NSG 3500
Maternal Health Nursing
— Examination 2 Review —
Comprehensive Questions & Verified Solutions
2026/2027 Academic Cycle
Institution: Galen College of Nursing
Course: NSG 3500 — Maternal Health Nursing
Exam: Examination 2
, Abstract
This comprehensive examination review document for NSG 3500 Maternal Health Nursing —
Examination 2 encompasses 50 evidence-based questions spanning ten critical domains of maternal-
child nursing practice. The domains include antepartum care and assessment, intrapartum
management and labor stages, postpartum care and complications, newborn assessment and
transition, high-risk pregnancy conditions, maternal-child pharmacology, patient education and
health promotion, ethical and legal considerations, cultural competency in maternal care, and
interprofessional collaboration. Each question is designed to assess clinical reasoning at the
application and analysis levels, incorporating current guidelines from the American College of
Obstetricians and Gynecologists (ACOG), the Association of Women's Health, Obstetric and Neonatal
Nurses (AWHONN), the Centers for Disease Control and Prevention (CDC), the World Health
Organization (WHO), and the American Academy of Pediatrics (AAP). Verified answers are provided
with detailed rationales citing authoritative sources, enabling students to understand the clinical
reasoning behind each correct response. This review is intended to prepare nursing students for the
NSG 3500 Examination 2 by reinforcing key concepts, promoting critical thinking, and integrating
interprofessional collaboration principles essential for safe, high-quality maternal-child nursing care.
Keywords: Antepartum Assessment, Intrapartum Management, Postpartum Complications,
Newborn Transition, High-Risk Pregnancy, Maternal-Child Pharmacology
2
, NSG 3500 — Examination 2 Review
Domain 1: Antepartum Care & Assessment
1. A nurse is conducting the initial prenatal visit for a client at 8 weeks gestation. Which
laboratory test should the nurse anticipate being ordered to screen for maternal
syphilis?
A) Rubella titer
B) Rapid plasma reagin (RPR)
C) 1-hour glucose challenge test
D) Group B Streptococcus culture
Answer: B) Rapid plasma reagin (RPR)
The RPR (or VDRL) is a routine screening test for syphilis at the initial prenatal visit, as
recommended by ACOG and CDC guidelines. Congenital syphilis can cause devastating fetal outcomes
including stillbirth, hydrops, and neonatal death if untreated. Early detection allows for treatment
with penicillin, which effectively prevents maternal-fetal transmission. The rubella titer (A) screens
for rubella immunity, the 1-hour glucose challenge test (C) is performed at 24–28 weeks to screen for
gestational diabetes, and the GBS culture (D) is obtained at 35–37 weeks gestation. Universal syphilis
screening at the first prenatal visit is a standard of care per CDC STD Treatment Guidelines [1][5][14].
2. A client at 32 weeks gestation calls the clinic reporting decreased fetal movement.
The nurse instructs the client to perform kick counts. Which instruction is most
appropriate?
A) Count fetal movements for 1 hour after breakfast; call if fewer than 4 movements are felt
B) Lie on the left side and count movements; 10 movements in 2 hours is reassuring
C) Count movements only after a meal; 6 movements in 30 minutes is normal
D) Sit upright and count movements for 15 minutes; any movement counts
Answer: B) Lie on the left side and count movements; 10 movements in 2 hours is
reassuring
Fetal kick counts are a validated method of assessing fetal well-being recommended by ACOG. The
standard protocol instructs the pregnant client to lie on her left side in a quiet environment and count
fetal movements; perception of 10 movements within 2 hours is considered reassuring. If fewer than
10 movements are perceived in 2 hours, the client should contact her provider immediately for further
evaluation, which may include a nonstress test or biophysical profile. The left lateral position
optimizes uteroplacental perfusion, making movements more perceptible. Option A uses an incorrect
threshold and duration; option C provides incorrect parameters; option D does not follow evidence-
based counting criteria [3][7][14].
3. During a prenatal visit at 28 weeks, the nurse measures the client's fundal height at
24 cm. Based on Naegele's rule and fundal height assessment, which interpretation is
most accurate?
A) The fundal height is appropriate for gestational age
B) The fundal height suggests possible intrauterine growth restriction
C) The client is likely at 24 weeks gestation, not 28 weeks
D) The measurement is normal; fundal height varies widely at this gestation
Answer: B) The fundal height suggests possible intrauterine growth restriction
Fundal height in centimeters should approximate gestational age in weeks from approximately 20
weeks until 36 weeks, with an acceptable variation of ±2 cm. At 28 weeks, the expected fundal height
is 26–30 cm. A measurement of 24 cm is 4 cm below the expected range, which may indicate
intrauterine growth restriction (IUGR), oligohydramnios, or an inaccurate gestational age estimate.
This finding warrants further evaluation with ultrasound to assess fetal growth, amniotic fluid volume,
and placental function. While minor variations can be normal, a discrepancy of 3 cm or more is
considered significant per ACOG guidelines and requires clinical correlation and follow-up [3][7][14].
