NSG222 / NSG 222 Exam 2
Family Nursing — Latest Update
Herzing University — 100 Verified Questions with Comprehensive Rationales
100% Correct Answers | Grade A | Aligned with NSG222 Curriculum Standards
Instructions: This comprehensive examination contains 100 multiple-choice questions distributed across nine content
domains reflecting the Herzing University NSG222 Family Nursing curriculum. Each question has four options (A, B,
C, D) with exactly one best answer. Approximately 70% of items are scenario-based, 20% assess direct recall, and 10%
require clinical judgment and prioritization. The cognitive distribution targets 25% recall, 50% application, and 25%
analysis. After each question, the verified correct answer and a 2-3 sentence family nursing rationale are provided,
integrating evidence-based practice, developmental theory, safety principles, and Herzing NSG222 course standards.
Use this examination for review, self-assessment, and clinical reasoning development in family nursing practice.
Section Domain Questions
1 Intrapartum Nursing and Labor Management Q1-Q18 (18)
2 Fetal Assessment and Monitoring Q19-Q28 (10)
3 Obstetrical Complications and High-Risk Pregnancy Q29-Q42 (14)
4 Postpartum Nursing and Maternal Adaptation Q43-Q52 (10)
5 Newborn Transition and Neonatal Assessment Q53-Q62 (10)
6 High-Risk Newborn and Neonatal Complications Q63-Q72 (10)
7 Pediatric Nursing and Family-Centered Care Q73-Q82 (10)
8 Pediatric Health Conditions and Alterations Q83-Q92 (10)
9 Integrated Clinical Case Scenarios and Prioritization Q93-Q100 (8)
TOTAL 100 Questions
Section 1: Intrapartum Nursing and Labor Management
,Q1: A 26-year-old primigravida at 39 weeks gestation calls the labor unit reporting contractions every 5
minutes that started 2 hours ago. She states the discomfort begins in her lower back and radiates around to
her abdomen, and she notices bloody show. Which finding most strongly indicates true labor?
A. Contractions are relieved by walking and position change.
B. Contractions occur at irregular intervals and decrease with rest.
C. Contractions cause progressive cervical dilation and are not relieved by sedation. [CORRECT]
D. Contractions are felt only in the lower abdomen without radiation.
Correct Answer: C
Rationale: True labor is characterized by regular contractions that increase in frequency, duration, and intensity, cause
progressive cervical dilation and effacement, are not relieved by sedation or ambulation, and are typically felt in the back
radiating to the abdomen. Options A, B, and D describe false labor, in which contractions are irregular, often relieved by rest
or sedation, and are not associated with cervical change. Bloody show may accompany both, but progressive cervical change
is the definitive marker of true labor per Herzing NSG222 labor assessment standards.
Q2: When explaining the factors influencing labor to a nursing student, the nurse identifies the Five P's.
Which of the following lists all five correctly?
A. Passenger, Passageway, Powers, Position, Psyche [CORRECT]
B. Pelvis, Placenta, Position, Pain, Preparation
C. Passenger, Pelvis, Pressure, Physician, Psychology
D. Power, Passage, Patient, Provider, Pain
Correct Answer: A
Rationale: The Five P's of labor are Passenger (fetus), Passageway (maternal pelvis and soft tissues), Powers (uterine
contractions), Position (maternal position and fetal presentation), and Psyche (maternal psychological response). These
interrelated factors determine whether labor progresses normally. The other options substitute incorrect terms such as
placenta, physician, or pain, which are not part of the classic framework taught in NSG222 family nursing content.
Q3: A laboring client is in the second stage of labor. The fetal head is beginning to distend the perineum,
and the nurse visualizes the occiput rotating from a transverse position to an anterior position beneath the
pubic symphysis. Which cardinal movement of labor is occurring?
