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Quizzes > Health & Medicine

Postpartum NCLEX Questions: Taking-Hold Phase Quiz

Test yourself with quick, free NCLEX postpartum practice questions. Instant results.

Editorial: Review CompletedCreated By: Byron GibsonUpdated Aug 23, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration of nursing mother and baby on teal background with NCLEX quiz cards and milestone icons

This quiz helps you practice postpartum NCLEX questions on the taking-hold phase, including breastfeeding cues, uterine involution, bonding, mood changes, and basic newborn checks. Get quick feedback and spot study gaps before the exam. For related practice, try intrapartum nclex questions, explore the hesi maternal newborn quiz, or learn with our postpartum depression quiz.

On postpartum day 3, the nurse expects the lochia to be which color?
Yellowish white
Bright red
Dark red with clots
Pinkish brown
Lochia serosa, which is pinkish brown, typically appears from day 3 to day 10 postpartum. Lochia rubra is bright red and occurs during the first 2 - 3 days. Lochia alba, yellowish-white, follows serosa and can persist up to 6 weeks.
On postpartum day 4, the nurse assesses the fundal height and expects it to be approximately:
4 cm below the umbilicus
At the level of the umbilicus
2 cm below the umbilicus
1 cm above the umbilicus
The uterus involutes roughly 1 cm per day postpartum. On day 1 it is at the umbilicus, so by day 4 it should be about 4 cm below. Deviations may indicate subinvolution or bladder distension.
Which maternal behavior is characteristic of the taking-hold phase?
Passive reliance on others
Focus on physical discomfort only
Eagerness to learn infant care
Resentment toward the newborn
In the taking-hold phase (days 2 - 10), mothers become more independent and eager to care for the infant. They start to master self-care and baby care skills. A passive or resentful attitude indicates difficulty progressing through this phase.
A mother experiences chills on postpartum day 2. The nurse's best action is to:
Obtain a blood culture
Provide a warm blanket and reassurance
Administer a PRN antipyretic
Notify the healthcare provider immediately
Postpartum chills in the first 2 hours are common and benign, caused by fluid shifts. Providing warmth and reassurance is appropriate. Persistent fever beyond 38 °C needs evaluation.
To promote comfort for engorged breasts, the nurse should instruct the mother to:
Use a warm shower before feeding
Avoid breastfeeding for 24 hours
Pump and discard all milk
Apply cold compresses before breastfeeding
Warmth before feeding helps soften the breast and improve let-down. Cold compresses after feeding reduce edema. Avoiding feeding or discarding milk is unnecessary in uncomplicated engorgement.
Which perineal care instruction is appropriate for a postpartum mother?
Dry the perineum vigorously with toilet paper
Use a peri-bottle to squirt warm water from front to back
Apply baby oil to the perineum daily
Wipe from back to front after voiding
Using a peri-bottle and wiping front to back helps prevent infection of the urethra and perineum. Drying too vigorously or using oils can irritate tissues.
Postpartum blues typically peak on which days after birth?
Days 7 - 10
Day 14
Days 3 - 5
Day 1
Postpartum blues often appear around day 2 or 3, peak by days 3 - 5, and resolve by two weeks. If symptoms persist beyond 2 weeks or worsen, evaluation for depression is needed.
The mother reports heavy night sweats. The nurse's best response is:
"Reduce your fluid intake before bedtime."
"It's normal; your body is eliminating excess fluid postpartum."
"You should sleep with more blankets then."
"This may indicate an infection. I'll check your vitals."
Postpartum diaphoresis is a normal mechanism for fluid elimination after delivery. Reassurance and light bedding are appropriate. It is not a sign of infection unless accompanied by fever.
The nurse notes the client has saturated a peripad in 1 hour with bright red bleeding and small clots. The nurse's first action should be to:
Notify the healthcare provider immediately
Have the client empty her bladder
Continue to monitor
Palpate the fundus and massage if boggy
A boggy uterus is the most common cause of excessive bleeding. Fundal massage stimulates contraction and reduces hemorrhage. Bladder distension can also displace the uterus but massage takes priority.
A nonimmune mother is identified postpartum. Which vaccine should the nurse administer before discharge?
Tdap
MMR
Varicella-Zoster
Influenza
Rubella (MMR) vaccine is contraindicated during pregnancy but recommended postpartum if the mother is nonimmune. It must be given before discharge to prevent congenital rubella in future pregnancies.
An Rh-negative mother has an Rh-positive infant. The nurse should plan to administer Rho(D) immune globulin within:
One week
At the mother's 6-week check-up
72 hours
24 hours
Rho(D) immune globulin should be administered within 72 hours postpartum to prevent maternal sensitization. Delays beyond this reduce efficacy in preventing isoimmunization.
To prevent constipation in a postpartum client, the nurse should recommend:
Fasting overnight to rest the bowel
