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NSG 3500
Maternal Health Nursing
—
Examination 3 Review
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━
Comprehensive Questions & Verified Solutions
2026/2027 Academic Cycle
Galen College of Nursing
NSG 3500 — Maternal Health Nursing
Examination 3
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━
, Abstract
This comprehensive examination review document for NSG 3500 Maternal Health
Nursing — Examination 3 provides a structured collection of 50 validated
questions and detailed solutions spanning ten essential domains of postpartum
nursing care. The domains covered include postpartum physiological adaptations
encompassing cardiovascular, hematologic, renal, endocrine, and integumentary
changes; systematic postpartum nursing assessment using the BUBBLE-LE
framework; lochia progression and uterine involution assessment; breastfeeding
physiology, lactogenesis stages, and lactation support; postpartum complications
including hemorrhage (4 T's framework), infection (endometritis, mastitis), and
thromboembolism; maternal-infant bonding and attachment across Rubin's
phases; contraception counseling and family planning with CDC Medical Eligibility
Criteria; discharge teaching and health promotion; cultural and psychosocial
considerations including Cuarentena, Zuo Yue Zi, and health disparities; and
interprofessional collaboration utilizing TeamSTEPPS, AIM safety bundles, and
Maternal Early Warning Criteria. Each question includes clinically relevant
scenarios testing application and analysis-level knowledge, with detailed rationales
citing current guidelines from AWHONN, ACOG, CDC, WHO, AAP, and
authoritative maternal-child nursing textbooks. This review is designed to prepare
nursing students for the NSG 3500 Examination 3 and to reinforce evidence-based
postpartum care practices.
Keywords: Postpartum Adaptations, Uterine Involution, Postpartum
Hemorrhage, Lactation Support, Maternal-Infant Bonding, Contraception
Counseling
Table of Contents
Domain 1: Postpartum Physiological Adaptations ............................................................1
Domain 2: Postpartum Nursing Assessment & Care........................................................ 2
Domain 3: Lochia & Uterine Involution .......................................................................... 3
Domain 4: Breastfeeding Physiology & Lactation Support .............................................. 5
Domain 5: Postpartum Complications — Hemorrhage, Infection, Thromboembolism ... 6
Domain 6: Maternal-Infant Bonding & Attachment ........................................................ 8
Domain 7: Contraception Counseling & Family Planning .............................................. 10
Domain 8: Discharge Teaching & Health Promotion ...................................................... 11
Domain 9: Cultural & Psychosocial Considerations in Postpartum Care .......................13
Domain 10: Interprofessional Collaboration in Postpartum Care .................................. 15
References ......................................................................................................................16
I
, NSG 3500 — Examination 3 Review
Domain 1: Postpartum Physiological Adaptations
1. A nurse is assessing a postpartum client 12 hours after an uncomplicated vaginal delivery. The
client's heart rate is 58 bpm and blood pressure is 118/72 mmHg. Which interpretation by the nurse is
most appropriate?
A) The client is experiencing hypovolemic shock
B) The client is demonstrating a normal postpartum cardiovascular adaptation
C) The client requires immediate fluid resuscitation
D) The client has developed a cardiac dysrhythmia
Answer: B) The client is demonstrating a normal postpartum cardiovascular adaptation
Rationale: Postpartum bradycardia with heart rates of 50–70 bpm is a normal physiological
adaptation resulting from reduced cardiac workload after placental delivery and the resolution of
aortocaval compression (Perry et al., 2022). Cardiac output peaks immediately postpartum due to
autotransfusion from the contracted uterus, then gradually decreases. This bradycardia, combined
with a normal blood pressure, indicates healthy cardiovascular adaptation rather than pathology.
AWHONN (2021) confirms that postpartum bradycardia does not require intervention in the absence
of other concerning signs [1][4][7].
2. A postpartum client who delivered 3 days ago reports profuse sweating, especially at night. The
client is afebrile and vital signs are within normal limits. Which response by the nurse is most
appropriate?