A. Engagement
B. Descent
C. Internal rotation [CORRECT]
D. Extension
Correct Answer: C
Rationale: Internal rotation occurs during the second stage as the fetal occiput rotates from a transverse or oblique position to
an anterior-posterior position beneath the pubic symphysis, allowing the longest diameters of the fetal head to align with the
longest diameters of the maternal pelvis. Engagement refers to descent of the presenting part to the level of the ischial spines,
descent is the downward passage through the birth canal, and extension occurs after internal rotation as the head passes under
the symphysis. The sequence is engagement, descent, flexion, internal rotation, extension, external restitution, and expulsion.
,Q4: A primigravida is admitted at 3 cm cervical dilation with contractions every 5-7 minutes lasting 30
seconds of mild intensity. The client is talkative and smiling. Which phase of the first stage of labor is she
experiencing?
A. Latent phase [CORRECT]
B. Active phase
C. Transition phase
D. Second stage
Correct Answer: A
Rationale: The latent phase of the first stage of labor extends from 0 to 3-4 cm dilation, with contractions every 5-20 minutes
lasting 30-45 seconds of mild intensity. The client is typically coping well, talkative, and eager. The active phase (4-7 cm)
features moderate contractions every 3-5 minutes lasting 40-60 seconds. The transition phase (8-10 cm) is marked by strong
contractions every 2-3 minutes lasting 60-90 seconds with significant discomfort, irritability, and anxiety.
Q5: A client in active labor is now 6 cm dilated with contractions every 3 minutes lasting 60 seconds and
moderate intensity. She requests an epidural. After epidural placement, which nursing intervention is the
highest priority?
A. Encourage ambulation to promote labor progress.
B. Maintain the supine position to enhance epidural spread.
C. Monitor maternal blood pressure every 1-5 minutes after the bolus and reposition side-to-side. [CORRECT]
D. Discontinue IV fluids to prevent fluid overload.
Correct Answer: C
Rationale: Epidural analgesia can cause sympathetic blockade leading to maternal hypotension, which reduces placental
perfusion and may cause fetal bradycardia. The nurse should monitor maternal blood pressure every 1-5 minutes for the first
15-30 minutes after the bolus, maintain a 500-1000 mL crystalloid preload, position the client side-to-side to relieve
aortocaval compression, and continuously monitor fetal heart rate. Ambulation is contraindicated after epidural placement,
the supine position causes supine hypotensive syndrome, and IV fluids should be maintained, not discontinued.
Q6: A multiparous client has been pushing for 90 minutes. The fetal head is visible at the introitus during
contractions. Which action by the nurse is most appropriate?
A. Encourage prolonged breath-holding while pushing for 30-40 seconds.
B. Assess for crowning and prepare for delivery of the fetal head. [CORRECT]
C. Administer oxytocin to augment contractions.
D. Place the client in high Fowler's position without pushing.
Correct Answer: B
Rationale: When the fetal head is visible at the introitus during contractions (crowning), the second stage is progressing and
delivery is imminent. The nurse should prepare for delivery by assessing for full crowning, supporting the perineum,
notifying the provider, and preparing the delivery area. Prolonged breath-holding (more than 6-8 seconds) risks decreased
placental perfusion and fetal compromise. Oxytocin is not indicated when delivery is imminent, and discontinuing pushing at
this stage would delay delivery.
, Q7: Thirty minutes after a vaginal delivery, the nurse observes a sudden gush of dark blood from the
vagina, the umbilical cord lengthens outside the vulva, and the uterus becomes firm and globular, rising
upward in the abdomen. What is the correct interpretation of these findings?
A. Signs of impending uterine atony.
B. Signs of placental separation and impending placental delivery. [CORRECT]
C. Signs of vaginal laceration requiring immediate repair.
D. Signs of retained placenta requiring manual removal.
Correct Answer: B
Rationale: The four classic signs of placental separation are: (1) lengthening of the umbilical cord outside the vulva, (2)
sudden gush of dark blood, (3) the uterus becoming firm and globular, and (4) the fundus rising in the abdomen. These
indicate the third stage of labor is completing and placental delivery is imminent. The nurse should prepare for controlled
cord traction and placental inspection. Atony would present as a boggy uterus with bright red bleeding; lacerations present
with a firm fundus but continued bright red bleeding.
