NSG 432 EXAM 2 NURSING CARE OF THE CHILDBEARING FAMILY - Higher Education Nursing
Curriculum - 2026/2027 Academic Year - 200 Verified Questions and Answers with
Evidence-Based Rationales - NEWEST
Antepartum Assessment Prenatal Care Evidence-Based
Description: Naegele's rule EDD LMP add 1 year subtract 3 months add 7 days first trimester ultrasound most accurate if discrepancy greater than 7 days ACOG, fundal
height 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus McDonald rule cm equals weeks plus minus 2 after 20 weeks discrepancy IUGR macrosomia
multiples poly oligo, prenatal labs first trimester blood type Rh antibody screen CBC rubella syphilis RPR HIV hep B urine culture GC chlamydia per USPSTF ACOG,
TORCH Toxoplasmosis Other syphilis Rubella CMV Herpes teratogenic avoid cat litter raw meat unpasteurized screening rubella immunity chickenpox vaccine
preconception CDC, GDM screening 24-28 weeks 1 hr 50 g GCT greater than 130-140 then 3 hr 100 g GTT 2 abnormal diagnosis diet exercise fasting less than 95 1 hr
less than 140 2 hr less than 120 insulin ADA ACOG, GBS screening 36-37 weeks vaginal rectal culture if positive penicillin G ampicillin during labor at least 4 hr prevents
early onset sepsis CDC ACOG, Bishop score dilation effacement station consistency position greater than 8 favorable less than 6 unfavorable needs ripening dinoprostone
misoprostol Foley balloon, amniotic fluid polyhydramnios AFI greater than 24 cm associated diabetes anencephaly oligohydramnios AFI less than 5 cm IUGR postterm
PROM renal agenesis.
Intrapartum Labor Fetal Monitoring Evidence-Based
Description: True vs false labor true regular increase frequency intensity duration with walking cervical effacement dilation false irregular no change Braxton Hicks, stages
labor Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr 4 hr with epidural multip 2 hr 3 hr with epidural third
placenta up to 30 min fourth 1-4 hr recovery ACOG 2014, FHR baseline 110-160 moderate variability 6-25 reassuring NICHD Category I normal Category II indeterminate
Category III abnormal absent variability recurrent late variable bradycardia sinusoidal requires intervention, VEAL CHOP Variable cord compression Early head
compression Accelerated OK Late placental insufficiency interventions reposition O2 stop oxytocin IV fluids AWHONN, oxytocin high alert dilute IV pump tachysystole
greater than 5 contractions 10 min or greater than 2 min duration or relaxation less than 30 sec discontinue reposition O2 fluids left lateral, epidural hypotension most
common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased urge fever coagulation platelets, cord prolapse emergency knee-chest
Trendelenburg elevate presenting part gloved hand O2 stop oxytocin tocolytic terbutaline emergency C-section, shoulder dystocia McRoberts flex hips suprapubic pressure
not fundal Wood screw Rubin posterior arm delivery ALSO course, placental abruption painful bleeding rigid tender hypertonic fetal distress DIC vs previa painless bright
red soft nontender, meconium stained vigorous term no routine tracheal suctioning NRP 2020.
High Risk Pregnancy Preeclampsia Preterm Labor Induction
Description: Preeclampsia severe features BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double AST ALT twice normal
pulmonary edema severe headache visual scotoma ACOG 2020, MgSO4 loading 4-6 g over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs
RR less than 12 urine less than 30 mL/hr decreased LOC cardiac arrest antidote calcium gluconate 1 g, induction methods oxytocin favorable cervix Bishop greater than 8
prostaglandins unfavorable Bishop less than 6 dinoprostone misoprostol Foley mechanical ripening amniotomy if engaged, preterm labor tocolytics delay 48 hr for steroids
betamethasone 12 mg IM 24 hr apart fetal lung maturity MgSO4 neuroprotection less than 32 weeks nifedipine indomethacin terbutaline not if greater than 34 weeks
dilation greater than 5 cm infection preeclampsia.
Postpartum Assessment Hemorrhage Mood Disorders Contraception
Description: Fundus firm midline at umbilicus 1 hr descends 1 cm per day involution 10 days pelvis boggy massage support lower segment full bladder displaces high
deviated, lochia rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive soaking pad less than 15 min large clots
greater than quarter abnormal, PPH 4 Ts Tone atony most common Tissue retained accreta Trauma laceration hematoma Thrombin DIC management fundal massage
oxytocin 30 units LR methylergonovine if not HTN hemabate if not asthma misoprostol TXA tranexamic acid 1 g IV within 3 hr WHO WOMAN trial QBL quantify blood loss,
RhoGAM Rh negative mother Rh positive baby 300 mcg IM 28 weeks and within 72 hr post delivery if baby Rh positive indirect Coombs negative also after abortion ectopic
amnio bleeding prevents sensitization, postpartum mood blues day 3-5 tearfulness resolves 2 weeks depression greater than 2 weeks persistent sadness anhedonia
functional impairment treatment therapy SSRI sertraline breastfeeding compatible psychosis rare first 2 weeks hallucinations delusions risk infanticide emergency DSM-5,
breastfeeding benefits newborn immunity decreased infection otitis diarrhea NEC SIDS maternal decreased bleeding involution decreased breast ovarian cancer bonding
WHO, contraception IUD immediate post placental or 4-6 weeks progestin only immediate combined estrogen wait 3-6 weeks VTE risk CDC US MEC.
