NUR 230 Exam 4
Galen College of Nursing -
OB/Peds
100 Questions & Answers with
Rationales Updated 2026 -
Guarantee Pass
Instructions:
This exam contains 100 multiple-choice questions covering Obstetrics and Pediatric
nursing. Each question includes the correct answer and a detailed Rationale. Review
all questions carefully and understand the Rationale for each correct answer.
Good luck with your studies!
Question 1: A pregnant client at 28 weeks gestation reports sudden onset of
severe headache, visual disturbances, and upper abdominal pain. Her blood
pressure is 162/104 mmHg. What is the nurse's priority action?
A. Administer prescribed antihypertensive medication
B. Place client in left lateral position and notify provider immediately
C. Start IV magnesium sulfate without provider order
D. Prepare client for immediate cesarean birth
Correct Answer B
Rationale: These are classic signs of severe preeclampsia. The priority is to prevent
seizures and placental abruption. Left lateral position improves placental perfusion,
and immediate provider notification is essential. Magnesium sulfate requires a
provider order.
Question 2: The nurse is assessing a newborn 2 hours after birth. Which finding
requires immediate intervention?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 58 breaths/minute
,C. Central cyanosis with grunting retractions
D. Irregular respiratory rhythm with brief pauses
Correct Answer C
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Grunting and retractions are signs of respiratory distress syndrome.
Acrocyanosis is normal in newborns, and periodic breathing with rates 30-60 is
normal.
Question 3: A client in active labor reports the urge to push. The nurse
performs a vaginal examination and finds the cervix is 8 cm dilated, 100%
effaced, and +1 station. What is the appropriate nursing action?
A. Encourage the client to push with contractions
B. Coach the client to use pant-blow breathing to avoid pushing
C. Prepare for immediate delivery
D. Administer oxytocin to speed dilation
Correct Answer B
,Rationale: The client is in transition (8 cm) with premature urge to push. Pushing
before complete dilation (10 cm) can cause cervical edema, lacerations, and
prolonged labor. Pant-blow breathing helps resist the urge to push until fully dilated.
Question 4: Which laboratory value is most important for the nurse to monitor
in a pregnant client with gestational diabetes?
A. Hemoglobin A1C
B. Fasting blood glucose
C. Glycosylated hemoglobin
D. Two-hour postprandial glucose
Correct Answer B
Rationale: Fasting blood glucose is the primary indicator used to diagnose and
monitor gestational diabetes. Target is <95 mg/dL. Postprandial levels are also
monitored, but fasting is most predictive of fetal outcomes and guides insulin therapy.
Question 5: The nurse is caring for a 4-year-old child post-tonsillectomy.
Which intervention is the priority?
A. Offer red-colored popsicles to assess bleeding
B. Encourage coughing to clear secretions
C. Position child on side and monitor for frequent swallowing
D. Administer aspirin for pain relief
Correct Answer C
Rationale: Frequent swallowing in a post-tonsillectomy child indicates hemorrhage.
The child should be positioned on the side to prevent aspiration of blood. Red liquids
mask bleeding, coughing increases bleeding risk, and aspirin is contraindicated due to
bleeding risk.
Question 6: A client at 32 weeks gestation is diagnosed with placenta previa
after sudden, painless vaginal bleeding. What is the priority nursing
intervention?
A. Perform a vaginal examination to assess cervical dilation
B. Prepare the client for immediate vaginal delivery
C. Maintain bed rest and monitor fetal heart rate continuously
D. Administer oxytocin to strengthen contractions
Correct Answer C
Rationale: Placenta previa causes painless bleeding; vaginal exams are
contraindicated as they can cause catastrophic hemorrhage. Management includes
, bed rest, continuous fetal monitoring, and preparation for possible cesarean birth if
bleeding is heavy.
Question 7: The nurse is teaching a new mother about breastfeeding. Which
statement by the mother indicates understanding of feeding cues?
A. 'I should feed my baby every 4 hours on a strict schedule'
B. 'I should wait until my baby cries before offering the breast'
C. 'I should offer the breast when my baby roots or sucks on hands'
D. 'I should only breastfeed for 10 minutes per side'
Correct Answer C
Rationale: Feeding cues include rooting, hand sucking, and lip smacking. Crying is a
late hunger cue. On-demand feeding is recommended over strict schedules, and
feeding duration varies based on infant needs and milk transfer.
