NSG 3500 EXAM 4 NURSING PRACTICE - MATERNAL HEALTH
– GALEN ACTUAL LATEST REVISION QUESTIONS WITH
CORRECT AND VERIFIED ANSWERS 2026
1. What are the 4 factors that influence initiation of the first
breath?:
Answer:
- Chemical factors (hypercarbia, acidosis, hypoxia)
- Sensory factors (stimuli such as noise, light, touch)
- Thermal factors (sudden temperature change)
- Mechanical factors (thoracic squeeze during birth clears lung fluid)
Explanation: These factors collectively stimulate the newborn’s respiratory
center to initiate and maintain effective breathing at birth.
2. Why does hypoxia, hypercarbia, and acidosis
trigger respirations?:
Answer:
- Hypoxia lowers blood oxygen (PO2) levels and pH, indicating oxygen
deficiency.
- Carbon dioxide (PCO2) levels rise, stimulating the respiratory center in the
medulla to increase respiratory effort.
Explanation: The medullary respiratory center responds to elevated CO2
and lowered O2/pH by triggering spontaneous breathing to oxygenate the
blood and remove excess CO2, essential for neonatal adaptation.
3. Periodic breathing in a newborn is not usually associated
with any change in skin color or HR. How long are these
pauses?:
Answer: 5-15 seconds
,Explanation: Periodic breathing is a benign, immature breathing pattern in
newborns involving brief pauses, generally up to 10-15 seconds, without
oxygen desaturation or cardiac changes.
4. What does each APGAR score mean?: cf
Answer: >7 = normal
4-6 = low
<3 = critical
Explanation: Scores above 7 indicate good newborn status; scores between
4-6 suggest mild to moderate distress and may require intervention; a score
less than 3 indicates severe distress and urgent resuscitation is required.
5. When is the APGAR score assigned?:
cf
Answer: At 1 and 5 minutes after birth
Explanation: The APGAR scoring system is a quick and standardized
cf
method to assess the health and immediate adaptation of a newborn at 1
minute and again at 5 minutes after birth. This allows healthcare providers to
determine if the infant needs urgent medical intervention and to evaluate
initial responses to resuscitation efforts.
6. What are the five categories of the APGAR score?:cf
Answer:
1. Heart Rate (HR)
2. Respiratory Rate (RR)
3. Muscle Tone
4. Reflex irritability (cry)
,5. Generalized Skin Color (coloring)
Explanation: These five criteria are evaluated and scored from 0 to 2 based
on the newborn’s condition immediately after birth to assess their
physiological stability.
7. When the APGAR score is <9 at 5 minutes, it is more
cf
important to stabilize the infant than keep them with mom.
T/F?
Answer: True
Explanation: While bonding with the mother is important, an APGAR scorecf
less than 9 indicates the newborn may need immediate interventions to
ensure adequate oxygenation and circulation, making stabilization the
priority.
8. What are indicators of respiratory difficulties in the newborn?:
Answer:
- Apnea >20 seconds
- Expiratory grunting
- Wheezing
- Nasal flaring
- Retractions
- Use of accessory muscles at rest
- Tachypnea (high respiratory rate)
Explanation: These signs indicate increased work of breathing or
cf
respiratory distress and warrant prompt assessment and intervention.
9. What are the five changes for successful
cardiopulmonary adaptation?:
, Answer:
- Increased aortic pressure
- Decreased venous pressure
- Increased systemic pressure
- Decreased pulmonary pressure
- Closure of foramen ovale, ductus arteriosus (DA), and ductus venosus (DV)
Explanation: These hemodynamic changes transition fetal circulation to
neonatal circulation, ensuring effective oxygen delivery outside the womb.
10. What is the HR when baby is first born?:
cf
Answer: 160-180 bpm, decreasing to 120-160 bpm within 30 minutes
Explanation: The initial heart rate is elevated due to birth stress and
catecholamine surge, then stabilizes as the newborn adapts.
11. The baby cannot become hypoglycemic from heat loss. T/F?
Answer: False
Explanation: Heat loss increases metabolic demand and glucose
consumption; therefore, hypoglycemia can result secondary to cold stress.
12. How do newborns respond to cold?:
cf
Answer: They metabolize (burn) brown adipose tissue (brown fat) since they
cannot shiver to maintain warmth
Explanation: Brown fat thermogenesis is the primary method of non-
shivering thermogenesis in neonates to maintain temperature.
