NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
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NSG 432 EXAM 2
NURSING CARE OF THE CHILDBEARING FAMILY
◆ ◆ ◆
Actual Exam with Verified Questions & Answers • A+ Graded
EVIDENCE-BASED PRACTICE • AWHONN PROTOCOLS • MATERNAL-NEWBORN STANDARDS
200 QUESTIONS 7 DOMAINS A+ GRADED
COMPETENCY GUIDELINES FORMAT
Maternal-Newborn AWHONN 2026/2027 Selected-Response
Nursing Evidence-Based + Clinical Scenarios
ANTEPARTUM INTRAPARTUM POSTPARTUM NEWBORN
GD, Preeclampsia Stages, FHR Involution APGAR
Placenta, PTL, PROM Pain, Oxytocin, OR Lochia, Mood, Lac Thermoreg, Screen
HIGH-RISK PHARMACOLOGY CULTURAL 200 Q TOTAL
Hemorrhage MgSO4, Betameth Family Dynamics A+ Graded
DIC, AFE, Cardiac Pitocin, Analgesia Equity, Discharge 2026/2027
NSG 432 • Nursing Care of the Childbearing Family • Exam 2 • AWHONN 2026/2027
ACTUAL EXAM FORMAT • VERIFIED CORRECT ANSWERS • EVIDENCE-BASED RATIONALES
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 1
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
CONTENTS
Your roadmap through 200 verified NSG 432 Exam 2 questions.
1 How to Use This Bank & Answer Format Legend .................................................................................................................... 3
2 Exam Overview — NSG 432 Childbearing Family Competencies........................................................................................ 3
3 Core Content Areas At-a-Glance .................................................................................................................................................. 4
4 What’s New for 2026/2027............................................................................................................................................................ 4
5 200 Verified Q&A ..............................................................................................................................................................................5
Domain 1 — Antepartum Complications (Q1–Q30) .............................................................................................................................5
Domain 2 — Intrapartum Nursing Care (Q31–Q65) ..........................................................................................................................10
Domain 3 — Postpartum Nursing Care (Q66–Q95) ........................................................................................................................... 16
Domain 4 — Newborn Assessment & Care (Q96–Q125) ................................................................................................................... 20
Domain 5 — High-Risk Maternal Conditions (Q126–Q155) ............................................................................................................. 24
Domain 6 — Pharmacology in Childbearing (Q156–Q180) .............................................................................................................. 28
Domain 7 — Cultural Competence & Family Dynamics (Q181–Q200)............................................................................................. 32
6 Quick-Check Answer Key ..............................................................................................................................................................35
7 Clinical Quick-Reference Tables ................................................................................................................................................. 37
8 References & Study Resources ................................................................................................................................................... 39
HOW TO USE THIS BANK • ANSWER FORMAT LEGEND
• Questions are in bold black. Clinical stems reflect actual NSG 432 exam style and critical thinking.
• Options A–D are in regular black. Single best answer — prioritize safety per AWHONN/ACOG.
EXAMPLE →
Q. A patient at 34 weeks with severe preeclampsia (BP 162/104, proteinuria, headache) — What is the FIRST nursing
action?
A. Administer IM oxytocin to induce labor
B. Initiate magnesium sulfate seizure prophylaxis and prepare for delivery per provider
C. Encourage ambulation to reduce BP
D. Restrict fluids to 100 mL/24 hr without provider order
Correct Answer: B. Initiate magnesium sulfate seizure prophylaxis and prepare for delivery per provider
Rationale: Severe preeclampsia ≥34 weeks requires delivery after maternal stabilization; magnesium sulfate (4–6 g IV load then 1–2 g/hr)
prevents eclampsia per ACOG/AWHONN. Maintain patent airway, seizure precautions, reflect magnesium toxicity monitoring. Oxytocin is not
for preeclampsia induction without seizure prophylaxis, ambulation increases risk, and fluid restriction without order risks renal compromise.
EXAM OVERVIEW — NSG 432 COMPETENCIES
NSG 432 Nursing Care of the Childbearing Family Exam 2 assesses maternal-newborn clinical judgment across the perinatal continuum — from
antepartum complications through intrapartum, postpartum, and newborn transition — plus high-risk, pharmacology, and family-centered culturally
congruent care. Aligned to AWHONN, ACOG, NRP 8th edition, and QSEN safety competencies.
