NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
NSG 3500 Exam 1 | Maternal Health
2026/2027 | Galen College of Nursing
Maternal-Newborn Nursing Comprehensive Practice Exam
Aligned with NSG 3500 Course Objectives · 100 Questions with Detailed Rationales
Section 1: Foundations of Maternal-Newborn Nursing (Q1-12)
Historical Perspectives, Trends, Family-Centered Care, & Community-Based Care
Q1: A nurse is describing the historical evolution of maternal-newborn nursing. Which 20th-century development
most significantly reduced maternal mortality rates in the United States?
A. Increased use of midwives in hospital births
B. The shift from home births to hospital-based childbirth with aseptic practices, antibiotics, and improved obstetric
anesthesia [CORRECT]
C. Use of forceps for routine deliveries
D. Increase in cesarean section rates
Correct Answer: B
Rationale: The transition from home births to hospital-based childbirth in the early-to-mid 20th century, along with aseptic technique,
antibiotics (post-1940s), safer anesthesia, and improved obstetric practices, dramatically reduced maternal mortality. Midwifery care
(Option A) also contributed to safe birth outcomes but the hospital-based shift was most influential in reducing U.S. maternal mortality.
Forceps (Option C) can cause trauma; rising cesarean rates (Option D) have not consistently improved maternal outcomes.
Q2: A nurse is implementing family-centered maternity care. Which intervention best reflects this philosophy?
A. Restricting visitation to designated hours only
B. Allowing the partner to remain with the laboring client throughout labor and birth, encouraging bonding, and including
the family in newborn care teaching [CORRECT]
C. Providing all newborn care in the nursery to allow the mother to rest
D. Making all decisions for the family without their input
Correct Answer: B
Rationale: Family-centered maternity care (FCMC) respects the family as a unit, encourages partner involvement throughout labor and
birth, promotes bonding and rooming-in, and includes the family in care decisions. Restricting visitation (Option A) and nursery-only
newborn care (Option C) contradict FCMC principles. Making decisions without family input (Option D) violates the principle of
informed, collaborative care.
Page 1
,NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q3: A community-based maternal-child nurse is providing care to a pregnant adolescent. Which intervention is most
appropriate?
A. Focusing exclusively on the medical aspects of pregnancy
B. Coordinating prenatal care, nutrition counseling, school continuation, psychosocial support, and connecting the
adolescent to community resources [CORRECT]
C. Advising the adolescent to drop out of school
D. Refusing to involve the adolescent's family in care decisions
Correct Answer: B
Rationale: Community-based maternal-child nursing addresses the holistic needs of pregnant clients, particularly vulnerable populations
such as adolescents. Coordinating medical care, nutrition, education continuation, psychosocial support, and community resources
optimizes outcomes. Focusing only on medical aspects (Option A) misses critical psychosocial needs. Dropping out of school (Option C)
worsens long-term outcomes. Refusing to involve family (Option D) ignores the support network critical to adolescent care.
Q4: Which current trend in maternal-newborn nursing addresses the rising cesarean birth rate in the United States?
A. Encouraging all low-risk pregnancies to deliver via elective cesarean
B. Promoting vaginal birth after cesarean (VBAC), reducing non-medically indicated inductions before 39 weeks, and
supporting midwifery and birth center care for low-risk pregnancies [CORRECT]
C. Increasing scheduled repeat cesareans without trial of labor
D. Eliminating midwifery care
Correct Answer: B
Rationale: Current trends to reduce cesarean rates include promoting VBAC for appropriate candidates, eliminating elective inductions
before 39 weeks (which increase cesarean risk), supporting midwifery and birth center care for low-risk pregnancies, and implementing
ACOG's strategies for safe reduction of primary cesareans. Elective cesareans for low-risk pregnancies (Option A) and increased
scheduled repeat cesareans (Option C) increase the cesarean rate. Eliminating midwifery (Option D) would worsen access to care.