High-fiber diet and increased fluids
Low-fiber diet with laxatives PRN
High-protein diet and bed rest
A high-fiber diet with adequate hydration promotes normal bowel function. Early ambulation also helps. Low-fiber diets or prolonged fasting can worsen constipation.
How many extra calories per day are recommended for a breastfeeding mother?
1,000 calories
200 calories
350 - 500 calories
700 - 800 calories
Breastfeeding requires additional energy; an extra 350 - 500 calories per day supports milk production. Insufficient caloric intake may affect milk supply.
Which analgesic is recommended for perineal pain in a breastfeeding mother?
Ibuprofen
Morphine
Oxycodone
Aspirin
Ibuprofen is an NSAID that is safe during breastfeeding and effectively reduces perineal pain. Aspirin is avoided due to Reye's risk, and opioids are reserved for severe pain.
A safe rate of weight loss for a breastfeeding mother after discharge is:
5 lbs per week
0.5 - 1 lb per week
No weight loss until 6 months
2 - 3 lbs per week
Weight loss of about 0.5 - 1 pound per week is safe for lactating women and supports adequate milk supply. Rapid weight loss can decrease milk production.
A postpartum client on day 5 reports foul-smelling lochia and fever of 38.5 °C with uterine tenderness. The nurse's priority action is to:
Notify the provider for a D&C
Encourage oral fluids and rest
Collect lochia cultures before antibiotics
Administer prescribed IV antibiotics
Endometritis presents with foul lochia, fever, and tenderness. Obtaining cultures before starting antibiotics guides therapy. Antibiotics are then initiated promptly.
A postpartum client on day 2 has a blood pressure of 170/110 mmHg and headache. Which intervention is highest priority?
Administer IV magnesium sulfate
Encourage oral hydration
Obtain a 12-lead ECG
Offer acetaminophen for headache
Severe hypertension postpartum suggests preeclampsia. Magnesium sulfate prevents seizures and is primary management. BP control and seizure prophylaxis are urgent.
Which screening tool is specifically recommended for identifying postpartum depression?
Edinburgh Postnatal Depression Scale
Beck Depression Inventory
Hamilton Anxiety Rating Scale
Postpartum PTSD Checklist
The Edinburgh Postnatal Depression Scale (EPDS) is validated for postpartum depression screening. It is quick and widely used in clinical settings. Other inventories target general depression or anxiety.
A mother expresses thoughts of harming her baby on day 7 postpartum. The nurse's best action is to:
Suggest increased rest and nutrition
Reassure her these thoughts are common
Refer her to community support groups
Initiate emergency psychiatric evaluation
Thoughts of harming the infant are a psychiatric emergency. Immediate assessment and possible hospitalization are required. Support groups are helpful but not sufficient in crisis.
When can a postpartum mother typically resume sexual intercourse?
After her first menstrual period
Two weeks postpartum
Six weeks postpartum
When she feels emotionally ready
Most providers recommend waiting about six weeks to allow cervical closure and perineal healing. Emotional readiness is important but medical clearance guides timing.
Which factor most contributes to uterine atony after birth?
Excessive analgesia
Bladder distension
Early ambulation
High-fiber diet
A distended bladder prevents the uterus from contracting fully, leading to atony and hemorrhage. Emptying the bladder helps the uterus contract. Other factors include overdistention and prolonged labor.
To reduce the risk of postpartum deep vein thrombosis, the nurse should:
Encourage early ambulation
Advise prolonged bed rest
Restrict oral fluids
Apply heat packs to the legs
Early ambulation promotes circulation and reduces DVT risk. Hydration and leg exercises also help. Prolonged bed rest and fluid restriction increase risk.
A postpartum client on day 12 continues to have lochia serosa. The nurse's best action is to:
Recommend bed rest until lochia stops
Assess for retained placental fragments
Instruct her to increase fluid intake
Reassure that this is normal up to 14 days
Lochia serosa typically lasts until about day 10. Persistence beyond 10 days may indicate retained placental tissue or infection. Assessing and possibly performing an ultrasound is warranted.
A client receives methylergonovine for postpartum hemorrhage. Which assessment finding requires immediate intervention?
Diaphoresis
Hypertension
Bradycardia
Decreased urine output
Methylergonovine causes vasoconstriction and can precipitate severe hypertension. Blood pressure must be monitored closely; medication is contraindicated in hypertension.
A breastfeeding mother requests contraception. Which advice is most appropriate?
Delay estrogen-containing contraceptives until at least 6 weeks
Initiate progestin-only methods any time
Use barrier methods only until 6 weeks
Start combination oral contraceptives immediately
Estrogen-containing contraceptives can reduce milk supply and are delayed until at least 6 weeks postpartum. Progestin-only methods may be used earlier. Barrier methods offer no hormonal impact but require consistent use.
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Study Outcomes