EXAM BLUEPRINT — 7 DOMAINS LOGISTICS & SUCCESS STRATEGY
Domain 1 — Antepartum Complications (15%)
GDM screening 24–28w 1‑hr 50g → 3‑hr 100g, preeclampsia with severe • Format: Selected‑response + scenario vignettes. Expect FHR strips, labs, med
features, placenta previa/accreta/abruption, cervical insufficiency, preterm labor orders, and discharge teaching — one best answer (safety first).
& PROM — tocolysis vs delivery, infection screening. • Scoring: A+ = ≥90%. Exams 1–2 build to final comprehensive; Exam 2
Domain 2 — Intrapartum (17.5%) emphasizes antepartum→postpartum continuity.
Stages of labor, Leopold, FHR categories I/II/III, VEAL CHOP, amniotomy, pain:
breathing, epidural, oxytocin titration per protocol, operative: • Safety anchor: When in doubt: ABCs → left uterine displacement → call
forceps/vacuum/C‑section. provider/RRT → prepare for delivery. Never delay escalation for Category III
FHR or severe features.
Domain 3 — Postpartum (15%)
Involution (fundus firm midline, descent 1 cm/d), lochia rubra→serosa→alba, • FHR in 10 steps: Baseline → variability → accelerations/decelerations →
perineal/laceration, hemorrhage BUBBLE‑EE, depression PHQ‑9/EPDS, category → underlying cause (VEAL CHOP) → intervention.
lactation LATCH, Rho(D)IG.
Domain 4 — Newborn (15%)
• Meds high‑yield: MgSO4 antidote Ca gluconate 1 g IV; oxytocin max per unit
protocol (often 20 mU/min titrate, never bolus); betamethasone 12 mg IM ×2
Transition (first 6 hr), APGAR, Ballard, vital signs, thermoregulation, doses 24 hr apart.
hypoglycemia, jaundice, NB screening (24–48 hr & CCHD pulse ox), reflexes,
safe sleep. • PPH cure: Quantify blood loss (weigh drapes), fundal massage, empty bladder,
Domain 5 — High‑Risk Maternal (15%) 4 Ts (Tone, Trauma, Tissue, Thrombin) + oxytocin first‑line.
PPH quantified blood loss, DIC clotting studies, amniotic fluid embolism, cardiac
disease NYHA, obesity/BMI, shoulder dystocia, sepsis, VTE.
• Newborn mantra: Warm → Dry → Stim → Suction if needed → APGAR at 1
& 5 min → Skin‑to‑skin + early latch → Screen at 24–48 hr.
Domain 6 — Pharmacology (12.5%)
Tip: 40% of misses are FHR + MgSO4/oxytocin errors. Master
MgSO4 toxicity (areflexia/resp depression → Ca gluconate), terbutaline black
Category II management and toxicity/antidote before content
box, betamethasone 24–34w, oxytocin water intoxication, analgesia/anesthesia,
review.
tocolytics, antihypertensives.
Domain 7 — Cultural & Family (10%)
Leininger cultural care, health equity/SDOH, support systems, shared
decision‑making, discharge TEACH‑back, family dynamics, bereavement.
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 2
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
CORE CONTENT AREAS AT-A-GLANCE
1 — ANTEPARTUM 2 — INTRAPARTUM 3 — POSTPARTUM 4 — NEWBORN
GDM, preeclampsia, placenta, PTL, PROM Stages, FHR, pain, oxytocin, operative Involution, lochia, wound, PPD, lactation APGAR, transition, screening, thermoreg
30 Qs • 15% 35 Qs • 17.5% 30 Qs • 15% 30 Qs • 15%
5 — HIGH-RISK 6 — PHARMACOLOGY 7 — CULTURAL & FAMILY 200 QUESTIONS TOTAL
Hemorrhage, DIC, AFE, cardiac, obesity MgSO4, terbutaline, betamethasone, Equity, support, education, discharge
30 Qs • 15% pitocin 20 Qs • 10%
25 Qs • 12.5%
✦ UPDATES FOR 2026/2027 — WHAT’S NEW
• Reflects current maternal-newborn nursing standards — AWHONN POEP & ACOG Practice Bulletins (preeclampsia, GDM, PTL, PROM).
• Updated pharmacological protocols for high-risk conditions — MgSO4 monitoring/Ca gluconate, low-dose oxytocin titration, antenatal corticosteroids
24+0–33+6w.
• Enhanced focus on postpartum mental health screening — universal EPDS/PHQ-9 at discharge & postpartum visit, PSI resources, and safety planning.
• New evidence on fetal monitoring and interpretation — NICHD 3‑tier FHR, Category II intrauterine resuscitation bundle, and timely escalation criteria.