Newborn Assessment Care Evidence-Based
Description: APGAR Appearance pulse grimace activity respiration 0-2 each total 10 at 1 and 5 min 7-10 normal 4-6 moderate 0-3 severe extended 10 15 20 min if less
than 7 NRP, thermoregulation 4 mechanisms conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects windows
WHO warm chain prevention skin-to-skin kangaroo care warm blankets hat dry immediately warm delivery room, respiratory distress tachypnea greater than 60 grunting
nasal flaring retractions cyanosis seesaw normal RR 30-60 TTN RDS meconium aspiration, neonatal hypoglycemia at risk IDM LGA SGA preterm postterm jitteriness
lethargy poor feeding hypothermia apnea glucose less than 40 term less than 45 preterm treatment early feeding colostrum dextrose gel 40 percent buccal 0.5 mL/kg
massaged plus breastfeeding Sugar Babies trial reduces NICU admission IV D10W 2 mL/kg, jaundice physiological after 24 hr peaks day 3-5 less than 12 term less than
15 preterm pathological before 24 hr rapid rise greater than 0.2 mg/dL/hr greater than 12-15 direct greater than 2 Rh incompatibility phototherapy exchange AAP 2022
nomogram, breastfeeding latch tummy to tummy nose to nipple wide mouth flanged lips areola audible swallow no clicking dimpling pain not normal beyond 30 sec nipple
trauma poor latch WHO UNICEF BFHI, newborn screening heel stick after 24 hr feeding milk before discharge PKU hypothyroidism sickle cell galactosemia early detection
prevents retardation AAP, meconium stained vigorous term no routine tracheal suctioning non-vigorous airway suctioning NRP 2020.
Page 1 - NSG 432 Exam 2 200Q 2026/2027 Newest
,Question 1: Q1: NSG 432 - Naegele's rule evidence-based EDD calculation LMP Jan 15 2026?
A. EDD Oct 22 2026 - LMP add 1 year minus 3 months plus 7 days evidence-based ACOG
B. EDD Oct 15 2026
C. EDD Sept 15 2026
D. EDD Jan 22 2027
CORRECT ANSWER: A. EDD Oct 22 2026 - LMP add 1 year minus 3 months plus 7 days evidence-based ACOG
RATIONALE:
Evidence-based: Naegele's rule LMP add 1 year subtract 3 months add 7 days Jan 15 2026 plus 1 year 2027 minus 3 months Oct 15 2026 plus 7 days Oct 22 2026
ACOG recommends first trimester ultrasound most accurate if discrepancy greater than 7 days.
Question 2: Q2: Fundal height assessment evidence-based gestational age?
A. Only symphysis pubis always
B. Only at xiphoid always
C. 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus 20 cm 36 weeks xiphoid McDonald rule cm equals weeks plus minus 2 after 20
weeks
D. No correlation gestational age
CORRECT ANSWER: C. 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus 20 cm 36 weeks xiphoid McDonald rule cm equals
weeks plus minus 2 after 20 weeks
RATIONALE:
Evidence-based: Fundal height 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus McDonald rule after 20 weeks fundal height cm approximately equals
gestational weeks plus minus 2 cm discrepancy suggests IUGR macrosomia multiples poly/oligo.
Question 3: Q3: Prenatal screening first trimester evidence-based labs?
A. Only CBC needed
B. Only blood type needed
C. No labs evidence-based
D. Blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B urine culture GC chlamydia evidence-based USPSTF
CORRECT ANSWER: D. Blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B urine culture GC chlamydia
evidence-based USPSTF
RATIONALE:
Evidence-based prenatal labs per ACOG USPSTF first visit blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B surface antigen urine
culture GC chlamydia TB if risk TSH if indicated.
Question 4: Q4: True vs false labor evidence-based differentiation?
A. True labor irregular no change
B. True labor regular increase frequency intensity duration with walking cervical effacement dilation false labor Braxton Hicks irregular no cervical change
dehydration rest improves evidence-based Friedman curve
C. False labor regular with change
D. No difference evidence
CORRECT ANSWER: B. True labor regular increase frequency intensity duration with walking cervical effacement dilation false labor Braxton
Hicks irregular no cervical change dehydration rest improves evidence-based Friedman curve
RATIONALE:
Evidence-based: True labor regular contractions increase frequency intensity duration with ambulation cervical change effacement dilation descent false labor irregular no
cervical change dehydration rest improves Friedman curve abnormal if protracted.