1
Maternal Health Nursing
— Examination 2 Review —
Comprehensive Questions & Verified Solutions
2026/2027 Academic Cycle
Institution: Galen College of Nursing
Course: NSG 3500 — Maternal Health Nursing
Exam: Examination 2
, Abstract
This comprehensive examination review document for NSG 3500 Maternal Health Nursing —
Examination 2 encompasses 50 evidence-based questions spanning ten critical domains of maternal-
child nursing practice. The domains include antepartum care and assessment, intrapartum
management and labor stages, postpartum care and complications, newborn assessment and
transition, high-risk pregnancy conditions, maternal-child pharmacology, patient education and
health promotion, ethical and legal considerations, cultural competency in maternal care, and
interprofessional collaboration. Each question is designed to assess clinical reasoning at the
application and analysis levels, incorporating current guidelines from the American College of
Obstetricians and Gynecologists (ACOG), the Association of Women's Health, Obstetric and Neonatal
Nurses (AWHONN), the Centers for Disease Control and Prevention (CDC), the World Health
Organization (WHO), and the American Academy of Pediatrics (AAP). Verified answers are provided
with detailed rationales citing authoritative sources, enabling students to understand the clinical
reasoning behind each correct response. This review is intended to prepare nursing students for the
NSG 3500 Examination 2 by reinforcing key concepts, promoting critical thinking, and integrating
interprofessional collaboration principles essential for safe, high-quality maternal-child nursing care.
Keywords: Antepartum Assessment, Intrapartum Management, Postpartum Complications,
Newborn Transition, High-Risk Pregnancy, Maternal-Child Pharmacology
2
, NSG 3500 — Examination 2 Review
Domain 1: Antepartum Care & Assessment
1. A nurse is conducting the initial prenatal visit for a client at 8 weeks gestation. Which
laboratory test should the nurse anticipate being ordered to screen for maternal
syphilis?
A) Rubella titer
B) Rapid plasma reagin (RPR)
C) 1-hour glucose challenge test
D) Group B Streptococcus culture
Answer: B) Rapid plasma reagin (RPR)
The RPR (or VDRL) is a routine screening test for syphilis at the initial prenatal visit, as
recommended by ACOG and CDC guidelines. Congenital syphilis can cause devastating fetal outcomes
including stillbirth, hydrops, and neonatal death if untreated. Early detection allows for treatment
with penicillin, which effectively prevents maternal-fetal transmission. The rubella titer (A) screens
for rubella immunity, the 1-hour glucose challenge test (C) is performed at 24–28 weeks to screen for
gestational diabetes, and the GBS culture (D) is obtained at 35–37 weeks gestation. Universal syphilis
screening at the first prenatal visit is a standard of care per CDC STD Treatment Guidelines [1][5][14].
2. A client at 32 weeks gestation calls the clinic reporting decreased fetal movement.
The nurse instructs the client to perform kick counts. Which instruction is most
appropriate?
A) Count fetal movements for 1 hour after breakfast; call if fewer than 4 movements are felt
B) Lie on the left side and count movements; 10 movements in 2 hours is reassuring
C) Count movements only after a meal; 6 movements in 30 minutes is normal
D) Sit upright and count movements for 15 minutes; any movement counts
Answer: B) Lie on the left side and count movements; 10 movements in 2 hours is
reassuring
Fetal kick counts are a validated method of assessing fetal well-being recommended by ACOG. The
standard protocol instructs the pregnant client to lie on her left side in a quiet environment and count
fetal movements; perception of 10 movements within 2 hours is considered reassuring. If fewer than
10 movements are perceived in 2 hours, the client should contact her provider immediately for further
evaluation, which may include a nonstress test or biophysical profile. The left lateral position
optimizes uteroplacental perfusion, making movements more perceptible. Option A uses an incorrect
threshold and duration; option C provides incorrect parameters; option D does not follow evidence-
based counting criteria [3][7][14].
3. During a prenatal visit at 28 weeks, the nurse measures the client's fundal height at
24 cm. Based on Naegele's rule and fundal height assessment, which interpretation is
most accurate?
A) The fundal height is appropriate for gestational age
B) The fundal height suggests possible intrauterine growth restriction
C) The client is likely at 24 weeks gestation, not 28 weeks
D) The measurement is normal; fundal height varies widely at this gestation
Answer: B) The fundal height suggests possible intrauterine growth restriction
Fundal height in centimeters should approximate gestational age in weeks from approximately 20
weeks until 36 weeks, with an acceptable variation of ±2 cm. At 28 weeks, the expected fundal height
is 26–30 cm. A measurement of 24 cm is 4 cm below the expected range, which may indicate
intrauterine growth restriction (IUGR), oligohydramnios, or an inaccurate gestational age estimate.
This finding warrants further evaluation with ultrasound to assess fetal growth, amniotic fluid volume,
and placental function. While minor variations can be normal, a discrepancy of 3 cm or more is
considered significant per ACOG guidelines and requires clinical correlation and follow-up [3][7][14].
1