KEY FEATURES • ✓ Actual NSG 432 exam format and question style • ✓ Verified correct answers with evidence-based rationales • ✓ Maternal-newborn nursing
competency coverage • ✓ Updated 2026/2027 AWHONN guidelines • ✓ 100% unique
200 QUESTIONS
DOMAIN 1 — ANTEPARTUM COMPLICATIONS • QUESTIONS 1–30 • 15%
Gestational diabetes, preeclampsia, placental abnormalities, preterm labor, PROM, infection, and fetal surveillance.
Q1. A patient at 28 weeks has a 1-hour 50-g GCT result 148 mg/dL. Next step?
A. Diagnose GDM and start insulin
B. Perform 3-hour 100-g OGTT to confirm
C. Reassure no further testing
D. Start oral hypoglycemic immediately
Correct Answer: B. Perform 3-hour 100-g OGTT to confirm
Rationale: 1-hr ≥130–140 is screen-positive per ACOG; requires 3-hr OGTT (Carpenter-Coustan: fasting 95/180/155/140 — 2 abnormals = GDM). 148
not diagnostic; counseling pending definitive test.
Q2. At 32 weeks: BP 158/102, headache, scotomata, 2+ proteinuria, platelets 98k, AST 78, Cr 1.1. Diagnosis?
A. Gestational hypertension outpatient
B. Preeclampsia with severe features — stabilize for delivery + MgSO4
C. Chronic hypertension only
D. UTI
Correct Answer: B. Preeclampsia with severe features — stabilize for delivery + MgSO4
Rationale: Severe features: BP≥160/110 or platelets <100k, AST/ALT 2×, Cr≥1.1, headache/visual. Here all present. Severe ≥34w → delivery after
MgSO4 4–6g +1–2g/hr and labetalol/hydralazine for ≥160/110 per ACOG PB 222.
Q3. Complete placenta previa at 31 weeks with painless bright-red bleeding, Category I, stable. Priority?
A. Perform vaginal exam
B. No vaginal/rectal exams, large-bore IVs, continuous FHR, type & crossmatch, prepare for possible delivery
C. Encourage ambulation
D. Give oxytocin
Correct Answer: B. No vaginal/rectal exams, large-bore IVs, continuous FHR, type & crossmatch, prepare for possible
delivery
Rationale: Previa → never SVE/rectal/intercourse (shear risk). Pelvic rest, betamethasone 24–33+6w, RhIG if Rh-neg, C-section 36–37+6w if stable.
Large-bore IV + blood hold.
Q4. At 30 weeks: regular contractions q5min, cervix 1→2 cm, intact membranes, fFN positive. Priority?
A. Preterm labor — transfer L&D, continuous FHR/toco, hydration, steroids, tocolysis if eligible, GBS prophylaxis, MgSO4 neuroprotection
23–31+6w
B. Discharge home
C. Castor oil
D. No treatment until 37w
Correct Answer: A. Preterm labor — transfer L&D, continuous FHR/toco, hydration, steroids, tocolysis if eligible, GBS
prophylaxis, MgSO4 neuroprotection 23–31+6w
Rationale: Preterm labor 20–36+6w = contractions + change. Steroids betamethasone 12 mg IM ×2 24h apart 24–33+6w, MgSO4 <32w
neuroprotection, nifedipine/indomethacin to allow window.
Q5. PPROM at 33+2w, 6 hr rupture, no fever, reassuring FHR, GBS unknown. Next?
A. Expectant with latency antibiotics (azithro+amp per Mercer), steroids, GBS prophylaxis at induction, daily NST/BPP
B. Immediate oxytocin regardless
C. No antibiotics
D. Strict Trendelenburg only
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 3
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
Correct Answer: A. Expectant with latency antibiotics (azithro+amp per Mercer), steroids, GBS prophylaxis at induction,
daily NST/BPP
Rationale: 24–33+6w expectant + latency antibiotics (48h ampicillin + azithro) + steroids + MgSO4 <32w, watch chorio
(fever/tachycardia/tender/foul). 34–36+6 shared decision.
Q6. At 36w: sudden severe pain, dark vaginal bleeding, hypertonic tender uterus, Category II late decels. Likely?
