Postpartum Quiz: Can You Catch the Complications?

1. Which of the following is the most common cause of postpartum hemorrhage in the immediate period after delivery?

Uterine atony

Placental retention

Coagulopathy

Cervical lacerations

2. A patient reports heavy vaginal bleeding with soaking 2 pads per hour on postpartum day 3. What is the first nursing action?

Administer ergot alkaloid

Assess fundal firmness and perform uterine massage

Call for blood transfusion

Insert a urinary catheter

3. Which clinical finding is most consistent with postpartum endometritis?

Fever >38.5°C, uterine tenderness, and lochia with foul odor

Chills without fever and lower abdominal pain

Hypertension and severe headache

Tachycardia with clear lochia

4. A postpartum patient reports leg swelling, warmth, and calf pain on day 5. Which condition should be suspected?

Mastitis

Deep vein thrombosis

Retained placenta

Perineal hematoma

5. What is the primary pathophysiology of postpartum preeclampsia?

Endothelial dysfunction and vasospasm

Decreased placental perfusion

Excessive oxytocin administration

Infection of the amniotic sac

6. A breastfeeding mother reports breast pain, redness, and fever on postpartum day 8. Which diagnosis is most likely?

Engorgement

Mastitis

Milk bleb

Nipple trauma

7. Which antibiotic is safe to use in a breastfeeding mother with postpartum endometritis?

Tetracycline

Cephalexin

Fluoroquinolone

Metronidazole monotherapy

8. What is the recommended duration of anticoagulation therapy for postpartum thromboembolism?

1 week

2–4 weeks

6 weeks minimum

12 months

9. A patient reports persistent sadness, inability to bond with infant, and sleep disturbance starting day 4. Which condition should be assessed?

Postpartum blues

Postpartum depression

Postpartum psychosis

Adjustment disorder

10. Which risk factor most strongly predicts postpartum hemorrhage?

Maternal age >35 years

Prolonged labor or uterine overdistension

Primigravida status

Spontaneous vaginal delivery

11. A perineal hematoma is suspected. Which imaging modality is most appropriate for diagnosis?

X-ray

Ultrasound

MRI

CT scan

12. What is the expected timeline for involution of the uterus to return to prepregnant size?

1 week

2 weeks

4–6 weeks

8–10 weeks

13. Which immunization is safe to administer in the immediate postpartum period to a non-immune mother?

Rubella vaccine

Tdap vaccine

MMR vaccine

Varicella vaccine

14. A postpartum patient reports chest pain and dyspnea on day 3. What is the most critical differential diagnosis?

Musculoskeletal pain

Pulmonary embolism

Anxiety disorder

Costochondritis

15. Which assessment finding indicates normal lochia on postpartum day 2?

Bright red flow, moderate amount, mild cramping

Scant white discharge with no odor

Brown discharge with foul odor

Minimal flow with large clots