INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
NUR231 — High Risk Pregnancy and Newborn Review 2026–
2027
NUR 231 | Concepts of Nursing: The Childbearing/Child Caring Family
Institution / scope: Galen College of Nursing
Contents: 80 independently authored educational practice questions with one keyed answer and a rationale per question;
quick answer key at the end.
Original practice questions
Labor
1. A laboring patient has a persistent fetal heart rate deceleration after a position change. What is the priority?
A. Promptly escalate and initiate the unit's intrauterine resuscitation measures
B. Document the tracing and continue routine observation
C. Increase uterotonic infusion without reassessment
D. Ask the patient to begin pushing immediately
Correct Answer: A — Promptly escalate and initiate the unit's intrauterine resuscitation measures
Rationale: Persistent concerning fetal heart patterns call for immediate maternal-fetal assessment and team
response.
2. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor always begins exactly at 40 weeks
B. Rupture of membranes is harmless for days
C. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
D. All contractions mean active labor
Correct Answer: C — Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date
hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
3. A laboring patient requests nonpharmacologic pain relief. Which option is appropriate?
A. Insist every patient use the same method
B. Discourage support-person presence universally
C. Offer position changes, breathing strategies, support, and counterpressure
D. Withhold hydration without indication
Correct Answer: C — Offer position changes, breathing strategies, support, and counterpressure
Rationale: Individualized comfort methods can improve coping and autonomy during labor.
4. A labouring patient experiences a sudden prolonged fetal heart-rate deceleration. What is the most appropriate
initial nursing response?
A. Prepare discharge instructions
B. Encourage the patient to walk alone without assessment
C. Ignore the tracing until the next scheduled recording
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
D. Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and immediately summon the
maternity team
Correct Answer: D — Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and
immediately summon the maternity team
Rationale: A sustained abnormal fetal heart pattern requires prompt bedside assessment, corrective measures as
directed, and escalation.
5. A newborn remains apneic with heart rate under 100 after initial steps. What is the lifesaving first intervention?
A. Vitamin K before airway support
B. Effective positive-pressure ventilation
C. Chest compressions immediately before ventilation
D. Routine bath
Correct Answer: B — Effective positive-pressure ventilation
Rationale: Newborn bradycardia is often respiratory, so assisted ventilation is the primary early resuscitative
intervention.
6. A patient in labor has a rigid tender uterus, dark bleeding, and a nonreassuring tracing. What complication is
concerning?
A. Normal cervical effacement
B. Placental abruption
C. Uncomplicated show
D. Physiologic postpartum lochia
Correct Answer: B — Placental abruption
Rationale: Pain, uterine hypertonicity, bleeding, and fetal distress are classic warning features of abruption.
7. When does the second stage of labor begin?
A. At the first prenatal contraction
B. When the placenta delivers
C. At rupture of membranes alone
D. At complete cervical dilation
Correct Answer: D — At complete cervical dilation
Rationale: The second stage runs from full cervical dilation until the infant is born.
8. Which element is critical in handoff for a laboring patient?
A. Only chosen music playlist
B. Only room number
C. Current fetal-heart category, contraction pattern, cervical progress, and medications
D. Only expected infant name
Correct Answer: C — Current fetal-heart category, contraction pattern, cervical progress, and medications
Rationale: Safe handoff communicates dynamic maternal-fetal assessment and interventions.
9. Which finding best represents the first stage of labor?
A. Cervical dilation from labor onset to complete dilation
B. First 24 hours after delivery
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
C. Birth of the placenta
D. Time from complete dilation to birth
Correct Answer: A — Cervical dilation from labor onset to complete dilation
Rationale: Stage one ends when the cervix is fully dilated; second stage then continues until birth.
10. Which maternal condition increases risk of neonatal hypoglycemia?
A. Normal maternal iron levels
B. Stable maternal glucose without diabetes
C. Poorly controlled gestational diabetes
D. Maternal Rh-negative status alone
Correct Answer: C — Poorly controlled gestational diabetes
Rationale: Maternal hyperglycemia drives fetal hyperinsulinemia, causing glucose to drop when placental supply
stops.
11. Why is fetal anomaly screening discussed using shared decision-making?
A. A positive screen proves a diagnosis
B. Only clinicians determine whether screening is permitted
C. Screening estimates risk and patients should understand benefits, limits, and choices
D. A negative screen excludes every disorder
Correct Answer: C — Screening estimates risk and patients should understand benefits, limits, and choices
Rationale: Informed discussion separates screening from diagnostic testing and supports patient preferences.
Newborn
12. Which action best supports safer infant sleep at home?
A. Use side sleeping and a positioner pillow
B. Have the newborn sleep in a car seat overnight
C. Place the infant supine on a firm flat sleep surface without loose bedding
D. Place a soft quilt beneath the infant
Correct Answer: C — Place the infant supine on a firm flat sleep surface without loose bedding
Rationale: Supine placement on a firm flat, uncluttered surface reduces sleep-related infant deaths.
13. A breastfeeding newborn is jittery and feeding poorly. Which priority assessment is appropriate?
A. Check only head circumference
B. Measure glucose promptly using neonatal protocol
C. Assume normal startle reflex exclusively
D. Delay all feeding assessment
Correct Answer: B — Measure glucose promptly using neonatal protocol
Rationale: These are possible hypoglycemia signs and warrant timely evaluation and intervention.
14. A family asks about sharing a bedroom with their newborn. What guidance is most consistent with Canadian
recommendations?
