NSG 3500 MATERNAL EXAM 4 REVIEW
[QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED
| DETAILED RATIONALES – PASS
GUARANTEED A+ GRADED | INSTANT
DOWNLOAD
Introduction
The NSG 3500 Maternal Exam 4 Review practice bank is designed to help nursing
students at Galen College of Nursing prepare for advanced maternal and newborn
nursing assessments. Maternal nursing requires strong clinical judgment, rapid
recognition of complications, safe medication administration, and evidence-based care
for pregnant patients, laboring patients, postpartum patients, and newborns.
This review emphasizes application-level decision-making through clinical scenarios
that require students to prioritize assessments, identify warning signs, interpret
maternal and fetal findings, and select appropriate nursing interventions. Topics
commonly included in comprehensive maternal nursing courses may include labor
and delivery, fetal monitoring, obstetric emergencies, postpartum complications,
newborn transition, medication safety, and patient education. The exact content of
Galen College's Exam 4 may vary by course section and instructor, so this practice
bank should be used alongside the official course objectives, assigned readings, and
review materials.
Each question includes four answer options, one clearly identified best answer, and a
rationale explaining the clinical reasoning behind the answer and why the alternatives
are less appropriate. Use the review to identify knowledge gaps, strengthen
prioritization skills, and practice applying maternal-newborn nursing principles to
realistic clinical situations.
Core domains tested
1.
Labor and delivery: Stages of labor, labor progress, maternal assessment, and
supportive nursing interventions.
2.
3.
,Fetal assessment: Fetal heart rate patterns, uteroplacental perfusion, and
intrauterine resuscitation.
4.
5.
Obstetric emergencies: Recognition and initial management of cord prolapse,
placental abruption, uterine rupture, and shoulder dystocia.
6.
7.
Hypertensive disorders: Preeclampsia, eclampsia, severe features, seizure
precautions, and magnesium sulfate safety.
8.
9.
Postpartum care: Uterine involution, lochia, perineal assessment, breastfeeding
support, and maternal recovery.
10.
11.
Postpartum complications: Hemorrhage, infection, thromboembolism, and
postpartum mood disorders.
12.
13.
Newborn transition: Respiratory adaptation, thermoregulation, feeding,
glucose monitoring, and routine newborn assessment.
14.
15.
Maternal-newborn medications: Oxytocin, uterotonics, magnesium sulfate,
corticosteroids, and medication precautions.
16.
17.
Patient education: Warning signs, discharge instructions, family support, and
follow-up.
18.
19.
, Clinical judgment and prioritization: ABCs, urgent versus routine findings,
escalation of care, and evidence-informed decision-making.
20.
QUESTIONS 1–100
Q1
A client at 39 weeks of gestation is in active labor. Shortly after spontaneous rupture
of membranes, the fetal heart rate drops to 70 beats/min and remains there. The nurse
observes a loop of umbilical cord at the vaginal opening. What is the nurse’s priority
action?
A) Encourage the client to push with the next contraction.
B) Call for emergency assistance, relieve pressure on the cord by elevating the
presenting part, and prepare for emergency birth.
C) Apply fundal pressure to accelerate delivery.
D) Continue routine fetal monitoring for another 10 minutes.
Rationale: B is correct because visible cord prolapse with persistent fetal bradycardia
is an obstetric emergency caused by compression of the umbilical cord. The nurse
should call for immediate help, manually elevate the presenting part to reduce
compression, position the client to relieve pressure, and prepare for expedited birth. A
may worsen compression if vaginal birth is not imminent. C can increase cord
compression and is unsafe. D delays definitive intervention and risks severe fetal
hypoxia.
Q2
A client receiving oxytocin for labor induction develops six contractions in 10
minutes, averaged over 30 minutes, and recurrent late fetal heart rate decelerations.
What should the nurse do first?
A) Increase the oxytocin infusion to improve labor progress.
B) Encourage the client to bear down.
