1. Your patient is 48 hours post-delivery. While assessing fundal height, you would expect the fundal height to be?
A. 1 cm above the umbilicus
B. 2 cm above the umbilicus
C. 1 cm below the umbilicus
D. 2 cm below the umbilicus
The answer is D. The fundal height will decrease by 1 cm per day below the umbilicus. Therefore, if the woman is 48 hours postpartum (2 days) the fundal height will be 2 cm BELOW the umbilicus.
2. You’re providing discharge teaching to a new mother who is going home after a vaginal delivery. The woman asks when the uterus will return to its pre-pregnancy size. Your response is?
A. At about 14 days
B. At about 6 months
C. At about 6 weeks
D. At about 7 days
The answer is C. The uterus will return to its pre-pregnancy state at about 6 weeks.
3. During a prenatal visit, you are assessing the fundal height. You find the fundus of the uterus to be right above the symphysis pubis. Based on this finding the patient is about how far along in her pregnancy?
A. 20 weeks
B. 12 weeks
C. 16 weeks
D. 24 weeks
The answer is B. At about 12 weeks of pregnancy, the fundal height can be found right above the symphysis pubis.
4. You’re assessing a patient’s chart and find that the patient is 36 weeks pregnant. Where should you find the fundus of the uterus during your assessment of fundal height?
A. midway between the umbilicus and xiphoid process
B. about 4 cm below the xiphoid process
C. at the xiphoid process
D. 5 cm above the umbilicus
The answer is C. At 36 weeks of pregnancy, the fundal height should be at the xiphoid process.
5. Your patient is 24 weeks pregnant, and you’re measuring the fundal height. Which finding below is a normal measurement for this patient?
A. 16 cm
B. 28 cm
C. 26 cm
D. 12 cm
The answer is C. The patient should be + or – 2 cm of their week of pregnancy. Remember that after 20 weeks of pregnancy the number of weeks the patient is pregnant will match the fundal height measurement plus or minus 2 cm. Therefore, if the patient is 24 weeks, a normal measurement would be either 22 cm to 26 cm.
6. A nursing student, who you are precepting during their OB rotation, asks you when the fundus of the uterus is no longer palpable. You answer:
A. at about 10 to 14 days
B. at about 7 days
C. at 6 weeks
D. 48 hours after the delivery of the baby.
The answer is A. This is when the uterus has entered back into the pelvic cavity and is no longer palpable.
7. A patient is 40 weeks pregnant, and you find the fundal height to be 4 cm below the xiphoid process. Your next nursing action is to:
A. Notify the MD immediately
B. Chart this as a normal finding
C. Place the patient on continuous fetal monitoring
D. Assess the baby’s heart rate with a Doppler
The answer is B. This is a normal finding. After 36 weeks of pregnancy, the fundal height will regress. Remember at 36 weeks the fundus will be at the xiphoid process. However, the fundus of the uterus will decrease about 4 cm from the xiphoid process at about 37-40 weeks of pregnancy. WHY? The baby has settled down into the pelvic cavity and preparing for delivery.
8. Which finding while measuring the fundal height of a patient who is 36 weeks pregnant would require immediate action?
A. The fundal height measures at 38 cm.
B. The patient complains of feeling lightheaded and dizzy.
C. The fundus of the uterus is at the xiphoid process.
D. The patient states she cannot sleep at night.
The answer is B. As the nurse, you must monitor the patient for supine hypotension while measuring the fundal height. This is because as the uterus enlarges it can compress the great vessel of the heart leading to supine hypotension. Therefore, if the patient complains of this during the measurement you would want to immediately place her on the left side.
9. One hour after delivery where do you expect to find the fundus of the uterus?
A. 4 cm below the xiphoid process
B. right above the symphysis pubis
C. At the umbilicus
D. 2 cm below the umbilicus
The answer is C.
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