Q8: During the fourth stage of labor, the nurse assesses a postpartum client 1 hour after vaginal delivery.
The fundus is firm, midline, and at the level of the umbilicus. Lochia is moderate rubra with small clots.
The client's blood pressure is 110/68 and pulse is 84. Which action is most appropriate?
A. Document findings as normal fourth-stage recovery. [CORRECT]
B. Administer oxytocin IV for uterine atony.
C. Perform fundal massage for at least 5 minutes.
D. Catheterize the client for urinary retention.
Correct Answer: A
Rationale: During the fourth stage of labor (1-4 hours postpartum), the fundus should be firm, midline, and at or one
fingerbreadth below the umbilicus. Lochia rubra should be moderate with small clots (less than 1 cm). Maternal vital signs
should be stable. These findings are normal and should be documented. Massage is only indicated for a boggy or deviated
fundus. Oxytocin is not needed when the uterus is firm. Catheterization is only indicated for bladder distention, which would
cause fundal deviation.
Q9: A laboring client requests non-pharmacological pain relief. The nurse applies firm pressure with a
tennis ball to the client's sacrum during each contraction. Which technique is being used, and what is its
primary mechanism of action?
A. Hydrotherapy; gate control of pain signals.
B. Counterpressure; interrupts pain transmission via the gate control theory. [CORRECT]
C. Aromatherapy; stimulates limbic system relaxation.
D. Effleurage; stimulates endorphin release through abdominal stroking.
Correct Answer: B
Rationale: Counterpressure involves applying steady firm pressure to the sacrum during contractions, which is particularly
effective for back labor caused by occiput posterior positioning. It works through the gate control theory of pain, in which
sustained sensory input (pressure) competes with and partially blocks the transmission of pain signals to the brain.
Hydrotherapy uses warm water immersion, aromatherapy uses scent, and effleurage is light abdominal stroking that also
works through gate control but in a different anatomic area.
Family Nursing — Latest Update
Herzing University — 100 Verified Questions with Comprehensive Rationales
100% Correct Answers | Grade A | Aligned with NSG222 Curriculum Standards
Instructions: This comprehensive examination contains 100 multiple-choice questions distributed across nine content
domains reflecting the Herzing University NSG222 Family Nursing curriculum. Each question has four options (A, B,
C, D) with exactly one best answer. Approximately 70% of items are scenario-based, 20% assess direct recall, and 10%
require clinical judgment and prioritization. The cognitive distribution targets 25% recall, 50% application, and 25%
analysis. After each question, the verified correct answer and a 2-3 sentence family nursing rationale are provided,
integrating evidence-based practice, developmental theory, safety principles, and Herzing NSG222 course standards.
Use this examination for review, self-assessment, and clinical reasoning development in family nursing practice.
Section Domain Questions
1 Intrapartum Nursing and Labor Management Q1-Q18 (18)
2 Fetal Assessment and Monitoring Q19-Q28 (10)
3 Obstetrical Complications and High-Risk Pregnancy Q29-Q42 (14)
4 Postpartum Nursing and Maternal Adaptation Q43-Q52 (10)
5 Newborn Transition and Neonatal Assessment Q53-Q62 (10)
6 High-Risk Newborn and Neonatal Complications Q63-Q72 (10)
7 Pediatric Nursing and Family-Centered Care Q73-Q82 (10)
8 Pediatric Health Conditions and Alterations Q83-Q92 (10)
9 Integrated Clinical Case Scenarios and Prioritization Q93-Q100 (8)
TOTAL 100 Questions
Section 1: Intrapartum Nursing and Labor Management
,Q1: A 26-year-old primigravida at 39 weeks gestation calls the labor unit reporting contractions every 5
minutes that started 2 hours ago. She states the discomfort begins in her lower back and radiates around to
her abdomen, and she notices bloody show. Which finding most strongly indicates true labor?
