NSG 432 Final Exam V1 | NSG 432
Maternal-Newborn Nursing / OB/GYN |
Actual Q&A with Rationale (NSG432 Final
Exam) | Grand Canyon University
1. A nurse is assessing a client at 34 weeks gestation who presents with a sudden onset of
severe abdominal pain and a board-like abdomen. Which risk factors are associated with this
condition? (Select All That Apply)
A. Cocaine use
B. Maternal hypertension
C. Abdominal trauma
D. Cigarette smoking
E. Low BMI
F. Placenta previa
Correct Answer: A, B, C, D
The clinical presentation of severe pain and a board-like abdomen is indicative of abruptio
placentae. Risk factors include hypertension, cocaine use, trauma, and smoking which
cause vascular constriction or damage. Nursing priority involves monitoring for
hemorrhage and fetal distress while preparing for potential emergency delivery.
,2. A nurse is monitoring a client in labor and notes a fetal heart rate pattern with a jagged,
erratic appearance and a baseline of 140 bpm. The variability is measured at 10 bpm. How
should the nurse document this variability?
A. Absent
B. Minimal
C. Moderate
D. Marked
Correct Answer: C
Moderate variability is defined as a fluctuations in the FHR baseline of 6 to 25 beats per
minute. This finding is highly predictive of normal fetal acid-base balance and is considered
a Category I tracing. The nurse should continue to monitor the labor progress and
document this reassuring sign.
3. Which medication should the nurse anticipate administering to a client at 30 weeks
gestation who is in preterm labor to enhance fetal lung maturity?
A. Magnesium sulfate
B. Terbutaline
C. Betamethasone
D. Indomethacin
Correct Answer: C
, Betamethasone is a corticosteroid administered to the mother to stimulate the production
of surfactant in the fetal lungs. This treatment is standard for women at risk of preterm
birth between 24 and 34 weeks of gestation. Reducing the incidence of respiratory distress
syndrome is the primary goal of this intervention.
4. A postpartum nurse is assessing a client 4 hours after a vaginal delivery. The nurse finds the
fundus is firm but shifted to the right of the midline. What is the priority nursing action?
A. Massage the fundus until firm.
B. Assist the client to the bathroom to void.
C. Notify the healthcare provider immediately.
D. Administer oxytocin as ordered.
Correct Answer: B
A fundus shifted to the right is a classic sign of bladder distention, which can prevent the
uterus from contracting properly. Over-distention of the bladder increases the risk of
postpartum hemorrhage. Assisting the client to empty her bladder will allow the uterus to
return to the midline and remain contracted.
5. A nurse is caring for a newborn immediately following birth. Which assessment finding
requires immediate intervention?
A. Acrocyanosis
B. Heart rate of 110 bpm
C. Nasal flaring and grunting
Maternal-Newborn Nursing / OB/GYN |
Actual Q&A with Rationale (NSG432 Final
Exam) | Grand Canyon University
1. A nurse is assessing a client at 34 weeks gestation who presents with a sudden onset of
severe abdominal pain and a board-like abdomen. Which risk factors are associated with this
condition? (Select All That Apply)
A. Cocaine use
B. Maternal hypertension
C. Abdominal trauma
D. Cigarette smoking
E. Low BMI
F. Placenta previa
Correct Answer: A, B, C, D
The clinical presentation of severe pain and a board-like abdomen is indicative of abruptio
placentae. Risk factors include hypertension, cocaine use, trauma, and smoking which
cause vascular constriction or damage. Nursing priority involves monitoring for
hemorrhage and fetal distress while preparing for potential emergency delivery.
,2. A nurse is monitoring a client in labor and notes a fetal heart rate pattern with a jagged,
erratic appearance and a baseline of 140 bpm. The variability is measured at 10 bpm. How
should the nurse document this variability?
A. Absent
B. Minimal
C. Moderate
D. Marked
Correct Answer: C
Moderate variability is defined as a fluctuations in the FHR baseline of 6 to 25 beats per
minute. This finding is highly predictive of normal fetal acid-base balance and is considered
a Category I tracing. The nurse should continue to monitor the labor progress and
document this reassuring sign.
3. Which medication should the nurse anticipate administering to a client at 30 weeks
gestation who is in preterm labor to enhance fetal lung maturity?
A. Magnesium sulfate
B. Terbutaline
C. Betamethasone
D. Indomethacin
Correct Answer: C
, Betamethasone is a corticosteroid administered to the mother to stimulate the production
of surfactant in the fetal lungs. This treatment is standard for women at risk of preterm
birth between 24 and 34 weeks of gestation. Reducing the incidence of respiratory distress
syndrome is the primary goal of this intervention.
4. A postpartum nurse is assessing a client 4 hours after a vaginal delivery. The nurse finds the
fundus is firm but shifted to the right of the midline. What is the priority nursing action?
A. Massage the fundus until firm.
B. Assist the client to the bathroom to void.
C. Notify the healthcare provider immediately.
D. Administer oxytocin as ordered.
Correct Answer: B
A fundus shifted to the right is a classic sign of bladder distention, which can prevent the
uterus from contracting properly. Over-distention of the bladder increases the risk of
postpartum hemorrhage. Assisting the client to empty her bladder will allow the uterus to
return to the midline and remain contracted.
5. A nurse is caring for a newborn immediately following birth. Which assessment finding
requires immediate intervention?
A. Acrocyanosis
B. Heart rate of 110 bpm
C. Nasal flaring and grunting
