NSG 3500 Maternal Health Exam 2 Q&A (PDF) |
Galen Nursing | Actual Questions and Correct
Answers with Rationale Latest 2026/2027 Already
Graded A+ Assured Pass
1. A nurse is reviewing the prenatal record of a client at 28 weeks' gestation.
Which finding should the nurse report to the provider immediately?
A) Fetal heart rate of 140 beats/min
B) Blood pressure 148/96 mm Hg on two occasions
C) Fundal height of 28 cm
D) Hemoglobin 11.2 g/dL
Answer: B) Blood pressure 148/96 mm Hg on two occasions
Rationale: Two readings of ≥140/90 mm Hg after 20 weeks' gestation suggest
gestational hypertension and require prompt provider notification. FHR of 140, fundal
height matching gestational age, and hemoglobin of 11.2 g/dL are all within expected
ranges for the third trimester.
2. A client in the first stage of labor is 4 cm dilated, 90% effaced, and having
contractions every 3 minutes lasting 50 seconds. She reports intense pain. Which
nursing action is the priority?
A) Offer a back rub and repositioning
B) Assess fetal heart rate and contraction pattern
C) Administer the prescribed IV opioid immediately
D) Encourage the client to push with contractions
Answer: B) Assess fetal heart rate and contraction pattern
Rationale: Assessment precedes intervention. Before administering analgesia or
comfort measures, the nurse must confirm fetal tolerance of labor. Pushing is
inappropriate at 4 cm — it risks cervical edema and injury.
,3. Which statement by a postpartum client 12 hours after a vaginal delivery
indicates a need for further teaching?
A) "I should change my perineal pad at least every 4 hours."
B) "I will wash my hands before and after changing my pad."
C) "I should expect my lochia to turn white within 24 hours."
D) "I can use a peri-bottle with warm water after voiding."
Answer: C) "I should expect my lochia to turn white within 24 hours."
Rationale: Lochia rubra lasts 3–4 days, then serosa (pink-brown) for 4–10 days, then
alba (white-yellow) up to 6 weeks. Expecting alba within 24 hours reflects a
misunderstanding and requires reteaching.
4. A newborn at 1 minute of life has: heart rate 130, respiratory effort slow and
irregular, some flexion of extremities, grimace on stimulation, and acrocyanosis.
What is the Apgar score?
A) 5
B) 6
C) 7
D) 8
Answer: B) 6
Rationale: HR 130 = 2; slow/irregular respirations = 1; some flexion = 1; grimace = 1;
acrocyanosis = 1. Total = 6. A score of 6 indicates moderate depression requiring
continued stimulation and reassessment.
5. Which client is at highest risk for postpartum hemorrhage?
A) A primigravida who delivered at 39 weeks
B) A client whose labor was induced with oxytocin and lasted 18 hours
,C) A client who received an epidural for pain relief
D) A client who had a spontaneous vaginal delivery of a 7-lb infant
Answer: B) A client whose labor was induced with oxytocin and lasted 18 hours
Rationale: Prolonged labor and oxytocin augmentation increase risk of uterine atony —
the leading cause of postpartum hemorrhage. Epidurals, spontaneous delivery, and term
primigravida delivery are not primary hemorrhage risk factors.
6. A nurse is interpreting a fetal monitoring strip showing variable decelerations.
Which action should the nurse take first?
A) Administer oxygen at 10 L/min via face mask
B) Reposition the client to a side-lying position
C) Increase the IV oxytocin rate
D) Notify the provider for an emergency cesarean
Answer: B) Reposition the client to a side-lying position
Rationale: Variable decelerations result from umbilical cord compression. Repositioning
(side-lying, knee-chest, or Trendelenburg) is the first intervention. Oxygen, provider
notification, and stopping oxytocin follow if repositioning does not resolve them — but
repositioning comes first.
7. A client at 36 weeks presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Vasa previa
Answer: A) Placenta previa
Rationale: Placenta previa classically presents with painless bright red bleeding in the
third trimester. Abruptio placentae presents with painful bleeding and a tender, rigid
, uterus. Uterine rupture is associated with loss of fetal station, and vasa previa causes
bleeding with membrane rupture.
8. Which finding in a newborn during the first hour of life requires immediate
intervention?
A) Respiratory rate of 50 breaths/min
B) Heart rate of 120 beats/min
C) Central cyanosis
D) Temperature of 36.8°C (98.2°F)
Answer: C) Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
assessment and intervention. The other values are within normal newborn ranges during
the first hour.
9. A nurse is teaching a pregnant client about danger signs. Which statement
indicates correct understanding?
A) "I should call my provider if I have a headache that won't go away."
B) "Spotting after intercourse is always an emergency."
C) "Swelling of the ankles in the evening is a danger sign."
D) "Braxton Hicks contractions mean I'm in labor."
Answer: A) "I should call my provider if I have a headache that won't go away."
Rationale: Persistent headache may indicate preeclampsia and warrants immediate
reporting. Post-coital spotting can be normal, dependent ankle edema is common, and
Braxton Hicks contractions do not indicate true labor.
10. Which intervention is appropriate for a client experiencing a postpartum
hemorrhage from uterine atony?
