u/Extension_Cost_6410

Came across this scenario while studying and most of my study group got it wrong on the first read. Posting it for anyone who wants a quick self-check.

A nurse is caring for a 28-year-old woman 2 hours after a vaginal delivery. The nurse notes a saturated peripad in the past 15 minutes, a boggy fundus that is displaced to the right, and BP 102/64 (down from 124/78 at delivery). Which action should the nurse take FIRST?

A) Notify the healthcare provider

😎 Administer oxytocin 10 units IM

C) Massage the fundus and assist the patient to void

D) Increase the IV fluid rate

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Drop your answer and reasoning. I'll come back in a few hours and post the rationale + why each distractor is tempting. Also curious, for those who got it wrong, what tipped you toward the wrong answer? That's usually where the real learning is.

I used to bomb every "which action should the nurse take FIRST?" question. The pattern that finally clicked: the right answer is almost always the one that addresses the cause of the problem, not the symptom.

Example pattern (without quoting an actual question): if a postpartum patient has a boggy fundus displaced to the right, the cause is usually a full bladder — so the first action is to massage and have the patient void, not to give oxytocin. Oxytocin treats the symptom (atony), not the cause (bladder distension).

Once I started asking "what's the cause?" before "what's the treatment?" my priority question accuracy jumped maybe 15%.

Curious — what tricks do you all use for first-action questions?