NSG 432 / NSG432 (Latest Update )
Nursing Care of the Childbearing Family
Exam 2 Guide Questions with Answers
100% Correct | Grade A | 75 Questions
Grand Canyon University
Aligned with 2026-2027 GCU Curriculum Standards
Intrapartum Complications | Dystocia & Malpresentation | Postpartum Complications
Newborn Complications | Integrated Clinical Scenarios
, NSG 432 Nursing Care of the Childbearing Family | Exam 2 Guide Questions | 75 Questions
Section 1: Intrapartum Complications (Preterm Labor, PROM, Placental
Abnormalities) (Q1-Q20)
Q1: A 30-week pregnant patient presents to the labor and delivery unit reporting regular uterine contractions every
8 minutes, pelvic pressure, and a change in vaginal discharge. Cervical exam reveals 2 cm dilated and 50% effaced.
Which finding meets the criteria for a diagnosis of preterm labor?
A. Irregular contractions without cervical change
B. Cervical dilation of 1 cm without effacement
C. Regular uterine contractions causing cervical change before 37 weeks gestation **[CORRECT]**
D. Pelvic pressure alone without uterine activity
Correct Answer: C
Rationale: Rationale: Preterm labor is defined as regular uterine contractions that cause cervical change (dilation and/or effacement)
before 37 weeks gestation. This patient at 30 weeks has regular contractions with documented cervical change (2 cm/50%), meeting the
diagnostic criteria. The GCU NSG 432 curriculum emphasizes distinguishing true preterm labor from Braxton Hicks contractions, which
are irregular and do not cause cervical change.
Q2: A nurse is caring for a patient at 28 weeks gestation who is receiving magnesium sulfate for preterm labor.
Which assessment finding requires immediate intervention by the nurse?
A. Flushing and feeling warm
B. Loss of deep tendon reflexes and respiratory rate of 10 breaths/min **[CORRECT]**
C. Mild nausea and headache
D. Drowsiness and lethargy
Correct Answer: B
Rationale: Rationale: Loss of deep tendon reflexes (DTRs) and respiratory depression (RR < 12/min) are signs of magnesium sulfate
toxicity. Magnesium sulfate is administered for neuroprotection of the preterm fetus and as a tocolytic. The antidote is calcium gluconate,
which must be readily available at the bedside. Flushing, nausea, and mild drowsiness are common side effects but are not
life-threatening. GCU NSG 432 emphasizes that DTR assessment and respiratory monitoring are critical during magnesium infusion.
Q3: A pregnant patient at 32 weeks gestation reports a sudden gush of clear fluid from the vagina. The Nitrazine
paper test turns blue, and a ferning pattern is observed under microscopy. What is the priority nursing
intervention?
A. Perform a sterile vaginal exam to assess cervical dilation
B. Assess fetal heart rate and monitor for signs of infection, avoiding vaginal exams **[CORRECT]**
C. Immediately induce labor regardless of gestational age
D. Apply a tight abdominal binder to prevent cord prolapse
Correct Answer: B
Rationale: Rationale: The findings (Nitrazine positive/alkaline, ferning pattern) confirm rupture of membranes. At 32 weeks, this is
preterm premature rupture of membranes (PPROM). The priority is to assess fetal well-being (FHR monitoring) and monitor for signs of
chorioamnionitis (fever, tachycardia, foul-smelling fluid, uterine tenderness) while avoiding vaginal exams, which increase infection risk.
Digital vaginal exams are specifically contraindicated in PPROM. Expectant management with corticosteroids and antibiotics is
appropriate at this gestational age.
Q4: A patient at 26 weeks gestation has a positive fetal fibronectin (fFN) test. The nurse understands that this
result indicates which of the following?
A. The patient will definitely deliver within 48 hours
Page 2
, NSG 432 Nursing Care of the Childbearing Family | Exam 2 Guide Questions | 75 Questions
B. The test has high negative predictive value, so a negative result would rule out preterm labor within 1-2 weeks
C. A positive fFN indicates increased risk of preterm birth within 7-14 days, but is not diagnostic alone
**[CORRECT]**
D. The test confirms that fetal lungs are mature
Correct Answer: C
Rationale: Rationale: A positive fetal fibronectin (fFN) test indicates that the protein 'glue' between the amniotic membranes and uterine
wall is disrupted, suggesting increased risk of preterm delivery within 7-14 days. However, fFN alone is not diagnostic of preterm labor.
The clinical value of fFN lies primarily in its high negative predictive value: a negative result makes preterm delivery within 1-2 weeks
very unlikely. Fetal lung maturity is assessed by lecithin/sphingomyelin (L/S) ratio or lamellar body count, not fFN. GCU curriculum
emphasizes using fFN results in conjunction with clinical assessment.
