NSG 3500 Maternal Exam 4 review |
Questions and Answers | 2026/2027
Updated | 100% Correct
NSG 3500 Maternal Exam 4 Review: Newborn Transition, Complications, and High-Risk
Maternal Care
50 Questions | Multiple Choice & SATA | Detailed Rationales | Complete Answer Key
Table of Contents
Section Topic Questions
I Newborn Transition to Extrauterine Life 1–10
II Newborn Assessment: Normal vs. Abnormal Findings 11–20
III Newborn Complications and Interventions 21–32
IV High-Risk Antepartum Care 33–42
V Postpartum Complications and Emergencies 43–50
— Complete Answer Key —
— High-Yield Review —
Section I: Newborn Transition to Extrauterine Life
Questions 1–10
,Question 1
The nurse is teaching new parents about the factors that stimulate a newborn's first breath.
Which factor is considered the most critical chemical stimulant?
A) The drop in ambient temperature upon delivery
B) Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
C) The thoracic squeeze during a vaginal birth
D) Tactile stimulation from drying the infant
Correct Answer: B) Hypoxia, hypercarbia, and acidosis from the clamping of the
umbilical cord
Rationale: Chemical factors are the most critical stimulants for the first breath. Falling
oxygen levels (hypoxia), rising carbon dioxide (hypercarbia), and falling pH (acidosis) stimulate
the medullary respiratory center to initiate breathing. The drop in ambient temperature (A) is a
thermal factor. The thoracic squeeze (C) is a mechanical factor. Tactile stimulation (D) is a
sensory factor. While all contribute, chemical changes are the primary drivers.
Question 2
A term newborn delivered by elective cesarean section is at increased risk for transient
tachypnea of the newborn (TTN). The nurse understands this is primarily due to:
A) Immature surfactant production
B) Lack of the mechanical thoracic squeeze during passage through the birth canal
C) Maternal diabetes during pregnancy
D) Meconium aspiration during delivery
Correct Answer: B) Lack of the mechanical thoracic squeeze during passage through
the birth canal
Rationale: During vaginal delivery, the fetal chest is compressed, which expels lung fluid.
This "thoracic squeeze" is absent in cesarean deliveries, leading to delayed clearance of fetal
lung fluid and TTN. Immature surfactant production (A) causes respiratory distress syndrome
(RDS), not TTN. Maternal diabetes (C) increases risk for macrosomia and hypoglycemia.
Meconium aspiration (D) is a separate complication.
Question 3
The nurse is assessing a newborn 2 hours after birth. The hands and feet are bluish, but the
trunk and mucous membranes are pink. The nurse documents this finding as:
, A) Central cyanosis
B) Acrocyanosis
C) Mottling
D) Pallor
Correct Answer: B) Acrocyanosis
Rationale: Acrocyanosis is a normal, benign finding in the first hours of life caused by
vasomotor instability and sluggish peripheral circulation. It presents as bluish hands and feet
with a pink trunk and mucous membranes. Central cyanosis (A) involves the trunk and mucous
membranes and is always abnormal. Mottling (C) is a lacy, red-blue pattern. Pallor (D) is
generalized paleness.
Question 4
A newborn's head has a soft, edematous swelling that crosses the sagittal suture line. The nurse
identifies this as:
A) Cephalohematoma
B) Caput succedaneum
C) Molding
D) Craniosynostosis
Correct Answer: B) Caput succedaneum
Rationale: Caput succedaneum is soft tissue edema of the scalp that crosses suture
lines, caused by pressure during delivery. It resolves in a few days. Cephalohematoma (A) is a
subperiosteal hemorrhage that does not cross sutures and resolves over weeks. Molding (C) is
overlapping of cranial bones. Craniosynostosis (D) is premature fusion of sutures.
