Chapter 21: Nursing Care of the Family During the
Postpartum Period – Lowdermilk Exam Questions and
Rationales Graded A+ Latest Updated 2026
1. A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care
provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a
stool softener. Which information regarding the clients condition is most closely correlated with
these orders?
a. Woman is a gravida 2, para 2.
b.Woman had a vacuum-assisted birth.
c.Woman received epidural anesthesia.
d.Woman has an episiotomy.
ANS: D
These orders are typical interventions for a woman who has had an episiotomy, lacerations, and
hemorrhoids. A multiparous classification is not an indication for these orders. A vacuum-
assisted birth may be used in conjunction with an episiotomy, which would indicate these
interventions. The use of an epidural anesthesia has no correlation with these orders.
2. The laboratory results for a postpartum woman are as follows: blood type, A; Rh status,
positive; rubella titer, 1:8 (enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the
nurse best interpret these data?
a.Rubella vaccine should be administered.
b.Blood transfusion is necessary.
c.Rh immune globulin is necessary within 72 hours of childbirth.
d. Kleihauer-Betke test should be performed.
ANS: A
This clients rubella titer indicates that she is not immune and needs to receive a vaccine. These
data do not indicate that the client needs a blood transfusion. Rh immune globulin is indicated
only if the client has an Rh-negative status and the infant has an Rh-positive status. A Kleihauer-
Betke test should be performed if a large fetomaternal transfusion is suspected, especially if the
mother is Rh negative. However, the data provided do not indicate a need for performing this
test.
, 3. A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed.
During the assessment, the nurse notices that both breasts are swollen, warm, and tender on
palpation. Which guidance should the nurse provide to the client at this time?
a. Run warm water on her breasts during a shower.
b. Apply ice to the breasts for comfort.
c. Express small amounts of milk from the breasts to relieve the pressure.
d. Wearing a loose-fitting bra to prevent nipple irritation.
ANS: B
Applying ice packs and cabbage leaves to the breasts for comfort is an appropriate intervention
for treating engorgement in a mother who is bottle feeding. The ice packs should be applied for
15 minutes on and 45 minutes off to avoid rebound engorgement. A bottle-feeding mother
should avoid any breast stimulation, including pumping or expressing milk. A bottle-feeding
mother should continuously wear a well-fitted support bra or breast binder for at least the first
72 hours after giving birth. A loose-fitting bra will not aid lactation suppression. Furthermore,
the shifting of the bra against the breasts may stimulate the nipples and thereby stimulate
lactation.
4. A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband
brings a large container of brown seaweed soup to the hospital. When the nurse enters the
room, the husband asks for help with warming the soup so that his wife can eat it. What is the
nurses most appropriate response?
a. Didnt you like your lunch?
b. Does your physician know that you are planning to eat that?
c. What is that anyway?
d. I'll warm the soup in the microwave for you.
ANS: D
Offering to warm the food shows cultural sensitivity to the dietary preferences of the woman
and is the most appropriate response. Cultural dietary preferences must be respected. Women
may request that family members bring favorite or culturally appropriate foods to the hospital.
Asking the woman to identify her food does not show cultural sensitivity.
5. A primiparous woman is to be discharged from the hospital the following day with her infant
girl. Which behavior indicates a need for further intervention by the nurse before the woman
can be discharged?
Postpartum Period – Lowdermilk Exam Questions and
Rationales Graded A+ Latest Updated 2026
1. A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care
provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a
stool softener. Which information regarding the clients condition is most closely correlated with
these orders?
a. Woman is a gravida 2, para 2.
b.Woman had a vacuum-assisted birth.
c.Woman received epidural anesthesia.
d.Woman has an episiotomy.
ANS: D
These orders are typical interventions for a woman who has had an episiotomy, lacerations, and
hemorrhoids. A multiparous classification is not an indication for these orders. A vacuum-
assisted birth may be used in conjunction with an episiotomy, which would indicate these
interventions. The use of an epidural anesthesia has no correlation with these orders.
2. The laboratory results for a postpartum woman are as follows: blood type, A; Rh status,
positive; rubella titer, 1:8 (enzyme immunoassay [EIA] 0.8); hematocrit, 30%. How should the
nurse best interpret these data?
a.Rubella vaccine should be administered.
b.Blood transfusion is necessary.
c.Rh immune globulin is necessary within 72 hours of childbirth.
d. Kleihauer-Betke test should be performed.
ANS: A
This clients rubella titer indicates that she is not immune and needs to receive a vaccine. These
data do not indicate that the client needs a blood transfusion. Rh immune globulin is indicated
only if the client has an Rh-negative status and the infant has an Rh-positive status. A Kleihauer-
Betke test should be performed if a large fetomaternal transfusion is suspected, especially if the
mother is Rh negative. However, the data provided do not indicate a need for performing this
test.
, 3. A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed.
During the assessment, the nurse notices that both breasts are swollen, warm, and tender on
palpation. Which guidance should the nurse provide to the client at this time?
a. Run warm water on her breasts during a shower.
b. Apply ice to the breasts for comfort.
c. Express small amounts of milk from the breasts to relieve the pressure.
d. Wearing a loose-fitting bra to prevent nipple irritation.
ANS: B
Applying ice packs and cabbage leaves to the breasts for comfort is an appropriate intervention
for treating engorgement in a mother who is bottle feeding. The ice packs should be applied for
15 minutes on and 45 minutes off to avoid rebound engorgement. A bottle-feeding mother
should avoid any breast stimulation, including pumping or expressing milk. A bottle-feeding
mother should continuously wear a well-fitted support bra or breast binder for at least the first
72 hours after giving birth. A loose-fitting bra will not aid lactation suppression. Furthermore,
the shifting of the bra against the breasts may stimulate the nipples and thereby stimulate
lactation.
4. A 25-year-old multiparous woman gave birth to an infant boy 1 day ago. Today her husband
brings a large container of brown seaweed soup to the hospital. When the nurse enters the
room, the husband asks for help with warming the soup so that his wife can eat it. What is the
nurses most appropriate response?
a. Didnt you like your lunch?
b. Does your physician know that you are planning to eat that?
c. What is that anyway?
d. I'll warm the soup in the microwave for you.
ANS: D
Offering to warm the food shows cultural sensitivity to the dietary preferences of the woman
and is the most appropriate response. Cultural dietary preferences must be respected. Women
may request that family members bring favorite or culturally appropriate foods to the hospital.
Asking the woman to identify her food does not show cultural sensitivity.
5. A primiparous woman is to be discharged from the hospital the following day with her infant
girl. Which behavior indicates a need for further intervention by the nurse before the woman
can be discharged?
