D447: Women’s & Children’s Health
2026 OA STUDY GUIDE | GUARANTEE PASS
200 High-Yield Questions & Actual-Style Rationales
Obstetrics - Fetal Heart Rate Patterns
1. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
Obstetrics - Postpartum Hemorrhage (PPH)
2. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What
is the nurse's first action?
A. Call the provider
B. Administer Oxytocin IV
C. Perform fundal massage
D. Insert a second large-bore IV
Correct Answer: C
Rationale: The first action for uterine atony (boggy uterus) is to perform fundal massage to stimulate
uterine contractions and minimize bleeding. Medications and notification follow if the massage is
ineffective.
WGU D447 OA Prep (2026)
, Pediatrics - Growth & Development (Milestones)
3. At which age should a nurse expect an infant to be able to sit unsupported and show
signs of separation anxiety?
A. 2 months
B. 4 months
C. 8 months
D. 12 months
Correct Answer: C
Rationale: Infants typically sit unsupported by 8 months. This is also the stage where stranger anxiety
and separation anxiety begin to manifest.
Pediatrics - Epiglotitis
4. A 4-year-old child presents with drooling, agitation, and a high fever. The child is sitting
in a 'tripod' position. What should the nurse avoid doing?
A. Administering humidified oxygen
B. Inspecting the throat with a tongue blade
C. Keeping the child in the parent's lap
D. Preparing for intubation
Correct Answer: B
Rationale: These are classic signs of Epiglottitis. Visualizing the throat with a tongue blade can cause
immediate laryngospasm and complete airway obstruction. This is a medical emergency.
Obstetrics - Preeclampsia
5. A client at 34 weeks gestation with preeclampsia is receiving Magnesium Sulfate.
Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Absent patellar reflexes
C. Increased urine output
D. Respiratory rate of 18
Correct Answer: B
Rationale: Magnesium Sulfate is a CNS depressant. Toxicity is characterized by loss of deep tendon
reflexes (DTRs), respiratory depression (<12), and decreased urine output (<30mL/hr).
WGU D447 OA Prep (2026)
, Obstetrics - Fetal Heart Rate Patterns
6. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
Obstetrics - Postpartum Hemorrhage (PPH)
7. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What
is the nurse's first action?
A. Call the provider
B. Administer Oxytocin IV
C. Perform fundal massage
D. Insert a second large-bore IV
Correct Answer: C
Rationale: The first action for uterine atony (boggy uterus) is to perform fundal massage to stimulate
uterine contractions and minimize bleeding. Medications and notification follow if the massage is
ineffective.
Pediatrics - Growth & Development (Milestones)
8. At which age should a nurse expect an infant to be able to sit unsupported and show
signs of separation anxiety?
A. 2 months
B. 4 months
C. 8 months
D. 12 months
Correct Answer: C
Rationale: Infants typically sit unsupported by 8 months. This is also the stage where stranger anxiety
and separation anxiety begin to manifest.
WGU D447 OA Prep (2026)
, Pediatrics - Epiglotitis
9. A 4-year-old child presents with drooling, agitation, and a high fever. The child is sitting
in a 'tripod' position. What should the nurse avoid doing?
A. Administering humidified oxygen
B. Inspecting the throat with a tongue blade
C. Keeping the child in the parent's lap
D. Preparing for intubation
Correct Answer: B
Rationale: These are classic signs of Epiglottitis. Visualizing the throat with a tongue blade can cause
immediate laryngospasm and complete airway obstruction. This is a medical emergency.
Obstetrics - Preeclampsia
10. A client at 34 weeks gestation with preeclampsia is receiving Magnesium Sulfate.
Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Absent patellar reflexes
C. Increased urine output
D. Respiratory rate of 18
Correct Answer: B
Rationale: Magnesium Sulfate is a CNS depressant. Toxicity is characterized by loss of deep tendon
reflexes (DTRs), respiratory depression (<12), and decreased urine output (<30mL/hr).
Obstetrics - Fetal Heart Rate Patterns
11. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
WGU D447 OA Prep (2026)
2026 OA STUDY GUIDE | GUARANTEE PASS
200 High-Yield Questions & Actual-Style Rationales
Obstetrics - Fetal Heart Rate Patterns
1. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
Obstetrics - Postpartum Hemorrhage (PPH)
2. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What
is the nurse's first action?