A. Placental abruption — hemorrhage protocol, left uterine displacement, O2, large-bore IVs, type & cross 4U, prepare emergent delivery,
monitor DIC
B. Previa
C. Normal labor
D. Braxton Hicks
Correct Answer: A. Placental abruption — hemorrhage protocol, left uterine displacement, O2, large-bore IVs, type & cross
4U, prepare emergent delivery, monitor DIC
Rationale: Abruption painful (concealed/revealed), woody uterus, coagulopathy (fibrinogen <200), FHR decels. Painless = previa. Stabilize, rapid
delivery, quantify QBL, correct DIC.
Q7. At 29w: cervical length 18 mm + prior PTB 27w. Counseling?
A. Vaginal progesterone 200 mg nightly + cerclage consideration per history/ultrasound — refer MFM
B. No prevention
C. Continuous NSAIDs
D. Length irrelevant
Correct Answer: A. Vaginal progesterone 200 mg nightly + cerclage consideration per history/ultrasound — refer MFM
Rationale: Short cervix ≤20 mm + prior PTB predicts recurrence. Vaginal progesterone 16–36w, ultrasound-indicated cerclage ≤24w if ≤25 mm with
prior PTB, history-indicated cerclage.
Q8. GDM at 34w: EFW 4200 g macrosomia, polyhydramnios AFI 26. Counseling?
A. Tight control (F<95, 1hr<140, 2hr<120), surveillance, C-section considered if EFW ≥4500 g in diabetics
B. Macrosomia unrelated to GDM
C. No surveillance
D. Induction 37w for all
Correct Answer: A. Tight control (F<95, 1hr<140, 2hr<120), surveillance, C-section considered if EFW ≥4500 g in diabetics
Rationale: Hyperglycemia → fetal hyperinsulin → macrosomia/polyhydramnios → shoulder dystocia risk. Diet/insulin, SMBG, testing 32–34w,
timing 39–39+6w diet-controlled, 4500 g threshold for CS.
Q9. Chronic HTN 22w develops superimposed preeclampsia. Severe feature?
A. BP 148/92 trace protein only
B. Platelets 85k or Cr 1.2 with unrelieved headache
C. Mild edema alone
D. Slight nausea
Correct Answer: B. Platelets 85k or Cr 1.2 with unrelieved headache
Rationale: Superimposed severe = chronic HTN + new severe lab/clinical: <100k, Cr ≥1.1, 2× LFT, pulmonary edema, HA/visual. 148/92 + trace not
severe.
Q10. Painless dilation with bulging membranes at 15w, no contractions/infection, 2 prior losses 18–20w. Diagnosis?
A. Cervical insufficiency — cerclage after excluding infection/labor/abruption + progesterone
B. Normal
C. Threatened abortion bedrest only
D. PTL tocolysis alone
Correct Answer: A. Cervical insufficiency — cerclage after excluding infection/labor/abruption + progesterone
Rationale: Classic insufficiency 12–24w painless dilation. History/physical-indicated cerclage after viable, no ROM/infection. Rescue cerclage if
bulging.
Q11. At 38w: decreased FM (6/2 hr after 28w), Category I reduced variability. Next?
A. Reassure
B. Comprehensive: NST/BPP, AF, Doppler, never single kick count alone — educate 10 in 2 hr
C. Ultrasound without maternal assessment
D. No testing
Correct Answer: B. Comprehensive: NST/BPP, AF, Doppler, never single kick count alone — educate 10 in 2 hr
Rationale: Decreased FM red flag <10/2 hr. Category I not definitive. NST/BPP + AF + Doppler as indicated, maternal vitals, provider notification.
Q12. Placenta accreta spectrum (lacunae hypervascular) at 34w. Plan?
A. Planned cesarean-hysterectomy 34–35+6w tertiary with blood, urology, IR backup, no placental removal attempt
B. Trial of labor
C. Manual removal vaginally
D. No planning
Correct Answer: A. Planned cesarean-hysterectomy 34–35+6w tertiary with blood, urology, IR backup, no placental
removal attempt
Rationale: PAS risk prior CS+previa. Never remove vaginally → hemorrhage. Preterm CS hysterectomy massive transfusion, cell saver, IR balloons.
34–35+6w after steroids.
Q13. At 26w Rh-negative antibody negative, minor bleed after trauma. Prophylaxis?