A. Contractions are relieved by walking and position change.
B. Contractions occur at irregular intervals and decrease with rest.
C. Contractions cause progressive cervical dilation and are not relieved by sedation. [CORRECT]
D. Contractions are felt only in the lower abdomen without radiation.
Correct Answer: C
Rationale: True labor is characterized by regular contractions that increase in frequency, duration, and intensity, cause
progressive cervical dilation and effacement, are not relieved by sedation or ambulation, and are typically felt in the back
radiating to the abdomen. Options A, B, and D describe false labor, in which contractions are irregular, often relieved by rest
or sedation, and are not associated with cervical change. Bloody show may accompany both, but progressive cervical change
is the definitive marker of true labor per Herzing NSG222 labor assessment standards.
Q2: When explaining the factors influencing labor to a nursing student, the nurse identifies the Five P's.
Which of the following lists all five correctly?
A. Passenger, Passageway, Powers, Position, Psyche [CORRECT]
B. Pelvis, Placenta, Position, Pain, Preparation
C. Passenger, Pelvis, Pressure, Physician, Psychology
D. Power, Passage, Patient, Provider, Pain
Correct Answer: A
Rationale: The Five P's of labor are Passenger (fetus), Passageway (maternal pelvis and soft tissues), Powers (uterine
contractions), Position (maternal position and fetal presentation), and Psyche (maternal psychological response). These
interrelated factors determine whether labor progresses normally. The other options substitute incorrect terms such as
placenta, physician, or pain, which are not part of the classic framework taught in NSG222 family nursing content.
Q3: A laboring client is in the second stage of labor. The fetal head is beginning to distend the perineum,
and the nurse visualizes the occiput rotating from a transverse position to an anterior position beneath the
pubic symphysis. Which cardinal movement of labor is occurring?
A. Engagement
B. Descent
C. Internal rotation [CORRECT]
D. Extension
Correct Answer: C
Rationale: Internal rotation occurs during the second stage as the fetal occiput rotates from a transverse or oblique position to
an anterior-posterior position beneath the pubic symphysis, allowing the longest diameters of the fetal head to align with the
longest diameters of the maternal pelvis. Engagement refers to descent of the presenting part to the level of the ischial spines,
descent is the downward passage through the birth canal, and extension occurs after internal rotation as the head passes under
the symphysis. The sequence is engagement, descent, flexion, internal rotation, extension, external restitution, and expulsion.
,Q4: A primigravida is admitted at 3 cm cervical dilation with contractions every 5-7 minutes lasting 30
seconds of mild intensity. The client is talkative and smiling. Which phase of the first stage of labor is she
experiencing?
A. Latent phase [CORRECT]
B. Active phase
C. Transition phase
D. Second stage
Correct Answer: A
Rationale: The latent phase of the first stage of labor extends from 0 to 3-4 cm dilation, with contractions every 5-20 minutes
lasting 30-45 seconds of mild intensity. The client is typically coping well, talkative, and eager. The active phase (4-7 cm)
features moderate contractions every 3-5 minutes lasting 40-60 seconds. The transition phase (8-10 cm) is marked by strong
contractions every 2-3 minutes lasting 60-90 seconds with significant discomfort, irritability, and anxiety.
Q5: A client in active labor is now 6 cm dilated with contractions every 3 minutes lasting 60 seconds and
moderate intensity. She requests an epidural. After epidural placement, which nursing intervention is the
highest priority?
A. Encourage ambulation to promote labor progress.
B. Maintain the supine position to enhance epidural spread.
C. Monitor maternal blood pressure every 1-5 minutes after the bolus and reposition side-to-side. [CORRECT]
D. Discontinue IV fluids to prevent fluid overload.
Correct Answer: C
Rationale: Epidural analgesia can cause sympathetic blockade leading to maternal hypotension, which reduces placental
perfusion and may cause fetal bradycardia. The nurse should monitor maternal blood pressure every 1-5 minutes for the first
15-30 minutes after the bolus, maintain a 500-1000 mL crystalloid preload, position the client side-to-side to relieve
aortocaval compression, and continuously monitor fetal heart rate. Ambulation is contraindicated after epidural placement,
the supine position causes supine hypotensive syndrome, and IV fluids should be maintained, not discontinued.
