NSG 3500 Exam 3 | Maternal Health (2026/2027)
Galen College of Nursing — Intrapartum and Postpartum Nursing
2026/2027 Edition | 100 Multiple-Choice Questions | 8 Sections | Aligned with AWHONN, ACOG, and NRP
Standards
Directions: Each question has four options (A–D). The correct option is marked [CORRECT] in accent color. A
detailed rationale follows each question, integrating intrapartum clinical reasoning with NSG 3500 verification against
Galen College of Nursing course objectives. Content spans intrapartum assessment, labor stages and phases, electronic
fetal monitoring, pain management, obstetric procedures, intrapartum complications, fetal complications, and
immediate postpartum/newborn transition. NCLEX-style prioritization frameworks (ABCs, Maslow, safety, least
restrictive) applied throughout.
Section 1: Intrapartum Nursing Assessment
Admission Assessment, Labor Onset, and Maternal/Fetal Baseline Data (Q1-Q12)
Q1: A primigravida at 39 weeks gestation presents to the labor unit reporting contractions every 5-7
minutes, mild in intensity, with no cervical change noted over the past 2 hours. Her membranes are
intact. Which finding BEST supports a diagnosis of false labor?
A. Contractions that increase with walking and are felt in the abdomen
B. Contractions that decrease with walking and are felt primarily in the lower abdomen and groin
[CORRECT]
C. Bloody show and cervical dilation of 3 cm
D. Regular contractions every 3 minutes with cervical change
Correct Answer: B
Rationale: False labor contractions are typically irregular, decrease with activity (walking, sedation), are felt in
the lower abdomen/groin (not back), and cause no cervical change. True labor contractions increase in
frequency, intensity, and duration with walking, are felt in the back and radiate to the abdomen, and cause
progressive cervical dilation and effacement. NSG 3500 verification: the nurse's priority when differentiating
true vs. false labor is to assess for cervical change over time, which is the definitive diagnostic criterion.
Page 1
,NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q2: On admission to the labor unit, a multigravida at 40 weeks gestation reports spontaneous rupture
of membranes 4 hours ago with clear fluid. The priority admission assessment is:
A. Maternal blood pressure and pulse
B. Fetal heart rate (FHR) immediately after ROM to detect cord compression or prolapse
[CORRECT]
C. Cervical dilation and effacement
D. Contraction pattern and intensity
Correct Answer: B
Rationale: After spontaneous rupture of membranes, the FIRST priority is to assess the fetal heart rate to detect
umbilical cord prolapse or cord compression, which are life-threatening emergencies. NSG 3500 verification:
assess FHR for at least 1 full minute; variable decelerations or bradycardia may indicate cord prolapse. Also
note color, odor, and amount of fluid (clear, pink-tinged, or meconium-stained). Maternal vital signs, cervical
exam, and contraction pattern follow, but FHR is the immediate priority.
Q3: A nurse is admitting a laboring client. Which finding should be reported to the healthcare
provider IMMEDIATELY before proceeding with a vaginal exam?
A. Cervical dilation of 6 cm with 80% effacement
B. Bright red vaginal bleeding that is increasing in amount [CORRECT]
C. Fetal station at +1
D. Bloody show with mucus plug
Correct Answer: B
Rationale: Bright red vaginal bleeding in labor is a medical emergency that may indicate placenta previa,
placental abruption, or vasa previa — a vaginal exam is CONTRAINDICATED until placenta previa is ruled out
by ultrasound. NSG 3500 verification: bloody show (pink-tinged mucus with small amount of blood) is normal
and indicates cervical change; bright red bleeding is abnormal. The nurse should NOT perform a vaginal exam,
should assess FHR and maternal vital signs, notify the provider STAT, and prepare for possible emergent
delivery.
Page 2
,NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q4: A client is admitted in active labor. The nurse performs Leopold's maneuvers and palpates a
hard, round, ballotable mass in the fundus, a soft broad structure on the right side, and small parts on
the left. The fetal heart rate is best auscultated in which quadrant?
