NRSG 112 Final Exam V3 | NRSG 112
Maternal-Child Nursing | Actual Q&A with
Rationale (NRSG112 Final Exam) | Ivy
Tech
1. A nurse is assessing a client who is at 34 weeks of gestation and has a prescription for a
nonstress test (NST). Which of the following results should the nurse identify as a reactive
NST?
A. Fetal heart rate accelerations of 10/min lasting for 10 seconds.
B. Fetal heart rate decelerations that mirror uterine contractions.
C. Absence of fetal heart rate accelerations over a 40-minute period.
D. Two fetal heart rate accelerations of 15/min lasting at least 15 seconds within a 20-
minute period.
E. A baseline fetal heart rate of 110/min with moderate variability.
Correct Answer: D
A reactive nonstress test is defined by the presence of at least two accelerations of 15
beats/minute above the baseline, lasting at least 15 seconds, within a 20-minute window.
This indicates fetal well-being and an intact central nervous system. If these criteria are not
met within 40 minutes, the test is considered nonreactive and further testing like a
biophysical profile is indicated.
,2. A nurse is caring for a client who is in the first stage of labor and has late decelerations on
the electronic fetal monitor. Which of the following actions should the nurse take first?
A. Turn the client onto her left side.
B. Administer oxygen via a nonrebreather mask.
C. Increase the rate of the IV fluid infusion.
D. Notify the provider of the decelerations.
Correct Answer: A
Late decelerations are indicative of uteroplacental insufficiency and require immediate
intervention to improve fetal oxygenation. The first priority is to change the maternal
position to the lateral side to relieve pressure on the vena cava and enhance placental
perfusion. While oxygen administration and IV fluids are also appropriate, repositioning is
the immediate first step in intrauterine resuscitation.
3. A nurse is providing teaching to a client who is at 12 weeks of gestation and has a new
prescription for prenatal vitamins. Which of the following substances should the nurse
instruct the client to avoid taking with the vitamins to ensure maximum absorption?
A. Orange juice
B. Milk
C. Water
D. Tomato juice
,Correct Answer: B
Calcium found in milk and dairy products can interfere with the absorption of iron, which
is a major component of prenatal vitamins. Clients should be encouraged to take iron
supplements with vitamin C, such as orange juice, to enhance absorption. It is best to wait
at least two hours between consuming calcium-rich foods and taking iron supplements.
4. A nurse is assessing a newborn who is 12 hours old. Which of the following findings is a
manifestation of respiratory distress?
A. Acrocyanosis
B. Nasal flaring
C. Respiratory rate of 45/min
D. Abdominal breathing
Correct Answer: B
Nasal flaring is a classic sign of respiratory distress in the neonate as they attempt to
decrease airway resistance and increase oxygen intake. Other signs include chest
retractions, grunting, and tachypnea. Acrocyanosis is a normal finding in the first 24 to 48
hours of life, and a respiratory rate of 45/min is within the expected range of 30 to 60/min.
5. A nurse is caring for a client who is 4 hours postpartum and has a boggy uterus with heavy
lochia rubra. Which of the following medications should the nurse expect the provider to
prescribe?
A. Terbutaline
, B. Magnesium sulfate
C. Oxytocin
D. Betamethasone
Correct Answer: C
Oxytocin is a uterotonic medication used to increase the strength and frequency of uterine
contractions, which helps to firm a boggy uterus and reduce postpartum hemorrhage.
Terbutaline and magnesium sulfate are tocolytics used to stop contractions during preterm
labor. Betamethasone is a corticosteroid used to promote fetal lung maturity in cases of
anticipated preterm birth.
6. A nurse is teaching a group of parents about the prevention of sudden infant death
syndrome (SIDS). Which of the following instructions should the nurse include?
A. Place the infant in a prone position for sleep.
B. Use soft pillows in the infant’s crib.
C. Place the infant on a firm mattress for sleep.
D. Ensure the infant is kept very warm with multiple blankets.
Correct Answer: C
To prevent SIDS, infants should always be placed on their backs to sleep on a firm, flat
mattress in a crib free of soft objects, toys, or loose bedding. Overheating and exposure to
Maternal-Child Nursing | Actual Q&A with
Rationale (NRSG112 Final Exam) | Ivy
Tech
1. A nurse is assessing a client who is at 34 weeks of gestation and has a prescription for a
nonstress test (NST). Which of the following results should the nurse identify as a reactive
NST?
