NSG 432 Exam 3 V3 | NSG 432 Maternal-
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 3) | Grand
Canyon University
1. A nurse is reviewing the medical record of a postpartum client. Which of the following
factors should the nurse identify as placing the client at a higher risk for postpartum
hemorrhage? (Select all that apply)
A. Polyhydramnios
B. Precipitous delivery
C. Macrosomic infant
D. Primigravida status
E. Chorioamnionitis
F. Magnesium sulfate infusion during labor
Correct Answer: A, B, C, E, F
Polyhydramnios, macrosomia, and multiple gestations cause overdistention of the uterus,
which impairs its ability to contract effectively after birth. Chorioamnionitis and
magnesium sulfate also lead to uterine atony by causing muscle fatigue or relaxation.
Precipitous labor, which is labor lasting less than 3 hours, significantly increases the risk
for trauma and uterine exhaustion.
,2. A client at 34 weeks gestation is receiving magnesium sulfate for the management of
preeclampsia. Which of the following findings should the nurse prioritize and report to the
healthcare provider?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 11 breaths per minute
C. Urinary output of 45 mL/hr
D. Report of a warm, flushed feeling
Correct Answer: B
A respiratory rate below 12 breaths per minute is a hallmark sign of magnesium sulfate
toxicity and requires immediate cessation of the infusion. Magnesium sulfate is a central
nervous system depressant, and toxicity can lead to respiratory failure and cardiac arrest.
The nurse must also monitor for loss of deep tendon reflexes and significantly decreased
urine output, which are additional indicators of toxicity.
3. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart rate of
110/min, a weak cry, some flexion of the extremities, grimaces when suctioned, and a pink
body with blue extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
,Correct Answer: C
The newborn receives 2 points for heart rate (>100), 1 point for respiratory effort (weak
cry), 1 point for muscle tone (some flexion), 1 point for reflex irritability (grimace), and 1
point for color (acrocyanosis). This results in a total Apgar score of 6. Scores between 4 and
6 indicate moderate distress and require close monitoring and potential intervention.
4. A nurse is teaching a breastfeeding client about the management of mastitis. Which of the
following instructions should the nurse include in the teaching?
A. Stop breastfeeding on the affected side until the infection clears.
B. Apply cold packs exclusively to the breast to reduce inflammation.
C. Limit fluid intake to reduce milk production and pressure.
D. Continue to breastfeed or pump frequently to ensure complete emptying.
Correct Answer: D
Mastitis management requires frequent emptying of the breast to prevent stasis and
further infection. The client should be encouraged to breastfeed or pump every 2 to 3
hours, starting on the unaffected side if necessary to trigger the let-down reflex. Antibiotic
therapy is necessary, but maintaining milk flow is critical for recovery and preventing
abscess formation.
5. A client with gestational diabetes mellitus (GDM) is being educated on blood glucose
monitoring. Which statement by the client indicates a need for further instruction?
A. I will check my blood sugar as soon as I wake up in the morning.
, B. If my blood sugar is low, I will drink a diet soda to help raise it.
C. I should keep a log of my food intake along with my glucose levels.
D. I will exercise moderately after meals to help control my sugar levels.
Correct Answer: B
Diet soda does not contain sugar and will not treat hypoglycemia; the client should use 15
grams of simple carbohydrates like orange juice or regular soda. Gestational diabetes
requires strict glycemic control to prevent fetal macrosomia and neonatal hypoglycemia.
Proper education involves understanding the ‘Rule of 15’ for managing low blood sugar
episodes.
6. A nurse is caring for a client at 32 weeks gestation who presents with painless, bright red
vaginal bleeding. Which of the following actions is contraindicated for this client?
