,Arizona College NUR 335 Exam 4 | Maternal Health
Theory & Application (2026) Q&A
1. Which of the following is the primary function of the ductus venosus in fetal circulation?
A) It connects the pulmonary artery to the aorta.
B) It shunts blood from the right atrium to the left atrium.
C) It diverts oxygenated blood away from the fetal liver.
D) It carries deoxygenated blood from the fetus to the placenta.
Correct Answer: It diverts oxygenated blood away from the fetal liver.
Rationale: The ductus venosus connects the umbilical vein to the inferior vena cava,
allowing oxygenated blood from the placenta to bypass the liver and enter the systemic
circulation. The foramen ovale shunts blood between the atria, and the ductus arteriosus
connects the pulmonary artery to the aorta.
2. A nurse is reviewing the transition to extrauterine life. Which event is responsible for the
closure of the foramen ovale after birth?
A) Increased pressure in the right atrium
B) Decreased pressure in the left atrium
C) Increased pressure in the left atrium
D) Decreased systemic vascular resistance
Correct Answer: Increased pressure in the left atrium
Rationale: After birth, pulmonary vascular resistance drops, and left atrial pressure
increases, which closes the foramen ovale. This change in pressure gradient is essential for
the transition from fetal to neonatal circulation.
,3. A newborn is placed under a radiant warmer after delivery. Which mechanism of heat
loss is the nurse primarily trying to prevent?
A) Evaporation
B) Conduction
C) Convection
D) Radiation
Correct Answer: Convection
Rationale: A radiant warmer prevents heat loss through convection by surrounding the
newborn with warm air. Convection is the loss of heat to cooler surrounding air currents.
4. A nurse is assessing a newborn's thermoregulation. Which of the following is a
consequence of cold stress in a newborn?
A) Hyperglycemia
B) Respiratory alkalosis
C) Increased surfactant production
D) Metabolic acidosis
Correct Answer: Metabolic acidosis
Rationale: Cold stress increases metabolic rate and oxygen consumption, leading to
anaerobic metabolism and metabolic acidosis. It can also cause hypoglycemia, hypoxia, and
decreased surfactant production.
5. Which of the following is the correct sequence for assessing the Apgar score?
A) Heart rate, respiratory effort, muscle tone, reflex irritability, color
, B) Respiratory effort, heart rate, color, muscle tone, reflex irritability
C) Muscle tone, heart rate, respiratory effort, color, reflex irritability
D) Color, heart rate, respiratory effort, muscle tone, reflex irritability
Correct Answer: Heart rate, respiratory effort, muscle tone, reflex irritability, color
Rationale: The Apgar score assesses five components: heart rate (most critical),
respiratory effort, muscle tone, reflex irritability, and color. Each is scored from 0 to 2 at one
and five minutes after birth.
6. A nurse is assessing a newborn and notes a bluish discoloration of the hands and feet
with a pink central body. How should the nurse document this finding?
A) Central cyanosis
B) Acrocyanosis
C) Pallor
D) Jaundice
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a normal finding in newborns, characterized by bluish
discoloration of the extremities with a pink central body. Central cyanosis, pallor, and
jaundice indicate other clinical conditions.
7. Which of the following newborns is at the highest risk for developing hypoglycemia?
A) A term infant born to a mother without diabetes
B) A large-for-gestational-age infant born to a mother with diabetes
C) A small-for-gestational-age infant born to a mother without diabetes
D) A term infant with a birth weight of 3,500 g
Theory & Application (2026) Q&A
1. Which of the following is the primary function of the ductus venosus in fetal circulation?
A) It connects the pulmonary artery to the aorta.
B) It shunts blood from the right atrium to the left atrium.
C) It diverts oxygenated blood away from the fetal liver.
D) It carries deoxygenated blood from the fetus to the placenta.
Correct Answer: It diverts oxygenated blood away from the fetal liver.
Rationale: The ductus venosus connects the umbilical vein to the inferior vena cava,
allowing oxygenated blood from the placenta to bypass the liver and enter the systemic
circulation. The foramen ovale shunts blood between the atria, and the ductus arteriosus
connects the pulmonary artery to the aorta.
2. A nurse is reviewing the transition to extrauterine life. Which event is responsible for the
closure of the foramen ovale after birth?
A) Increased pressure in the right atrium
B) Decreased pressure in the left atrium
C) Increased pressure in the left atrium
D) Decreased systemic vascular resistance
Correct Answer: Increased pressure in the left atrium
Rationale: After birth, pulmonary vascular resistance drops, and left atrial pressure
increases, which closes the foramen ovale. This change in pressure gradient is essential for
the transition from fetal to neonatal circulation.
,3. A newborn is placed under a radiant warmer after delivery. Which mechanism of heat
loss is the nurse primarily trying to prevent?
A) Evaporation
B) Conduction
C) Convection
D) Radiation
Correct Answer: Convection
Rationale: A radiant warmer prevents heat loss through convection by surrounding the
newborn with warm air. Convection is the loss of heat to cooler surrounding air currents.
4. A nurse is assessing a newborn's thermoregulation. Which of the following is a
consequence of cold stress in a newborn?
A) Hyperglycemia
B) Respiratory alkalosis
C) Increased surfactant production
D) Metabolic acidosis
Correct Answer: Metabolic acidosis
Rationale: Cold stress increases metabolic rate and oxygen consumption, leading to
anaerobic metabolism and metabolic acidosis. It can also cause hypoglycemia, hypoxia, and
decreased surfactant production.
5. Which of the following is the correct sequence for assessing the Apgar score?
A) Heart rate, respiratory effort, muscle tone, reflex irritability, color
, B) Respiratory effort, heart rate, color, muscle tone, reflex irritability
C) Muscle tone, heart rate, respiratory effort, color, reflex irritability
D) Color, heart rate, respiratory effort, muscle tone, reflex irritability
Correct Answer: Heart rate, respiratory effort, muscle tone, reflex irritability, color
Rationale: The Apgar score assesses five components: heart rate (most critical),
respiratory effort, muscle tone, reflex irritability, and color. Each is scored from 0 to 2 at one
and five minutes after birth.
6. A nurse is assessing a newborn and notes a bluish discoloration of the hands and feet
with a pink central body. How should the nurse document this finding?
A) Central cyanosis
B) Acrocyanosis
C) Pallor
D) Jaundice
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a normal finding in newborns, characterized by bluish
discoloration of the extremities with a pink central body. Central cyanosis, pallor, and
jaundice indicate other clinical conditions.
7. Which of the following newborns is at the highest risk for developing hypoglycemia?
A) A term infant born to a mother without diabetes
B) A large-for-gestational-age infant born to a mother with diabetes
C) A small-for-gestational-age infant born to a mother without diabetes
D) A term infant with a birth weight of 3,500 g
