RNC-MNN STUDY 400
QUESTIONS AND CORRECT
DETAILED ANSWERS
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
QUESTIONS AND CORRECT
DETAILED ANSWERS
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