Q6: A multiparous client has been pushing for 90 minutes. The fetal head is visible at the introitus during
contractions. Which action by the nurse is most appropriate?
A. Encourage prolonged breath-holding while pushing for 30-40 seconds.
B. Assess for crowning and prepare for delivery of the fetal head. [CORRECT]
C. Administer oxytocin to augment contractions.
D. Place the client in high Fowler's position without pushing.
Correct Answer: B
Rationale: When the fetal head is visible at the introitus during contractions (crowning), the second stage is progressing and
delivery is imminent. The nurse should prepare for delivery by assessing for full crowning, supporting the perineum,
notifying the provider, and preparing the delivery area. Prolonged breath-holding (more than 6-8 seconds) risks decreased
placental perfusion and fetal compromise. Oxytocin is not indicated when delivery is imminent, and discontinuing pushing at
this stage would delay delivery.
, Q7: Thirty minutes after a vaginal delivery, the nurse observes a sudden gush of dark blood from the
vagina, the umbilical cord lengthens outside the vulva, and the uterus becomes firm and globular, rising
upward in the abdomen. What is the correct interpretation of these findings?
A. Signs of impending uterine atony.
B. Signs of placental separation and impending placental delivery. [CORRECT]
C. Signs of vaginal laceration requiring immediate repair.
D. Signs of retained placenta requiring manual removal.
Correct Answer: B
Rationale: The four classic signs of placental separation are: (1) lengthening of the umbilical cord outside the vulva, (2)
sudden gush of dark blood, (3) the uterus becoming firm and globular, and (4) the fundus rising in the abdomen. These
indicate the third stage of labor is completing and placental delivery is imminent. The nurse should prepare for controlled
cord traction and placental inspection. Atony would present as a boggy uterus with bright red bleeding; lacerations present
with a firm fundus but continued bright red bleeding.
Q8: During the fourth stage of labor, the nurse assesses a postpartum client 1 hour after vaginal delivery.
The fundus is firm, midline, and at the level of the umbilicus. Lochia is moderate rubra with small clots.
The client's blood pressure is 110/68 and pulse is 84. Which action is most appropriate?
A. Document findings as normal fourth-stage recovery. [CORRECT]
B. Administer oxytocin IV for uterine atony.
C. Perform fundal massage for at least 5 minutes.
D. Catheterize the client for urinary retention.
Correct Answer: A
Rationale: During the fourth stage of labor (1-4 hours postpartum), the fundus should be firm, midline, and at or one
fingerbreadth below the umbilicus. Lochia rubra should be moderate with small clots (less than 1 cm). Maternal vital signs
should be stable. These findings are normal and should be documented. Massage is only indicated for a boggy or deviated
fundus. Oxytocin is not needed when the uterus is firm. Catheterization is only indicated for bladder distention, which would
cause fundal deviation.
Q9: A laboring client requests non-pharmacological pain relief. The nurse applies firm pressure with a
tennis ball to the client's sacrum during each contraction. Which technique is being used, and what is its
primary mechanism of action?
A. Hydrotherapy; gate control of pain signals.
B. Counterpressure; interrupts pain transmission via the gate control theory. [CORRECT]
C. Aromatherapy; stimulates limbic system relaxation.
D. Effleurage; stimulates endorphin release through abdominal stroking.
Correct Answer: B
Rationale: Counterpressure involves applying steady firm pressure to the sacrum during contractions, which is particularly
effective for back labor caused by occiput posterior positioning. It works through the gate control theory of pain, in which
sustained sensory input (pressure) competes with and partially blocks the transmission of pain signals to the brain.
Hydrotherapy uses warm water immersion, aromatherapy uses scent, and effleurage is light abdominal stroking that also
works through gate control but in a different anatomic area.
