Fifteen minutes after a vaginal birth, the nurse finds a soft, boggy fundus and heavy bleeding. What should the nurse do first?

A. Massage the fundus until it is firm
B. Give an IV fluid bolus
C. Notify the provider
D. Check the client's blood pressure

Show answer and rationale

Correct answer: A

Uterine atony is the most common cause of postpartum hemorrhage. Fundal massage stimulates contraction and is the first step, followed by uterotonic drugs and calling for help.

Source: ACOG. Practice Bulletin 183: Postpartum Hemorrhage

Keep practicing Physiological Adaptation

This question is one of 162 Physiological Adaptation items in NCLEXSim. On the NCLEX-RN, this category makes up 11–17% of the exam.

Practice more Physiological Adaptation questions free Create a free account

Study tip

Study emergencies as a sequence: what you see, what it means, what you do first (DKA, sepsis, stroke, PE, anaphylaxis, tension pneumothorax).
Review fluid and electrolyte imbalances by their ECG and neuromuscular signs (peaked T waves, Chvostek and Trousseau signs).

Practice the way the NCLEX tests you

1,059 fact-checked questions, a full adaptive exam that stops by the real rules, a proctored test-day mode with an integrity report, 8 NGN case studies, bedside simulations, and ACLS megacodes. Free.

Take the free adaptive exam Rehearse test day

Fifteen minutes after a vaginal birth, the nurse finds a soft, boggy fundus and heavy bleeding. What should the nurse do first?

Keep practicing Physiological Adaptation

More free Physiological Adaptation questions

Practice the way the NCLEX tests you