Page 1 of 79
NSG 3500 EXAM 3 – MATERNITY (GALEN COLLEGE OF
NURSING) EXAM LATEST VERSION QUESTIONS AND ANSWERS
2026 EDITION
NSG 3500 Exam 3 – Maternity (Galen College of Nursing)
250 Practice Questions with Rationales
SECTION 1: INTRAPARTUM FETAL MONITORING (Questions 1-40)
1. A nurse is monitoring a client in labor and notes a fetal heart rate pattern with
variable decelerations. Which of the following is the most likely cause?
A. Head compression
B. Uteroplacental insufficiency
C. Fetal hypoxia
D. Umbilical cord compression
Answer: D. Umbilical cord compression
Rationale: Variable decelerations are typically caused by umbilical cord compression.
Head compression causes early decelerations, and uteroplacental insufficiency causes
late decelerations. Variable decelerations are characterized by a rapid drop and return
to baseline .
2. Which of the following interventions is the priority for a nurse when late
decelerations are observed on the fetal monitor?
A. Perform a vaginal exam
B. Increase the IV pitocin rate
C. Assist the client into a side-lying position
D. Administer oxygen via nasal cannula at 2 L/min
Answer: C. Assist the client into a side-lying position
, Page 2 of 79
Rationale: The priority intervention for late decelerations is to improve placental
perfusion, which is best achieved by repositioning the mother to her side. Late
decelerations indicate uteroplacental insufficiency .
3. The nurse notes that the fetal heart rate has late decelerations. What is the
nurse's priority action?
A. Increase the oxytocin infusion
B. Place the client in the left lateral position
C. Encourage the client to push with contractions
D. Check for cord prolapse
Answer: B. Place the client in the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning to the
left lateral side improves blood flow and oxygenation. Left lateral positioning increases
placental perfusion .
4. A client at 36 weeks gestation reports a sudden gush of fluid from the vagina.
What should the nurse do first?
A. Check fetal heart tones
B. Perform a vaginal exam
C. Notify the provider
D. Test the fluid with nitrazine paper
Answer: A. Check fetal heart tones
Rationale: The priority after rupture of membranes is to assess fetal well-being and rule
out cord prolapse by checking FHR. The nurse should listen for fetal heart tones
immediately .
5. A patient at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia.
Which finding should the nurse report immediately?
A. Respiratory rate of 16 breaths per minute
B. Absent deep tendon reflexes
C. Urine output of 40 mL per hour
D. Increased lethargy
Answer: B. Absent deep tendon reflexes
, Page 3 of 79
Rationale: Magnesium toxicity is characterized by the loss of deep tendon reflexes,
respiratory depression (<12/min), and decreased urine output (<30 mL/hr). Absent
reflexes are a critical early sign of toxicity .
6. The nurse is monitoring a client receiving magnesium sulfate for preeclampsia.
Which finding indicates magnesium toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate 10/min
C. Urine output 40 mL/hr
D. BP 150/90 mmHg
Answer: B. Respiratory rate 10/min
Rationale: Respiratory depression (<12/min) indicates magnesium toxicity — stop
infusion and prepare to administer calcium gluconate as the antidote .
7. Which assessment finding is characteristic of Abruptio Placentae?
A. Painless, bright red vaginal bleeding
B. Soft, non-tender abdomen
C. High fetal heart rate variability
D. Board-like, tender abdomen with dark red bleeding
Answer: D. Board-like, tender abdomen with dark red bleeding
Rationale: Abruptio placentae involves the premature separation of the placenta,
causing severe abdominal pain and a rigid, board-like uterus. Bleeding is often dark red
and may be concealed .
8. A client at 32 weeks gestation complains of painless bright red vaginal bleeding.
What should the nurse suspect?
A. Placenta previa
B. Placental abruption
C. Cervical laceration
D. Threatened abortion
Answer: A. Placenta previa
Rationale: Painless bright red bleeding in late pregnancy is characteristic of placenta
previa, where the placenta partially or completely covers the cervical os .
, Page 4 of 79
9. A client in the active phase of labor (stage 1) should be expected to have a
cervical dilation of:
A. 4 to 7 cm
B. 0 to 3 cm
C. 8 to 10 cm
D. Full dilation
Answer: A. 4 to 7 cm
Rationale: The active phase of the first stage of labor is characterized by cervical dilation
of 4 to 7 cm. The latent phase is 0-3 cm, and the transition phase is 8-10 cm .
10. The nurse is assessing fetal heart rate patterns. Which finding is considered
reassuring?
A. Late decelerations
B. Variable decelerations with a V-shape
C. Accelerations with fetal movement
D. Prolonged decelerations
Answer: C. Accelerations with fetal movement
Rationale: Accelerations with fetal movement are a reassuring sign of fetal well-being.
Late decelerations indicate uteroplacental insufficiency .
11. Which of the following is an appropriate nursing intervention for variable
decelerations?
A. Increase IV fluids
B. Change maternal position
C. Administer oxygen
D. Discontinue oxytocin
Answer: B. Change maternal position
Rationale: Variable decelerations are caused by cord compression. Repositioning the
mother (e.g., to knee-chest position) can relieve cord compression .