A. RhIG 300 µg IM within 72 hr + KB to quantify FMH
B. No RhIG until delivery
C. Only postpartum
D. No KB needed
Correct Answer: A. RhIG 300 µg IM within 72 hr + KB to quantify FMH
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 4
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NSG 432 EXAM 2
NURSING CARE OF THE CHILDBEARING FAMILY
◆ ◆ ◆
Actual Exam with Verified Questions & Answers • A+ Graded
EVIDENCE-BASED PRACTICE • AWHONN PROTOCOLS • MATERNAL-NEWBORN STANDARDS
200 QUESTIONS 7 DOMAINS A+ GRADED
COMPETENCY GUIDELINES FORMAT
Maternal-Newborn AWHONN 2026/2027 Selected-Response
Nursing Evidence-Based + Clinical Scenarios
ANTEPARTUM INTRAPARTUM POSTPARTUM NEWBORN
GD, Preeclampsia Stages, FHR Involution APGAR
Placenta, PTL, PROM Pain, Oxytocin, OR Lochia, Mood, Lac Thermoreg, Screen
HIGH-RISK PHARMACOLOGY CULTURAL 200 Q TOTAL
Hemorrhage MgSO4, Betameth Family Dynamics A+ Graded
DIC, AFE, Cardiac Pitocin, Analgesia Equity, Discharge 2026/2027
NSG 432 • Nursing Care of the Childbearing Family • Exam 2 • AWHONN 2026/2027
ACTUAL EXAM FORMAT • VERIFIED CORRECT ANSWERS • EVIDENCE-BASED RATIONALES
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 1
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
CONTENTS
Your roadmap through 200 verified NSG 432 Exam 2 questions.
1 How to Use This Bank & Answer Format Legend .................................................................................................................... 3
2 Exam Overview — NSG 432 Childbearing Family Competencies........................................................................................ 3
3 Core Content Areas At-a-Glance .................................................................................................................................................. 4
4 What’s New for 2026/2027............................................................................................................................................................ 4
5 200 Verified Q&A ..............................................................................................................................................................................5
Domain 1 — Antepartum Complications (Q1–Q30) .............................................................................................................................5
Domain 2 — Intrapartum Nursing Care (Q31–Q65) ..........................................................................................................................10
Domain 3 — Postpartum Nursing Care (Q66–Q95) ........................................................................................................................... 16
Domain 4 — Newborn Assessment & Care (Q96–Q125) ................................................................................................................... 20
Domain 5 — High-Risk Maternal Conditions (Q126–Q155) ............................................................................................................. 24
Domain 6 — Pharmacology in Childbearing (Q156–Q180) .............................................................................................................. 28
Domain 7 — Cultural Competence & Family Dynamics (Q181–Q200)............................................................................................. 32
6 Quick-Check Answer Key ..............................................................................................................................................................35
7 Clinical Quick-Reference Tables ................................................................................................................................................. 37
8 References & Study Resources ................................................................................................................................................... 39
HOW TO USE THIS BANK • ANSWER FORMAT LEGEND
• Questions are in bold black. Clinical stems reflect actual NSG 432 exam style and critical thinking.
• Options A–D are in regular black. Single best answer — prioritize safety per AWHONN/ACOG.
EXAMPLE →
Q. A patient at 34 weeks with severe preeclampsia (BP 162/104, proteinuria, headache) — What is the FIRST nursing
action?
A. Administer IM oxytocin to induce labor
B. Initiate magnesium sulfate seizure prophylaxis and prepare for delivery per provider
C. Encourage ambulation to reduce BP
D. Restrict fluids to 100 mL/24 hr without provider order
Correct Answer: B. Initiate magnesium sulfate seizure prophylaxis and prepare for delivery per provider
Rationale: Severe preeclampsia ≥34 weeks requires delivery after maternal stabilization; magnesium sulfate (4–6 g IV load then 1–2 g/hr)
prevents eclampsia per ACOG/AWHONN. Maintain patent airway, seizure precautions, reflect magnesium toxicity monitoring. Oxytocin is not
for preeclampsia induction without seizure prophylaxis, ambulation increases risk, and fluid restriction without order risks renal compromise.
EXAM OVERVIEW — NSG 432 COMPETENCIES
NSG 432 Nursing Care of the Childbearing Family Exam 2 assesses maternal-newborn clinical judgment across the perinatal continuum — from
antepartum complications through intrapartum, postpartum, and newborn transition — plus high-risk, pharmacology, and family-centered culturally
congruent care. Aligned to AWHONN, ACOG, NRP 8th edition, and QSEN safety competencies.
EXAM BLUEPRINT — 7 DOMAINS LOGISTICS & SUCCESS STRATEGY
Domain 1 — Antepartum Complications (15%)
GDM screening 24–28w 1‑hr 50g → 3‑hr 100g, preeclampsia with severe • Format: Selected‑response + scenario vignettes. Expect FHR strips, labs, med
features, placenta previa/accreta/abruption, cervical insufficiency, preterm labor orders, and discharge teaching — one best answer (safety first).
