NSG 3500 Maternal Exam 4 review |
Questions and Answers | 2026/2027 Updated
| 100% Correct - Galen College!!
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
48 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses the application of evidence-based nursing care for women and newborns during the
intrapartum and postpartum periods, including fetal monitoring, complications of labor, postpartum
hemorrhage, and newborn transition. It emphasizes clinical judgment, prioritization, and current
ACOG/AWHONN/NRP standards. Items require interpretation of data and selection of safe nursing actions.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75%.
HIGHP - Page 1 of 17
,1. A laboring client at 7 cm dilation suddenly develops a prolonged deceleration to 80 bpm
lasting 3 minutes. What is the nurse's priority initial action?
[ ] A. Administer oxygen at 10 L/min via nonrebreather mask.
[ ] B. Reposition the client to left lateral and increase IV fluids.
[ ] C. Prepare for immediate cesarean birth.
[ ] D. Perform a sterile vaginal exam to check for cord prolapse.
CORRECT: B. Reposition the client to left lateral and increase IV fluids.
Intrauterine resuscitation begins with maternal repositioning (left lateral) and IV fluid bolus to improve
uteroplacental perfusion. Oxygen is no longer routinely recommended unless maternal hypoxemia is present.
Cesarean preparation and vaginal exam follow if the deceleration does not resolve.
2. Which finding in a client 1 hour after a spontaneous vaginal birth requires immediate
follow-up?
[ ] A. Fundus firm at umbilicus, midline
[ ] B. Saturating one peripad within 15 minutes
[ ] C. Lochia rubra with small clots
[ ] D. Perineal edema with mild discomfort
CORRECT: B. Saturating one peripad within 15 minutes
Saturating a peripad in 15 minutes indicates excessive bleeding and possible postpartum hemorrhage,
requiring immediate assessment. A firm midline fundus, small clots, and mild edema are expected findings.
Rapid pad saturation is the key sign of hemorrhage.
3. A newborn at 1 minute of life has heart rate 110, slow irregular respirations, some
flexion of extremities, grimace to suction, and acrocyanosis. What Apgar score should the
nurse assign?
[ ] A. 5
[ ] B. 6
[ ] C. 7
[ ] D. 8
CORRECT: B. 6
Scoring: heart rate 110 = 2, slow irregular respirations = 1, some flexion = 1, grimace = 1, acrocyanosis = 1;
total = 6. This reflects moderate depression requiring continued stimulation and monitoring. Scores of 5, 7, or
8 would misrepresent the components.
4. Which client is at highest risk for developing a postpartum venous thromboembolism?
[ ] A. A client with a history of gestational diabetes controlled by diet
[ ] B. A client who had a cesarean birth after prolonged labor
HIGHP - Page 2 of 17
, [ ] C. A client who is breastfeeding and ambulating frequently
[ ] D. A client with mild preeclampsia who received magnesium sulfate
CORRECT: B. A client who had a cesarean birth after prolonged labor
Cesarean birth, especially after prolonged labor, is a major risk factor for VTE due to immobility, surgical
trauma, and venous stasis. Diet-controlled gestational diabetes, frequent ambulation, and magnesium
therapy are not primary VTE risks. Early ambulation and prophylaxis are key for the high-risk client.
5. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep tendon reflexes. Which action should the nurse take first?
[ ] A. Administer calcium gluconate IV.
[ ] B. Stop the magnesium infusion.
[ ] C. Increase the magnesium infusion rate.
[ ] D. Prepare for immediate delivery.
CORRECT: B. Stop the magnesium infusion.
Signs of magnesium toxicity include respiratory depression and loss of deep tendon reflexes; the first action
is to stop the infusion. Calcium gluconate is the antidote but is given after stopping the infusion. Increasing
the rate would worsen toxicity, and delivery is not the immediate priority.
6. Which statement by a client at 2 weeks postpartum indicates a need for further teaching
about postpartum depression?
[ ] A. I should call my provider if I have thoughts of harming my baby.
[ ] B. It is normal to feel sad for a few days, but it should improve.
[ ] C. I can continue breastfeeding while taking sertraline.
[ ] D. I should avoid all physical activity until my 6-week checkup.
CORRECT: D. I should avoid all physical activity until my 6-week checkup.
Physical activity is encouraged postpartum as tolerated; avoiding all activity is incorrect. Reporting harmful
thoughts, recognizing transient baby blues, and continuing breastfeeding on sertraline are accurate. This
statement indicates a need for further teaching.
7. A newborn is 30 minutes old and has not yet passed meconium. Which assessment
finding is most concerning?
[ ] A. Abdominal distension with bilious emesis
[ ] B. Heart rate of 120 bpm
[ ] C. Respiratory rate of 50/min
[ ] D. Axillary temperature of 97.8°F (36.6°C)
HIGHP - Page 3 of 17
Questions and Answers | 2026/2027 Updated
| 100% Correct - Galen College!!
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
48 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses the application of evidence-based nursing care for women and newborns during the
intrapartum and postpartum periods, including fetal monitoring, complications of labor, postpartum
hemorrhage, and newborn transition. It emphasizes clinical judgment, prioritization, and current
ACOG/AWHONN/NRP standards. Items require interpretation of data and selection of safe nursing actions.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75%.
HIGHP - Page 1 of 17
,1. A laboring client at 7 cm dilation suddenly develops a prolonged deceleration to 80 bpm
lasting 3 minutes. What is the nurse's priority initial action?
[ ] A. Administer oxygen at 10 L/min via nonrebreather mask.
[ ] B. Reposition the client to left lateral and increase IV fluids.
[ ] C. Prepare for immediate cesarean birth.
[ ] D. Perform a sterile vaginal exam to check for cord prolapse.
CORRECT: B. Reposition the client to left lateral and increase IV fluids.
Intrauterine resuscitation begins with maternal repositioning (left lateral) and IV fluid bolus to improve
uteroplacental perfusion. Oxygen is no longer routinely recommended unless maternal hypoxemia is present.
Cesarean preparation and vaginal exam follow if the deceleration does not resolve.
2. Which finding in a client 1 hour after a spontaneous vaginal birth requires immediate
follow-up?
[ ] A. Fundus firm at umbilicus, midline
[ ] B. Saturating one peripad within 15 minutes
[ ] C. Lochia rubra with small clots
[ ] D. Perineal edema with mild discomfort
CORRECT: B. Saturating one peripad within 15 minutes
Saturating a peripad in 15 minutes indicates excessive bleeding and possible postpartum hemorrhage,
requiring immediate assessment. A firm midline fundus, small clots, and mild edema are expected findings.
Rapid pad saturation is the key sign of hemorrhage.
3. A newborn at 1 minute of life has heart rate 110, slow irregular respirations, some
flexion of extremities, grimace to suction, and acrocyanosis. What Apgar score should the
nurse assign?
[ ] A. 5
[ ] B. 6
[ ] C. 7
[ ] D. 8
CORRECT: B. 6
Scoring: heart rate 110 = 2, slow irregular respirations = 1, some flexion = 1, grimace = 1, acrocyanosis = 1;
total = 6. This reflects moderate depression requiring continued stimulation and monitoring. Scores of 5, 7, or
8 would misrepresent the components.
4. Which client is at highest risk for developing a postpartum venous thromboembolism?
[ ] A. A client with a history of gestational diabetes controlled by diet
[ ] B. A client who had a cesarean birth after prolonged labor
HIGHP - Page 2 of 17
, [ ] C. A client who is breastfeeding and ambulating frequently
[ ] D. A client with mild preeclampsia who received magnesium sulfate
CORRECT: B. A client who had a cesarean birth after prolonged labor
Cesarean birth, especially after prolonged labor, is a major risk factor for VTE due to immobility, surgical
trauma, and venous stasis. Diet-controlled gestational diabetes, frequent ambulation, and magnesium
therapy are not primary VTE risks. Early ambulation and prophylaxis are key for the high-risk client.
5. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep tendon reflexes. Which action should the nurse take first?
[ ] A. Administer calcium gluconate IV.
[ ] B. Stop the magnesium infusion.
[ ] C. Increase the magnesium infusion rate.
[ ] D. Prepare for immediate delivery.
CORRECT: B. Stop the magnesium infusion.
Signs of magnesium toxicity include respiratory depression and loss of deep tendon reflexes; the first action
is to stop the infusion. Calcium gluconate is the antidote but is given after stopping the infusion. Increasing
the rate would worsen toxicity, and delivery is not the immediate priority.
6. Which statement by a client at 2 weeks postpartum indicates a need for further teaching
about postpartum depression?
[ ] A. I should call my provider if I have thoughts of harming my baby.
[ ] B. It is normal to feel sad for a few days, but it should improve.
[ ] C. I can continue breastfeeding while taking sertraline.
[ ] D. I should avoid all physical activity until my 6-week checkup.
CORRECT: D. I should avoid all physical activity until my 6-week checkup.
Physical activity is encouraged postpartum as tolerated; avoiding all activity is incorrect. Reporting harmful
thoughts, recognizing transient baby blues, and continuing breastfeeding on sertraline are accurate. This
statement indicates a need for further teaching.
7. A newborn is 30 minutes old and has not yet passed meconium. Which assessment
finding is most concerning?
[ ] A. Abdominal distension with bilious emesis
[ ] B. Heart rate of 120 bpm
[ ] C. Respiratory rate of 50/min
[ ] D. Axillary temperature of 97.8°F (36.6°C)
HIGHP - Page 3 of 17
