NSG 432 Exam 2 V2 | NSG 432 Maternal-
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 2) | Grand
Canyon University
1. A nurse is reviewing a fetal heart rate (FHR) tracing for a client in active labor and notes a
pattern of variable decelerations. What is the priority nursing intervention?
A. Increase the rate of the primary intravenous infusion.
B. Discontinue the oxytocin (Pitocin) infusion immediately.
C. Administer oxygen at 8 to 10 L/min via a nonrebreather face mask.
D. Change the maternal position to a lateral or knee-chest position.
Correct Answer: D
Variable decelerations are indicative of umbilical cord compression, which can lead to
fetal hypoxia if left unaddressed. Changing the maternal position is the first-line
intervention to relieve pressure on the cord and improve fetal blood flow. The nurse must
continue to monitor the FHR to evaluate the effectiveness of the position change before
proceeding to more invasive measures.
2. A nurse is caring for a client with severe preeclampsia who is receiving magnesium sulfate
via continuous IV infusion. Which of the following findings should the nurse identify as signs
of magnesium toxicity? (Select all that apply)
A. Respiratory rate less than 12 breaths/minute
,B. Absence of deep tendon reflexes (DTRs)
C. Urine output less than 30 mL/hr
D. Decreased level of consciousness or extreme lethargy
E. Hyperreflexia and increased irritability
F. Tachycardia and hypertension
Correct Answer: A, B, C, D
Magnesium sulfate is a central nervous system depressant, and toxicity can lead to life-
threatening respiratory arrest. Clinical indicators of toxicity include bradypnea, loss of
patellar reflexes, and oliguria, which prevents the clearance of the drug. The nurse must be
vigilant in monitoring these parameters and have calcium gluconate available as an
antidote.
3. A client at 34 weeks of gestation presents to the labor and delivery unit with a complaint of
sudden, dark red vaginal bleeding and intense abdominal pain. The nurse notes that the
abdomen is rigid and board-like. Which condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Vasa previa
D. Uterine rupture
Correct Answer: A
, Abruptio placentae is characterized by the premature separation of the placenta from the
uterine wall, typically presenting with painful, dark red bleeding and uterine tenderness. A
rigid, board-like abdomen is a classic sign of a concealed or significant abruption due to
blood accumulating in the uterine muscle. In contrast, placenta previa usually presents
with painless, bright red bleeding.
4. A nurse is performing a Bishop score to assess the readiness of a client’s cervix for
induction of labor. Which factors are included in this scoring system? (Select all that apply)
A. Cervical dilation
B. Cervical effacement
C. Fetal station
D. Cervical consistency
E. Cervical position
Correct Answer: A, B, C, D, E
The Bishop score is a standardized tool used to predict the success of labor induction by
evaluating five cervical and fetal parameters. A higher score indicates a ‘ripe’ cervix that is
more likely to respond to induction methods. Accurate assessment of these factors helps
the healthcare provider decide whether to use mechanical or pharmacological cervical
ripening agents.
, 5. A nurse is monitoring a client in the second stage of labor. Which of the following should
the nurse recognize as a characteristic of this stage?
A. The onset of regular uterine contractions.
B. The complete effacement and dilation of the cervix.
C. The delivery of the newborn.
D. The delivery of the placenta.
Correct Answer: C
The second stage of labor begins when the cervix is fully dilated at 10 cm and ends with
the birth of the infant. This stage involves active pushing efforts by the mother to facilitate
the descent of the fetus through the birth canal. It is distinct from the first stage (dilation)
and the third stage (placental delivery).
6. A client is scheduled for an external cephalic version (ECV). Which of the following is a
prerequisite for this procedure?
A. A reactive non-stress test (NST) prior to the procedure.
B. Active labor contractions.
C. Ruptured membranes.
D. Presence of a previous cesarean section scar.
Correct Answer: A
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 2) | Grand
Canyon University
1. A nurse is reviewing a fetal heart rate (FHR) tracing for a client in active labor and notes a
pattern of variable decelerations. What is the priority nursing intervention?
A. Increase the rate of the primary intravenous infusion.
B. Discontinue the oxytocin (Pitocin) infusion immediately.
C. Administer oxygen at 8 to 10 L/min via a nonrebreather face mask.
D. Change the maternal position to a lateral or knee-chest position.
Correct Answer: D
Variable decelerations are indicative of umbilical cord compression, which can lead to
fetal hypoxia if left unaddressed. Changing the maternal position is the first-line
intervention to relieve pressure on the cord and improve fetal blood flow. The nurse must
continue to monitor the FHR to evaluate the effectiveness of the position change before
proceeding to more invasive measures.
2. A nurse is caring for a client with severe preeclampsia who is receiving magnesium sulfate
via continuous IV infusion. Which of the following findings should the nurse identify as signs
of magnesium toxicity? (Select all that apply)
A. Respiratory rate less than 12 breaths/minute
,B. Absence of deep tendon reflexes (DTRs)
C. Urine output less than 30 mL/hr
D. Decreased level of consciousness or extreme lethargy
E. Hyperreflexia and increased irritability
F. Tachycardia and hypertension
Correct Answer: A, B, C, D
Magnesium sulfate is a central nervous system depressant, and toxicity can lead to life-
threatening respiratory arrest. Clinical indicators of toxicity include bradypnea, loss of
patellar reflexes, and oliguria, which prevents the clearance of the drug. The nurse must be
vigilant in monitoring these parameters and have calcium gluconate available as an
antidote.
3. A client at 34 weeks of gestation presents to the labor and delivery unit with a complaint of
sudden, dark red vaginal bleeding and intense abdominal pain. The nurse notes that the
abdomen is rigid and board-like. Which condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Vasa previa
D. Uterine rupture
Correct Answer: A
, Abruptio placentae is characterized by the premature separation of the placenta from the
uterine wall, typically presenting with painful, dark red bleeding and uterine tenderness. A
rigid, board-like abdomen is a classic sign of a concealed or significant abruption due to
blood accumulating in the uterine muscle. In contrast, placenta previa usually presents
with painless, bright red bleeding.
4. A nurse is performing a Bishop score to assess the readiness of a client’s cervix for
induction of labor. Which factors are included in this scoring system? (Select all that apply)
A. Cervical dilation
B. Cervical effacement
C. Fetal station
D. Cervical consistency
E. Cervical position
Correct Answer: A, B, C, D, E
The Bishop score is a standardized tool used to predict the success of labor induction by
evaluating five cervical and fetal parameters. A higher score indicates a ‘ripe’ cervix that is
more likely to respond to induction methods. Accurate assessment of these factors helps
the healthcare provider decide whether to use mechanical or pharmacological cervical
ripening agents.
, 5. A nurse is monitoring a client in the second stage of labor. Which of the following should
the nurse recognize as a characteristic of this stage?
A. The onset of regular uterine contractions.
B. The complete effacement and dilation of the cervix.
C. The delivery of the newborn.
D. The delivery of the placenta.
Correct Answer: C
The second stage of labor begins when the cervix is fully dilated at 10 cm and ends with
the birth of the infant. This stage involves active pushing efforts by the mother to facilitate
the descent of the fetus through the birth canal. It is distinct from the first stage (dilation)
and the third stage (placental delivery).
6. A client is scheduled for an external cephalic version (ECV). Which of the following is a
prerequisite for this procedure?
A. A reactive non-stress test (NST) prior to the procedure.
B. Active labor contractions.
C. Ruptured membranes.
D. Presence of a previous cesarean section scar.
Correct Answer: A