Question 5: Q5: Labor stages evidence-based duration primip vs multip?
A. Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr with epidural 4 hr multip 2 hr with epidural 3
hr third placenta up to 30 min fourth 1-4 hr recovery evidence-based ACOG 2014
B. Only stage 1 exists
C. Only stage 2 exists
D. No stages evidence
CORRECT ANSWER: A. Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr with
epidural 4 hr multip 2 hr with epidural 3 hr third placenta up to 30 min fourth 1-4 hr recovery evidence-based ACOG 2014
RATIONALE:
Evidence-based ACOG 2014: Stage 1 latent 0-6 cm slow active 6-10 cm rapid second stage pushing primip up to 3 hr 4 hr with epidural multip up to 2 hr 3 hr with epidural
third placenta up to 30 min fourth recovery fundus vitals lochia.
Question 6: Q6: FHR baseline variability evidence-based NICHD categories?
A. Baseline 180-200 normal always
B. Baseline 80 normal
C. Baseline 110-160 moderate variability 6-25 reassuring Category I normal Category II indeterminate Category III abnormal absent variability with
recurrent late variable bradycardia requires intervention
D. No categories evidence
CORRECT ANSWER: C. Baseline 110-160 moderate variability 6-25 reassuring Category I normal Category II indeterminate Category III
abnormal absent variability with recurrent late variable bradycardia requires intervention
RATIONALE:
Evidence-based NICHD: FHR baseline 110-160 moderate variability 6-25 reassuring accelerations 15 bpm 15 sec Category I normal Category II indeterminate Category
III abnormal absent variability plus recurrent late variable decelerations bradycardia sinusoidal requires urgent intervention.
Question 7: Q7: VEAL CHOP evidence-based deceleration interventions?
A. Early cord compression
Page 2 - NSG 432 Exam 2 200Q 2026/2027 Newest
, B. Variable placental insufficiency
C. Late head compression
D. Variable cord compression reposition O2 stop oxytocin Early head compression benign no action Late placental insufficiency reposition O2 stop
oxytocin IV fluids evidence-based AWHONN
CORRECT ANSWER: D. Variable cord compression reposition O2 stop oxytocin Early head compression benign no action Late placental
insufficiency reposition O2 stop oxytocin IV fluids evidence-based AWHONN
RATIONALE:
Evidence-based VEAL CHOP Variable cord compression Early head compression Accelerated OK Late placental insufficiency interventions variable reposition lateral O2
10 L stop oxytocin tocolytic amnioinfusion Early benign Late reposition O2 stop oxytocin IV fluids prepare delivery.
Question 8: Q8: Epidural anesthesia evidence-based nursing considerations?
A. Hypertension most common
B. Hypotension most common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased urge fever coagulation check
platelets evidence-based anesthesia guidelines
C. No hypotension risk
D. Only hypertension risk
CORRECT ANSWER: B. Hypotension most common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased
urge fever coagulation check platelets evidence-based anesthesia guidelines
RATIONALE:
Evidence-based: Epidural sympathetic blockade hypotension most common preload 500-1000 mL LR monitor BP q2-5 min bladder distension decreased urge sensation
fever thermoregulation coagulation check platelets less than 100K contraindicated.
Question 9: Q9: Oxytocin administration high alert evidence-based protocol?
A. High alert dilute IV pump discontinue if tachysystole greater than 5 contractions 10 min or contraction greater than 2 min or relaxation less than 30 sec
or Category II III FHR reposition O2 IV fluids notify provider evidence-based ACOG
B. Bolus IV push quickly
C. No monitoring needed
D. Continue even with tachysystole
CORRECT ANSWER: A. High alert dilute IV pump discontinue if tachysystole greater than 5 contractions 10 min or contraction greater than 2
min or relaxation less than 30 sec or Category II III FHR reposition O2 IV fluids notify provider evidence-based ACOG
RATIONALE:
Evidence-based high alert oxytocin dilute infusion pump monitor uterine activity tachysystole greater than 5 contractions 10 min or contraction greater than 2 min or
relaxation less than 30 sec or Category II III FHR discontinue reposition O2 10 L IV fluids left lateral notify provider.
Question 10: Q10: Preeclampsia severe features evidence-based criteria ACOG 2020?
A. No labs criteria evidence
B. BP 120/80 severe
C. BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double liver enzymes twice normal pulmonary edema
severe headache visual scotoma evidence-based
D. Only edema criteria
CORRECT ANSWER: C. BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double liver enzymes twice
normal pulmonary edema severe headache visual scotoma evidence-based
RATIONALE:
Evidence-based ACOG 2020: Preeclampsia severe features BP greater than or equal to 160/110 on 2 occasions 4 hr apart platelets less than 100K creatinine greater
than 1.1 or doubling AST ALT twice normal pulmonary edema severe headache visual disturbances.
Page 3 - NSG 432 Exam 2 200Q 2026/2027 Newest
, Question 11: Q11: MgSO4 administration toxicity antidote evidence-based?