12. Early decelerations of the fetal heart rate are caused by:
NSG 3500 EXAM 3 – MATERNITY (GALEN COLLEGE OF
NURSING) EXAM LATEST VERSION QUESTIONS AND ANSWERS
2026 EDITION
NSG 3500 Exam 3 – Maternity (Galen College of Nursing)
250 Practice Questions with Rationales
SECTION 1: INTRAPARTUM FETAL MONITORING (Questions 1-40)
1. A nurse is monitoring a client in labor and notes a fetal heart rate pattern with
variable decelerations. Which of the following is the most likely cause?
A. Head compression
B. Uteroplacental insufficiency
C. Fetal hypoxia
D. Umbilical cord compression
Answer: D. Umbilical cord compression
Rationale: Variable decelerations are typically caused by umbilical cord compression.
Head compression causes early decelerations, and uteroplacental insufficiency causes
late decelerations. Variable decelerations are characterized by a rapid drop and return
to baseline .
2. Which of the following interventions is the priority for a nurse when late
decelerations are observed on the fetal monitor?
A. Perform a vaginal exam
B. Increase the IV pitocin rate
C. Assist the client into a side-lying position
D. Administer oxygen via nasal cannula at 2 L/min
Answer: C. Assist the client into a side-lying position
, Page 2 of 79
Rationale: The priority intervention for late decelerations is to improve placental
perfusion, which is best achieved by repositioning the mother to her side. Late
decelerations indicate uteroplacental insufficiency .
3. The nurse notes that the fetal heart rate has late decelerations. What is the
nurse's priority action?
A. Increase the oxytocin infusion
B. Place the client in the left lateral position
C. Encourage the client to push with contractions
D. Check for cord prolapse
Answer: B. Place the client in the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning to the
left lateral side improves blood flow and oxygenation. Left lateral positioning increases
placental perfusion .
4. A client at 36 weeks gestation reports a sudden gush of fluid from the vagina.
What should the nurse do first?
A. Check fetal heart tones
B. Perform a vaginal exam
C. Notify the provider
D. Test the fluid with nitrazine paper
Answer: A. Check fetal heart tones
Rationale: The priority after rupture of membranes is to assess fetal well-being and rule
out cord prolapse by checking FHR. The nurse should listen for fetal heart tones
immediately .
5. A patient at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia.
Which finding should the nurse report immediately?
A. Respiratory rate of 16 breaths per minute
B. Absent deep tendon reflexes
C. Urine output of 40 mL per hour
D. Increased lethargy
Answer: B. Absent deep tendon reflexes
, Page 3 of 79
Rationale: Magnesium toxicity is characterized by the loss of deep tendon reflexes,
respiratory depression (<12/min), and decreased urine output (<30 mL/hr). Absent
reflexes are a critical early sign of toxicity .
6. The nurse is monitoring a client receiving magnesium sulfate for preeclampsia.
Which finding indicates magnesium toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate 10/min
C. Urine output 40 mL/hr
D. BP 150/90 mmHg
Answer: B. Respiratory rate 10/min
Rationale: Respiratory depression (<12/min) indicates magnesium toxicity — stop
infusion and prepare to administer calcium gluconate as the antidote .
7. Which assessment finding is characteristic of Abruptio Placentae?
A. Painless, bright red vaginal bleeding
B. Soft, non-tender abdomen
C. High fetal heart rate variability
D. Board-like, tender abdomen with dark red bleeding
Answer: D. Board-like, tender abdomen with dark red bleeding
Rationale: Abruptio placentae involves the premature separation of the placenta,
causing severe abdominal pain and a rigid, board-like uterus. Bleeding is often dark red
and may be concealed .
8. A client at 32 weeks gestation complains of painless bright red vaginal bleeding.
What should the nurse suspect?
A. Placenta previa
B. Placental abruption
C. Cervical laceration
D. Threatened abortion
Answer: A. Placenta previa
Rationale: Painless bright red bleeding in late pregnancy is characteristic of placenta
previa, where the placenta partially or completely covers the cervical os .
, Page 4 of 79
9. A client in the active phase of labor (stage 1) should be expected to have a
cervical dilation of:
A. 4 to 7 cm
B. 0 to 3 cm
C. 8 to 10 cm
D. Full dilation
Answer: A. 4 to 7 cm
Rationale: The active phase of the first stage of labor is characterized by cervical dilation
of 4 to 7 cm. The latent phase is 0-3 cm, and the transition phase is 8-10 cm .
10. The nurse is assessing fetal heart rate patterns. Which finding is considered
reassuring?
A. Late decelerations
B. Variable decelerations with a V-shape
C. Accelerations with fetal movement
D. Prolonged decelerations
Answer: C. Accelerations with fetal movement
Rationale: Accelerations with fetal movement are a reassuring sign of fetal well-being.
Late decelerations indicate uteroplacental insufficiency .
11. Which of the following is an appropriate nursing intervention for variable
decelerations?
A. Increase IV fluids
B. Change maternal position
C. Administer oxygen
D. Discontinue oxytocin
Answer: B. Change maternal position
Rationale: Variable decelerations are caused by cord compression. Repositioning the
mother (e.g., to knee-chest position) can relieve cord compression .
12. Early decelerations of the fetal heart rate are caused by:
