NUR 230 EXAM 3: MATERNAL & PEDIATRIC NURSING | V1 AND
V2 | QUESTIONS AND ANSWERS WITH RATIONALES |
2026/2027 UPDATED | 100% CORRECT – GALEN COLLEGE OF
NURSING
Core Domains
High-Risk Pregnancy: Hypertensive Disorders
High-Risk Pregnancy: Hemorrhagic Disorders
Intrapartum Complications and Fetal Monitoring
Postpartum Complications and Management
Newborn Assessment and Complications
Pediatric Cardiac and Respiratory Conditions
Pediatric Gastrointestinal and Genitourinary Disorders
Growth and Development Across the Lifespan
Medications in Maternal-Newborn Nursing
Family-Centered Care and Patient Education
Introduction
The NUR 230 Exam 3: Maternal & Pediatric Nursing assessment
evaluates nursing students for competency in high-risk maternal-
newborn nursing care and pediatric nursing concepts. The
examination focuses on hypertensive disorders of pregnancy,
hemorrhagic complications, intrapartum emergencies, postpartum
complications, newborn assessment, pediatric cardiac and
respiratory conditions, and growth and development principles.
Questions utilize multiple-choice and scenario-based formats
requiring application of evidence-based knowledge to real-world
clinical decision-making. Emphasis is placed on prioritization,
recognition of complications, safe nursing interventions across the
perinatal continuum, and family-centered care for pediatric
patients.
,Section One: Questions 1–100
Question 1
A client at 34 weeks gestation presents with a blood pressure of
158/102 mmHg, severe headache, and visual disturbances. Which
condition should the nurse suspect?
A. Gestational hypertension
B. Chronic hypertension
C. Preeclampsia with severe features
D. Eclampsia
🟢 C. Preeclampsia with severe features
🔴 RATIONALE: Preeclampsia with severe features is diagnosed
when blood pressure is ≥160/110 mmHg on two occasions or
≥140/90 mmHg with signs of organ dysfunction including severe
headache and visual disturbances. Eclampsia would involve
seizures. Gestational hypertension lacks the severe features.
Question 2
A nurse is administering magnesium sulfate to a client with
preeclampsia. Which assessment finding indicates magnesium
toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate of 10 breaths/min
C. Urine output of 40 mL/hr
D. Blood pressure of 130/80 mmHg
🟢 B. Respiratory rate of 10 breaths/min
🔴 RATIONALE: Respiratory depression (rate <12/min) is a sign of
magnesium toxicity. Other signs include loss of deep tendon
reflexes, oliguria, and cardiac arrest. The antidote is calcium
gluconate.
,Question 3
A client receiving magnesium sulfate has a serum magnesium
level of 9 mEq/L. What is the priority nursing action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Stop the infusion and notify the provider
D. Administer a diuretic
🟢 C. Stop the infusion and notify the provider
🔴 RATIONALE: Therapeutic magnesium level for preeclampsia is
4–7 mEq/L. A level of 9 mEq/L indicates toxicity. The infusion
should be stopped immediately, and the provider notified.
Calcium gluconate may be administered as the antidote.
Question 4
A client at 36 weeks gestation presents with painless, bright red
vaginal bleeding. Which action should the nurse take FIRST?
A. Perform a vaginal examination
B. Assess fetal heart tones
C. Prepare for immediate delivery
D. Administer oxytocin
🟢 B. Assess fetal heart tones
🔴 RATIONALE: Painless, bright red bleeding suggests placenta
previa. Vaginal examination is contraindicated until placenta
previa is ruled out. Fetal heart tones should be assessed to
evaluate fetal status, which is the priority nursing action before
preparing for delivery.
Question 5
A client with suspected abruptio placentae has dark red vaginal
, bleeding and reports severe abdominal pain. Which finding is
most concerning?
A. Blood pressure 110/70 mmHg
B. Uterine tenderness
C. Board-like abdomen with fetal bradycardia
D. Mild contractions every 10 minutes
🟢 C. Board-like abdomen with fetal bradycardia
🔴 RATIONALE: A board-like abdomen with fetal bradycardia
indicates severe abruption with fetal compromise. This is a
medical emergency requiring immediate delivery. Dark red
bleeding with pain is the classic presentation of abruption.
Question 6
A postpartum client has a boggy uterus and heavy bleeding. What
is the FIRST nursing action?
A. Notify the provider
B. Massage the fundus
C. Assess vital signs
D. Start a second IV line
🟢 B. Massage the fundus
🔴 RATIONALE: A boggy uterus indicates uterine atony, the most
common cause of postpartum hemorrhage. Fundal massage is the
first intervention to stimulate uterine contraction and prevent
further hemorrhage. Notifying the provider and starting IV fluids
are subsequent actions.
Question 7
A nurse assessing a postpartum client notes a boggy uterus
deviated to the right. What is the most likely contributing factor?