Q5: A nurse is administering betamethasone to a patient at 29 weeks gestation who is in preterm labor. The patient
asks why this medication is being given. Which response by the nurse is most accurate?
A. It will stop your contractions and prevent preterm delivery
B. It accelerates fetal lung maturity by promoting surfactant production to reduce the risk of respiratory
distress syndrome **[CORRECT]**
C. It treats an infection that may be causing your preterm labor
D. It prevents bleeding complications from placental abruption
Correct Answer: B
Rationale: Rationale: Betamethasone (or dexamethasone) is a corticosteroid administered between 24 and 34 weeks gestation to accelerate
fetal lung maturity by stimulating surfactant production in the fetal lungs. This significantly reduces the incidence and severity of
neonatal respiratory distress syndrome (RDS). The optimal benefit occurs approximately 48 hours after administration, with benefits
decreasing after 7 days. Corticosteroids do not stop contractions (tocolytics do that) and are not antibiotics. This is a key pharmacological
intervention emphasized in GCU NSG 432.
Q6: A patient at 35 weeks gestation presents with painless, bright red vaginal bleeding. The uterus is soft and
non-tender on palpation. Fetal heart rate is reassuring. Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa **[CORRECT]**
C. Vasa previa
D. Uterine rupture
Correct Answer: B
Rationale: Rationale: Painless, bright red vaginal bleeding in the third trimester with a soft, non-tender uterus is the classic presentation of
placenta previa, where the placenta implants over or near the internal cervical os. In contrast, placental abruption typically presents with
painful vaginal bleeding (dark red) and a tender, rigid, or 'board-like' uterus. Vasa previa presents with painless bleeding at membrane
rupture. Uterine rupture presents with sudden severe pain, cessation of contractions, and FHR bradycardia. The critical nursing
intervention for placenta previa is to avoid vaginal exams, which can trigger massive hemorrhage.
Q7: A patient at 33 weeks gestation is admitted with a diagnosis of placenta previa. Which nursing intervention is
MOST important for this patient?
A. Perform a vaginal exam to assess cervical dilation and effacement
B. Administer oxytocin to induce labor
C. Avoid vaginal examinations and monitor the amount and character of bleeding **[CORRECT]**
D. Encourage ambulation to promote circulation
Correct Answer: C
Page 3
Nursing Care of the Childbearing Family
Exam 2 Guide Questions with Answers
100% Correct | Grade A | 75 Questions
Grand Canyon University
Aligned with 2026-2027 GCU Curriculum Standards
Intrapartum Complications | Dystocia & Malpresentation | Postpartum Complications
Newborn Complications | Integrated Clinical Scenarios
, NSG 432 Nursing Care of the Childbearing Family | Exam 2 Guide Questions | 75 Questions
Section 1: Intrapartum Complications (Preterm Labor, PROM, Placental
Abnormalities) (Q1-Q20)
Q1: A 30-week pregnant patient presents to the labor and delivery unit reporting regular uterine contractions every
8 minutes, pelvic pressure, and a change in vaginal discharge. Cervical exam reveals 2 cm dilated and 50% effaced.
Which finding meets the criteria for a diagnosis of preterm labor?
A. Irregular contractions without cervical change
B. Cervical dilation of 1 cm without effacement
C. Regular uterine contractions causing cervical change before 37 weeks gestation **[CORRECT]**
D. Pelvic pressure alone without uterine activity
Correct Answer: C
Rationale: Rationale: Preterm labor is defined as regular uterine contractions that cause cervical change (dilation and/or effacement)
before 37 weeks gestation. This patient at 30 weeks has regular contractions with documented cervical change (2 cm/50%), meeting the
diagnostic criteria. The GCU NSG 432 curriculum emphasizes distinguishing true preterm labor from Braxton Hicks contractions, which
are irregular and do not cause cervical change.
Q2: A nurse is caring for a patient at 28 weeks gestation who is receiving magnesium sulfate for preterm labor.
Which assessment finding requires immediate intervention by the nurse?
A. Flushing and feeling warm
B. Loss of deep tendon reflexes and respiratory rate of 10 breaths/min **[CORRECT]**
C. Mild nausea and headache
D. Drowsiness and lethargy
Correct Answer: B
Rationale: Rationale: Loss of deep tendon reflexes (DTRs) and respiratory depression (RR < 12/min) are signs of magnesium sulfate
toxicity. Magnesium sulfate is administered for neuroprotection of the preterm fetus and as a tocolytic. The antidote is calcium gluconate,
which must be readily available at the bedside. Flushing, nausea, and mild drowsiness are common side effects but are not
life-threatening. GCU NSG 432 emphasizes that DTR assessment and respiratory monitoring are critical during magnesium infusion.