Question 5
The nurse is observing a newborn's respiratory pattern. The newborn has pauses in breathing
lasting 10 seconds without any change in heart rate or skin color. This is documented as:
A) Apnea
B) Periodic breathing
C) Respiratory distress
D) Bradypnea
Correct Answer: B) Periodic breathing
Questions and Answers | 2026/2027
Updated | 100% Correct
NSG 3500 Maternal Exam 4 Review: Newborn Transition, Complications, and High-Risk
Maternal Care
50 Questions | Multiple Choice & SATA | Detailed Rationales | Complete Answer Key
Table of Contents
Section Topic Questions
I Newborn Transition to Extrauterine Life 1–10
II Newborn Assessment: Normal vs. Abnormal Findings 11–20
III Newborn Complications and Interventions 21–32
IV High-Risk Antepartum Care 33–42
V Postpartum Complications and Emergencies 43–50
— Complete Answer Key —
— High-Yield Review —
Section I: Newborn Transition to Extrauterine Life
Questions 1–10
,Question 1
The nurse is teaching new parents about the factors that stimulate a newborn's first breath.
Which factor is considered the most critical chemical stimulant?
A) The drop in ambient temperature upon delivery
B) Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
C) The thoracic squeeze during a vaginal birth
D) Tactile stimulation from drying the infant
Correct Answer: B) Hypoxia, hypercarbia, and acidosis from the clamping of the
umbilical cord
Rationale: Chemical factors are the most critical stimulants for the first breath. Falling
oxygen levels (hypoxia), rising carbon dioxide (hypercarbia), and falling pH (acidosis) stimulate
the medullary respiratory center to initiate breathing. The drop in ambient temperature (A) is a
thermal factor. The thoracic squeeze (C) is a mechanical factor. Tactile stimulation (D) is a
sensory factor. While all contribute, chemical changes are the primary drivers.
Question 2
A term newborn delivered by elective cesarean section is at increased risk for transient
tachypnea of the newborn (TTN). The nurse understands this is primarily due to:
A) Immature surfactant production
B) Lack of the mechanical thoracic squeeze during passage through the birth canal
C) Maternal diabetes during pregnancy
D) Meconium aspiration during delivery
Correct Answer: B) Lack of the mechanical thoracic squeeze during passage through
the birth canal
Rationale: During vaginal delivery, the fetal chest is compressed, which expels lung fluid.
This "thoracic squeeze" is absent in cesarean deliveries, leading to delayed clearance of fetal
lung fluid and TTN. Immature surfactant production (A) causes respiratory distress syndrome
(RDS), not TTN. Maternal diabetes (C) increases risk for macrosomia and hypoglycemia.
Meconium aspiration (D) is a separate complication.
Question 3
The nurse is assessing a newborn 2 hours after birth. The hands and feet are bluish, but the
trunk and mucous membranes are pink. The nurse documents this finding as:
, A) Central cyanosis
B) Acrocyanosis
C) Mottling
D) Pallor
Correct Answer: B) Acrocyanosis
Rationale: Acrocyanosis is a normal, benign finding in the first hours of life caused by
vasomotor instability and sluggish peripheral circulation. It presents as bluish hands and feet
with a pink trunk and mucous membranes. Central cyanosis (A) involves the trunk and mucous
membranes and is always abnormal. Mottling (C) is a lacy, red-blue pattern. Pallor (D) is
generalized paleness.
Question 4
A newborn's head has a soft, edematous swelling that crosses the sagittal suture line. The nurse
identifies this as:
A) Cephalohematoma
B) Caput succedaneum
C) Molding
D) Craniosynostosis
Correct Answer: B) Caput succedaneum
Rationale: Caput succedaneum is soft tissue edema of the scalp that crosses suture
lines, caused by pressure during delivery. It resolves in a few days. Cephalohematoma (A) is a
subperiosteal hemorrhage that does not cross sutures and resolves over weeks. Molding (C) is
overlapping of cranial bones. Craniosynostosis (D) is premature fusion of sutures.
Question 5
The nurse is observing a newborn's respiratory pattern. The newborn has pauses in breathing
lasting 10 seconds without any change in heart rate or skin color. This is documented as:
A) Apnea
B) Periodic breathing
C) Respiratory distress
D) Bradypnea
Correct Answer: B) Periodic breathing