C) Stop the oxytocin infusion and initiate measures to improve uteroplacental
perfusion while summoning assistance.
D) Document the findings and reassess in 30 minutes.
, Rationale: C is correct because uterine tachysystole with recurrent late decelerations
suggests compromised fetal oxygenation. Stopping oxytocin removes the uterine
stimulant, while repositioning the client, assessing maternal status, and escalating care
support fetal recovery. A may worsen tachysystole. B is inappropriate unless the
client is fully dilated and birth is imminent. D delays intervention during a potentially
deteriorating fetal condition.
Q3
A client at 34 weeks of gestation presents with severe headache, visual disturbances,
right upper-quadrant pain, and a blood pressure of 168/112 mmHg. Which
interpretation is most appropriate?
A) These findings are expected discomforts of late pregnancy.
B) The client most likely has uncomplicated gestational hypertension.
C) The client has findings concerning for preeclampsia with severe features and
requires urgent evaluation and management.
D) The client should be discharged with instructions to rest at home.
Rationale: C is correct because severe-range hypertension, neurologic symptoms, and
right upper-quadrant pain are warning signs of severe preeclampsia and possible end-
organ involvement. A dismisses dangerous findings. B does not account for the severe
symptoms and blood pressure. D risks progression to eclampsia, stroke, or other
serious complications.
Q4
A postpartum client has heavy vaginal bleeding and a boggy uterus. The nurse has
already called for assistance. Which intervention is the most appropriate initial
nursing action?
A) Encourage the client to ambulate to the bathroom.
B) Perform uterine massage while assessing bleeding and vital signs.
C) Place the client in a warm bath.
D) Delay intervention until the next scheduled assessment.
Rationale: B is correct because a boggy uterus commonly indicates uterine atony, a
leading cause of postpartum hemorrhage. Uterine massage helps stimulate contraction
while the team evaluates blood loss, establishes appropriate access, and administers
prescribed treatment. A may be unsafe during active hemorrhage. C delays care and is
inappropriate. D risks worsening blood loss and hemodynamic instability.
[QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED
| DETAILED RATIONALES – PASS
GUARANTEED A+ GRADED | INSTANT
DOWNLOAD
Introduction
The NSG 3500 Maternal Exam 4 Review practice bank is designed to help nursing
students at Galen College of Nursing prepare for advanced maternal and newborn
nursing assessments. Maternal nursing requires strong clinical judgment, rapid
recognition of complications, safe medication administration, and evidence-based care
for pregnant patients, laboring patients, postpartum patients, and newborns.
This review emphasizes application-level decision-making through clinical scenarios
that require students to prioritize assessments, identify warning signs, interpret
maternal and fetal findings, and select appropriate nursing interventions. Topics
commonly included in comprehensive maternal nursing courses may include labor
and delivery, fetal monitoring, obstetric emergencies, postpartum complications,
newborn transition, medication safety, and patient education. The exact content of
Galen College's Exam 4 may vary by course section and instructor, so this practice
bank should be used alongside the official course objectives, assigned readings, and
review materials.
Each question includes four answer options, one clearly identified best answer, and a
rationale explaining the clinical reasoning behind the answer and why the alternatives
are less appropriate. Use the review to identify knowledge gaps, strengthen
prioritization skills, and practice applying maternal-newborn nursing principles to
realistic clinical situations.
Core domains tested
1.
Labor and delivery: Stages of labor, labor progress, maternal assessment, and
supportive nursing interventions.
2.
3.
,Fetal assessment: Fetal heart rate patterns, uteroplacental perfusion, and
intrauterine resuscitation.
4.
5.
Obstetric emergencies: Recognition and initial management of cord prolapse,
placental abruption, uterine rupture, and shoulder dystocia.
6.
7.
Hypertensive disorders: Preeclampsia, eclampsia, severe features, seizure
precautions, and magnesium sulfate safety.
8.
9.
Postpartum care: Uterine involution, lochia, perineal assessment, breastfeeding
support, and maternal recovery.