A) Assess for signs of hyperthyroidism
B) Encourage increased fluid intake and explain this is a normal diaphoresis
response
C) Obtain blood cultures to rule out infection
D) Administer an antipyretic medication
Answer: B) Encourage increased fluid intake and explain this is a normal diaphoresis
response
Rationale: Diaphoresis is a normal postpartum adaptation occurring 2–3 days after delivery as the
body eliminates the excess extracellular fluid retained during pregnancy (Perry et al., 2022). During
pregnancy, blood volume increases by approximately 40–50%, and postpartum diuresis and
diaphoresis serve to restore normal fluid balance. This physiological process requires no treatment
other than reassurance and adequate fluid replacement. The absence of fever distinguishes normal
diaphoresis from infection (ACOG, 2023) [1][4][8].
3. A nurse is reviewing laboratory results for a postpartum client on day 1 after delivery. The white
blood cell count is 18,000/mm³. Based on this finding, which action should the nurse take?
A) Notify the provider immediately to initiate antibiotic therapy
B) Obtain blood cultures and a urinalysis
C) Document the finding as an expected postpartum leukocytosis
D) Assess the client's temperature every hour for the next 24 hours
Answer: C) Document the finding as an expected postpartum leukocytosis
Rationale: Postpartum leukocytosis with WBC counts of 15,000–20,000/mm³ is a normal
physiological response to the stress of labor and delivery, primarily characterized by neutrophilia
(Perry et al., 2022). This elevation is not indicative of infection in the absence of other clinical signs
such as fever, uterine tenderness, or foul-smelling lochia. AWHONN (2021) and CDC (2023)
guidelines emphasize that isolated leukocytosis without clinical signs of infection does not warrant
antibiotic therapy. The nurse should document the finding and continue routine assessment [1][4][5].
4. Which postpartum client is at the highest risk for venous thromboembolism (VTE) during the first
two weeks after delivery?
A) A 22-year-old primipara who had an uncomplicated vaginal delivery
B) A 35-year-old client who underwent a cesarean delivery and has a BMI of 34
C) A 28-year-old breastfeeding mother who delivered vaginally
D) A 20-year-old client with a second-degree laceration after vaginal delivery
1
━━━━━━━━━━━━━━━
NSG 3500
Maternal Health Nursing
—
Examination 3 Review
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━
Comprehensive Questions & Verified Solutions
2026/2027 Academic Cycle
Galen College of Nursing
NSG 3500 — Maternal Health Nursing
Examination 3
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━
, Abstract
This comprehensive examination review document for NSG 3500 Maternal Health
Nursing — Examination 3 provides a structured collection of 50 validated
questions and detailed solutions spanning ten essential domains of postpartum
nursing care. The domains covered include postpartum physiological adaptations
encompassing cardiovascular, hematologic, renal, endocrine, and integumentary
changes; systematic postpartum nursing assessment using the BUBBLE-LE
framework; lochia progression and uterine involution assessment; breastfeeding
physiology, lactogenesis stages, and lactation support; postpartum complications
including hemorrhage (4 T's framework), infection (endometritis, mastitis), and
thromboembolism; maternal-infant bonding and attachment across Rubin's
phases; contraception counseling and family planning with CDC Medical Eligibility
Criteria; discharge teaching and health promotion; cultural and psychosocial
considerations including Cuarentena, Zuo Yue Zi, and health disparities; and
interprofessional collaboration utilizing TeamSTEPPS, AIM safety bundles, and
Maternal Early Warning Criteria. Each question includes clinically relevant
scenarios testing application and analysis-level knowledge, with detailed rationales
citing current guidelines from AWHONN, ACOG, CDC, WHO, AAP, and
authoritative maternal-child nursing textbooks. This review is designed to prepare
nursing students for the NSG 3500 Examination 3 and to reinforce evidence-based
postpartum care practices.