A. Initiating continuous fetal heart rate monitoring
B. Performing a manual vaginal examination
C. Administering IV fluids as ordered
D. Obtaining a baseline hemoglobin and hematocrit
Correct Answer: B
Painless bright red bleeding is a classic sign of placenta previa, where the placenta covers
the cervical os. Performing a manual vaginal exam can cause placental abruption or severe
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 3) | Grand
Canyon University
1. A nurse is reviewing the medical record of a postpartum client. Which of the following
factors should the nurse identify as placing the client at a higher risk for postpartum
hemorrhage? (Select all that apply)
A. Polyhydramnios
B. Precipitous delivery
C. Macrosomic infant
D. Primigravida status
E. Chorioamnionitis
F. Magnesium sulfate infusion during labor
Correct Answer: A, B, C, E, F
Polyhydramnios, macrosomia, and multiple gestations cause overdistention of the uterus,
which impairs its ability to contract effectively after birth. Chorioamnionitis and
magnesium sulfate also lead to uterine atony by causing muscle fatigue or relaxation.
Precipitous labor, which is labor lasting less than 3 hours, significantly increases the risk
for trauma and uterine exhaustion.
,2. A client at 34 weeks gestation is receiving magnesium sulfate for the management of
preeclampsia. Which of the following findings should the nurse prioritize and report to the
healthcare provider?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 11 breaths per minute
C. Urinary output of 45 mL/hr
D. Report of a warm, flushed feeling
Correct Answer: B
A respiratory rate below 12 breaths per minute is a hallmark sign of magnesium sulfate
toxicity and requires immediate cessation of the infusion. Magnesium sulfate is a central
nervous system depressant, and toxicity can lead to respiratory failure and cardiac arrest.
The nurse must also monitor for loss of deep tendon reflexes and significantly decreased
urine output, which are additional indicators of toxicity.
3. A nurse is assessing a newborn 1 minute after birth. The newborn has a heart rate of
110/min, a weak cry, some flexion of the extremities, grimaces when suctioned, and a pink
body with blue extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
,Correct Answer: C
The newborn receives 2 points for heart rate (>100), 1 point for respiratory effort (weak
cry), 1 point for muscle tone (some flexion), 1 point for reflex irritability (grimace), and 1
point for color (acrocyanosis). This results in a total Apgar score of 6. Scores between 4 and
6 indicate moderate distress and require close monitoring and potential intervention.
4. A nurse is teaching a breastfeeding client about the management of mastitis. Which of the
following instructions should the nurse include in the teaching?
A. Stop breastfeeding on the affected side until the infection clears.
B. Apply cold packs exclusively to the breast to reduce inflammation.
C. Limit fluid intake to reduce milk production and pressure.
D. Continue to breastfeed or pump frequently to ensure complete emptying.
Correct Answer: D
Mastitis management requires frequent emptying of the breast to prevent stasis and
further infection. The client should be encouraged to breastfeed or pump every 2 to 3
hours, starting on the unaffected side if necessary to trigger the let-down reflex. Antibiotic
therapy is necessary, but maintaining milk flow is critical for recovery and preventing
abscess formation.
5. A client with gestational diabetes mellitus (GDM) is being educated on blood glucose
monitoring. Which statement by the client indicates a need for further instruction?
A. I will check my blood sugar as soon as I wake up in the morning.
, B. If my blood sugar is low, I will drink a diet soda to help raise it.
C. I should keep a log of my food intake along with my glucose levels.
D. I will exercise moderately after meals to help control my sugar levels.
Correct Answer: B
Diet soda does not contain sugar and will not treat hypoglycemia; the client should use 15
grams of simple carbohydrates like orange juice or regular soda. Gestational diabetes
requires strict glycemic control to prevent fetal macrosomia and neonatal hypoglycemia.
Proper education involves understanding the ‘Rule of 15’ for managing low blood sugar
episodes.
6. A nurse is caring for a client at 32 weeks gestation who presents with painless, bright red
vaginal bleeding. Which of the following actions is contraindicated for this client?
A. Initiating continuous fetal heart rate monitoring
B. Performing a manual vaginal examination
C. Administering IV fluids as ordered
D. Obtaining a baseline hemoglobin and hematocrit
Correct Answer: B
Painless bright red bleeding is a classic sign of placenta previa, where the placenta covers
the cervical os. Performing a manual vaginal exam can cause placental abruption or severe