& PROM — tocolysis vs delivery, infection screening. • Scoring: A+ = ≥90%. Exams 1–2 build to final comprehensive; Exam 2
Domain 2 — Intrapartum (17.5%) emphasizes antepartum→postpartum continuity.
Stages of labor, Leopold, FHR categories I/II/III, VEAL CHOP, amniotomy, pain:
breathing, epidural, oxytocin titration per protocol, operative: • Safety anchor: When in doubt: ABCs → left uterine displacement → call
forceps/vacuum/C‑section. provider/RRT → prepare for delivery. Never delay escalation for Category III
FHR or severe features.
Domain 3 — Postpartum (15%)
Involution (fundus firm midline, descent 1 cm/d), lochia rubra→serosa→alba, • FHR in 10 steps: Baseline → variability → accelerations/decelerations →
perineal/laceration, hemorrhage BUBBLE‑EE, depression PHQ‑9/EPDS, category → underlying cause (VEAL CHOP) → intervention.
lactation LATCH, Rho(D)IG.
Domain 4 — Newborn (15%)
• Meds high‑yield: MgSO4 antidote Ca gluconate 1 g IV; oxytocin max per unit
protocol (often 20 mU/min titrate, never bolus); betamethasone 12 mg IM ×2
Transition (first 6 hr), APGAR, Ballard, vital signs, thermoregulation, doses 24 hr apart.
hypoglycemia, jaundice, NB screening (24–48 hr & CCHD pulse ox), reflexes,
safe sleep. • PPH cure: Quantify blood loss (weigh drapes), fundal massage, empty bladder,
Domain 5 — High‑Risk Maternal (15%) 4 Ts (Tone, Trauma, Tissue, Thrombin) + oxytocin first‑line.
PPH quantified blood loss, DIC clotting studies, amniotic fluid embolism, cardiac
disease NYHA, obesity/BMI, shoulder dystocia, sepsis, VTE.
• Newborn mantra: Warm → Dry → Stim → Suction if needed → APGAR at 1
& 5 min → Skin‑to‑skin + early latch → Screen at 24–48 hr.
Domain 6 — Pharmacology (12.5%)
Tip: 40% of misses are FHR + MgSO4/oxytocin errors. Master
MgSO4 toxicity (areflexia/resp depression → Ca gluconate), terbutaline black
Category II management and toxicity/antidote before content
box, betamethasone 24–34w, oxytocin water intoxication, analgesia/anesthesia,
review.
tocolytics, antihypertensives.
Domain 7 — Cultural & Family (10%)
Leininger cultural care, health equity/SDOH, support systems, shared
decision‑making, discharge TEACH‑back, family dynamics, bereavement.
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 2
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
CORE CONTENT AREAS AT-A-GLANCE
1 — ANTEPARTUM 2 — INTRAPARTUM 3 — POSTPARTUM 4 — NEWBORN
GDM, preeclampsia, placenta, PTL, PROM Stages, FHR, pain, oxytocin, operative Involution, lochia, wound, PPD, lactation APGAR, transition, screening, thermoreg
30 Qs • 15% 35 Qs • 17.5% 30 Qs • 15% 30 Qs • 15%
5 — HIGH-RISK 6 — PHARMACOLOGY 7 — CULTURAL & FAMILY 200 QUESTIONS TOTAL
Hemorrhage, DIC, AFE, cardiac, obesity MgSO4, terbutaline, betamethasone, Equity, support, education, discharge
30 Qs • 15% pitocin 20 Qs • 10%
25 Qs • 12.5%
✦ UPDATES FOR 2026/2027 — WHAT’S NEW
• Reflects current maternal-newborn nursing standards — AWHONN POEP & ACOG Practice Bulletins (preeclampsia, GDM, PTL, PROM).
• Updated pharmacological protocols for high-risk conditions — MgSO4 monitoring/Ca gluconate, low-dose oxytocin titration, antenatal corticosteroids
24+0–33+6w.
• Enhanced focus on postpartum mental health screening — universal EPDS/PHQ-9 at discharge & postpartum visit, PSI resources, and safety planning.
• New evidence on fetal monitoring and interpretation — NICHD 3‑tier FHR, Category II intrauterine resuscitation bundle, and timely escalation criteria.