A. No toxicity monitoring
B. No loading needed
C. No antidote
D. Loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs RR less than 12 urine less than 30 mL/hr
decreased LOC cardiac arrest antidote calcium gluconate 1 g or calcium chloride 10 mL 10 percent evidence-based
CORRECT ANSWER: D. Loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs RR less than 12
urine less than 30 mL/hr decreased LOC cardiac arrest antidote calcium gluconate 1 g or calcium chloride 10 mL 10 percent evidence-based
RATIONALE:
Evidence-based: MgSO4 loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL monitor DTRs RR urine output LOC toxicity loss DTRs RR less
than 12 urine less than 30 mL/hr respiratory depression cardiac arrest antidote calcium gluconate 1 g IV slow.
Question 12: Q12: Postpartum hemorrhage 4 Ts evidence-based management?
A. Only tone
B. Tone atony most common Tissue retained Trauma laceration Thrombin coagulopathy management fundal massage oxytocin 30 units LR empty
bladder quantify blood loss TXA within 3 hr evidence-based WHO WOMAN trial
C. Only tissue
D. No management evidence
CORRECT ANSWER: B. Tone atony most common Tissue retained Trauma laceration Thrombin coagulopathy management fundal massage
oxytocin 30 units LR empty bladder quantify blood loss TXA within 3 hr evidence-based WHO WOMAN trial
RATIONALE:
Evidence-based: PPH 4 Ts Tone atony most common Tissue retained placenta accreta Trauma laceration hematoma Thrombin DIC management fundal massage boggy
fundus oxytocin 30 units LR methylergonovine if not HTN hemabate if not asthma misoprostol TXA tranexamic acid 1 g IV within 3 hr WHO WOMAN trial reduces mortality
empty bladder QBL quantify blood loss.
Question 13: Q13: Fundal assessment postpartum evidence-based expected?
A. Fundus firm midline at umbilicus 1 hr after delivery descends 1 cm per day involution 10 days in pelvis boggy fundus massage support lower segment
full bladder displaces high deviated evidence-based
B. Fundus high deviated full bladder normal no intervention
C. Fundus boggy no massage evidence
D. Fundus at xiphoid 1 hr normal
CORRECT ANSWER: A. Fundus firm midline at umbilicus 1 hr after delivery descends 1 cm per day involution 10 days in pelvis boggy fundus
massage support lower segment full bladder displaces high deviated evidence-based
RATIONALE:
Evidence-based: Fundus firm midline at umbilicus or 1-2 cm below 1 hr postpartum descends 1 cm per day involution 10 days in pelvis boggy fundus massage support
lower segment full bladder displaces high deviated lochia rubra serosa alba assessment.
Question 14: Q14: Lochia assessment abnormal evidence-based?
A. Foul odor normal
B. Lochia alba day 1 normal
C. Rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive soaking pad less than 15 min large
clots greater than quarter size abnormal evidence-based
D. Large clots normal evidence
CORRECT ANSWER: C. Rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive
soaking pad less than 15 min large clots greater than quarter size abnormal evidence-based
RATIONALE:
Evidence-based: Lochia rubra red days 1-3 serosa pink brown days 4-10 alba yellow white days 11-6 weeks foul odor indicates infection endometritis excessive bleeding
soaking pad less than 15 min large clots greater than quarter size abnormal notify provider.
Question 15: Q15: APGAR scoring evidence-based timing interpretation?
A. Only appearance matters
B. Only 1 min needed
C. No scoring evidence
D. 0-2 each Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 7-10 normal 4-6 moderate resuscitation 0-3 severe
asphyxia at 1 and 5 min extended 10 15 20 min if less than 7 evidence-based NRP
CORRECT ANSWER: D. 0-2 each Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 7-10 normal 4-6
moderate resuscitation 0-3 severe asphyxia at 1 and 5 min extended 10 15 20 min if less than 7 evidence-based NRP
RATIONALE:
Evidence-based NRP: APGAR Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 0-2 each total 10 at 1 and 5 min 7-10 normal 4-6
moderate resuscitation 0-3 severe asphyxia extended 10 15 20 min if less than 7.
Question 16: Q16: Newborn thermoregulation evidence-based 4 mechanisms prevention?