A. Call the provider
B. Administer Oxytocin IV
C. Perform fundal massage
D. Insert a second large-bore IV
Correct Answer: C
Rationale: The first action for uterine atony (boggy uterus) is to perform fundal massage to stimulate
uterine contractions and minimize bleeding. Medications and notification follow if the massage is
ineffective.
WGU D447 OA Prep (2026)
, Pediatrics - Growth & Development (Milestones)
3. At which age should a nurse expect an infant to be able to sit unsupported and show
signs of separation anxiety?
A. 2 months
B. 4 months
C. 8 months
D. 12 months
Correct Answer: C
Rationale: Infants typically sit unsupported by 8 months. This is also the stage where stranger anxiety
and separation anxiety begin to manifest.
Pediatrics - Epiglotitis
4. A 4-year-old child presents with drooling, agitation, and a high fever. The child is sitting
in a 'tripod' position. What should the nurse avoid doing?
A. Administering humidified oxygen
B. Inspecting the throat with a tongue blade
C. Keeping the child in the parent's lap
D. Preparing for intubation
Correct Answer: B
Rationale: These are classic signs of Epiglottitis. Visualizing the throat with a tongue blade can cause
immediate laryngospasm and complete airway obstruction. This is a medical emergency.
Obstetrics - Preeclampsia
5. A client at 34 weeks gestation with preeclampsia is receiving Magnesium Sulfate.
Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Absent patellar reflexes
C. Increased urine output
D. Respiratory rate of 18
Correct Answer: B
Rationale: Magnesium Sulfate is a CNS depressant. Toxicity is characterized by loss of deep tendon
reflexes (DTRs), respiratory depression (<12), and decreased urine output (<30mL/hr).
WGU D447 OA Prep (2026)
, Obstetrics - Fetal Heart Rate Patterns
6. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
Obstetrics - Postpartum Hemorrhage (PPH)
7. A postpartum client is experiencing heavy vaginal bleeding and a boggy uterus. What
is the nurse's first action?
A. Call the provider
B. Administer Oxytocin IV
C. Perform fundal massage
D. Insert a second large-bore IV
Correct Answer: C
Rationale: The first action for uterine atony (boggy uterus) is to perform fundal massage to stimulate
uterine contractions and minimize bleeding. Medications and notification follow if the massage is
ineffective.
Pediatrics - Growth & Development (Milestones)
8. At which age should a nurse expect an infant to be able to sit unsupported and show
signs of separation anxiety?
A. 2 months
B. 4 months
C. 8 months
D. 12 months
Correct Answer: C
Rationale: Infants typically sit unsupported by 8 months. This is also the stage where stranger anxiety
and separation anxiety begin to manifest.
WGU D447 OA Prep (2026)
, Pediatrics - Epiglotitis
9. A 4-year-old child presents with drooling, agitation, and a high fever. The child is sitting
in a 'tripod' position. What should the nurse avoid doing?
A. Administering humidified oxygen
B. Inspecting the throat with a tongue blade
C. Keeping the child in the parent's lap
D. Preparing for intubation
Correct Answer: B
Rationale: These are classic signs of Epiglottitis. Visualizing the throat with a tongue blade can cause
immediate laryngospasm and complete airway obstruction. This is a medical emergency.
Obstetrics - Preeclampsia
10. A client at 34 weeks gestation with preeclampsia is receiving Magnesium Sulfate.
Which finding would indicate magnesium toxicity?
A. Hyperactive deep tendon reflexes (4+)
B. Absent patellar reflexes
C. Increased urine output
D. Respiratory rate of 18
Correct Answer: B
Rationale: Magnesium Sulfate is a CNS depressant. Toxicity is characterized by loss of deep tendon
reflexes (DTRs), respiratory depression (<12), and decreased urine output (<30mL/hr).
Obstetrics - Fetal Heart Rate Patterns
11. While monitoring a client in labor, the nurse notes early decelerations on the fetal
monitor. What is the priority nursing action?
A. Turn the client to the left side
B. Document the finding and continue to monitor
C. Prepare for an emergency Cesarean section
D. Administer oxygen at 10L via non-rebreather
Correct Answer: B
Rationale: Early decelerations are caused by fetal head compression during contractions. They are
considered benign and 'reassuring,' mirroring the contraction. No intervention is needed other than
documentation.
WGU D447 OA Prep (2026)