Keywords: Postpartum Adaptations, Uterine Involution, Postpartum
Hemorrhage, Lactation Support, Maternal-Infant Bonding, Contraception
Counseling
Table of Contents
Domain 1: Postpartum Physiological Adaptations ............................................................1
Domain 2: Postpartum Nursing Assessment & Care........................................................ 2
Domain 3: Lochia & Uterine Involution .......................................................................... 3
Domain 4: Breastfeeding Physiology & Lactation Support .............................................. 5
Domain 5: Postpartum Complications — Hemorrhage, Infection, Thromboembolism ... 6
Domain 6: Maternal-Infant Bonding & Attachment ........................................................ 8
Domain 7: Contraception Counseling & Family Planning .............................................. 10
Domain 8: Discharge Teaching & Health Promotion ...................................................... 11
Domain 9: Cultural & Psychosocial Considerations in Postpartum Care .......................13
Domain 10: Interprofessional Collaboration in Postpartum Care .................................. 15
References ......................................................................................................................16
I
, NSG 3500 — Examination 3 Review
Domain 1: Postpartum Physiological Adaptations
1. A nurse is assessing a postpartum client 12 hours after an uncomplicated vaginal delivery. The
client's heart rate is 58 bpm and blood pressure is 118/72 mmHg. Which interpretation by the nurse is
most appropriate?
A) The client is experiencing hypovolemic shock
B) The client is demonstrating a normal postpartum cardiovascular adaptation
C) The client requires immediate fluid resuscitation
D) The client has developed a cardiac dysrhythmia
Answer: B) The client is demonstrating a normal postpartum cardiovascular adaptation
Rationale: Postpartum bradycardia with heart rates of 50–70 bpm is a normal physiological
adaptation resulting from reduced cardiac workload after placental delivery and the resolution of
aortocaval compression (Perry et al., 2022). Cardiac output peaks immediately postpartum due to
autotransfusion from the contracted uterus, then gradually decreases. This bradycardia, combined
with a normal blood pressure, indicates healthy cardiovascular adaptation rather than pathology.
AWHONN (2021) confirms that postpartum bradycardia does not require intervention in the absence
of other concerning signs [1][4][7].
2. A postpartum client who delivered 3 days ago reports profuse sweating, especially at night. The
client is afebrile and vital signs are within normal limits. Which response by the nurse is most
appropriate?
A) Assess for signs of hyperthyroidism
B) Encourage increased fluid intake and explain this is a normal diaphoresis
response
C) Obtain blood cultures to rule out infection
D) Administer an antipyretic medication
Answer: B) Encourage increased fluid intake and explain this is a normal diaphoresis
response
Rationale: Diaphoresis is a normal postpartum adaptation occurring 2–3 days after delivery as the
body eliminates the excess extracellular fluid retained during pregnancy (Perry et al., 2022). During
pregnancy, blood volume increases by approximately 40–50%, and postpartum diuresis and
diaphoresis serve to restore normal fluid balance. This physiological process requires no treatment
other than reassurance and adequate fluid replacement. The absence of fever distinguishes normal
diaphoresis from infection (ACOG, 2023) [1][4][8].
3. A nurse is reviewing laboratory results for a postpartum client on day 1 after delivery. The white
blood cell count is 18,000/mm³. Based on this finding, which action should the nurse take?
A) Notify the provider immediately to initiate antibiotic therapy
B) Obtain blood cultures and a urinalysis
C) Document the finding as an expected postpartum leukocytosis
D) Assess the client's temperature every hour for the next 24 hours
Answer: C) Document the finding as an expected postpartum leukocytosis
Rationale: Postpartum leukocytosis with WBC counts of 15,000–20,000/mm³ is a normal
physiological response to the stress of labor and delivery, primarily characterized by neutrophilia
(Perry et al., 2022). This elevation is not indicative of infection in the absence of other clinical signs
such as fever, uterine tenderness, or foul-smelling lochia. AWHONN (2021) and CDC (2023)
guidelines emphasize that isolated leukocytosis without clinical signs of infection does not warrant
antibiotic therapy. The nurse should document the finding and continue routine assessment [1][4][5].
4. Which postpartum client is at the highest risk for venous thromboembolism (VTE) during the first
two weeks after delivery?
A) A 22-year-old primipara who had an uncomplicated vaginal delivery
B) A 35-year-old client who underwent a cesarean delivery and has a BMI of 34
C) A 28-year-old breastfeeding mother who delivered vaginally
D) A 20-year-old client with a second-degree laceration after vaginal delivery
1
