NSG 432 Exam 4 V1 | NSG 432 Maternal-
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 4) | Grand
Canyon University
1. A nurse is reviewing the medical records of several postpartum clients. Which of the
following conditions should the nurse identify as increasing the risk for postpartum
hemorrhage? (Select All That Apply)
A. Uterine atony
B. Placenta previa
C. Polyhydramnios
D. Retained placental fragments
E. Macrosomic infant
F. Oligohydramnios
Correct Answer: A, B, C, D, E
Uterine atony is the most common cause of postpartum hemorrhage due to the failure of
the muscle to contract. Conditions that overstretch the uterus, such as polyhydramnios and
a macrosomic infant, significantly increase this risk. Retained fragments and placenta
previa also predispose the client to excessive bleeding post-delivery.
,2. A nurse is monitoring a client who is receiving magnesium sulfate for the treatment of
preeclampsia. Which of the following findings should the nurse report to the provider as a
sign of toxicity?
A. Respiratory rate of 10/min
B. Hyperreflexia
C. Blood pressure 150/90 mmHg
D. Increased urinary output
Correct Answer: A
Magnesium sulfate is a central nervous system depressant used to prevent seizures in
preeclampsia. A respiratory rate below 12/min is a primary indicator of magnesium
toxicity and requires immediate intervention. The nurse should also monitor for absent
deep tendon reflexes and decreased urinary output.
3. A nurse is caring for a client in the first stage of labor and notes late decelerations on the
fetal heart rate monitor. Which of the following actions should the nurse take first?
A. Perform a vaginal exam
B. Turn the client onto her side
C. Increase the oxytocin infusion rate
D. Administer oxygen via nasal cannulae
Correct Answer: B
, Late decelerations are indicative of uteroplacental insufficiency and fetal distress.
Repositioning the client to a lateral position is the priority action to improve blood flow to
the placenta. Following repositioning, the nurse should increase IV fluids and administer
oxygen via a non-rebreather mask.
4. A nurse is assessing a newborn 1 hour after birth. Which of the following respiratory
findings is considered normal for a newborn?
A. Nasal flaring
B. Expiratory grunting
C. Irregular respirations with short periods of apnea (less than 15 seconds)
D. Respiratory rate of 70/min
Correct Answer: C
Newborns typically exhibit a periodic breathing pattern which includes irregular rhythms
and brief pauses in breathing. Normal respiratory rates for a newborn range from 30 to 60
breaths per minute. Findings such as grunting, flaring, or tachypnea indicate respiratory
distress and require further assessment.
5. A nurse is teaching a parent about the purpose of the Vitamin K injection given to their
newborn. Which of the following statements by the nurse is correct?
A. It prevents neonatal infections like Group B Strep
B. It stimulates the production of red blood cells
C. It helps clear bilirubin from the liver
Newborn Nursing / OB/GYN | Actual Q&A
with Rationale (NSG432 Exam 4) | Grand
Canyon University
1. A nurse is reviewing the medical records of several postpartum clients. Which of the
following conditions should the nurse identify as increasing the risk for postpartum
hemorrhage? (Select All That Apply)
A. Uterine atony
B. Placenta previa
C. Polyhydramnios
D. Retained placental fragments
E. Macrosomic infant
F. Oligohydramnios
Correct Answer: A, B, C, D, E
Uterine atony is the most common cause of postpartum hemorrhage due to the failure of
the muscle to contract. Conditions that overstretch the uterus, such as polyhydramnios and
a macrosomic infant, significantly increase this risk. Retained fragments and placenta
previa also predispose the client to excessive bleeding post-delivery.
,2. A nurse is monitoring a client who is receiving magnesium sulfate for the treatment of
preeclampsia. Which of the following findings should the nurse report to the provider as a
sign of toxicity?
A. Respiratory rate of 10/min
B. Hyperreflexia
C. Blood pressure 150/90 mmHg
D. Increased urinary output
Correct Answer: A
Magnesium sulfate is a central nervous system depressant used to prevent seizures in
preeclampsia. A respiratory rate below 12/min is a primary indicator of magnesium
toxicity and requires immediate intervention. The nurse should also monitor for absent
deep tendon reflexes and decreased urinary output.
3. A nurse is caring for a client in the first stage of labor and notes late decelerations on the
fetal heart rate monitor. Which of the following actions should the nurse take first?
A. Perform a vaginal exam
B. Turn the client onto her side
C. Increase the oxytocin infusion rate
D. Administer oxygen via nasal cannulae
Correct Answer: B
, Late decelerations are indicative of uteroplacental insufficiency and fetal distress.
Repositioning the client to a lateral position is the priority action to improve blood flow to
the placenta. Following repositioning, the nurse should increase IV fluids and administer
oxygen via a non-rebreather mask.
4. A nurse is assessing a newborn 1 hour after birth. Which of the following respiratory
findings is considered normal for a newborn?
A. Nasal flaring
B. Expiratory grunting
C. Irregular respirations with short periods of apnea (less than 15 seconds)
D. Respiratory rate of 70/min
Correct Answer: C
Newborns typically exhibit a periodic breathing pattern which includes irregular rhythms
and brief pauses in breathing. Normal respiratory rates for a newborn range from 30 to 60
breaths per minute. Findings such as grunting, flaring, or tachypnea indicate respiratory
distress and require further assessment.
5. A nurse is teaching a parent about the purpose of the Vitamin K injection given to their
newborn. Which of the following statements by the nurse is correct?
A. It prevents neonatal infections like Group B Strep
B. It stimulates the production of red blood cells
C. It helps clear bilirubin from the liver
