NUR 231 Final Exam: Childbearing & Child Caring Family Study Guide
2026 Galen College
1. A nurse is assessing a client who is at 34 weeks of gestation and has a
prescription for magnesium sulfate. Which of the following findings should the
nurse identify as a manifestation of magnesium toxicity?
A. Hyperreflexia
B. Respiratory rate of 10/min
C. Increased urinary output
D. Blood pressure of 150/90 mmHg
Answer: B
Rationale: Magnesium toxicity causes CNS depression, leading to decreased respiratory
rate (below 12/min), loss of deep tendon reflexes, and decreased urinary output.
2. A client is in the first stage of labor and has a fetal heart rate (FHR) tracing
showing late decelerations. Which of the following actions should the nurse
take first?
A. Assist the client into a side-lying position
B. Increase the IV fluid rate
C. Perform a vaginal exam
D. Administer oxygen via nonrebreather mask
Answer: A
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority action (L-
I-O-N) is to position the client on her side to improve blood flow to the placenta.
,3. A nurse is caring for a newborn immediately after delivery. Which of the
following is the priority intervention?
A. Administer Vitamin K
B. Obtain the newborn’s weight
C. Apply erythromycin ophthalmic ointment
D. Dry the newborn and maintain thermoregulation
Answer: D
Rationale: Cold stress can lead to respiratory distress and hypoglycemia. Drying the
newborn is the priority according to the ABCs and immediate stability.
4. Which of the following GTPAL scores would the nurse record for a client who
is currently pregnant, had a twin birth at 38 weeks, and a spontaneous abortion
at 10 weeks?
A. G2, T1, P0, A1, L2
B. G2, T2, P0, A1, L1
C. G3, T2, P0, A1, L2
D. G3, T1, P0, A1, L2
Answer: D
Rationale: G (Gravida) is 3 (current, twins, abortion). T (Term) is 1 (twins count as one
birth event). P (Preterm) is 0. A (Abortion) is 1. L (Living) is 2 (twins).
5. A client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. The nurse should suspect which condition?
A. Abruptio placentae
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Answer: D
, Rationale: Painless, bright red bleeding in the third trimester is the hallmark sign of
placenta previa.
6. Which medication is typically administered to the mother to stimulate fetal
lung maturity in cases of preterm labor?
A. Terbutaline
B. Oxytocin
C. Betamethasone
D. Nifedipine
Answer: C
Rationale: Betamethasone is a corticosteroid given to pregnant clients in preterm labor to
promote fetal lung surfactant production.
7. A nurse is assessing a 2-hour-old newborn. Which of the following findings
should the nurse report to the provider?
A. Generalized petechiae
B. Acrocyanosis
C. Heart rate of 140/min
D. Molding of the head
Answer: A
Rationale: Generalized petechiae can indicate a clotting factor deficiency or infection and
must be reported. Acrocyanosis and molding are normal findings.
8. A nurse is assessing a 4-year-old child. According to Erikson, which
developmental stage should the child be achieving?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Industry vs. Inferiority
D. Initiative vs. Guilt
Answer: D
2026 Galen College
1. A nurse is assessing a client who is at 34 weeks of gestation and has a
prescription for magnesium sulfate. Which of the following findings should the
nurse identify as a manifestation of magnesium toxicity?
A. Hyperreflexia
B. Respiratory rate of 10/min
C. Increased urinary output
D. Blood pressure of 150/90 mmHg
Answer: B
Rationale: Magnesium toxicity causes CNS depression, leading to decreased respiratory
rate (below 12/min), loss of deep tendon reflexes, and decreased urinary output.
2. A client is in the first stage of labor and has a fetal heart rate (FHR) tracing
showing late decelerations. Which of the following actions should the nurse
take first?
A. Assist the client into a side-lying position
B. Increase the IV fluid rate
C. Perform a vaginal exam
D. Administer oxygen via nonrebreather mask
Answer: A
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority action (L-
I-O-N) is to position the client on her side to improve blood flow to the placenta.
,3. A nurse is caring for a newborn immediately after delivery. Which of the
following is the priority intervention?
A. Administer Vitamin K
B. Obtain the newborn’s weight
C. Apply erythromycin ophthalmic ointment
D. Dry the newborn and maintain thermoregulation
Answer: D
Rationale: Cold stress can lead to respiratory distress and hypoglycemia. Drying the
newborn is the priority according to the ABCs and immediate stability.
4. Which of the following GTPAL scores would the nurse record for a client who
is currently pregnant, had a twin birth at 38 weeks, and a spontaneous abortion
at 10 weeks?
A. G2, T1, P0, A1, L2
B. G2, T2, P0, A1, L1
C. G3, T2, P0, A1, L2
D. G3, T1, P0, A1, L2
Answer: D
Rationale: G (Gravida) is 3 (current, twins, abortion). T (Term) is 1 (twins count as one
birth event). P (Preterm) is 0. A (Abortion) is 1. L (Living) is 2 (twins).
5. A client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. The nurse should suspect which condition?
A. Abruptio placentae
B. Uterine rupture
C. Preterm labor
D. Placenta previa
Answer: D
, Rationale: Painless, bright red bleeding in the third trimester is the hallmark sign of
placenta previa.
6. Which medication is typically administered to the mother to stimulate fetal
lung maturity in cases of preterm labor?
A. Terbutaline
B. Oxytocin
C. Betamethasone
D. Nifedipine
Answer: C
Rationale: Betamethasone is a corticosteroid given to pregnant clients in preterm labor to
promote fetal lung surfactant production.
7. A nurse is assessing a 2-hour-old newborn. Which of the following findings
should the nurse report to the provider?
A. Generalized petechiae
B. Acrocyanosis
C. Heart rate of 140/min
D. Molding of the head
Answer: A
Rationale: Generalized petechiae can indicate a clotting factor deficiency or infection and
must be reported. Acrocyanosis and molding are normal findings.
8. A nurse is assessing a 4-year-old child. According to Erikson, which
developmental stage should the child be achieving?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Industry vs. Inferiority
D. Initiative vs. Guilt
Answer: D
