANSWER ANS:
B
Almost all instances of acute mastitis can be avoided by using proper breastfeeding
technique to prevent cracked nipples. Washing the nipples and breasts daily is no
longer indicated. In fact this can cause tissue dryness and irritation which can lead
to tissue breakdown and infection. Wearing a nipple shield does not prevent
mastitis. Wearing a supportive bra 24 hours a day may contribute to mastitis
especially if an underwire bra is worn because it may put pressure on the upper
outer area of the breast contributing to blocked ducts and mastitis.
Which statement is true with regard to postpartum hemorrhage (PPH)?
a. PPH is easy to recognize early after all the woman is bleeding.
b. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500
mL after Caesarean birth to define the condition as PPH.
c. If anything nurses and doctors tend to overestimate the amount of blood loss.