Q5: A nurse is discussing the principles of family-centered care with a pregnant client. Which statement by the client
indicates understanding?
A. 'My family should stay in the waiting room during labor so the staff can work.'
B. 'I should be involved in decisions about my care and my baby's care, and my partner can stay with me throughout labor.'
[CORRECT]
C. 'The nurse will make all decisions for me and my baby.'
D. 'I will not be allowed to see my baby until discharge.'
Correct Answer: B
Rationale: Family-centered care principles include client and family involvement in care decisions, partner presence during labor and
birth, rooming-in, and open communication. The other statements reflect outdated, paternalistic models of maternity care that are
inconsistent with FCMC and AWHONN standards.
Page 2
,NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q6: Which statement best reflects the concept of perinatal nursing as defined by AWHONN?
A. Perinatal nursing begins at the time of delivery and ends at 28 days postpartum.
B. Perinatal nursing encompasses care from before conception through pregnancy, childbirth, and the postpartum period,
including the newborn's first month of life [CORRECT]
C. Perinatal nursing only involves intrapartum care
D. Perinatal nursing only involves newborn care after birth
Correct Answer: B
Rationale: AWHONN defines perinatal nursing as care that spans from before conception through the pregnancy, childbirth, and
postpartum period, including the newborn's first month. This broad scope emphasizes continuity of care. The other options incorrectly
limit the scope to a single phase.
Q7: Which organization publishes the Standards for Professional Registered Nurse Staffing for Perinatal Units,
which guides maternal-newborn nursing practice in the U.S.?
A. American Hospital Association
B. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) [CORRECT]
C. American Medical Association
D. American Public Health Association
Correct Answer: B
Rationale: AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) is the leading professional organization for
maternal-newborn nurses in the U.S. It publishes the Standards for Professional Registered Nurse Staffing for Perinatal Units, which
guides safe nursing care delivery. Other organizations (AMA, AHA, APHA) do not set perinatal nursing standards.
Q8: A nurse is providing community-based prenatal care to an undocumented immigrant woman. Which ethical
principle is most relevant?
A. Justice - ensuring fair and equitable access to care regardless of immigration status [CORRECT]
B. Veracity
C. Fidelity
D. Beneficence only
Correct Answer: A
Rationale: Justice requires fair, equitable distribution of healthcare resources regardless of race, ethnicity, immigration status, or
socioeconomic status. All pregnant women in the U.S. are eligible for emergency Medicaid for labor and delivery, and community-based
prenatal care improves maternal and neonatal outcomes. The other principles are important but secondary to equity of access in this
scenario.
Q9: Which community-based intervention has demonstrated the greatest reduction in infant mortality in high-risk
populations?
A. Hospital-based prenatal care only
B. Home visiting programs by nurses (e.g., Nurse-Family Partnership) providing intensive support from pregnancy through
the first 2 years of life [CORRECT]
C. Telephone advice lines only
D. Random distribution of prenatal vitamins
Correct Answer: B
Rationale: The Nurse-Family Partnership and similar evidence-based home visiting programs reduce infant mortality, improve prenatal
health behaviors, reduce subsequent pregnancies, and improve long-term child outcomes. Hospital-only care (Option A) misses social
determinants. Telephone-only advice (Option C) and random vitamin distribution (Option D) lack the sustained relationship that drives
behavior change.
Page 3
, NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q10: A nurse is caring for a pregnant woman who recently emigrated from Southeast Asia. Which approach is most
culturally responsive?
A. Assuming she has the same values as American-born clients
B. Conducting a cultural assessment to understand her beliefs, practices, and preferences regarding pregnancy, birth, and
postpartum care, and incorporating them into the plan of care when safe [CORRECT]
C. Insisting she follow only Western medical practices
D. Refusing to involve her husband in care decisions
Correct Answer: B
Rationale: Culturally responsive nursing requires conducting a cultural assessment (using models like Leininger's Cultural Care or
Campinha-Bacote's Process of Cultural Competence) to understand the client's beliefs, values, and practices, then integrating them into
care when safe and feasible. The other options reflect cultural imposition or ethnocentrism.