13. What can the nurse do to regulate temperature in
the newborn?:
– GALEN ACTUAL LATEST REVISION QUESTIONS WITH
CORRECT AND VERIFIED ANSWERS 2026
1. What are the 4 factors that influence initiation of the first
breath?:
Answer:
- Chemical factors (hypercarbia, acidosis, hypoxia)
- Sensory factors (stimuli such as noise, light, touch)
- Thermal factors (sudden temperature change)
- Mechanical factors (thoracic squeeze during birth clears lung fluid)
Explanation: These factors collectively stimulate the newborn’s respiratory
center to initiate and maintain effective breathing at birth.
2. Why does hypoxia, hypercarbia, and acidosis
trigger respirations?:
Answer:
- Hypoxia lowers blood oxygen (PO2) levels and pH, indicating oxygen
deficiency.
- Carbon dioxide (PCO2) levels rise, stimulating the respiratory center in the
medulla to increase respiratory effort.
Explanation: The medullary respiratory center responds to elevated CO2
and lowered O2/pH by triggering spontaneous breathing to oxygenate the
blood and remove excess CO2, essential for neonatal adaptation.
3. Periodic breathing in a newborn is not usually associated
with any change in skin color or HR. How long are these
pauses?:
Answer: 5-15 seconds
,Explanation: Periodic breathing is a benign, immature breathing pattern in
newborns involving brief pauses, generally up to 10-15 seconds, without
oxygen desaturation or cardiac changes.
4. What does each APGAR score mean?: cf
Answer: >7 = normal
4-6 = low
<3 = critical
Explanation: Scores above 7 indicate good newborn status; scores between
4-6 suggest mild to moderate distress and may require intervention; a score
less than 3 indicates severe distress and urgent resuscitation is required.
5. When is the APGAR score assigned?:
cf
Answer: At 1 and 5 minutes after birth
Explanation: The APGAR scoring system is a quick and standardized
cf
method to assess the health and immediate adaptation of a newborn at 1
minute and again at 5 minutes after birth. This allows healthcare providers to
determine if the infant needs urgent medical intervention and to evaluate
initial responses to resuscitation efforts.
6. What are the five categories of the APGAR score?:cf
Answer:
1. Heart Rate (HR)
2. Respiratory Rate (RR)
3. Muscle Tone
4. Reflex irritability (cry)
,5. Generalized Skin Color (coloring)
Explanation: These five criteria are evaluated and scored from 0 to 2 based
on the newborn’s condition immediately after birth to assess their
physiological stability.
7. When the APGAR score is <9 at 5 minutes, it is more
cf
important to stabilize the infant than keep them with mom.
T/F?
Answer: True
Explanation: While bonding with the mother is important, an APGAR scorecf
less than 9 indicates the newborn may need immediate interventions to
ensure adequate oxygenation and circulation, making stabilization the
priority.
8. What are indicators of respiratory difficulties in the newborn?:
Answer:
- Apnea >20 seconds
- Expiratory grunting
- Wheezing
- Nasal flaring
- Retractions
- Use of accessory muscles at rest
- Tachypnea (high respiratory rate)
Explanation: These signs indicate increased work of breathing or
cf
respiratory distress and warrant prompt assessment and intervention.
9. What are the five changes for successful
cardiopulmonary adaptation?:
, Answer:
- Increased aortic pressure
- Decreased venous pressure
- Increased systemic pressure
- Decreased pulmonary pressure
- Closure of foramen ovale, ductus arteriosus (DA), and ductus venosus (DV)
Explanation: These hemodynamic changes transition fetal circulation to
neonatal circulation, ensuring effective oxygen delivery outside the womb.
10. What is the HR when baby is first born?:
cf
Answer: 160-180 bpm, decreasing to 120-160 bpm within 30 minutes
Explanation: The initial heart rate is elevated due to birth stress and
catecholamine surge, then stabilizes as the newborn adapts.
11. The baby cannot become hypoglycemic from heat loss. T/F?
Answer: False
Explanation: Heat loss increases metabolic demand and glucose
consumption; therefore, hypoglycemia can result secondary to cold stress.
12. How do newborns respond to cold?:
cf
Answer: They metabolize (burn) brown adipose tissue (brown fat) since they
cannot shiver to maintain warmth
Explanation: Brown fat thermogenesis is the primary method of non-
shivering thermogenesis in neonates to maintain temperature.
13. What can the nurse do to regulate temperature in
the newborn?:
