Galen College NSG 3500 Exam 4 (pdf) | 2026/2027 | Maternal Health
Q&A | Maternal Health Nursing
1. A nurse observes a bluish discoloration on the hands and feet of a
newborn 2 hours after birth. The rest of the infant's body is pink. How should
the nurse interpret this finding?
A) A sign of a cardiac abnormality
B) A normal finding known as acrocyanosis
C) Indicative of respiratory distress
D) A symptom of cold stress
Correct Answer: A normal finding known as acrocyanosis
Rationale: Acrocyanosis is a normal finding in newborns during the first 24-48
hours of life. It results from immature peripheral circulation and is
characterized by bluish discoloration of the hands and feet while the trunk
remains pink. It is not a sign of cardiac or respiratory compromise.
2. What is the normal heart rate range for a newborn?
A) 80-100 bpm
B) 100-140 bpm
C) 110-160 bpm
D) 140-180 bpm
Correct Answer: 110-160 bpm
Rationale: The normal newborn heart rate is 110-160 bpm (some sources
state 120-160 bpm). Tachycardia is defined as >160 bpm and bradycardia as
<110 bpm.
,3. What is the normal respiratory rate range for a newborn?
A) 20-40 breaths per minute
B) 30-60 breaths per minute
C) 40-80 breaths per minute
D) 50-100 breaths per minute
Correct Answer: 30-60 breaths per minute
Rationale: The normal respiratory rate for a newborn is 30-60 breaths per
minute. Newborn breathing is often irregular, shallow, and diaphragmatic.
Grunting, nasal flaring, and retractions are signs of respiratory distress that
require further evaluation.
4. A newborn has an Apgar score of 6 at 1 minute and 8 at 5 minutes. The
nurse should interpret this as:
A) The newborn is in severe distress and requires resuscitation
B) The newborn is transitioning well and is in good condition
C) The newborn has a congenital anomaly
D) The newborn requires immediate transfer to the NICU
Correct Answer: The newborn is transitioning well and is in good condition
Rationale: An Apgar score of 7-10 is generally considered normal. A score of
6 at 1 minute is low but an improvement to 8 at 5 minutes indicates the
newborn is transitioning well. A score of 4-6 requires some intervention, and
a score of 0-3 indicates critical distress requiring immediate resuscitation.
5. At what intervals is the Apgar score typically assigned?
A) At 1 and 5 minutes after birth
,B) At 5 and 10 minutes after birth
C) At 1, 5, and 10 minutes after birth
D) Immediately after birth only
Correct Answer: At 1 and 5 minutes after birth
Rationale: The Apgar score is assigned at 1 minute and 5 minutes after birth.
If the score is low (less than 7) at 5 minutes, it may be repeated at 10
minutes.
6. What are the five categories of the Apgar score?
A) Heart rate, respiratory rate, muscle tone, reflex irritability, and color
B) Heart rate, blood pressure, muscle tone, reflex irritability, and color
C) Respiratory rate, temperature, muscle tone, reflex irritability, and color
D) Heart rate, respiratory rate, muscle tone, feeding ability, and color
Correct Answer: Heart rate, respiratory rate, muscle tone, reflex irritability,
and color
Rationale: The Apgar score assesses five components: heart rate, respiratory
effort, muscle tone, reflex irritability, and color. Each component is scored 0,
1, or 2, with a maximum total score of 10.
7. Which of the following is a sign of respiratory distress in a newborn?
A) Irregular breathing
B) Acrocyanosis
C) Grunting respirations
D) Diaphragmatic breathing
, Correct Answer: Grunting respirations
Rationale: Grunting respirations are a sign of respiratory distress in a
newborn. They indicate that the newborn is trying to maintain functional
residual capacity and prevent alveolar collapse. Other signs include nasal
flaring, retractions, and tachypnea. Irregular and diaphragmatic breathing
are normal in newborns.
8. A newborn is diagnosed with transient tachypnea of the newborn (TTN).
Which finding is consistent with this condition?
A) Rapid respiratory rate that resolves within 24-72 hours
B) Grunting respirations with retractions
C) Cyanosis that does not improve with oxygen
D) Persistent tachypnea lasting more than 1 week
Correct Answer: Rapid respiratory rate that resolves within 24-72 hours
Rationale: Transient tachypnea of the newborn (TTN) is characterized by a
rapid respiratory rate that typically resolves within 24-72 hours. It is more
common in infants born via cesarean section or those with delayed clearance
of fetal lung fluid.
9. A newborn is diagnosed with respiratory distress syndrome (RDS). The
nurse understands that RDS is caused by:
A) A deficiency of surfactant
B) An excess of surfactant
C) A congenital heart defect
D) Meconium aspiration
Q&A | Maternal Health Nursing
1. A nurse observes a bluish discoloration on the hands and feet of a
newborn 2 hours after birth. The rest of the infant's body is pink. How should
the nurse interpret this finding?
A) A sign of a cardiac abnormality
B) A normal finding known as acrocyanosis
C) Indicative of respiratory distress
D) A symptom of cold stress
Correct Answer: A normal finding known as acrocyanosis
Rationale: Acrocyanosis is a normal finding in newborns during the first 24-48
hours of life. It results from immature peripheral circulation and is
characterized by bluish discoloration of the hands and feet while the trunk
remains pink. It is not a sign of cardiac or respiratory compromise.
2. What is the normal heart rate range for a newborn?
A) 80-100 bpm
B) 100-140 bpm
C) 110-160 bpm
D) 140-180 bpm
Correct Answer: 110-160 bpm
Rationale: The normal newborn heart rate is 110-160 bpm (some sources
state 120-160 bpm). Tachycardia is defined as >160 bpm and bradycardia as
<110 bpm.
,3. What is the normal respiratory rate range for a newborn?
A) 20-40 breaths per minute
B) 30-60 breaths per minute
C) 40-80 breaths per minute
D) 50-100 breaths per minute
Correct Answer: 30-60 breaths per minute
Rationale: The normal respiratory rate for a newborn is 30-60 breaths per
minute. Newborn breathing is often irregular, shallow, and diaphragmatic.
Grunting, nasal flaring, and retractions are signs of respiratory distress that
require further evaluation.
4. A newborn has an Apgar score of 6 at 1 minute and 8 at 5 minutes. The
nurse should interpret this as:
A) The newborn is in severe distress and requires resuscitation
B) The newborn is transitioning well and is in good condition
C) The newborn has a congenital anomaly
D) The newborn requires immediate transfer to the NICU
Correct Answer: The newborn is transitioning well and is in good condition
Rationale: An Apgar score of 7-10 is generally considered normal. A score of
6 at 1 minute is low but an improvement to 8 at 5 minutes indicates the
newborn is transitioning well. A score of 4-6 requires some intervention, and
a score of 0-3 indicates critical distress requiring immediate resuscitation.
5. At what intervals is the Apgar score typically assigned?
A) At 1 and 5 minutes after birth
,B) At 5 and 10 minutes after birth
C) At 1, 5, and 10 minutes after birth
D) Immediately after birth only
Correct Answer: At 1 and 5 minutes after birth
Rationale: The Apgar score is assigned at 1 minute and 5 minutes after birth.
If the score is low (less than 7) at 5 minutes, it may be repeated at 10
minutes.
6. What are the five categories of the Apgar score?
A) Heart rate, respiratory rate, muscle tone, reflex irritability, and color
B) Heart rate, blood pressure, muscle tone, reflex irritability, and color
C) Respiratory rate, temperature, muscle tone, reflex irritability, and color
D) Heart rate, respiratory rate, muscle tone, feeding ability, and color
Correct Answer: Heart rate, respiratory rate, muscle tone, reflex irritability,
and color
Rationale: The Apgar score assesses five components: heart rate, respiratory
effort, muscle tone, reflex irritability, and color. Each component is scored 0,
1, or 2, with a maximum total score of 10.
7. Which of the following is a sign of respiratory distress in a newborn?
A) Irregular breathing
B) Acrocyanosis
C) Grunting respirations
D) Diaphragmatic breathing
, Correct Answer: Grunting respirations
Rationale: Grunting respirations are a sign of respiratory distress in a
newborn. They indicate that the newborn is trying to maintain functional
residual capacity and prevent alveolar collapse. Other signs include nasal
flaring, retractions, and tachypnea. Irregular and diaphragmatic breathing
are normal in newborns.
8. A newborn is diagnosed with transient tachypnea of the newborn (TTN).
Which finding is consistent with this condition?
A) Rapid respiratory rate that resolves within 24-72 hours
B) Grunting respirations with retractions
C) Cyanosis that does not improve with oxygen
D) Persistent tachypnea lasting more than 1 week
Correct Answer: Rapid respiratory rate that resolves within 24-72 hours
Rationale: Transient tachypnea of the newborn (TTN) is characterized by a
rapid respiratory rate that typically resolves within 24-72 hours. It is more
common in infants born via cesarean section or those with delayed clearance
of fetal lung fluid.
9. A newborn is diagnosed with respiratory distress syndrome (RDS). The
nurse understands that RDS is caused by:
A) A deficiency of surfactant
B) An excess of surfactant
C) A congenital heart defect
D) Meconium aspiration