Q11: Which statistic is the most sensitive indicator of a nation's overall health and healthcare quality for women and
infants?
A. Total fertility rate
B. Infant mortality rate - particularly the neonatal mortality rate (deaths in the first 28 days of life) [CORRECT]
C. Crude birth rate
D. Maternal age at first birth
Correct Answer: B
Rationale: Infant mortality rate (number of deaths in infants <1 year per 1,000 live births), and especially neonatal mortality (first 28
days), is widely considered the most sensitive indicator of a nation's health. The U.S. infant mortality rate is higher than other developed
nations, largely due to racial disparities (non-Hispanic Black infants have 2-3x the mortality of non-Hispanic White infants).
Q12: A nurse is providing care to a same-sex female couple seeking to conceive via donor insemination. Which
intervention reflects culturally competent care?
A. Refusing care due to personal objections
B. Acknowledging both partners as equal parents-to-be, using inclusive language, addressing both as parents, and providing
the same prenatal education offered to heterosexual couples [CORRECT]
C. Asking one partner to leave the room during care
D. Referring the couple to another provider without explanation
Correct Answer: B
Rationale: Culturally competent, family-centered care of LGBTQ+ clients includes using inclusive language, acknowledging both
partners as parents-to-be, providing equal education and visitation, and avoiding heteronormative assumptions. Refusing care, excluding
a partner, or referring without explanation violates professional ethical standards and AWHONN/AACN position statements on
inclusivity.
Section 2: Reproductive Anatomy, Physiology, and the Menstrual Cycle (Q13-25)
Female/Male Reproductive Systems, Hormonal Regulation, & Menstruation
Page 4
NSG 3500 Exam 1 | Maternal Health
2026/2027 | Galen College of Nursing
Maternal-Newborn Nursing Comprehensive Practice Exam
Aligned with NSG 3500 Course Objectives · 100 Questions with Detailed Rationales
Section 1: Foundations of Maternal-Newborn Nursing (Q1-12)
Historical Perspectives, Trends, Family-Centered Care, & Community-Based Care
Q1: A nurse is describing the historical evolution of maternal-newborn nursing. Which 20th-century development
most significantly reduced maternal mortality rates in the United States?
A. Increased use of midwives in hospital births
B. The shift from home births to hospital-based childbirth with aseptic practices, antibiotics, and improved obstetric
anesthesia [CORRECT]
C. Use of forceps for routine deliveries
D. Increase in cesarean section rates
Correct Answer: B
Rationale: The transition from home births to hospital-based childbirth in the early-to-mid 20th century, along with aseptic technique,
antibiotics (post-1940s), safer anesthesia, and improved obstetric practices, dramatically reduced maternal mortality. Midwifery care
(Option A) also contributed to safe birth outcomes but the hospital-based shift was most influential in reducing U.S. maternal mortality.
Forceps (Option C) can cause trauma; rising cesarean rates (Option D) have not consistently improved maternal outcomes.
Q2: A nurse is implementing family-centered maternity care. Which intervention best reflects this philosophy?
A. Restricting visitation to designated hours only
B. Allowing the partner to remain with the laboring client throughout labor and birth, encouraging bonding, and including
the family in newborn care teaching [CORRECT]
C. Providing all newborn care in the nursery to allow the mother to rest
D. Making all decisions for the family without their input
Correct Answer: B
Rationale: Family-centered maternity care (FCMC) respects the family as a unit, encourages partner involvement throughout labor and
birth, promotes bonding and rooming-in, and includes the family in care decisions. Restricting visitation (Option A) and nursery-only
newborn care (Option C) contradict FCMC principles. Making decisions without family input (Option D) violates the principle of
informed, collaborative care.
