1
MATERNAL AND PEDIATRIC NURSING MIDTERM EXAM
NEWEST VERSION -2025/2026- 100+ Q AND ANS MOST
POPULAR EXAMS GUARANTEED SUCCESS
The perinatal nurse assisting with establishing lactation is aware that which action
can minimize acute mastitis?
a. Washing the nipples and breasts with mild soap and water once a day
b. Using proper breastfeeding techniques
c. Wearing a nipple shield for the first few days of breastfeeding
d. Wearing a supportive bra 24 hours a day
ANS: B
Almost all instances of acute mastitis can be avoided by using proper
breastfeeding technique to prevent cracked nipples. Washing the nipples and
breasts daily is no longer indicated. In fact this can cause tissue dryness and
irritation which can lead to tissue breakdown and infection. Wearing a nipple
shield does not prevent mastitis. Wearing a supportive bra 24 hours a day may
contribute to mastitis especially if an underwire bra is worn because it may put
pressure on the upper outer area of the breast contributing to blocked ducts and
mastitis.
Which is the most likely cause of late postpartum hemorrhage (PPH)?
a. Subinvolution of the placental site
b. Defective vascularity of the decidua
c. Cervical lacerations
d. Coagulation disorders
, 2
ANS: A
Late PPH may be the result of subinvolution of the uterus pelvic infection or
retained placental fragments. Late PPH is not typically a result of defective
vascularity of the decidua cervical lacerations or coagulation disorders.
What woman is at greatest risk for early postpartum hemorrhage (PPH)?
a. A primiparous woman being prepared for an emergency Caesarean birth for
fetal distress
b. A woman with severe pre-eclampsia on magnesium sulphate whose labour is
being induced
c. A multiparous woman with an 8-hour labour
d. A primigravida in spontaneous labour with preterm twins
ANS: B
Magnesium sulphate administration during labour poses a risk for PPH.
Magnesium acts as a smooth muscle relaxant thereby contributing to uterine
relaxation and atony. Although many causes and risk factors are associated with
PPH the primiparous woman being prepared for an emergency Caesarian birth the
multiparous woman with 8-hour labour and the primigravida in spontaneous
labour are not at risk for early PPH.
What is the initial priority nursing intervention when a nurse observes profuse
postpartum bleeding?
a. Call the woman's primary health care provider.
b. Administer the standing order for an oxytocic.
c. Palpate the uterus and massage it if it is boggy.
d. Assess maternal blood pressure (BP) and pulse for signs of hypovolemic shock.
ANS: C
, 3
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although calling the health care provider administering an
oxytocic and assessing maternal BP are appropriate interventions the primary
intervention should be to assess the uterus. Uterine atony is the leading cause of
postpartum hemorrhage.
What is the most objective and least invasive assessment of adequate organ
perfusion and oxygenation when caring for a postpartum woman experiencing
hemorrhagic shock?
a. Absence of cyanosis in the buccal mucosa
b. Cool dry skin
c. Diminished restlessness
d. Urinary output of at least 30 mL/hr
ANS: D
Hemorrhage may result in hemorrhagic shock. Shock is an emergency situation in
which the perfusion of body organs may become severely compromised and
death may occur. The presence of adequate urinary output indicates adequate
tissue perfusion. The assessment of the buccal mucosa for cyanosis can be
subjective in nature. The presence of cool pale clammy skin would be an indicative
finding associated with hemorrhagic shock. Hemorrhagic shock is associated with
lethargy not restlessness.
Which is one of the first symptoms of puerperal infection to assess for in the
postpartum woman?
a. Fatigue continuing for longer than 1 week
b. Pain with voiding
c. Profuse vaginal bleeding with ambulation
d. Temperature of 38.6° C
, 4
ANS: D
Postpartum or puerperal infection is any clinical infection of the genital canal that
occurs within 28 days after miscarriage induced abortion or childbirth. A
temperature greater than 38° C warrants further investigation for a puerperal
infection. Fatigue would be a late finding associated with infection. Pain with
voiding may indicate a urinary tract infection but it is not typically one of the
earlier symptoms of infection. Profuse lochia may be associated with endometritis
but it is not the first symptom associated with infection.
Which statement is true with regard to postpartum hemorrhage (PPH)?
a. PPH is easy to recognize early after all the woman is bleeding.
b. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500
mL after Caesarean birth to define the condition as PPH.
c. If anything nurses and doctors tend to overestimate the amount of blood loss.
d. Traditionally PPH has been classified as early or late with respect to birth.
ANS: D
Early PPH is also known as primary or acute PPH late PPH is known as secondary
PPH. Unfortunately PPH can occur with little warning and often is recognized only
after the mother has profound symptoms. Traditionally a 500-mL blood loss after a
vaginal birth and a 1000-mL blood loss after a Caesarean birth constitute PPH.
Health care personnel tend to underestimate blood loss by 33 to 55% in their
subjective observations.
A woman who has recently given birth complains of pain and tenderness in her
leg. On physical examination the nurse notices warmth and redness over an
enlarged hardened area. What should the nurse suspect and then what should the
nurse implement to confirm the diagnosis?
a. Disseminated intravascular coagulation ask for laboratory tests.
b. von Willebrand disease note whether bleeding times have been extended.
c. Thrombophlebitis use real-time and colour Doppler ultrasound.