A. Right upper quadrant
B. Left lower quadrant (the fetal back is on the left, so FHR best heard through the fetal back)
[CORRECT]
C. Right lower quadrant
D. Midline above the symphysis
Correct Answer: B
Rationale: Leopold's maneuvers identify fetal presentation, position, and lie. The fetal back is on the mother's
left (soft broad structure on the right is the small parts/fetal limbs), the head is in the fundus (breech
presentation). NSG 3500 verification: FHR is best auscultated through the fetal back because sound transmits
best through solid tissue; the back's location determines where the Doppler/fetoscope is placed on the maternal
abdomen. In cephalic presentation with left occiput anterior (LOA) position, FHR is best heard in the left lower
quadrant.
Q5: A laboring client's cervical exam reveals: dilation 4 cm, effacement 80%, station -1, presentation
cephalic, position ROA, and membrane status intact. Which documentation is MOST accurate
regarding fetal station?
A. Fetus is floating above the ischial spines
B. Fetal presenting part is 1 cm above the ischial spines (station -1, engagement has not yet occurred)
[CORRECT]
C. Fetal presenting part is at the ischial spines (station 0)
D. Fetal presenting part is 1 cm below the ischial spines
Correct Answer: B
Rationale: Station refers to the relationship of the fetal presenting part to the ischial spines (the narrowest part
of the maternal pelvis). Negative stations (-5 to -1) are above the spines; station 0 is at the spines (engagement
has occurred); positive stations (+1 to +5) are below the spines. NSG 3500 verification: station -1 means the
presenting part is 1 cm above the ischial spines, indicating engagement has not yet occurred. Engagement
(station 0) is the descent of the biparietal diameter to the level of the ischial spines.
Page 3
, NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q6: During admission assessment, the nurse notes the following maternal vital signs: BP 138/88, HR
92, RR 20, T 99.2°F, and fetal heart rate 145. The client denies pain at this time. Which finding
requires further evaluation?
A. Maternal BP 138/88
B. Maternal HR 92
C. Maternal temperature 99.2°F (low-grade temp early in labor may be normal, but trends upward
suggest infection, especially with ROM) [CORRECT]
D. Fetal heart rate 145 (normal range is 110-160 bpm)
Correct Answer: C
Rationale: All other vital signs are within normal limits for a laboring client. Maternal temp 99.2°F is
borderline; if it trends upward (>100.4°F or 38°C), especially with prolonged rupture of membranes, it suggests
intrauterine infection (chorioamnionitis) which increases maternal and fetal morbidity. NSG 3500 verification:
normal maternal BP in labor <140/90, HR 60-100, RR 12-20, temp <99.6°F (some sources <100.4°F). FHR
110-160 bpm. A single borderline temp warrants monitoring every 2 hours (or q1h with ROM) and reporting if it
rises.
Q7: A client at 38 weeks gestation arrives reporting contractions every 4 minutes. The nurse palpates
the abdomen between contractions and notes it feels soft, easily indentable. This finding indicates:
A. Hypertonic uterine dysfunction (high resting tone)
B. Normal uterine resting tone between contractions [CORRECT]
C. Placental abruption
D. Uterine tachysystole
Correct Answer: B
Rationale: Between contractions, the uterus should relax completely and feel soft to palpation, allowing
placental perfusion. NSG 3500 verification: resting tone should be palpable as soft (or measured <20 mmHg via
intrauterine pressure catheter). Hypertonicity (firm, tense uterus between contractions) is abnormal and may
indicate abruptio placentae, hypertonic labor dysfunction, or tachysystole from oxytocin. Tachysystole is >5
contractions in 10 minutes; hypertonus is resting tone >20 mmHg; both require intervention
(decrease/discontinue oxytocin, tocolytics, position change, notify provider).
