Final Maternal

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Sample questions from Final Maternal

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a postpartum unit, which client should the nurse assess first?

   • A.A client 2 days after birth asking for help with breastfeeding
   • B.A client 2 hours after birth with a boggy uterus and heavy lochia
   • C.A client 1 day after birth with a temperature of 37.8 C (100 F)
   • D.A client 12 hours after birth reporting perineal pain rated 6 of 10

   Rationale: A boggy uterus with heavy lochia suggests uterine atony and potentially life-threatening hemorrhage. Pain, a mildly elevated temperature, and breastfeeding assistance require attention but are less urgent without additional concerning findings. Prioritize the client with evidence of active blood loss.

2. 2.During a home visit, a public health nurse finds that a postpartum client has not filled a prescription for an antihypertensive because of cost. Which action is best?

   • A.Tell the client to take half the prescribed dose until the next appointment
   • B.Document the client's decision and end the visit
   • C.Notify the provider and help the client access an affordable prescription program
   • D.Advise the client to use a family member's medication

   Rationale: The nurse should address the financial barrier collaboratively and promptly, particularly because untreated postpartum hypertension can be dangerous. Changing the dose or using another person's medication is unsafe and outside the client's prescription. Documentation alone does not resolve the barrier.

3. 3.On a postpartum unit, a 29-year-old client has a history of postpartum hemorrhage and is receiving oxytocin after vaginal birth. Which tasks may the RN delegate to an experienced unlicensed assistive personnel (UAP)? Select all that apply.

   • A.Obtain and report the client's routine vital signs
   • B.Teach the client how to recognize postpartum hemorrhage
   • C.Measure and report the amount of urine in a collection hat
   • D.Assist the stable client to the bathroom after the RN assesses readiness
   • E.Assess uterine tone and determine whether it is boggy

   Rationale: Obtaining routine vital signs, assisting a client already assessed as safe to ambulate, and measuring urine are predictable tasks that may be delegated with direction. Assessing uterine tone requires nursing judgment, and teaching must be performed by the RN. The RN remains responsible for evaluating reported findings and responding to changes.

4. 4.A provider prescribes an epidural for a laboring client. The client is 5 cm dilated, has a blood pressure of 108/66 mm Hg, and has a reassuring fetal heart rate. Which action should the nurse take before the procedure?

   • A.Review the client's platelet count and administer the prescribed IV fluid bolus
   • B.Withhold all fluids until after the epidural is placed
   • C.Place the client supine and keep the position during insertion
   • D.Ask the UAP to obtain consent for the procedure

   Answer and rationale are in the full material.

5. 5.A primigravida at 39 weeks is fully dilated and has a strong urge to push. The fetal heart rate is 140/min with moderate variability. Which action is appropriate?

   • A.Administer a tocolytic to reduce contraction frequency
   • B.Delay pushing until the fetal head is visible at the perineum
   • C.Prepare the client for an emergency cesarean birth
   • D.Coach the client to push with contractions and support the chosen position

   Answer and rationale are in the full material.