A. Only conduction
B. Conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects windows prevention skin-to-skin
warm blankets hat dry immediately evidence-based WHO warm chain
C. Only convection
D. Only radiation
CORRECT ANSWER: B. Conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects
windows prevention skin-to-skin warm blankets hat dry immediately evidence-based WHO warm chain
RATIONALE:
Page 4 - NSG 432 Exam 2 200Q 2026/2027 Newest
Curriculum - 2026/2027 Academic Year - 200 Verified Questions and Answers with
Evidence-Based Rationales - NEWEST
Antepartum Assessment Prenatal Care Evidence-Based
Description: Naegele's rule EDD LMP add 1 year subtract 3 months add 7 days first trimester ultrasound most accurate if discrepancy greater than 7 days ACOG, fundal
height 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus McDonald rule cm equals weeks plus minus 2 after 20 weeks discrepancy IUGR macrosomia
multiples poly oligo, prenatal labs first trimester blood type Rh antibody screen CBC rubella syphilis RPR HIV hep B urine culture GC chlamydia per USPSTF ACOG,
TORCH Toxoplasmosis Other syphilis Rubella CMV Herpes teratogenic avoid cat litter raw meat unpasteurized screening rubella immunity chickenpox vaccine
preconception CDC, GDM screening 24-28 weeks 1 hr 50 g GCT greater than 130-140 then 3 hr 100 g GTT 2 abnormal diagnosis diet exercise fasting less than 95 1 hr
less than 140 2 hr less than 120 insulin ADA ACOG, GBS screening 36-37 weeks vaginal rectal culture if positive penicillin G ampicillin during labor at least 4 hr prevents
early onset sepsis CDC ACOG, Bishop score dilation effacement station consistency position greater than 8 favorable less than 6 unfavorable needs ripening dinoprostone
misoprostol Foley balloon, amniotic fluid polyhydramnios AFI greater than 24 cm associated diabetes anencephaly oligohydramnios AFI less than 5 cm IUGR postterm
PROM renal agenesis.
Intrapartum Labor Fetal Monitoring Evidence-Based
Description: True vs false labor true regular increase frequency intensity duration with walking cervical effacement dilation false irregular no change Braxton Hicks, stages
labor Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr 4 hr with epidural multip 2 hr 3 hr with epidural third
placenta up to 30 min fourth 1-4 hr recovery ACOG 2014, FHR baseline 110-160 moderate variability 6-25 reassuring NICHD Category I normal Category II indeterminate
Category III abnormal absent variability recurrent late variable bradycardia sinusoidal requires intervention, VEAL CHOP Variable cord compression Early head
compression Accelerated OK Late placental insufficiency interventions reposition O2 stop oxytocin IV fluids AWHONN, oxytocin high alert dilute IV pump tachysystole
greater than 5 contractions 10 min or greater than 2 min duration or relaxation less than 30 sec discontinue reposition O2 fluids left lateral, epidural hypotension most
common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased urge fever coagulation platelets, cord prolapse emergency knee-chest
Trendelenburg elevate presenting part gloved hand O2 stop oxytocin tocolytic terbutaline emergency C-section, shoulder dystocia McRoberts flex hips suprapubic pressure
not fundal Wood screw Rubin posterior arm delivery ALSO course, placental abruption painful bleeding rigid tender hypertonic fetal distress DIC vs previa painless bright
red soft nontender, meconium stained vigorous term no routine tracheal suctioning NRP 2020.
High Risk Pregnancy Preeclampsia Preterm Labor Induction
Description: Preeclampsia severe features BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double AST ALT twice normal
pulmonary edema severe headache visual scotoma ACOG 2020, MgSO4 loading 4-6 g over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs
RR less than 12 urine less than 30 mL/hr decreased LOC cardiac arrest antidote calcium gluconate 1 g, induction methods oxytocin favorable cervix Bishop greater than 8
prostaglandins unfavorable Bishop less than 6 dinoprostone misoprostol Foley mechanical ripening amniotomy if engaged, preterm labor tocolytics delay 48 hr for steroids
betamethasone 12 mg IM 24 hr apart fetal lung maturity MgSO4 neuroprotection less than 32 weeks nifedipine indomethacin terbutaline not if greater than 34 weeks
dilation greater than 5 cm infection preeclampsia.
Postpartum Assessment Hemorrhage Mood Disorders Contraception
Description: Fundus firm midline at umbilicus 1 hr descends 1 cm per day involution 10 days pelvis boggy massage support lower segment full bladder displaces high
deviated, lochia rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive soaking pad less than 15 min large clots
greater than quarter abnormal, PPH 4 Ts Tone atony most common Tissue retained accreta Trauma laceration hematoma Thrombin DIC management fundal massage
oxytocin 30 units LR methylergonovine if not HTN hemabate if not asthma misoprostol TXA tranexamic acid 1 g IV within 3 hr WHO WOMAN trial QBL quantify blood loss,
RhoGAM Rh negative mother Rh positive baby 300 mcg IM 28 weeks and within 72 hr post delivery if baby Rh positive indirect Coombs negative also after abortion ectopic
amnio bleeding prevents sensitization, postpartum mood blues day 3-5 tearfulness resolves 2 weeks depression greater than 2 weeks persistent sadness anhedonia
functional impairment treatment therapy SSRI sertraline breastfeeding compatible psychosis rare first 2 weeks hallucinations delusions risk infanticide emergency DSM-5,
breastfeeding benefits newborn immunity decreased infection otitis diarrhea NEC SIDS maternal decreased bleeding involution decreased breast ovarian cancer bonding
WHO, contraception IUD immediate post placental or 4-6 weeks progestin only immediate combined estrogen wait 3-6 weeks VTE risk CDC US MEC.