Page 4
Galen College of Nursing — Intrapartum and Postpartum Nursing
2026/2027 Edition | 100 Multiple-Choice Questions | 8 Sections | Aligned with AWHONN, ACOG, and NRP
Standards
Directions: Each question has four options (A–D). The correct option is marked [CORRECT] in accent color. A
detailed rationale follows each question, integrating intrapartum clinical reasoning with NSG 3500 verification against
Galen College of Nursing course objectives. Content spans intrapartum assessment, labor stages and phases, electronic
fetal monitoring, pain management, obstetric procedures, intrapartum complications, fetal complications, and
immediate postpartum/newborn transition. NCLEX-style prioritization frameworks (ABCs, Maslow, safety, least
restrictive) applied throughout.
Section 1: Intrapartum Nursing Assessment
Admission Assessment, Labor Onset, and Maternal/Fetal Baseline Data (Q1-Q12)
Q1: A primigravida at 39 weeks gestation presents to the labor unit reporting contractions every 5-7
minutes, mild in intensity, with no cervical change noted over the past 2 hours. Her membranes are
intact. Which finding BEST supports a diagnosis of false labor?
A. Contractions that increase with walking and are felt in the abdomen
B. Contractions that decrease with walking and are felt primarily in the lower abdomen and groin
[CORRECT]
C. Bloody show and cervical dilation of 3 cm
D. Regular contractions every 3 minutes with cervical change
Correct Answer: B
Rationale: False labor contractions are typically irregular, decrease with activity (walking, sedation), are felt in
the lower abdomen/groin (not back), and cause no cervical change. True labor contractions increase in
frequency, intensity, and duration with walking, are felt in the back and radiate to the abdomen, and cause
progressive cervical dilation and effacement. NSG 3500 verification: the nurse's priority when differentiating
true vs. false labor is to assess for cervical change over time, which is the definitive diagnostic criterion.
Page 1
,NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q2: On admission to the labor unit, a multigravida at 40 weeks gestation reports spontaneous rupture
of membranes 4 hours ago with clear fluid. The priority admission assessment is:
A. Maternal blood pressure and pulse
B. Fetal heart rate (FHR) immediately after ROM to detect cord compression or prolapse
[CORRECT]
C. Cervical dilation and effacement
D. Contraction pattern and intensity
Correct Answer: B
Rationale: After spontaneous rupture of membranes, the FIRST priority is to assess the fetal heart rate to detect
umbilical cord prolapse or cord compression, which are life-threatening emergencies. NSG 3500 verification:
assess FHR for at least 1 full minute; variable decelerations or bradycardia may indicate cord prolapse. Also
note color, odor, and amount of fluid (clear, pink-tinged, or meconium-stained). Maternal vital signs, cervical
exam, and contraction pattern follow, but FHR is the immediate priority.
Q3: A nurse is admitting a laboring client. Which finding should be reported to the healthcare
provider IMMEDIATELY before proceeding with a vaginal exam?
A. Cervical dilation of 6 cm with 80% effacement
B. Bright red vaginal bleeding that is increasing in amount [CORRECT]
C. Fetal station at +1
D. Bloody show with mucus plug
Correct Answer: B
Rationale: Bright red vaginal bleeding in labor is a medical emergency that may indicate placenta previa,
placental abruption, or vasa previa — a vaginal exam is CONTRAINDICATED until placenta previa is ruled out
by ultrasound. NSG 3500 verification: bloody show (pink-tinged mucus with small amount of blood) is normal
and indicates cervical change; bright red bleeding is abnormal. The nurse should NOT perform a vaginal exam,
should assess FHR and maternal vital signs, notify the provider STAT, and prepare for possible emergent
delivery.
Page 2
,NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q4: A client is admitted in active labor. The nurse performs Leopold's maneuvers and palpates a
hard, round, ballotable mass in the fundus, a soft broad structure on the right side, and small parts on
the left. The fetal heart rate is best auscultated in which quadrant?