A. Keep the infant's separate crib or bassinet in the caregivers' room for the first six months
B. Share a recliner for unsupervised sleep
NUR231 | Original educational practice • 3
NUR231 — High Risk Pregnancy and Newborn Review 2026–
2027
NUR 231 | Concepts of Nursing: The Childbearing/Child Caring Family
Institution / scope: Galen College of Nursing
Contents: 80 independently authored educational practice questions with one keyed answer and a rationale per question;
quick answer key at the end.
Original practice questions
Labor
1. A laboring patient has a persistent fetal heart rate deceleration after a position change. What is the priority?
A. Promptly escalate and initiate the unit's intrauterine resuscitation measures
B. Document the tracing and continue routine observation
C. Increase uterotonic infusion without reassessment
D. Ask the patient to begin pushing immediately
Correct Answer: A — Promptly escalate and initiate the unit's intrauterine resuscitation measures
Rationale: Persistent concerning fetal heart patterns call for immediate maternal-fetal assessment and team
response.
2. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor always begins exactly at 40 weeks
B. Rupture of membranes is harmless for days
C. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
D. All contractions mean active labor
Correct Answer: C — Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date
hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
3. A laboring patient requests nonpharmacologic pain relief. Which option is appropriate?
A. Insist every patient use the same method
B. Discourage support-person presence universally
C. Offer position changes, breathing strategies, support, and counterpressure
D. Withhold hydration without indication
Correct Answer: C — Offer position changes, breathing strategies, support, and counterpressure
Rationale: Individualized comfort methods can improve coping and autonomy during labor.
4. A labouring patient experiences a sudden prolonged fetal heart-rate deceleration. What is the most appropriate
initial nursing response?
A. Prepare discharge instructions
B. Encourage the patient to walk alone without assessment
C. Ignore the tracing until the next scheduled recording
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
D. Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and immediately summon the
maternity team
Correct Answer: D — Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and
immediately summon the maternity team
Rationale: A sustained abnormal fetal heart pattern requires prompt bedside assessment, corrective measures as
directed, and escalation.
5. A newborn remains apneic with heart rate under 100 after initial steps. What is the lifesaving first intervention?
A. Vitamin K before airway support
B. Effective positive-pressure ventilation
C. Chest compressions immediately before ventilation
D. Routine bath
Correct Answer: B — Effective positive-pressure ventilation
Rationale: Newborn bradycardia is often respiratory, so assisted ventilation is the primary early resuscitative
intervention.
6. A patient in labor has a rigid tender uterus, dark bleeding, and a nonreassuring tracing. What complication is
concerning?
A. Normal cervical effacement
B. Placental abruption
C. Uncomplicated show
D. Physiologic postpartum lochia
Correct Answer: B — Placental abruption
Rationale: Pain, uterine hypertonicity, bleeding, and fetal distress are classic warning features of abruption.
7. When does the second stage of labor begin?
A. At the first prenatal contraction
B. When the placenta delivers
C. At rupture of membranes alone
D. At complete cervical dilation
Correct Answer: D — At complete cervical dilation
Rationale: The second stage runs from full cervical dilation until the infant is born.
8. Which element is critical in handoff for a laboring patient?
A. Only chosen music playlist
B. Only room number
C. Current fetal-heart category, contraction pattern, cervical progress, and medications
D. Only expected infant name
Correct Answer: C — Current fetal-heart category, contraction pattern, cervical progress, and medications
Rationale: Safe handoff communicates dynamic maternal-fetal assessment and interventions.
9. Which finding best represents the first stage of labor?
A. Cervical dilation from labor onset to complete dilation
B. First 24 hours after delivery
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
C. Birth of the placenta
D. Time from complete dilation to birth
Correct Answer: A — Cervical dilation from labor onset to complete dilation
Rationale: Stage one ends when the cervix is fully dilated; second stage then continues until birth.
10. Which maternal condition increases risk of neonatal hypoglycemia?
A. Normal maternal iron levels
B. Stable maternal glucose without diabetes
C. Poorly controlled gestational diabetes
D. Maternal Rh-negative status alone
Correct Answer: C — Poorly controlled gestational diabetes
Rationale: Maternal hyperglycemia drives fetal hyperinsulinemia, causing glucose to drop when placental supply
stops.
11. Why is fetal anomaly screening discussed using shared decision-making?
A. A positive screen proves a diagnosis
B. Only clinicians determine whether screening is permitted
C. Screening estimates risk and patients should understand benefits, limits, and choices
D. A negative screen excludes every disorder
Correct Answer: C — Screening estimates risk and patients should understand benefits, limits, and choices
Rationale: Informed discussion separates screening from diagnostic testing and supports patient preferences.
Newborn
12. Which action best supports safer infant sleep at home?
A. Use side sleeping and a positioner pillow
B. Have the newborn sleep in a car seat overnight
C. Place the infant supine on a firm flat sleep surface without loose bedding
D. Place a soft quilt beneath the infant
Correct Answer: C — Place the infant supine on a firm flat sleep surface without loose bedding
Rationale: Supine placement on a firm flat, uncluttered surface reduces sleep-related infant deaths.
13. A breastfeeding newborn is jittery and feeding poorly. Which priority assessment is appropriate?
A. Check only head circumference
B. Measure glucose promptly using neonatal protocol
C. Assume normal startle reflex exclusively
D. Delay all feeding assessment
Correct Answer: B — Measure glucose promptly using neonatal protocol
Rationale: These are possible hypoglycemia signs and warrant timely evaluation and intervention.
14. A family asks about sharing a bedroom with their newborn. What guidance is most consistent with Canadian
recommendations?
A. Keep the infant's separate crib or bassinet in the caregivers' room for the first six months
B. Share a recliner for unsupervised sleep
NUR231 | Original educational practice • 3