MATERNAL AND PEDIATRIC NURSING MIDTERM EXAM
NEWEST VERSION -2025/2026- 100+ Q AND ANS MOST
POPULAR EXAMS GUARANTEED SUCCESS
The perinatal nurse assisting with establishing lactation is aware that which action
can minimize acute mastitis?
a. Washing the nipples and breasts with mild soap and water once a day
b. Using proper breastfeeding techniques
c. Wearing a nipple shield for the first few days of breastfeeding
d. Wearing a supportive bra 24 hours a day
ANS: B
Almost all instances of acute mastitis can be avoided by using proper
breastfeeding technique to prevent cracked nipples. Washing the nipples and
breasts daily is no longer indicated. In fact this can cause tissue dryness and
irritation which can lead to tissue breakdown and infection. Wearing a nipple
shield does not prevent mastitis. Wearing a supportive bra 24 hours a day may
contribute to mastitis especially if an underwire bra is worn because it may put
pressure on the upper outer area of the breast contributing to blocked ducts and
mastitis.
Which is the most likely cause of late postpartum hemorrhage (PPH)?
a. Subinvolution of the placental site
b. Defective vascularity of the decidua
c. Cervical lacerations
d. Coagulation disorders
, 2
ANS: A
Late PPH may be the result of subinvolution of the uterus pelvic infection or
retained placental fragments. Late PPH is not typically a result of defective
vascularity of the decidua cervical lacerations or coagulation disorders.
What woman is at greatest risk for early postpartum hemorrhage (PPH)?
a. A primiparous woman being prepared for an emergency Caesarean birth for
fetal distress
b. A woman with severe pre-eclampsia on magnesium sulphate whose labour is
being induced
c. A multiparous woman with an 8-hour labour
d. A primigravida in spontaneous labour with preterm twins
ANS: B
Magnesium sulphate administration during labour poses a risk for PPH.
Magnesium acts as a smooth muscle relaxant thereby contributing to uterine
relaxation and atony. Although many causes and risk factors are associated with
PPH the primiparous woman being prepared for an emergency Caesarian birth the
multiparous woman with 8-hour labour and the primigravida in spontaneous
labour are not at risk for early PPH.
What is the initial priority nursing intervention when a nurse observes profuse
postpartum bleeding?
a. Call the woman's primary health care provider.
b. Administer the standing order for an oxytocic.
c. Palpate the uterus and massage it if it is boggy.
d. Assess maternal blood pressure (BP) and pulse for signs of hypovolemic shock.
ANS: C
, 3
The initial management of excessive postpartum bleeding is firm massage of the
uterine fundus. Although calling the health care provider administering an
oxytocic and assessing maternal BP are appropriate interventions the primary
intervention should be to assess the uterus. Uterine atony is the leading cause of
postpartum hemorrhage.
What is the most objective and least invasive assessment of adequate organ
perfusion and oxygenation when caring for a postpartum woman experiencing
hemorrhagic shock?
a. Absence of cyanosis in the buccal mucosa
b. Cool dry skin
c. Diminished restlessness
d. Urinary output of at least 30 mL/hr
ANS: D
Hemorrhage may result in hemorrhagic shock. Shock is an emergency situation in
which the perfusion of body organs may become severely compromised and
death may occur. The presence of adequate urinary output indicates adequate
tissue perfusion. The assessment of the buccal mucosa for cyanosis can be
subjective in nature. The presence of cool pale clammy skin would be an indicative
finding associated with hemorrhagic shock. Hemorrhagic shock is associated with
lethargy not restlessness.
Which is one of the first symptoms of puerperal infection to assess for in the
postpartum woman?
a. Fatigue continuing for longer than 1 week
b. Pain with voiding
c. Profuse vaginal bleeding with ambulation
d. Temperature of 38.6° C
, 4
ANS: D
Postpartum or puerperal infection is any clinical infection of the genital canal that
occurs within 28 days after miscarriage induced abortion or childbirth. A
temperature greater than 38° C warrants further investigation for a puerperal
infection. Fatigue would be a late finding associated with infection. Pain with
voiding may indicate a urinary tract infection but it is not typically one of the
earlier symptoms of infection. Profuse lochia may be associated with endometritis
but it is not the first symptom associated with infection.
Which statement is true with regard to postpartum hemorrhage (PPH)?
a. PPH is easy to recognize early after all the woman is bleeding.
b. Traditionally it takes more than 1000 mL of blood after vaginal birth and 2500
mL after Caesarean birth to define the condition as PPH.
c. If anything nurses and doctors tend to overestimate the amount of blood loss.
d. Traditionally PPH has been classified as early or late with respect to birth.
ANS: D
Early PPH is also known as primary or acute PPH late PPH is known as secondary
PPH. Unfortunately PPH can occur with little warning and often is recognized only
after the mother has profound symptoms. Traditionally a 500-mL blood loss after a
vaginal birth and a 1000-mL blood loss after a Caesarean birth constitute PPH.
Health care personnel tend to underestimate blood loss by 33 to 55% in their
subjective observations.
A woman who has recently given birth complains of pain and tenderness in her
leg. On physical examination the nurse notices warmth and redness over an
enlarged hardened area. What should the nurse suspect and then what should the
nurse implement to confirm the diagnosis?
a. Disseminated intravascular coagulation ask for laboratory tests.
b. von Willebrand disease note whether bleeding times have been extended.
c. Thrombophlebitis use real-time and colour Doppler ultrasound.