Galen Nursing | Actual Questions and Correct
Answers with Rationale Latest 2026/2027 Already
Graded A+ Assured Pass
1. A nurse is reviewing the prenatal record of a client at 28 weeks' gestation.
Which finding should the nurse report to the provider immediately?
A) Fetal heart rate of 140 beats/min
B) Blood pressure 148/96 mm Hg on two occasions
C) Fundal height of 28 cm
D) Hemoglobin 11.2 g/dL
Answer: B) Blood pressure 148/96 mm Hg on two occasions
Rationale: Two readings of ≥140/90 mm Hg after 20 weeks' gestation suggest
gestational hypertension and require prompt provider notification. FHR of 140, fundal
height matching gestational age, and hemoglobin of 11.2 g/dL are all within expected
ranges for the third trimester.
2. A client in the first stage of labor is 4 cm dilated, 90% effaced, and having
contractions every 3 minutes lasting 50 seconds. She reports intense pain. Which
nursing action is the priority?
A) Offer a back rub and repositioning
B) Assess fetal heart rate and contraction pattern
C) Administer the prescribed IV opioid immediately
D) Encourage the client to push with contractions
Answer: B) Assess fetal heart rate and contraction pattern
Rationale: Assessment precedes intervention. Before administering analgesia or
comfort measures, the nurse must confirm fetal tolerance of labor. Pushing is
inappropriate at 4 cm — it risks cervical edema and injury.
,3. Which statement by a postpartum client 12 hours after a vaginal delivery
indicates a need for further teaching?
A) "I should change my perineal pad at least every 4 hours."
B) "I will wash my hands before and after changing my pad."
C) "I should expect my lochia to turn white within 24 hours."
D) "I can use a peri-bottle with warm water after voiding."
Answer: C) "I should expect my lochia to turn white within 24 hours."
Rationale: Lochia rubra lasts 3–4 days, then serosa (pink-brown) for 4–10 days, then
alba (white-yellow) up to 6 weeks. Expecting alba within 24 hours reflects a
misunderstanding and requires reteaching.
4. A newborn at 1 minute of life has: heart rate 130, respiratory effort slow and
irregular, some flexion of extremities, grimace on stimulation, and acrocyanosis.
What is the Apgar score?
A) 5
B) 6
C) 7
D) 8
Answer: B) 6
Rationale: HR 130 = 2; slow/irregular respirations = 1; some flexion = 1; grimace = 1;
acrocyanosis = 1. Total = 6. A score of 6 indicates moderate depression requiring
continued stimulation and reassessment.
5. Which client is at highest risk for postpartum hemorrhage?
A) A primigravida who delivered at 39 weeks
B) A client whose labor was induced with oxytocin and lasted 18 hours
,C) A client who received an epidural for pain relief
D) A client who had a spontaneous vaginal delivery of a 7-lb infant
Answer: B) A client whose labor was induced with oxytocin and lasted 18 hours
Rationale: Prolonged labor and oxytocin augmentation increase risk of uterine atony —
the leading cause of postpartum hemorrhage. Epidurals, spontaneous delivery, and term
primigravida delivery are not primary hemorrhage risk factors.
6. A nurse is interpreting a fetal monitoring strip showing variable decelerations.
Which action should the nurse take first?
A) Administer oxygen at 10 L/min via face mask
B) Reposition the client to a side-lying position
C) Increase the IV oxytocin rate
D) Notify the provider for an emergency cesarean
Answer: B) Reposition the client to a side-lying position
Rationale: Variable decelerations result from umbilical cord compression. Repositioning
(side-lying, knee-chest, or Trendelenburg) is the first intervention. Oxygen, provider
notification, and stopping oxytocin follow if repositioning does not resolve them — but
repositioning comes first.
7. A client at 36 weeks presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Vasa previa
Answer: A) Placenta previa
Rationale: Placenta previa classically presents with painless bright red bleeding in the
third trimester. Abruptio placentae presents with painful bleeding and a tender, rigid
, uterus. Uterine rupture is associated with loss of fetal station, and vasa previa causes
bleeding with membrane rupture.
8. Which finding in a newborn during the first hour of life requires immediate
intervention?
A) Respiratory rate of 50 breaths/min
B) Heart rate of 120 beats/min
C) Central cyanosis
D) Temperature of 36.8°C (98.2°F)
Answer: C) Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
assessment and intervention. The other values are within normal newborn ranges during
the first hour.
9. A nurse is teaching a pregnant client about danger signs. Which statement
indicates correct understanding?
A) "I should call my provider if I have a headache that won't go away."
B) "Spotting after intercourse is always an emergency."
C) "Swelling of the ankles in the evening is a danger sign."
D) "Braxton Hicks contractions mean I'm in labor."
Answer: A) "I should call my provider if I have a headache that won't go away."
Rationale: Persistent headache may indicate preeclampsia and warrants immediate
reporting. Post-coital spotting can be normal, dependent ankle edema is common, and
Braxton Hicks contractions do not indicate true labor.
10. Which intervention is appropriate for a client experiencing a postpartum
hemorrhage from uterine atony?
