CPM CPM Postpartum Care and Recovery 1 — Questions and Answers
Question 1: What is the normal uterine position 24 hours after a vaginal birth?
- At the level of the umbilicus (Correct answer)
- Two fingerbreadths above the umbilicus
- Below the umbilicus
- At the symphysis pubis
Correct answer: At the level of the umbilicus
At 24 hours postpartum, the uterine fundus is typically palpable at the level of the umbilicus and descends approximately one fingerbreadth per day.
Question 2: A postpartum client presents with a firm, midline uterus but reports saturating a pad in 15 minutes. What is the most likely cause?
- Uterine atony
- Cervical or vaginal laceration (Correct answer)
- Retained placental fragments
- Coagulopathy
Correct answer: Cervical or vaginal laceration
A firm, contracted uterus with excessive bleeding points to a cervical or vaginal laceration rather than uterine atony, which would present with a boggy uterus.
Question 3: Which finding in the first 24 hours postpartum warrants immediate evaluation for postpartum hemorrhage?
- Pulse of 60 bpm
- Blood pressure of 110/70 mmHg
- Saturating more than one pad per hour for two consecutive hours (Correct answer)
- Lochia rubra with small clots
Correct answer: Saturating more than one pad per hour for two consecutive hours
Saturating more than one perineal pad per hour for two or more consecutive hours is a clinical threshold that indicates postpartum hemorrhage requiring urgent assessment.
Question 4: When assessing a breastfeeding client on day 3 postpartum who reports engorged, firm breasts and a temperature of 38.0°C, what is the most appropriate first intervention?
- Prescribe antibiotics immediately
- Encourage frequent feeding and breast emptying (Correct answer)
- Recommend immediate weaning
- Apply ice packs and restrict fluids
Correct answer: Encourage frequent feeding and breast emptying
Day 3 engorgement with a low-grade fever is common with milk coming in; frequent, effective feeding and ensuring complete breast emptying usually resolves it without antibiotics.
Question 5: How long after birth should a midwife perform a routine postpartum home visit if the client gave birth at a freestanding birth center?
- Within 24 hours
- Within 48–72 hours (Correct answer)
- At 1 week only
- At 2 weeks only
Correct answer: Within 48–72 hours
NARM and MANA standards recommend a postpartum home visit within 48–72 hours after birth to assess maternal and newborn wellbeing.
Question 6: A client at 4 days postpartum reports perineal pain, dysuria, and a foul-smelling lochia. Which condition do these findings most suggest?
- Normal lochia serosa transition
- Endometritis (Correct answer)
- Urinary tract infection only
- Perineal hematoma
Correct answer: Endometritis
Foul-smelling lochia combined with systemic symptoms such as dysuria at 4 days postpartum is classic for endometritis and requires prompt antibiotic treatment.
CPM CPM Postpartum Care and Recovery 1
What is the normal uterine position 24 hours after a vaginal birth?