NU 170 EXAM 1, 2, 3 AND 4 MATERNAL-CHILD NURSING
| GALEN COLLEGE | HIGH-YIELD QS & RATIONALES
Key Topics Covered
Exam 1 – Antepartum & Reproductive Health
• Prenatal care, physiologic changes, nutrition
• Fetal development, genetics, teratogens
• Complications: hyperemesis, gestational diabetes, preeclampsia, placenta previa, abruption, ectopic
pregnancy
Exam 2 – Intrapartum
• Stages of labor, fetal monitoring, pain management
• Induction/augmentation, dystocia, prolapsed cord, uterine rupture
• Cesarean birth, operative delivery
Exam 3 – Postpartum
• Postpartum hemorrhage, infection, DVT
• Perineal care, breastfeeding, emotional changes
• Discharge teaching, contraception
Exam 4 – Newborn & Pediatric
• Newborn assessment, APGAR, thermoregulation, jaundice
• Congenital anomalies, birth injuries, newborn screening
• Pediatric growth & development, immunizations, common illnesses, safety
1. A client at 38 weeks gestation presents with a blood pressure of 150/95 mmHg and proteinuria
(2+). She denies headache or visual changes. Which diagnosis is most likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Answer B: Preeclampsia without severe features
Rationale: New hypertension after 20 weeks with proteinuria defines preeclampsia. No severe features (BP
<160/110, normal labs).
,2. A nurse is assessing a fetal heart rate tracing and notes late decelerations. Which action should the
nurse take first?
A) Administer oxygen via face mask
B) Change the mother's position to left lateral
C) Increase the IV fluid rate
D) Discontinue oxytocin if infusing
Answer B: Change the mother's position to left lateral
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning improves uterine blood
flow.
3. A postpartum client who delivered 2 hours ago has a boggy fundus displaced to the right and heavy
lochia with clots. What is the priority nursing action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder; emptying allows the uterus to
contract.
4. A newborn is 5 minutes old. The nurse assigns an APGAR score of 8. What was the most likely
reason for the deduction?
A) Heart rate 100 bpm
B) Acrocyanosis (blue hands and feet)
C) Weak cry
D) Limp body tone
Answer B: Acrocyanosis (blue hands and feet)
Rationale: Acrocyanosis is normal; APGAR 8 often deducts 1 for color and 1 for another minor finding.
5. A client at 32 weeks gestation reports painless, bright red vaginal bleeding. Which condition is
most likely?
,A) Abruptio placentae
B) Placenta previa
C) Vasa previa
D) Labor
Answer B: Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta previa.
6. A nurse is monitoring a client receiving IV magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A) Urine output 40 mL/hr
B) Respiratory rate 10 breaths/min
C) Deep tendon reflexes 2+
D) Serum magnesium level 4.5 mg/dL
Answer B: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12/min) is a sign of magnesium toxicity; calcium gluconate is the
antidote.
7. A client in active labor has a fetal heart rate tracing with variable decelerations. What is the most
common cause?
A) Uteroplacental insufficiency
B) Cord compression
C) Head compression
D) Maternal fever
Answer B: Cord compression
Rationale: Variable decelerations are caused by umbilical cord compression.
8. A postpartum client with a history of deep vein thrombosis develops sudden shortness of breath
and chest pain. Which action should the nurse take first?
A) Apply oxygen at 2 L/min
B) Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer enoxaparin
D) Notify the provider
Answer B: Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
, Rationale: Suspected pulmonary embolism requires immediate oxygenation and positioning.
9. A client at 40 weeks gestation is admitted with contractions every 3 minutes, cervix 5 cm, 90%
effaced, station 0. The fetal heart rate baseline is 140 bpm with moderate variability. Which finding is
most reassuring?
A) Early decelerations
B) Moderate variability
C) Late decelerations
D) Variable decelerations with overshoot
Answer B: Moderate variability
Rationale: Moderate variability (6-25 bpm) indicates a well-oxygenated fetal nervous system.
10. A nurse is teaching a breastfeeding client about signs of adequate milk transfer. Which statement
indicates understanding?
A) "My baby should feed for exactly 10 minutes on each side."
B) "My baby has 6-8 wet diapers and several stools per day."
C) "I should wake my baby every 2 hours to feed."
D) "My baby will lose weight for the first 2 weeks."
Answer B: "My baby has 6-8 wet diapers and several stools per day."
Rationale: Adequate output is the best indicator of adequate intake.
11. A client with preeclampsia is receiving IV magnesium sulfate. Which medication should be readily
available at the bedside?
A) Naloxone
B) Calcium gluconate
C) Vitamin K
D) Protamine sulfate
Answer B: Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium toxicity.