Q3: A pregnant patient at 32 weeks gestation reports a sudden gush of clear fluid from the vagina. The Nitrazine
paper test turns blue, and a ferning pattern is observed under microscopy. What is the priority nursing
intervention?
A. Perform a sterile vaginal exam to assess cervical dilation
B. Assess fetal heart rate and monitor for signs of infection, avoiding vaginal exams **[CORRECT]**
C. Immediately induce labor regardless of gestational age
D. Apply a tight abdominal binder to prevent cord prolapse
Correct Answer: B
Rationale: Rationale: The findings (Nitrazine positive/alkaline, ferning pattern) confirm rupture of membranes. At 32 weeks, this is
preterm premature rupture of membranes (PPROM). The priority is to assess fetal well-being (FHR monitoring) and monitor for signs of
chorioamnionitis (fever, tachycardia, foul-smelling fluid, uterine tenderness) while avoiding vaginal exams, which increase infection risk.
Digital vaginal exams are specifically contraindicated in PPROM. Expectant management with corticosteroids and antibiotics is
appropriate at this gestational age.
Q4: A patient at 26 weeks gestation has a positive fetal fibronectin (fFN) test. The nurse understands that this
result indicates which of the following?
A. The patient will definitely deliver within 48 hours
Page 2
, NSG 432 Nursing Care of the Childbearing Family | Exam 2 Guide Questions | 75 Questions
B. The test has high negative predictive value, so a negative result would rule out preterm labor within 1-2 weeks
C. A positive fFN indicates increased risk of preterm birth within 7-14 days, but is not diagnostic alone
**[CORRECT]**
D. The test confirms that fetal lungs are mature
Correct Answer: C
Rationale: Rationale: A positive fetal fibronectin (fFN) test indicates that the protein 'glue' between the amniotic membranes and uterine
wall is disrupted, suggesting increased risk of preterm delivery within 7-14 days. However, fFN alone is not diagnostic of preterm labor.
The clinical value of fFN lies primarily in its high negative predictive value: a negative result makes preterm delivery within 1-2 weeks
very unlikely. Fetal lung maturity is assessed by lecithin/sphingomyelin (L/S) ratio or lamellar body count, not fFN. GCU curriculum
emphasizes using fFN results in conjunction with clinical assessment.
Q5: A nurse is administering betamethasone to a patient at 29 weeks gestation who is in preterm labor. The patient
asks why this medication is being given. Which response by the nurse is most accurate?
A. It will stop your contractions and prevent preterm delivery
B. It accelerates fetal lung maturity by promoting surfactant production to reduce the risk of respiratory
distress syndrome **[CORRECT]**
C. It treats an infection that may be causing your preterm labor
D. It prevents bleeding complications from placental abruption
Correct Answer: B
Rationale: Rationale: Betamethasone (or dexamethasone) is a corticosteroid administered between 24 and 34 weeks gestation to accelerate
fetal lung maturity by stimulating surfactant production in the fetal lungs. This significantly reduces the incidence and severity of
neonatal respiratory distress syndrome (RDS). The optimal benefit occurs approximately 48 hours after administration, with benefits
decreasing after 7 days. Corticosteroids do not stop contractions (tocolytics do that) and are not antibiotics. This is a key pharmacological
intervention emphasized in GCU NSG 432.
Q6: A patient at 35 weeks gestation presents with painless, bright red vaginal bleeding. The uterus is soft and
non-tender on palpation. Fetal heart rate is reassuring. Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa **[CORRECT]**
C. Vasa previa
D. Uterine rupture
Correct Answer: B
Rationale: Rationale: Painless, bright red vaginal bleeding in the third trimester with a soft, non-tender uterus is the classic presentation of
placenta previa, where the placenta implants over or near the internal cervical os. In contrast, placental abruption typically presents with
painful vaginal bleeding (dark red) and a tender, rigid, or 'board-like' uterus. Vasa previa presents with painless bleeding at membrane
rupture. Uterine rupture presents with sudden severe pain, cessation of contractions, and FHR bradycardia. The critical nursing
intervention for placenta previa is to avoid vaginal exams, which can trigger massive hemorrhage.
Q7: A patient at 33 weeks gestation is admitted with a diagnosis of placenta previa. Which nursing intervention is
MOST important for this patient?
A. Perform a vaginal exam to assess cervical dilation and effacement
B. Administer oxytocin to induce labor
C. Avoid vaginal examinations and monitor the amount and character of bleeding **[CORRECT]**
D. Encourage ambulation to promote circulation
Correct Answer: C
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