Eve is 2 days postpartum. During palpation, where would you normally expect to find her fundus?
a. at the level of the umbilicus
b. 2 fingers below umbilicus
c. 5 fingers below umbilicus
d. non-palpable at this time
b. 2 fingers below umbilicus
Keisha delivered her third child about 24 ...
where would you normally expect to find her fundus
keisha delivered her third child about 24 hours ago she
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RNC-MNN Study Questions
Eve is 2 days postpartum. During palpation, where would you normally expect to find
her fundus?
a. at the level of the umbilicus
b. 2 fingers below umbilicus
c. 5 fingers below umbilicus
d. non-palpable at this time - Answer b. 2 fingers below umbilicus
Keisha delivered her third child about 24 hours ago. She begins to c/o severe uterine
cramping while breastfeeding. She is experiencing:
a. exfoliation of dead tissue
b. involution of uterus
c. shedding of the endometrium
d. after pains - Answer d. after pains
Three days after delivering her child, Gretchen calls the 24 hour hotline. She is crying
and states that her breasts suddenly became "bigger" and "really hurt." She is
experiencing:
a. colostrum production
b. a breast tumor
c. engorgement
d. overproduction of milk - Answer c. engorgement
Tiffany delivered via cesarean 2 days ago. She is frustrated by constant perspiration
and urination. This is likely the result of:
a. changes in urine pH and a possible UTI
b. drinking too much fluid in the early postpartum period
c. the body's removal of fluids accumulated during pregnancy
d. receiving excessive amounts of IV fluids during labor - Answer c. the body's removal
of fluids accumulated during pregnancy
While assessing Sierra, a 32yo mother of 3, you notice uterine bleeding and find that
her uterus is displayed upward and to the right. This is probably cause by:
a. retained placental fragments
b. rupture of the uterus
c. distention of the bladder
d. cervical bruising - Answer c. distention of the bladder
,Olga, a 38yo patient whom you administered the rubella vaccine, states that at her age
she plans to get pregnant right away. You tell her she should:
a. avoid pregnancy for at least 8 weeks after receiving the MMR vaccine
b. get pregnant ASAP because of her age
c. avoid getting pregnant for at least a year after receiving the MMR vaccine
d. abstain from sex for 2 weeks after delivery - Answer a. avoid pregnancy for at least 8
weeks after receiving the MMR vaccine
Joan is a 17yo and just delivered a healthy baby boy 6 hours ago. She talks on her cell
phone whenever you are in the room and refuses to touch or hold her baby, even when
he cries. You overhear Joan tell someone that the baby is "ugly like his father." Joan is
most likely experiencing:
a. exhaustion
b. mal-attachment
c. normal attachment
d. postpartum depression - Answer b. mal-attachment
Recommended advice for breastfeeding mothers include:
a. avoid the use of a sports bra
b. wash the nipples with soap and water after each feeding
c. apply a warm compress to ease nipple pain
d. "conditioning" the nipples by gently rubbing them with moist tea bags - Answer c.
apply a warm compress to ease nipple pain
Samantha read in the discharge booklet that postpartum patients are at risk for
thrombophlebitis, and she asks you how she can prevent this from happening. You
instruct her to:
a. remain on strict bedrest
b. ambulate frequently
c. cross her legs while sitting
d. avoid elevating her legs - Answer b. ambulate frequently
Suzanne delivered vaginally 8 hours ago. She has uterine cramping and rates her pain
a "9" but refuses pain medication. What is your best response regarding her pain?
a. tell her she should take the ibuprofen as prescribed by her MD
b. encourage her to fight the pain because it will make her stronger
c. ask her to use the call button if she changes her mind about taking pain medication
d. offer her a non-drug option such as a hot pack or massage - Answer d. offer her a
non-drug option such as a hot pack or massage
,Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She reports she is
"bleeding a lot" and her perineal pad, changed 45 minutes ago, is fully saturated.
Palpation reveals a boggy uterus. Your first intervention is:
a. start IV fluids
b. place a catheter
c. massage her uterus until firm
d. call the MD - Answer c. massage her uterus until firm
Mei experienced premature rupture of membranes during her pregnancy and her
internal fetal monitors placed during labor. She later delivered by cesarean. 12 hours
after delivery, her HR is 104 and her lochia smells foul. You suspect:
a. endometriosis
b. mastitis
c. uterine cancer
d. endometritis - Answer d. endometritis
You are preparing to discharge Maria after delivering a healthy boy. You believe Maria
understands the discharge teaching instructions when she states:
a. it is acceptable to have bleeding nipples after breastfeeding for the first few days
b. I should not worry if I have a large mass under my breasts
c. I will call my nurse-midwife if I saturate a pad in one hour
d. suicidal thoughts are okay because the baby blues are normal - Answer c. I will call
my nurse-midwife if I saturate a pad in one hour
An infant born to a mother who abused drugs during pregnancy exhibited withdrawal
signs in the nursery that included fever and poor state control. After stabilization and
discharge, the caretaker called to report a return of withdrawal symptoms. This pattern
is consistent with maternal abuse of:
a. alcohol
b. cocaine
c. methadone - Answer b. cocaine
Leukocytosis that occurs in normal postpartum adaptation can be differentiated from an
infectious process by the presence of:
a. a 30% increase in WBC count in a 6 hour period
b. a concominant increase in the sedimentation rate
c. any elevation in temperature - Answer b. a concominant increase in the
sedimentation rate
Tachypnea, tachycardia, and poor feeding in a 12 hour old neonate, born to a mother
with diabetes mellitus, would be more consistent with the onset of:
, a. congestive heart failure
b. hypoglycemia
c. respiratory distress syndrome - Answer b. hypoglycemia
A postpartum woman has a BP of 150/92 at 6 hours. Later, the BP is 148/90. This
finding most likely:
a. diminished venous return
b. reflects postpartum peak in cardiac output
c. requires evaluation for postpartum preeclampsia - Answer c. requires evaluation for
postpartum preeclampsia
The let down reflex in the breastfeeding woman is responsible for
a. movement of the milk from ducts to the nipple
b. regulation of milk release to ensure milk is available at any given time
c. release of the milk to the alveoli - Answer a. movement of the milk from ducts to the
nipple
A woman plans not to breastfeed and asks about how to suppress lactation. She should
be advised that:
a. mechanical suppression occurs with the use of a supportive bra
b. medications can be prescribes to stop lactation
c. physiologically, lactation will not proceed without breastfeeding and no intervention is
needed - Answer a. mechanical suppression occurs with the use of a supportive bra
Spinal blockade occurring with epidural anesthesia results in
a. hypotension
b. tachycardia
c. vertigo - Answer a. hypotension
Synthesis of vitamin K in the neonate is dependent upon the presence of
a. amino acids derived from human or formula proteins
b. appropriate bacteria in the GI tract
c. passively acquired maternal antibodies - Answer b. appropriate bacteria in the GI
tract
A woman with a history of breast augmentation asks if she will be able to breastfeed her
baby. The factor that will most influence her ability to breastfeed is
a. time interval since the surgery
b. type of implant
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