10.
11.
Postpartum complications: Hemorrhage, infection, thromboembolism, and
postpartum mood disorders.
12.
13.
Newborn transition: Respiratory adaptation, thermoregulation, feeding,
glucose monitoring, and routine newborn assessment.
14.
15.
Maternal-newborn medications: Oxytocin, uterotonics, magnesium sulfate,
corticosteroids, and medication precautions.
16.
17.
Patient education: Warning signs, discharge instructions, family support, and
follow-up.
18.
19.
, Clinical judgment and prioritization: ABCs, urgent versus routine findings,
escalation of care, and evidence-informed decision-making.
20.
QUESTIONS 1–100
Q1
A client at 39 weeks of gestation is in active labor. Shortly after spontaneous rupture
of membranes, the fetal heart rate drops to 70 beats/min and remains there. The nurse
observes a loop of umbilical cord at the vaginal opening. What is the nurse’s priority
action?
A) Encourage the client to push with the next contraction.
B) Call for emergency assistance, relieve pressure on the cord by elevating the
presenting part, and prepare for emergency birth.
C) Apply fundal pressure to accelerate delivery.
D) Continue routine fetal monitoring for another 10 minutes.
Rationale: B is correct because visible cord prolapse with persistent fetal bradycardia
is an obstetric emergency caused by compression of the umbilical cord. The nurse
should call for immediate help, manually elevate the presenting part to reduce
compression, position the client to relieve pressure, and prepare for expedited birth. A
may worsen compression if vaginal birth is not imminent. C can increase cord
compression and is unsafe. D delays definitive intervention and risks severe fetal
hypoxia.
Q2
A client receiving oxytocin for labor induction develops six contractions in 10
minutes, averaged over 30 minutes, and recurrent late fetal heart rate decelerations.
What should the nurse do first?
A) Increase the oxytocin infusion to improve labor progress.
B) Encourage the client to bear down.
C) Stop the oxytocin infusion and initiate measures to improve uteroplacental
perfusion while summoning assistance.
D) Document the findings and reassess in 30 minutes.
, Rationale: C is correct because uterine tachysystole with recurrent late decelerations
suggests compromised fetal oxygenation. Stopping oxytocin removes the uterine
stimulant, while repositioning the client, assessing maternal status, and escalating care
support fetal recovery. A may worsen tachysystole. B is inappropriate unless the
client is fully dilated and birth is imminent. D delays intervention during a potentially
deteriorating fetal condition.
Q3
A client at 34 weeks of gestation presents with severe headache, visual disturbances,
right upper-quadrant pain, and a blood pressure of 168/112 mmHg. Which
interpretation is most appropriate?
A) These findings are expected discomforts of late pregnancy.
B) The client most likely has uncomplicated gestational hypertension.
C) The client has findings concerning for preeclampsia with severe features and
requires urgent evaluation and management.
D) The client should be discharged with instructions to rest at home.
Rationale: C is correct because severe-range hypertension, neurologic symptoms, and
right upper-quadrant pain are warning signs of severe preeclampsia and possible end-
organ involvement. A dismisses dangerous findings. B does not account for the severe
symptoms and blood pressure. D risks progression to eclampsia, stroke, or other
serious complications.
Q4
A postpartum client has heavy vaginal bleeding and a boggy uterus. The nurse has
already called for assistance. Which intervention is the most appropriate initial
nursing action?
A) Encourage the client to ambulate to the bathroom.
B) Perform uterine massage while assessing bleeding and vital signs.
C) Place the client in a warm bath.
D) Delay intervention until the next scheduled assessment.
Rationale: B is correct because a boggy uterus commonly indicates uterine atony, a
leading cause of postpartum hemorrhage. Uterine massage helps stimulate contraction
while the team evaluates blood loss, establishes appropriate access, and administers
prescribed treatment. A may be unsafe during active hemorrhage. C delays care and is
inappropriate. D risks worsening blood loss and hemodynamic instability.