Newborn Assessment Care Evidence-Based
Description: APGAR Appearance pulse grimace activity respiration 0-2 each total 10 at 1 and 5 min 7-10 normal 4-6 moderate 0-3 severe extended 10 15 20 min if less
than 7 NRP, thermoregulation 4 mechanisms conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects windows
WHO warm chain prevention skin-to-skin kangaroo care warm blankets hat dry immediately warm delivery room, respiratory distress tachypnea greater than 60 grunting
nasal flaring retractions cyanosis seesaw normal RR 30-60 TTN RDS meconium aspiration, neonatal hypoglycemia at risk IDM LGA SGA preterm postterm jitteriness
lethargy poor feeding hypothermia apnea glucose less than 40 term less than 45 preterm treatment early feeding colostrum dextrose gel 40 percent buccal 0.5 mL/kg
massaged plus breastfeeding Sugar Babies trial reduces NICU admission IV D10W 2 mL/kg, jaundice physiological after 24 hr peaks day 3-5 less than 12 term less than
15 preterm pathological before 24 hr rapid rise greater than 0.2 mg/dL/hr greater than 12-15 direct greater than 2 Rh incompatibility phototherapy exchange AAP 2022
nomogram, breastfeeding latch tummy to tummy nose to nipple wide mouth flanged lips areola audible swallow no clicking dimpling pain not normal beyond 30 sec nipple
trauma poor latch WHO UNICEF BFHI, newborn screening heel stick after 24 hr feeding milk before discharge PKU hypothyroidism sickle cell galactosemia early detection
prevents retardation AAP, meconium stained vigorous term no routine tracheal suctioning non-vigorous airway suctioning NRP 2020.
Page 1 - NSG 432 Exam 2 200Q 2026/2027 Newest
,Question 1: Q1: NSG 432 - Naegele's rule evidence-based EDD calculation LMP Jan 15 2026?
A. EDD Oct 22 2026 - LMP add 1 year minus 3 months plus 7 days evidence-based ACOG
B. EDD Oct 15 2026
C. EDD Sept 15 2026
D. EDD Jan 22 2027
CORRECT ANSWER: A. EDD Oct 22 2026 - LMP add 1 year minus 3 months plus 7 days evidence-based ACOG
RATIONALE:
Evidence-based: Naegele's rule LMP add 1 year subtract 3 months add 7 days Jan 15 2026 plus 1 year 2027 minus 3 months Oct 15 2026 plus 7 days Oct 22 2026
ACOG recommends first trimester ultrasound most accurate if discrepancy greater than 7 days.
Question 2: Q2: Fundal height assessment evidence-based gestational age?
A. Only symphysis pubis always
B. Only at xiphoid always
C. 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus 20 cm 36 weeks xiphoid McDonald rule cm equals weeks plus minus 2 after 20
weeks
D. No correlation gestational age
CORRECT ANSWER: C. 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus 20 cm 36 weeks xiphoid McDonald rule cm equals
weeks plus minus 2 after 20 weeks
RATIONALE:
Evidence-based: Fundal height 12 weeks symphysis pubis 16 weeks halfway 20 weeks umbilicus McDonald rule after 20 weeks fundal height cm approximately equals
gestational weeks plus minus 2 cm discrepancy suggests IUGR macrosomia multiples poly/oligo.
Question 3: Q3: Prenatal screening first trimester evidence-based labs?
A. Only CBC needed
B. Only blood type needed
C. No labs evidence-based
D. Blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B urine culture GC chlamydia evidence-based USPSTF
CORRECT ANSWER: D. Blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B urine culture GC chlamydia
evidence-based USPSTF
RATIONALE:
Evidence-based prenatal labs per ACOG USPSTF first visit blood type Rh antibody screen CBC Hgb Hct rubella immunity syphilis RPR HIV hep B surface antigen urine
culture GC chlamydia TB if risk TSH if indicated.
Question 4: Q4: True vs false labor evidence-based differentiation?
A. True labor irregular no change
B. True labor regular increase frequency intensity duration with walking cervical effacement dilation false labor Braxton Hicks irregular no cervical change
dehydration rest improves evidence-based Friedman curve
C. False labor regular with change
D. No difference evidence
CORRECT ANSWER: B. True labor regular increase frequency intensity duration with walking cervical effacement dilation false labor Braxton
Hicks irregular no cervical change dehydration rest improves evidence-based Friedman curve
RATIONALE:
Evidence-based: True labor regular contractions increase frequency intensity duration with ambulation cervical change effacement dilation descent false labor irregular no
cervical change dehydration rest improves Friedman curve abnormal if protracted.
Question 5: Q5: Labor stages evidence-based duration primip vs multip?
A. Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr with epidural 4 hr multip 2 hr with epidural 3
hr third placenta up to 30 min fourth 1-4 hr recovery evidence-based ACOG 2014
B. Only stage 1 exists
C. Only stage 2 exists
D. No stages evidence
CORRECT ANSWER: A. Stage 1 0-10 cm latent 0-6 slow active 6-10 rapid second stage 10 cm to delivery pushing primip up to 3 hr with
epidural 4 hr multip 2 hr with epidural 3 hr third placenta up to 30 min fourth 1-4 hr recovery evidence-based ACOG 2014
RATIONALE:
Evidence-based ACOG 2014: Stage 1 latent 0-6 cm slow active 6-10 cm rapid second stage pushing primip up to 3 hr 4 hr with epidural multip up to 2 hr 3 hr with epidural
third placenta up to 30 min fourth recovery fundus vitals lochia.
Question 6: Q6: FHR baseline variability evidence-based NICHD categories?
A. Baseline 180-200 normal always
B. Baseline 80 normal
C. Baseline 110-160 moderate variability 6-25 reassuring Category I normal Category II indeterminate Category III abnormal absent variability with
recurrent late variable bradycardia requires intervention
D. No categories evidence
CORRECT ANSWER: C. Baseline 110-160 moderate variability 6-25 reassuring Category I normal Category II indeterminate Category III
abnormal absent variability with recurrent late variable bradycardia requires intervention
RATIONALE:
Evidence-based NICHD: FHR baseline 110-160 moderate variability 6-25 reassuring accelerations 15 bpm 15 sec Category I normal Category II indeterminate Category
III abnormal absent variability plus recurrent late variable decelerations bradycardia sinusoidal requires urgent intervention.
Question 7: Q7: VEAL CHOP evidence-based deceleration interventions?
A. Early cord compression
Page 2 - NSG 432 Exam 2 200Q 2026/2027 Newest
, B. Variable placental insufficiency
C. Late head compression
D. Variable cord compression reposition O2 stop oxytocin Early head compression benign no action Late placental insufficiency reposition O2 stop
oxytocin IV fluids evidence-based AWHONN
CORRECT ANSWER: D. Variable cord compression reposition O2 stop oxytocin Early head compression benign no action Late placental
insufficiency reposition O2 stop oxytocin IV fluids evidence-based AWHONN
RATIONALE:
Evidence-based VEAL CHOP Variable cord compression Early head compression Accelerated OK Late placental insufficiency interventions variable reposition lateral O2
10 L stop oxytocin tocolytic amnioinfusion Early benign Late reposition O2 stop oxytocin IV fluids prepare delivery.
Question 8: Q8: Epidural anesthesia evidence-based nursing considerations?
A. Hypertension most common
B. Hypotension most common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased urge fever coagulation check
platelets evidence-based anesthesia guidelines
C. No hypotension risk
D. Only hypertension risk
CORRECT ANSWER: B. Hypotension most common sympathetic blockade preload 500-1000 mL LR monitor BP bladder distension decreased
urge fever coagulation check platelets evidence-based anesthesia guidelines
RATIONALE:
Evidence-based: Epidural sympathetic blockade hypotension most common preload 500-1000 mL LR monitor BP q2-5 min bladder distension decreased urge sensation
fever thermoregulation coagulation check platelets less than 100K contraindicated.
Question 9: Q9: Oxytocin administration high alert evidence-based protocol?
A. High alert dilute IV pump discontinue if tachysystole greater than 5 contractions 10 min or contraction greater than 2 min or relaxation less than 30 sec
or Category II III FHR reposition O2 IV fluids notify provider evidence-based ACOG
B. Bolus IV push quickly
C. No monitoring needed
D. Continue even with tachysystole
CORRECT ANSWER: A. High alert dilute IV pump discontinue if tachysystole greater than 5 contractions 10 min or contraction greater than 2
min or relaxation less than 30 sec or Category II III FHR reposition O2 IV fluids notify provider evidence-based ACOG
RATIONALE:
Evidence-based high alert oxytocin dilute infusion pump monitor uterine activity tachysystole greater than 5 contractions 10 min or contraction greater than 2 min or
relaxation less than 30 sec or Category II III FHR discontinue reposition O2 10 L IV fluids left lateral notify provider.
Question 10: Q10: Preeclampsia severe features evidence-based criteria ACOG 2020?
A. No labs criteria evidence
B. BP 120/80 severe
C. BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double liver enzymes twice normal pulmonary edema
severe headache visual scotoma evidence-based
D. Only edema criteria
CORRECT ANSWER: C. BP greater than or equal to 160/110 platelets less than 100K creatinine greater than 1.1 or double liver enzymes twice
normal pulmonary edema severe headache visual scotoma evidence-based
RATIONALE:
Evidence-based ACOG 2020: Preeclampsia severe features BP greater than or equal to 160/110 on 2 occasions 4 hr apart platelets less than 100K creatinine greater
than 1.1 or doubling AST ALT twice normal pulmonary edema severe headache visual disturbances.
Page 3 - NSG 432 Exam 2 200Q 2026/2027 Newest
, Question 11: Q11: MgSO4 administration toxicity antidote evidence-based?