Page 1
,NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q3: A community-based maternal-child nurse is providing care to a pregnant adolescent. Which intervention is most
appropriate?
A. Focusing exclusively on the medical aspects of pregnancy
B. Coordinating prenatal care, nutrition counseling, school continuation, psychosocial support, and connecting the
adolescent to community resources [CORRECT]
C. Advising the adolescent to drop out of school
D. Refusing to involve the adolescent's family in care decisions
Correct Answer: B
Rationale: Community-based maternal-child nursing addresses the holistic needs of pregnant clients, particularly vulnerable populations
such as adolescents. Coordinating medical care, nutrition, education continuation, psychosocial support, and community resources
optimizes outcomes. Focusing only on medical aspects (Option A) misses critical psychosocial needs. Dropping out of school (Option C)
worsens long-term outcomes. Refusing to involve family (Option D) ignores the support network critical to adolescent care.
Q4: Which current trend in maternal-newborn nursing addresses the rising cesarean birth rate in the United States?
A. Encouraging all low-risk pregnancies to deliver via elective cesarean
B. Promoting vaginal birth after cesarean (VBAC), reducing non-medically indicated inductions before 39 weeks, and
supporting midwifery and birth center care for low-risk pregnancies [CORRECT]
C. Increasing scheduled repeat cesareans without trial of labor
D. Eliminating midwifery care
Correct Answer: B
Rationale: Current trends to reduce cesarean rates include promoting VBAC for appropriate candidates, eliminating elective inductions
before 39 weeks (which increase cesarean risk), supporting midwifery and birth center care for low-risk pregnancies, and implementing
ACOG's strategies for safe reduction of primary cesareans. Elective cesareans for low-risk pregnancies (Option A) and increased
scheduled repeat cesareans (Option C) increase the cesarean rate. Eliminating midwifery (Option D) would worsen access to care.
Q5: A nurse is discussing the principles of family-centered care with a pregnant client. Which statement by the client
indicates understanding?
A. 'My family should stay in the waiting room during labor so the staff can work.'
B. 'I should be involved in decisions about my care and my baby's care, and my partner can stay with me throughout labor.'
[CORRECT]
C. 'The nurse will make all decisions for me and my baby.'
D. 'I will not be allowed to see my baby until discharge.'
Correct Answer: B
Rationale: Family-centered care principles include client and family involvement in care decisions, partner presence during labor and
birth, rooming-in, and open communication. The other statements reflect outdated, paternalistic models of maternity care that are
inconsistent with FCMC and AWHONN standards.
Page 2
,NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q6: Which statement best reflects the concept of perinatal nursing as defined by AWHONN?
A. Perinatal nursing begins at the time of delivery and ends at 28 days postpartum.
B. Perinatal nursing encompasses care from before conception through pregnancy, childbirth, and the postpartum period,
including the newborn's first month of life [CORRECT]
C. Perinatal nursing only involves intrapartum care
D. Perinatal nursing only involves newborn care after birth
Correct Answer: B
Rationale: AWHONN defines perinatal nursing as care that spans from before conception through the pregnancy, childbirth, and
postpartum period, including the newborn's first month. This broad scope emphasizes continuity of care. The other options incorrectly
limit the scope to a single phase.
Q7: Which organization publishes the Standards for Professional Registered Nurse Staffing for Perinatal Units,
which guides maternal-newborn nursing practice in the U.S.?
A. American Hospital Association
B. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) [CORRECT]
C. American Medical Association
D. American Public Health Association
Correct Answer: B
Rationale: AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) is the leading professional organization for
maternal-newborn nurses in the U.S. It publishes the Standards for Professional Registered Nurse Staffing for Perinatal Units, which
guides safe nursing care delivery. Other organizations (AMA, AHA, APHA) do not set perinatal nursing standards.