  1. Understand the Taking-Hold Phase -

    Clarify the physiological and emotional transitions that define the taking-hold phase of postpartum care, enabling accurate assessment and support during this critical period.

  2. Identify Key Maternal Milestones -

    Recognize typical recovery markers such as uterine involution, lochia progression, and bonding behaviors to anticipate normal postpartum NCLEX questions scenarios.

  3. Interpret Assessment Data -

    Analyze vital signs, fundal assessments, and maternal self-care indicators to distinguish between expected findings and potential complications in the taking-hold phase.

  4. Apply Evidence-Based Interventions -

    Implement nursing actions for comfort, education, and emotional support that align with best practices for postpartum NCLEX questions focused on maternal care.

  5. Solve Postpartum NCLEX Questions with Confidence -

    Utilize targeted strategies to navigate common question formats and apply clinical reasoning skills specific to the taking-hold phase.

  6. Evaluate Personal Competence -

    Assess your own knowledge gaps and track improvement areas to boost overall nursing confidence and proficiency in obstetrical care.

Cheat Sheet

  1. Timing and Emotional Adjustment in the Taking-Hold Phase -

    The taking-hold phase spans approximately days 2 - 10 postpartum, when mothers shift from passive to active care and show increased confidence (AWHONN, 2015). This stage often appears in postpartum NCLEX questions to assess your ability to recognize emotional milestones. Use the "RISE" mnemonic - Readiness, Independence, Support, Education - to recall the four hallmarks of this phase.

  2. Systematic Postpartum Assessment with BUBBLE-HE -

    BUBBLE-HE stands for Breasts, Uterus, Bladder, Bowels, Lochia, Episiotomy, Homan's sign (or Extremities), and Emotional status (ACOG). This mnemonic ensures a thorough check for complications such as mastitis, uterine subinvolution, or DVT. Practice applying BUBBLE-HE in NCLEX-style scenarios to build speed and accuracy.

  3. Uterine Involution and Lochia Monitoring -

    Fundal descent follows a simple "1 cm/day" rule: on day n postpartum, the fundus is about n cm below the umbilicus (WHO). Lochia should progress from rubra to serosa to alba; saturation of one pad per hour or return to bright red bleeding signals concern. Chart these trends in practice quizzes to reinforce normal vs. abnormal findings.

  4. Breastfeeding Support Using the LATCH Tool -

    The LATCH scoring system (Latch, Audible swallowing, Type of nipple, Comfort, Hold) rates breastfeeding sessions 0 - 2 per category, with a target total ≥8 (Academy of Breastfeeding Medicine). This objective tool aids in identifying latch issues or maternal discomfort early. Role-play LATCH assessments in study groups to gain confidence for both clinical and NCLEX testing.

  5. Educating on Self-Care and Warning Signs -

    Empower mothers with the "SAFE" checklist: Signs of infection, Activity modifications, Fluid intake, Emotional health screening. Encourage daily perineal care, hydration, and monitoring for fever, calf pain, or mood swings (CDC). Embedding SAFE in teaching plans sharpens your patient education skills and readies you for related postpartum NCLEX questions.

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