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NUR 230 Exam 3 Childbearing and Pediatric
Nursing 2026/2027 Study Questions with Verified
Answers and Detailed Rationales Grade A - Galen
1. A patient is admitted to the labor and delivery unit with vaginal
bleeding. To differentiate between placenta previa and placental
abruption, the nurse will assess?
A) Abdominal pain
B) Fetal heart rate pattern
C) Pad counts
D) Hemoglobin and hematocrit counts
Correct Answer: A) Abdominal pain
Rationale:
1. Placenta previa typically presents with painless, bright red vaginal bleeding.
2. Placental abruption typically presents with painful, dark red bleeding and a
rigid, tender uterus.
3. Abdominal pain is the key distinguishing feature (present in abruption, absent
in previa).
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2. There are many associated risk factors in the development of placenta
previa. (Select all that apply.)
A) Jogger with low body mass index
B) First time mother who smokes 2 packs of cigarettes per day
C) Registered nurse who works 3 busy 12-hour shifts a week on a med-surg
floor
D) A client who delivered at 32 weeks SVD with her last pregnancy due to pre-
eclampsia
E) Client pregnant with triplets
F) A client who has a history of two previous cesarean sections
Correct Answer: B) First time mother who smokes 2 packs of cigarettes
per day, E) Client pregnant with triplets, and F) A client who has a history
of two previous cesarean sections
Rationale:
1. Smoking damages the placenta and increases previa risk.
2. Multiple gestation increases placental size and previa risk.
3. Prior cesarean section increases risk of placenta previa and accreta.
3. A client at 24 weeks of gestation is admitted to the emergency
department after sustaining severe internal injuries during a motor
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vehicle accident. The nurse suspects internal bleeding and placental
abruption. The suspicion is supported by which finding?
A) Early decelerations are noted on the EFM
B) Kleihauer Betke is positive
C) Late decelerations are noted on the EFM
D) The blood pressure was 110/58 an hour ago and is now 108/56
Correct Answer: C) Late decelerations are noted on the EFM
Rationale:
1. Late decelerations indicate uteroplacental insufficiency.
2. Abruption causes decreased oxygen transfer to the fetus.
3. Late decelerations are a sign of fetal distress from abruption.
4. Which of the following signs/symptoms would the nurse expect to see
in the woman with a placental abruption?
A) Pain-free vaginal bleeding
B) Increasing abdominal girth
C) Fetal heart rate accelerations
D) Blood pressure 110/60, pulse 80
Correct Answer: B) Increasing abdominal girth (due to accumulation of
blood in the myometrium)
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Rationale:
1. Concealed abruption causes blood to pool behind the placenta.
2. Increasing abdominal girth indicates intrauterine bleeding.
3. The uterus becomes tense and tender (Couvelaire uterus).
5. A client is admitted to the labor and delivery unit with vaginal
bleeding at 25 weeks gestation. To begin to differentiate between
placenta previa and placental abruption, the nurse will?
A) Palpate the fundus
B) Assess orthostatic blood pressures and pulse rate
C) Evaluate the hemoglobin and hematocrit counts
D) Begin pad counts
Correct Answer: A) Palpate the fundus
Rationale:
1. In placenta previa, the uterus is soft and non-tender.
2. In placental abruption, the uterus is often hard, rigid, and tender.
3. Fundal palpation is the first step in differentiation.
NUR 230 Exam 3 Childbearing and Pediatric
Nursing 2026/2027 Study Questions with Verified
Answers and Detailed Rationales Grade A - Galen
1. A patient is admitted to the labor and delivery unit with vaginal
bleeding. To differentiate between placenta previa and placental
abruption, the nurse will assess?
A) Abdominal pain
B) Fetal heart rate pattern
C) Pad counts
D) Hemoglobin and hematocrit counts
Correct Answer: A) Abdominal pain
Rationale:
1. Placenta previa typically presents with painless, bright red vaginal bleeding.
2. Placental abruption typically presents with painful, dark red bleeding and a
rigid, tender uterus.
3. Abdominal pain is the key distinguishing feature (present in abruption, absent
in previa).
,2|Page
2. There are many associated risk factors in the development of placenta
previa. (Select all that apply.)
A) Jogger with low body mass index
B) First time mother who smokes 2 packs of cigarettes per day
C) Registered nurse who works 3 busy 12-hour shifts a week on a med-surg
floor
D) A client who delivered at 32 weeks SVD with her last pregnancy due to pre-
eclampsia
E) Client pregnant with triplets
F) A client who has a history of two previous cesarean sections
Correct Answer: B) First time mother who smokes 2 packs of cigarettes
per day, E) Client pregnant with triplets, and F) A client who has a history
of two previous cesarean sections
Rationale:
1. Smoking damages the placenta and increases previa risk.
2. Multiple gestation increases placental size and previa risk.
3. Prior cesarean section increases risk of placenta previa and accreta.
3. A client at 24 weeks of gestation is admitted to the emergency
department after sustaining severe internal injuries during a motor
,3|Page
vehicle accident. The nurse suspects internal bleeding and placental
abruption. The suspicion is supported by which finding?
A) Early decelerations are noted on the EFM
B) Kleihauer Betke is positive
C) Late decelerations are noted on the EFM
D) The blood pressure was 110/58 an hour ago and is now 108/56
Correct Answer: C) Late decelerations are noted on the EFM
Rationale:
1. Late decelerations indicate uteroplacental insufficiency.
2. Abruption causes decreased oxygen transfer to the fetus.
3. Late decelerations are a sign of fetal distress from abruption.
4. Which of the following signs/symptoms would the nurse expect to see
in the woman with a placental abruption?
A) Pain-free vaginal bleeding
B) Increasing abdominal girth
C) Fetal heart rate accelerations
D) Blood pressure 110/60, pulse 80
Correct Answer: B) Increasing abdominal girth (due to accumulation of
blood in the myometrium)
, 4|Page
Rationale:
1. Concealed abruption causes blood to pool behind the placenta.
2. Increasing abdominal girth indicates intrauterine bleeding.
3. The uterus becomes tense and tender (Couvelaire uterus).
5. A client is admitted to the labor and delivery unit with vaginal
bleeding at 25 weeks gestation. To begin to differentiate between
placenta previa and placental abruption, the nurse will?
A) Palpate the fundus
B) Assess orthostatic blood pressures and pulse rate
C) Evaluate the hemoglobin and hematocrit counts
D) Begin pad counts
Correct Answer: A) Palpate the fundus
Rationale:
1. In placenta previa, the uterus is soft and non-tender.
2. In placental abruption, the uterus is often hard, rigid, and tender.
3. Fundal palpation is the first step in differentiation.