Q8: A nurse is providing community-based prenatal care to an undocumented immigrant woman. Which ethical
principle is most relevant?
A. Justice - ensuring fair and equitable access to care regardless of immigration status [CORRECT]
B. Veracity
C. Fidelity
D. Beneficence only
Correct Answer: A
Rationale: Justice requires fair, equitable distribution of healthcare resources regardless of race, ethnicity, immigration status, or
socioeconomic status. All pregnant women in the U.S. are eligible for emergency Medicaid for labor and delivery, and community-based
prenatal care improves maternal and neonatal outcomes. The other principles are important but secondary to equity of access in this
scenario.
Q9: Which community-based intervention has demonstrated the greatest reduction in infant mortality in high-risk
populations?
A. Hospital-based prenatal care only
B. Home visiting programs by nurses (e.g., Nurse-Family Partnership) providing intensive support from pregnancy through
the first 2 years of life [CORRECT]
C. Telephone advice lines only
D. Random distribution of prenatal vitamins
Correct Answer: B
Rationale: The Nurse-Family Partnership and similar evidence-based home visiting programs reduce infant mortality, improve prenatal
health behaviors, reduce subsequent pregnancies, and improve long-term child outcomes. Hospital-only care (Option A) misses social
determinants. Telephone-only advice (Option C) and random vitamin distribution (Option D) lack the sustained relationship that drives
behavior change.
Page 3
, NSG 3500 Exam 1 | Maternal Health 2026/2027 | Galen College of Nursing Maternal-Newborn Nursing
Q10: A nurse is caring for a pregnant woman who recently emigrated from Southeast Asia. Which approach is most
culturally responsive?
A. Assuming she has the same values as American-born clients
B. Conducting a cultural assessment to understand her beliefs, practices, and preferences regarding pregnancy, birth, and
postpartum care, and incorporating them into the plan of care when safe [CORRECT]
C. Insisting she follow only Western medical practices
D. Refusing to involve her husband in care decisions
Correct Answer: B
Rationale: Culturally responsive nursing requires conducting a cultural assessment (using models like Leininger's Cultural Care or
Campinha-Bacote's Process of Cultural Competence) to understand the client's beliefs, values, and practices, then integrating them into
care when safe and feasible. The other options reflect cultural imposition or ethnocentrism.
Q11: Which statistic is the most sensitive indicator of a nation's overall health and healthcare quality for women and
infants?
A. Total fertility rate
B. Infant mortality rate - particularly the neonatal mortality rate (deaths in the first 28 days of life) [CORRECT]
C. Crude birth rate
D. Maternal age at first birth
Correct Answer: B
Rationale: Infant mortality rate (number of deaths in infants <1 year per 1,000 live births), and especially neonatal mortality (first 28
days), is widely considered the most sensitive indicator of a nation's health. The U.S. infant mortality rate is higher than other developed
nations, largely due to racial disparities (non-Hispanic Black infants have 2-3x the mortality of non-Hispanic White infants).
Q12: A nurse is providing care to a same-sex female couple seeking to conceive via donor insemination. Which
intervention reflects culturally competent care?
A. Refusing care due to personal objections
B. Acknowledging both partners as equal parents-to-be, using inclusive language, addressing both as parents, and providing
the same prenatal education offered to heterosexual couples [CORRECT]
C. Asking one partner to leave the room during care
D. Referring the couple to another provider without explanation
Correct Answer: B
Rationale: Culturally competent, family-centered care of LGBTQ+ clients includes using inclusive language, acknowledging both
partners as parents-to-be, providing equal education and visitation, and avoiding heteronormative assumptions. Refusing care, excluding
a partner, or referring without explanation violates professional ethical standards and AWHONN/AACN position statements on
inclusivity.
Section 2: Reproductive Anatomy, Physiology, and the Menstrual Cycle (Q13-25)
Female/Male Reproductive Systems, Hormonal Regulation, & Menstruation
Page 4