A. No toxicity monitoring
B. No loading needed
C. No antidote
D. Loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs RR less than 12 urine less than 30 mL/hr
decreased LOC cardiac arrest antidote calcium gluconate 1 g or calcium chloride 10 mL 10 percent evidence-based
CORRECT ANSWER: D. Loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL toxicity loss DTRs RR less than 12
urine less than 30 mL/hr decreased LOC cardiac arrest antidote calcium gluconate 1 g or calcium chloride 10 mL 10 percent evidence-based
RATIONALE:
Evidence-based: MgSO4 loading 4-6 g IV over 20-30 min maintenance 1-2 g/hr therapeutic 4.8-8.4 mg/dL monitor DTRs RR urine output LOC toxicity loss DTRs RR less
than 12 urine less than 30 mL/hr respiratory depression cardiac arrest antidote calcium gluconate 1 g IV slow.
Question 12: Q12: Postpartum hemorrhage 4 Ts evidence-based management?
A. Only tone
B. Tone atony most common Tissue retained Trauma laceration Thrombin coagulopathy management fundal massage oxytocin 30 units LR empty
bladder quantify blood loss TXA within 3 hr evidence-based WHO WOMAN trial
C. Only tissue
D. No management evidence
CORRECT ANSWER: B. Tone atony most common Tissue retained Trauma laceration Thrombin coagulopathy management fundal massage
oxytocin 30 units LR empty bladder quantify blood loss TXA within 3 hr evidence-based WHO WOMAN trial
RATIONALE:
Evidence-based: PPH 4 Ts Tone atony most common Tissue retained placenta accreta Trauma laceration hematoma Thrombin DIC management fundal massage boggy
fundus oxytocin 30 units LR methylergonovine if not HTN hemabate if not asthma misoprostol TXA tranexamic acid 1 g IV within 3 hr WHO WOMAN trial reduces mortality
empty bladder QBL quantify blood loss.
Question 13: Q13: Fundal assessment postpartum evidence-based expected?
A. Fundus firm midline at umbilicus 1 hr after delivery descends 1 cm per day involution 10 days in pelvis boggy fundus massage support lower segment
full bladder displaces high deviated evidence-based
B. Fundus high deviated full bladder normal no intervention
C. Fundus boggy no massage evidence
D. Fundus at xiphoid 1 hr normal
CORRECT ANSWER: A. Fundus firm midline at umbilicus 1 hr after delivery descends 1 cm per day involution 10 days in pelvis boggy fundus
massage support lower segment full bladder displaces high deviated evidence-based
RATIONALE:
Evidence-based: Fundus firm midline at umbilicus or 1-2 cm below 1 hr postpartum descends 1 cm per day involution 10 days in pelvis boggy fundus massage support
lower segment full bladder displaces high deviated lochia rubra serosa alba assessment.
Question 14: Q14: Lochia assessment abnormal evidence-based?
A. Foul odor normal
B. Lochia alba day 1 normal
C. Rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive soaking pad less than 15 min large
clots greater than quarter size abnormal evidence-based
D. Large clots normal evidence
CORRECT ANSWER: C. Rubra days 1-3 red serosa days 4-10 pink brown alba days 11-6 weeks yellow white foul odor infection excessive
soaking pad less than 15 min large clots greater than quarter size abnormal evidence-based
RATIONALE:
Evidence-based: Lochia rubra red days 1-3 serosa pink brown days 4-10 alba yellow white days 11-6 weeks foul odor indicates infection endometritis excessive bleeding
soaking pad less than 15 min large clots greater than quarter size abnormal notify provider.
Question 15: Q15: APGAR scoring evidence-based timing interpretation?
A. Only appearance matters
B. Only 1 min needed
C. No scoring evidence
D. 0-2 each Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 7-10 normal 4-6 moderate resuscitation 0-3 severe
asphyxia at 1 and 5 min extended 10 15 20 min if less than 7 evidence-based NRP
CORRECT ANSWER: D. 0-2 each Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 7-10 normal 4-6
moderate resuscitation 0-3 severe asphyxia at 1 and 5 min extended 10 15 20 min if less than 7 evidence-based NRP
RATIONALE:
Evidence-based NRP: APGAR Appearance color pulse HR grimace reflex irritability activity muscle tone respiration 0-2 each total 10 at 1 and 5 min 7-10 normal 4-6
moderate resuscitation 0-3 severe asphyxia extended 10 15 20 min if less than 7.
Question 16: Q16: Newborn thermoregulation evidence-based 4 mechanisms prevention?
A. Only conduction
B. Conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects windows prevention skin-to-skin
warm blankets hat dry immediately evidence-based WHO warm chain
C. Only convection
D. Only radiation
CORRECT ANSWER: B. Conduction direct contact cold surface convection air currents evaporation wet amniotic fluid radiation cold objects
windows prevention skin-to-skin warm blankets hat dry immediately evidence-based WHO warm chain
RATIONALE:
Page 4 - NSG 432 Exam 2 200Q 2026/2027 Newest