V2 | QUESTIONS AND ANSWERS WITH RATIONALES |
2026/2027 UPDATED | 100% CORRECT – GALEN COLLEGE OF
NURSING
Core Domains
High-Risk Pregnancy: Hypertensive Disorders
High-Risk Pregnancy: Hemorrhagic Disorders
Intrapartum Complications and Fetal Monitoring
Postpartum Complications and Management
Newborn Assessment and Complications
Pediatric Cardiac and Respiratory Conditions
Pediatric Gastrointestinal and Genitourinary Disorders
Growth and Development Across the Lifespan
Medications in Maternal-Newborn Nursing
Family-Centered Care and Patient Education
Introduction
The NUR 230 Exam 3: Maternal & Pediatric Nursing assessment
evaluates nursing students for competency in high-risk maternal-
newborn nursing care and pediatric nursing concepts. The
examination focuses on hypertensive disorders of pregnancy,
hemorrhagic complications, intrapartum emergencies, postpartum
complications, newborn assessment, pediatric cardiac and
respiratory conditions, and growth and development principles.
Questions utilize multiple-choice and scenario-based formats
requiring application of evidence-based knowledge to real-world
clinical decision-making. Emphasis is placed on prioritization,
recognition of complications, safe nursing interventions across the
perinatal continuum, and family-centered care for pediatric
patients.
,Section One: Questions 1–100
Question 1
A client at 34 weeks gestation presents with a blood pressure of
158/102 mmHg, severe headache, and visual disturbances. Which
condition should the nurse suspect?
A. Gestational hypertension
B. Chronic hypertension
C. Preeclampsia with severe features
D. Eclampsia
🟢 C. Preeclampsia with severe features
🔴 RATIONALE: Preeclampsia with severe features is diagnosed
when blood pressure is ≥160/110 mmHg on two occasions or
≥140/90 mmHg with signs of organ dysfunction including severe
headache and visual disturbances. Eclampsia would involve
seizures. Gestational hypertension lacks the severe features.
Question 2
A nurse is administering magnesium sulfate to a client with
preeclampsia. Which assessment finding indicates magnesium
toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate of 10 breaths/min
C. Urine output of 40 mL/hr
D. Blood pressure of 130/80 mmHg
🟢 B. Respiratory rate of 10 breaths/min
🔴 RATIONALE: Respiratory depression (rate <12/min) is a sign of
magnesium toxicity. Other signs include loss of deep tendon
reflexes, oliguria, and cardiac arrest. The antidote is calcium
gluconate.
,Question 3
A client receiving magnesium sulfate has a serum magnesium
level of 9 mEq/L. What is the priority nursing action?
A. Continue the infusion as ordered
B. Increase the infusion rate
C. Stop the infusion and notify the provider
D. Administer a diuretic
🟢 C. Stop the infusion and notify the provider
🔴 RATIONALE: Therapeutic magnesium level for preeclampsia is
4–7 mEq/L. A level of 9 mEq/L indicates toxicity. The infusion
should be stopped immediately, and the provider notified.
Calcium gluconate may be administered as the antidote.
Question 4
A client at 36 weeks gestation presents with painless, bright red
vaginal bleeding. Which action should the nurse take FIRST?
A. Perform a vaginal examination
B. Assess fetal heart tones
C. Prepare for immediate delivery
D. Administer oxytocin
🟢 B. Assess fetal heart tones
🔴 RATIONALE: Painless, bright red bleeding suggests placenta
previa. Vaginal examination is contraindicated until placenta
previa is ruled out. Fetal heart tones should be assessed to
evaluate fetal status, which is the priority nursing action before
preparing for delivery.
Question 5
A client with suspected abruptio placentae has dark red vaginal
, bleeding and reports severe abdominal pain. Which finding is
most concerning?
A. Blood pressure 110/70 mmHg
B. Uterine tenderness
C. Board-like abdomen with fetal bradycardia
D. Mild contractions every 10 minutes
🟢 C. Board-like abdomen with fetal bradycardia
🔴 RATIONALE: A board-like abdomen with fetal bradycardia
indicates severe abruption with fetal compromise. This is a
medical emergency requiring immediate delivery. Dark red
bleeding with pain is the classic presentation of abruption.
Question 6
A postpartum client has a boggy uterus and heavy bleeding. What
is the FIRST nursing action?
A. Notify the provider
B. Massage the fundus
C. Assess vital signs
D. Start a second IV line
🟢 B. Massage the fundus
🔴 RATIONALE: A boggy uterus indicates uterine atony, the most
common cause of postpartum hemorrhage. Fundal massage is the
first intervention to stimulate uterine contraction and prevent
further hemorrhage. Notifying the provider and starting IV fluids
are subsequent actions.
Question 7
A nurse assessing a postpartum client notes a boggy uterus
deviated to the right. What is the most likely contributing factor?