12. A newborn has an APGAR score of 4 at 1 minute. Which intervention should the nurse perform
first?
| GALEN COLLEGE | HIGH-YIELD QS & RATIONALES
Key Topics Covered
Exam 1 – Antepartum & Reproductive Health
• Prenatal care, physiologic changes, nutrition
• Fetal development, genetics, teratogens
• Complications: hyperemesis, gestational diabetes, preeclampsia, placenta previa, abruption, ectopic
pregnancy
Exam 2 – Intrapartum
• Stages of labor, fetal monitoring, pain management
• Induction/augmentation, dystocia, prolapsed cord, uterine rupture
• Cesarean birth, operative delivery
Exam 3 – Postpartum
• Postpartum hemorrhage, infection, DVT
• Perineal care, breastfeeding, emotional changes
• Discharge teaching, contraception
Exam 4 – Newborn & Pediatric
• Newborn assessment, APGAR, thermoregulation, jaundice
• Congenital anomalies, birth injuries, newborn screening
• Pediatric growth & development, immunizations, common illnesses, safety
1. A client at 38 weeks gestation presents with a blood pressure of 150/95 mmHg and proteinuria
(2+). She denies headache or visual changes. Which diagnosis is most likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Answer B: Preeclampsia without severe features
Rationale: New hypertension after 20 weeks with proteinuria defines preeclampsia. No severe features (BP
<160/110, normal labs).
,2. A nurse is assessing a fetal heart rate tracing and notes late decelerations. Which action should the
nurse take first?
A) Administer oxygen via face mask
B) Change the mother's position to left lateral
C) Increase the IV fluid rate
D) Discontinue oxytocin if infusing
Answer B: Change the mother's position to left lateral
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning improves uterine blood
flow.
3. A postpartum client who delivered 2 hours ago has a boggy fundus displaced to the right and heavy
lochia with clots. What is the priority nursing action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder; emptying allows the uterus to
contract.
4. A newborn is 5 minutes old. The nurse assigns an APGAR score of 8. What was the most likely
reason for the deduction?
A) Heart rate 100 bpm
B) Acrocyanosis (blue hands and feet)
C) Weak cry
D) Limp body tone
Answer B: Acrocyanosis (blue hands and feet)
Rationale: Acrocyanosis is normal; APGAR 8 often deducts 1 for color and 1 for another minor finding.
5. A client at 32 weeks gestation reports painless, bright red vaginal bleeding. Which condition is
most likely?
,A) Abruptio placentae
B) Placenta previa
C) Vasa previa
D) Labor
Answer B: Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta previa.
6. A nurse is monitoring a client receiving IV magnesium sulfate for preeclampsia. Which finding
indicates magnesium toxicity?
A) Urine output 40 mL/hr
B) Respiratory rate 10 breaths/min
C) Deep tendon reflexes 2+
D) Serum magnesium level 4.5 mg/dL
Answer B: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12/min) is a sign of magnesium toxicity; calcium gluconate is the
antidote.
7. A client in active labor has a fetal heart rate tracing with variable decelerations. What is the most
common cause?
A) Uteroplacental insufficiency
B) Cord compression
C) Head compression
D) Maternal fever
Answer B: Cord compression
Rationale: Variable decelerations are caused by umbilical cord compression.
8. A postpartum client with a history of deep vein thrombosis develops sudden shortness of breath
and chest pain. Which action should the nurse take first?
A) Apply oxygen at 2 L/min
B) Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer enoxaparin
D) Notify the provider
Answer B: Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
, Rationale: Suspected pulmonary embolism requires immediate oxygenation and positioning.
9. A client at 40 weeks gestation is admitted with contractions every 3 minutes, cervix 5 cm, 90%
effaced, station 0. The fetal heart rate baseline is 140 bpm with moderate variability. Which finding is
most reassuring?
A) Early decelerations
B) Moderate variability
C) Late decelerations
D) Variable decelerations with overshoot
Answer B: Moderate variability
Rationale: Moderate variability (6-25 bpm) indicates a well-oxygenated fetal nervous system.
10. A nurse is teaching a breastfeeding client about signs of adequate milk transfer. Which statement
indicates understanding?
A) "My baby should feed for exactly 10 minutes on each side."
B) "My baby has 6-8 wet diapers and several stools per day."
C) "I should wake my baby every 2 hours to feed."
D) "My baby will lose weight for the first 2 weeks."
Answer B: "My baby has 6-8 wet diapers and several stools per day."
Rationale: Adequate output is the best indicator of adequate intake.
11. A client with preeclampsia is receiving IV magnesium sulfate. Which medication should be readily
available at the bedside?
A) Naloxone
B) Calcium gluconate
C) Vitamin K
D) Protamine sulfate
Answer B: Calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium toxicity.
12. A newborn has an APGAR score of 4 at 1 minute. Which intervention should the nurse perform
first?