KEY FEATURES • ✓ Actual NSG 432 exam format and question style • ✓ Verified correct answers with evidence-based rationales • ✓ Maternal-newborn nursing
competency coverage • ✓ Updated 2026/2027 AWHONN guidelines • ✓ 100% unique
200 QUESTIONS
DOMAIN 1 — ANTEPARTUM COMPLICATIONS • QUESTIONS 1–30 • 15%
Gestational diabetes, preeclampsia, placental abnormalities, preterm labor, PROM, infection, and fetal surveillance.
Q1. A patient at 28 weeks has a 1-hour 50-g GCT result 148 mg/dL. Next step?
A. Diagnose GDM and start insulin
B. Perform 3-hour 100-g OGTT to confirm
C. Reassure no further testing
D. Start oral hypoglycemic immediately
Correct Answer: B. Perform 3-hour 100-g OGTT to confirm
Rationale: 1-hr ≥130–140 is screen-positive per ACOG; requires 3-hr OGTT (Carpenter-Coustan: fasting 95/180/155/140 — 2 abnormals = GDM). 148
not diagnostic; counseling pending definitive test.
Q2. At 32 weeks: BP 158/102, headache, scotomata, 2+ proteinuria, platelets 98k, AST 78, Cr 1.1. Diagnosis?
A. Gestational hypertension outpatient
B. Preeclampsia with severe features — stabilize for delivery + MgSO4
C. Chronic hypertension only
D. UTI
Correct Answer: B. Preeclampsia with severe features — stabilize for delivery + MgSO4
Rationale: Severe features: BP≥160/110 or platelets <100k, AST/ALT 2×, Cr≥1.1, headache/visual. Here all present. Severe ≥34w → delivery after
MgSO4 4–6g +1–2g/hr and labetalol/hydralazine for ≥160/110 per ACOG PB 222.
Q3. Complete placenta previa at 31 weeks with painless bright-red bleeding, Category I, stable. Priority?
A. Perform vaginal exam
B. No vaginal/rectal exams, large-bore IVs, continuous FHR, type & crossmatch, prepare for possible delivery
C. Encourage ambulation
D. Give oxytocin
Correct Answer: B. No vaginal/rectal exams, large-bore IVs, continuous FHR, type & crossmatch, prepare for possible
delivery
Rationale: Previa → never SVE/rectal/intercourse (shear risk). Pelvic rest, betamethasone 24–33+6w, RhIG if Rh-neg, C-section 36–37+6w if stable.
Large-bore IV + blood hold.
Q4. At 30 weeks: regular contractions q5min, cervix 1→2 cm, intact membranes, fFN positive. Priority?
A. Preterm labor — transfer L&D, continuous FHR/toco, hydration, steroids, tocolysis if eligible, GBS prophylaxis, MgSO4 neuroprotection
23–31+6w
B. Discharge home
C. Castor oil
D. No treatment until 37w
Correct Answer: A. Preterm labor — transfer L&D, continuous FHR/toco, hydration, steroids, tocolysis if eligible, GBS
prophylaxis, MgSO4 neuroprotection 23–31+6w
Rationale: Preterm labor 20–36+6w = contractions + change. Steroids betamethasone 12 mg IM ×2 24h apart 24–33+6w, MgSO4 <32w
neuroprotection, nifedipine/indomethacin to allow window.
Q5. PPROM at 33+2w, 6 hr rupture, no fever, reassuring FHR, GBS unknown. Next?
A. Expectant with latency antibiotics (azithro+amp per Mercer), steroids, GBS prophylaxis at induction, daily NST/BPP
B. Immediate oxytocin regardless
C. No antibiotics
D. Strict Trendelenburg only
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 3
, NSG 432 EXAM 2 • NURSING CARE OF THE CHILDBEARING FAMILY • 2026/2027
Correct Answer: A. Expectant with latency antibiotics (azithro+amp per Mercer), steroids, GBS prophylaxis at induction,
daily NST/BPP
Rationale: 24–33+6w expectant + latency antibiotics (48h ampicillin + azithro) + steroids + MgSO4 <32w, watch chorio
(fever/tachycardia/tender/foul). 34–36+6 shared decision.
Q6. At 36w: sudden severe pain, dark vaginal bleeding, hypertonic tender uterus, Category II late decels. Likely?
