Editing Maternal and Newborn Nursing – LPN Practice Questions (section)

==Question 1==
An LPN checks a client 4 hours after a vaginal birth and finds the fundus firm but located 2 cm above the umbilicus and displaced to the right. Which action should the LPN take '''first'''?
# Massage the fundus until it descends to the midline.
# Assist the client to the bathroom to empty her bladder.
# Report a possible postpartum hemorrhage to the registered nurse.
# Document the finding as an expected postpartum change.

'''Answer:''' 2 (B). Assist the client to the bathroom to empty her bladder.

''Rationale:'' A fundus that is firm but high and displaced to one side, usually the right, is the classic picture of a '''full bladder'''. A distended bladder pushes the uterus up and out of the midline and prevents it from contracting fully, which increases bleeding. Having the client void is a safe, independent nursing action, and the fundus is then reassessed. Option 1 is unnecessary because the fundus is already firm, and massage will not correct a bladder problem. Option 3 is premature; the LPN takes the simple corrective step first and reports if the fundus does not return to midline afterward. Option 4 is wrong because a displaced fundus is not an expected finding and needs action.