A. Right upper quadrant
B. Left lower quadrant (the fetal back is on the left, so FHR best heard through the fetal back)
[CORRECT]
C. Right lower quadrant
D. Midline above the symphysis
Correct Answer: B
Rationale: Leopold's maneuvers identify fetal presentation, position, and lie. The fetal back is on the mother's
left (soft broad structure on the right is the small parts/fetal limbs), the head is in the fundus (breech
presentation). NSG 3500 verification: FHR is best auscultated through the fetal back because sound transmits
best through solid tissue; the back's location determines where the Doppler/fetoscope is placed on the maternal
abdomen. In cephalic presentation with left occiput anterior (LOA) position, FHR is best heard in the left lower
quadrant.
Q5: A laboring client's cervical exam reveals: dilation 4 cm, effacement 80%, station -1, presentation
cephalic, position ROA, and membrane status intact. Which documentation is MOST accurate
regarding fetal station?
A. Fetus is floating above the ischial spines
B. Fetal presenting part is 1 cm above the ischial spines (station -1, engagement has not yet occurred)
[CORRECT]
C. Fetal presenting part is at the ischial spines (station 0)
D. Fetal presenting part is 1 cm below the ischial spines
Correct Answer: B
Rationale: Station refers to the relationship of the fetal presenting part to the ischial spines (the narrowest part
of the maternal pelvis). Negative stations (-5 to -1) are above the spines; station 0 is at the spines (engagement
has occurred); positive stations (+1 to +5) are below the spines. NSG 3500 verification: station -1 means the
presenting part is 1 cm above the ischial spines, indicating engagement has not yet occurred. Engagement
(station 0) is the descent of the biparietal diameter to the level of the ischial spines.
Page 3
, NSG 3500 Exam 3 | Maternal Health | 100 Questions
Q6: During admission assessment, the nurse notes the following maternal vital signs: BP 138/88, HR
92, RR 20, T 99.2°F, and fetal heart rate 145. The client denies pain at this time. Which finding
requires further evaluation?
A. Maternal BP 138/88
B. Maternal HR 92
C. Maternal temperature 99.2°F (low-grade temp early in labor may be normal, but trends upward
suggest infection, especially with ROM) [CORRECT]
D. Fetal heart rate 145 (normal range is 110-160 bpm)
Correct Answer: C
Rationale: All other vital signs are within normal limits for a laboring client. Maternal temp 99.2°F is
borderline; if it trends upward (>100.4°F or 38°C), especially with prolonged rupture of membranes, it suggests
intrauterine infection (chorioamnionitis) which increases maternal and fetal morbidity. NSG 3500 verification:
normal maternal BP in labor <140/90, HR 60-100, RR 12-20, temp <99.6°F (some sources <100.4°F). FHR
110-160 bpm. A single borderline temp warrants monitoring every 2 hours (or q1h with ROM) and reporting if it
rises.
Q7: A client at 38 weeks gestation arrives reporting contractions every 4 minutes. The nurse palpates
the abdomen between contractions and notes it feels soft, easily indentable. This finding indicates:
A. Hypertonic uterine dysfunction (high resting tone)
B. Normal uterine resting tone between contractions [CORRECT]
C. Placental abruption
D. Uterine tachysystole
Correct Answer: B
Rationale: Between contractions, the uterus should relax completely and feel soft to palpation, allowing
placental perfusion. NSG 3500 verification: resting tone should be palpable as soft (or measured <20 mmHg via
intrauterine pressure catheter). Hypertonicity (firm, tense uterus between contractions) is abnormal and may
indicate abruptio placentae, hypertonic labor dysfunction, or tachysystole from oxytocin. Tachysystole is >5
contractions in 10 minutes; hypertonus is resting tone >20 mmHg; both require intervention
(decrease/discontinue oxytocin, tocolytics, position change, notify provider).
Page 4