A. Placental abruption — hemorrhage protocol, left uterine displacement, O2, large-bore IVs, type & cross 4U, prepare emergent delivery,
monitor DIC
B. Previa
C. Normal labor
D. Braxton Hicks
Correct Answer: A. Placental abruption — hemorrhage protocol, left uterine displacement, O2, large-bore IVs, type & cross
4U, prepare emergent delivery, monitor DIC
Rationale: Abruption painful (concealed/revealed), woody uterus, coagulopathy (fibrinogen <200), FHR decels. Painless = previa. Stabilize, rapid
delivery, quantify QBL, correct DIC.
Q7. At 29w: cervical length 18 mm + prior PTB 27w. Counseling?
A. Vaginal progesterone 200 mg nightly + cerclage consideration per history/ultrasound — refer MFM
B. No prevention
C. Continuous NSAIDs
D. Length irrelevant
Correct Answer: A. Vaginal progesterone 200 mg nightly + cerclage consideration per history/ultrasound — refer MFM
Rationale: Short cervix ≤20 mm + prior PTB predicts recurrence. Vaginal progesterone 16–36w, ultrasound-indicated cerclage ≤24w if ≤25 mm with
prior PTB, history-indicated cerclage.
Q8. GDM at 34w: EFW 4200 g macrosomia, polyhydramnios AFI 26. Counseling?
A. Tight control (F<95, 1hr<140, 2hr<120), surveillance, C-section considered if EFW ≥4500 g in diabetics
B. Macrosomia unrelated to GDM
C. No surveillance
D. Induction 37w for all
Correct Answer: A. Tight control (F<95, 1hr<140, 2hr<120), surveillance, C-section considered if EFW ≥4500 g in diabetics
Rationale: Hyperglycemia → fetal hyperinsulin → macrosomia/polyhydramnios → shoulder dystocia risk. Diet/insulin, SMBG, testing 32–34w,
timing 39–39+6w diet-controlled, 4500 g threshold for CS.
Q9. Chronic HTN 22w develops superimposed preeclampsia. Severe feature?
A. BP 148/92 trace protein only
B. Platelets 85k or Cr 1.2 with unrelieved headache
C. Mild edema alone
D. Slight nausea
Correct Answer: B. Platelets 85k or Cr 1.2 with unrelieved headache
Rationale: Superimposed severe = chronic HTN + new severe lab/clinical: <100k, Cr ≥1.1, 2× LFT, pulmonary edema, HA/visual. 148/92 + trace not
severe.
Q10. Painless dilation with bulging membranes at 15w, no contractions/infection, 2 prior losses 18–20w. Diagnosis?
A. Cervical insufficiency — cerclage after excluding infection/labor/abruption + progesterone
B. Normal
C. Threatened abortion bedrest only
D. PTL tocolysis alone
Correct Answer: A. Cervical insufficiency — cerclage after excluding infection/labor/abruption + progesterone
Rationale: Classic insufficiency 12–24w painless dilation. History/physical-indicated cerclage after viable, no ROM/infection. Rescue cerclage if
bulging.
Q11. At 38w: decreased FM (6/2 hr after 28w), Category I reduced variability. Next?
A. Reassure
B. Comprehensive: NST/BPP, AF, Doppler, never single kick count alone — educate 10 in 2 hr
C. Ultrasound without maternal assessment
D. No testing
Correct Answer: B. Comprehensive: NST/BPP, AF, Doppler, never single kick count alone — educate 10 in 2 hr
Rationale: Decreased FM red flag <10/2 hr. Category I not definitive. NST/BPP + AF + Doppler as indicated, maternal vitals, provider notification.
Q12. Placenta accreta spectrum (lacunae hypervascular) at 34w. Plan?
A. Planned cesarean-hysterectomy 34–35+6w tertiary with blood, urology, IR backup, no placental removal attempt
B. Trial of labor
C. Manual removal vaginally
D. No planning
Correct Answer: A. Planned cesarean-hysterectomy 34–35+6w tertiary with blood, urology, IR backup, no placental
removal attempt
Rationale: PAS risk prior CS+previa. Never remove vaginally → hemorrhage. Preterm CS hysterectomy massive transfusion, cell saver, IR balloons.
34–35+6w after steroids.
Q13. At 26w Rh-negative antibody negative, minor bleed after trauma. Prophylaxis?
A. RhIG 300 µg IM within 72 hr + KB to quantify FMH
B. No RhIG until delivery
C. Only postpartum
D. No KB needed
Correct Answer: A. RhIG 300 µg IM within 72 hr + KB to quantify FMH
NSG 432 Exam 2 Nursing Care Childbearing Family | 2026/2027 Edition | DOCX Format | No Repeated Questions | Complete Exam Preparation • Page 4