A. Fetal heart rate accelerations of 10/min lasting for 10 seconds.
B. Fetal heart rate decelerations that mirror uterine contractions.
C. Absence of fetal heart rate accelerations over a 40-minute period.
D. Two fetal heart rate accelerations of 15/min lasting at least 15 seconds within a 20-
minute period.
E. A baseline fetal heart rate of 110/min with moderate variability.
Correct Answer: D
A reactive nonstress test is defined by the presence of at least two accelerations of 15
beats/minute above the baseline, lasting at least 15 seconds, within a 20-minute window.
This indicates fetal well-being and an intact central nervous system. If these criteria are not
met within 40 minutes, the test is considered nonreactive and further testing like a
biophysical profile is indicated.
,2. A nurse is caring for a client who is in the first stage of labor and has late decelerations on
the electronic fetal monitor. Which of the following actions should the nurse take first?
A. Turn the client onto her left side.
B. Administer oxygen via a nonrebreather mask.
C. Increase the rate of the IV fluid infusion.
D. Notify the provider of the decelerations.
Correct Answer: A
Late decelerations are indicative of uteroplacental insufficiency and require immediate
intervention to improve fetal oxygenation. The first priority is to change the maternal
position to the lateral side to relieve pressure on the vena cava and enhance placental
perfusion. While oxygen administration and IV fluids are also appropriate, repositioning is
the immediate first step in intrauterine resuscitation.
3. A nurse is providing teaching to a client who is at 12 weeks of gestation and has a new
prescription for prenatal vitamins. Which of the following substances should the nurse
instruct the client to avoid taking with the vitamins to ensure maximum absorption?
A. Orange juice
B. Milk
C. Water
D. Tomato juice
,Correct Answer: B
Calcium found in milk and dairy products can interfere with the absorption of iron, which
is a major component of prenatal vitamins. Clients should be encouraged to take iron
supplements with vitamin C, such as orange juice, to enhance absorption. It is best to wait
at least two hours between consuming calcium-rich foods and taking iron supplements.
4. A nurse is assessing a newborn who is 12 hours old. Which of the following findings is a
manifestation of respiratory distress?
A. Acrocyanosis
B. Nasal flaring
C. Respiratory rate of 45/min
D. Abdominal breathing
Correct Answer: B
Nasal flaring is a classic sign of respiratory distress in the neonate as they attempt to
decrease airway resistance and increase oxygen intake. Other signs include chest
retractions, grunting, and tachypnea. Acrocyanosis is a normal finding in the first 24 to 48
hours of life, and a respiratory rate of 45/min is within the expected range of 30 to 60/min.
5. A nurse is caring for a client who is 4 hours postpartum and has a boggy uterus with heavy
lochia rubra. Which of the following medications should the nurse expect the provider to
prescribe?
A. Terbutaline
, B. Magnesium sulfate
C. Oxytocin
D. Betamethasone
Correct Answer: C
Oxytocin is a uterotonic medication used to increase the strength and frequency of uterine
contractions, which helps to firm a boggy uterus and reduce postpartum hemorrhage.
Terbutaline and magnesium sulfate are tocolytics used to stop contractions during preterm
labor. Betamethasone is a corticosteroid used to promote fetal lung maturity in cases of
anticipated preterm birth.
6. A nurse is teaching a group of parents about the prevention of sudden infant death
syndrome (SIDS). Which of the following instructions should the nurse include?
A. Place the infant in a prone position for sleep.
B. Use soft pillows in the infant’s crib.
C. Place the infant on a firm mattress for sleep.
D. Ensure the infant is kept very warm with multiple blankets.
Correct Answer: C
To prevent SIDS, infants should always be placed on their backs to sleep on a firm, flat
mattress in a crib free of soft objects, toys, or loose bedding. Overheating and exposure to