Galen College of Nursing -
OB/Peds
100 Questions & Answers with
Rationales Updated 2026 -
Guarantee Pass
Instructions:
This exam contains 100 multiple-choice questions covering Obstetrics and Pediatric
nursing. Each question includes the correct answer and a detailed Rationale. Review
all questions carefully and understand the Rationale for each correct answer.
Good luck with your studies!
Question 1: A pregnant client at 28 weeks gestation reports sudden onset of
severe headache, visual disturbances, and upper abdominal pain. Her blood
pressure is 162/104 mmHg. What is the nurse's priority action?
A. Administer prescribed antihypertensive medication
B. Place client in left lateral position and notify provider immediately
C. Start IV magnesium sulfate without provider order
D. Prepare client for immediate cesarean birth
Correct Answer B
Rationale: These are classic signs of severe preeclampsia. The priority is to prevent
seizures and placental abruption. Left lateral position improves placental perfusion,
and immediate provider notification is essential. Magnesium sulfate requires a
provider order.
Question 2: The nurse is assessing a newborn 2 hours after birth. Which finding
requires immediate intervention?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 58 breaths/minute
,C. Central cyanosis with grunting retractions
D. Irregular respiratory rhythm with brief pauses
Correct Answer C
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate
intervention. Grunting and retractions are signs of respiratory distress syndrome.
Acrocyanosis is normal in newborns, and periodic breathing with rates 30-60 is
normal.
Question 3: A client in active labor reports the urge to push. The nurse
performs a vaginal examination and finds the cervix is 8 cm dilated, 100%
effaced, and +1 station. What is the appropriate nursing action?
A. Encourage the client to push with contractions
B. Coach the client to use pant-blow breathing to avoid pushing
C. Prepare for immediate delivery
D. Administer oxytocin to speed dilation
Correct Answer B
,Rationale: The client is in transition (8 cm) with premature urge to push. Pushing
before complete dilation (10 cm) can cause cervical edema, lacerations, and
prolonged labor. Pant-blow breathing helps resist the urge to push until fully dilated.
Question 4: Which laboratory value is most important for the nurse to monitor
in a pregnant client with gestational diabetes?
A. Hemoglobin A1C
B. Fasting blood glucose
C. Glycosylated hemoglobin
D. Two-hour postprandial glucose
Correct Answer B
Rationale: Fasting blood glucose is the primary indicator used to diagnose and
monitor gestational diabetes. Target is <95 mg/dL. Postprandial levels are also
monitored, but fasting is most predictive of fetal outcomes and guides insulin therapy.
Question 5: The nurse is caring for a 4-year-old child post-tonsillectomy.
Which intervention is the priority?
A. Offer red-colored popsicles to assess bleeding
B. Encourage coughing to clear secretions
C. Position child on side and monitor for frequent swallowing
D. Administer aspirin for pain relief
Correct Answer C
Rationale: Frequent swallowing in a post-tonsillectomy child indicates hemorrhage.
The child should be positioned on the side to prevent aspiration of blood. Red liquids
mask bleeding, coughing increases bleeding risk, and aspirin is contraindicated due to
bleeding risk.
Question 6: A client at 32 weeks gestation is diagnosed with placenta previa
after sudden, painless vaginal bleeding. What is the priority nursing
intervention?
A. Perform a vaginal examination to assess cervical dilation
B. Prepare the client for immediate vaginal delivery
C. Maintain bed rest and monitor fetal heart rate continuously
D. Administer oxytocin to strengthen contractions
Correct Answer C
Rationale: Placenta previa causes painless bleeding; vaginal exams are
contraindicated as they can cause catastrophic hemorrhage. Management includes
, bed rest, continuous fetal monitoring, and preparation for possible cesarean birth if
bleeding is heavy.
Question 7: The nurse is teaching a new mother about breastfeeding. Which
statement by the mother indicates understanding of feeding cues?
A. 'I should feed my baby every 4 hours on a strict schedule'
B. 'I should wait until my baby cries before offering the breast'
C. 'I should offer the breast when my baby roots or sucks on hands'
D. 'I should only breastfeed for 10 minutes per side'
Correct Answer C
Rationale: Feeding cues include rooting, hand sucking, and lip smacking. Crying is a
late hunger cue. On-demand feeding is recommended over strict schedules, and
feeding duration varies based on infant needs and milk transfer.
