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HESI Obstestrics And Maternity
Case Study 2025-2026
Medical-Surgical Nursing, (Harvard University)
HESI
Obstetr ics/Mater nity
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Casestu dy
(NGN-Style & Case Scenario)
Below Is A :
Set
Of Structured Questions Aligned With The NCLEX
Next-Generation (NGN) Style, Complete With
Scenarios, Vital Signs, Questions, Answer Choices,
Correct Answers, And Expert Rationales
### Scenario 1
Scenario: Fifteen Minutes After The Initial Assessment, The
Nurse Finds The Client Disoriented And Lying On Her Back In A
Pool Of Vaginal Blood, With The Sheets Beneath Her Saturated
With Blood.
Vital Signs:
- Blood Pressure: 90/50 Mmhg
- Heart Rate: 120 Bpm
Question: Which Action Is Most Important For The Nurse
To Implement Immediately?
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Answer Choices:
a. Take Vital Signs.
b. Massage The Fundus.
c. Check The Bladder.
d. Increase The IV Rate.
ANSWER:B. Massage The Fundus.
Expert Rationale:
A Boggy Fundus Is A Common Cause Of Postpartum
Hemorrhage.
Immediate Fundal Massage Is Crucial To Stimulate Uterine
Contraction And Mitigate The Risk Of Significant Blood Loss. The
Nurse Should Also Call For Assistance Given The Severity Of The
Situation.
### Scenario 2
Scenario: A Nurse Performs The First Assessment Upon The
Client's Arrival To The Postpartum Unit.
Question: Where Would The Nurse Expect To Palpate The
Fundus?
Answer Choices:
a. 3 Cm Above The Umbilicus.
b. 1 Cm Above The Umbilicus.
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c. To The Right Of The Umbilicus.
d. Midway Between The Umbilicus And The Pubic Bone.
B. ANSWER:1 Cm Above The Umbilicus.
Expert Rationale:
Within The First 12 Hours Postpartum, The Fundus Should Be In
The Range Of 1- 2 Cm Above The Umbilicus. This Indicates That
The Uterus Is Contracting Properly And Is Returning To Its
Normal Size.
### Scenario 3
Scenario: A Postpartum Client Is Hemorrhaging And The Nurse
Suspects A Common Cause.
Question: What Is The Most Likely Reason A Postpartum
Patient Would Be Hemorrhaging
?
ANSWER:Uterine Atony (A "Boggy" Fundus).
Expert Rationale:
Uterine Atony Is The Inability Of The Uterus To Contract
Effectively, Which Is A Leading Cause Of Postpartum
Downloaded by NELSON KIIRU ()
Lomoarcpsd|26582732
HESI Obstestrics And Maternity
Case Study 2025-2026
Medical-Surgical Nursing, (Harvard University)
HESI
Obstetr ics/Mater nity
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Casestu dy
(NGN-Style & Case Scenario)
Below Is A :
Set
Of Structured Questions Aligned With The NCLEX
Next-Generation (NGN) Style, Complete With
Scenarios, Vital Signs, Questions, Answer Choices,
Correct Answers, And Expert Rationales
### Scenario 1
Scenario: Fifteen Minutes After The Initial Assessment, The
Nurse Finds The Client Disoriented And Lying On Her Back In A
Pool Of Vaginal Blood, With The Sheets Beneath Her Saturated
With Blood.
Vital Signs:
- Blood Pressure: 90/50 Mmhg
- Heart Rate: 120 Bpm
Question: Which Action Is Most Important For The Nurse
To Implement Immediately?
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, lOMoARcPSD|26582732
Answer Choices:
a. Take Vital Signs.
b. Massage The Fundus.
c. Check The Bladder.
d. Increase The IV Rate.
ANSWER:B. Massage The Fundus.
Expert Rationale:
A Boggy Fundus Is A Common Cause Of Postpartum
Hemorrhage.
Immediate Fundal Massage Is Crucial To Stimulate Uterine
Contraction And Mitigate The Risk Of Significant Blood Loss. The
Nurse Should Also Call For Assistance Given The Severity Of The
Situation.
### Scenario 2
Scenario: A Nurse Performs The First Assessment Upon The
Client's Arrival To The Postpartum Unit.
Question: Where Would The Nurse Expect To Palpate The
Fundus?
Answer Choices:
a. 3 Cm Above The Umbilicus.
b. 1 Cm Above The Umbilicus.
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c. To The Right Of The Umbilicus.
d. Midway Between The Umbilicus And The Pubic Bone.
B. ANSWER:1 Cm Above The Umbilicus.
Expert Rationale:
Within The First 12 Hours Postpartum, The Fundus Should Be In
The Range Of 1- 2 Cm Above The Umbilicus. This Indicates That
The Uterus Is Contracting Properly And Is Returning To Its
Normal Size.
### Scenario 3
Scenario: A Postpartum Client Is Hemorrhaging And The Nurse
Suspects A Common Cause.
Question: What Is The Most Likely Reason A Postpartum
Patient Would Be Hemorrhaging
?
ANSWER:Uterine Atony (A "Boggy" Fundus).
Expert Rationale:
Uterine Atony Is The Inability Of The Uterus To Contract
Effectively, Which Is A Leading Cause Of Postpartum
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