NSG 3500 Maternal Exam 3 Review | and
Answers with Rationales | 2026/2027
Updated | 100% Correct - Galen College.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
50 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses nursing knowledge of high-risk maternal and newborn conditions, including hypertensive
disorders of pregnancy, gestational diabetes, preterm labor, fetal monitoring, labor complications, postpartum
hemorrhage, and newborn transition. Content aligns with the latest ACOG, AWHONN, and NRP guidelines for
safe maternal-newborn care.
STUDY GUIDE
Recommended duration: 2.5 hours. Passing target: 75%.
HIGHP - Page 1 of 18
,1. A patient at 34 weeks' gestation is admitted with severe preeclampsia. Which prescribed
intervention should the nurse question?
[ ] A. Administer magnesium sulfate IV per protocol.
[ ] B. Initiate continuous fetal monitoring.
[ ] C. Administer betamethasone IM for fetal lung maturity.
[ ] D. Restrict oral fluids to 1,000 mL per 24 hours.
CORRECT: D. Restrict oral fluids to 1,000 mL per 24 hours.
Fluid restriction is not recommended in severe preeclampsia and may worsen hemoconcentration and
placental perfusion; maintenance IV fluids are typically given. Magnesium sulfate is standard for seizure
prophylaxis, fetal monitoring is required, and betamethasone is indicated for fetal lung maturity between 24
and 34 weeks. Therefore, option D is the prescription the nurse should question.
2. A patient with type 1 diabetes is in the first stage of labor. Which finding requires
immediate intervention?
[ ] A. Maternal blood glucose 110 mg/dL
[ ] B. Fetal heart rate baseline 140 bpm
[ ] C. Maternal blood glucose 45 mg/dL
[ ] D. Contractions every 3 minutes lasting 50 seconds
CORRECT: C. Maternal blood glucose 45 mg/dL
Maternal hypoglycemia (blood glucose <60 mg/dL) during labor can lead to maternal seizures, altered
consciousness, and fetal compromise; it requires immediate treatment with IV dextrose. A glucose of 110
mg/dL, a baseline FHR of 140 bpm, and the described contraction pattern are within normal limits and do not
require immediate intervention.
3. A patient at 32 weeks' gestation presents with painless, bright red vaginal bleeding.
Which assessment finding is most concerning for placental abruption rather than placenta
previa?
[ ] A. Uterine tenderness and board-like rigidity
[ ] B. Soft, non-tender uterus
[ ] C. Fetal heart rate baseline of 150 bpm
[ ] D. Fundal height appropriate for gestation
CORRECT: A. Uterine tenderness and board-like rigidity
Placental abruption typically presents with painful vaginal bleeding, uterine tenderness, and a rigid or
board-like abdomen due to retroplacental blood accumulation. Placenta previa classically presents with
painless bleeding and a soft, non-tender uterus. The other findings are non-specific and do not differentiate
between the two conditions.
HIGHP - Page 2 of 18
, 4. A laboring patient at 41 weeks' gestation has a fetal heart rate tracing showing recurrent
late decelerations. Which action should the nurse take first?
[ ] A. Increase the oxytocin infusion rate to augment labor.
[ ] B. Reposition the patient to a left lateral position.
[ ] C. Prepare for an immediate cesarean delivery.
[ ] D. Document the finding and continue monitoring.
CORRECT: B. Reposition the patient to a left lateral position.
Late decelerations indicate uteroplacental insufficiency; the first nursing action is to improve placental
perfusion by repositioning the patient laterally, administering oxygen, and increasing IV fluids. Increasing
oxytocin would worsen the insufficiency, cesarean delivery is not the first action, and documentation alone
would delay necessary intervention.
5. A patient receiving magnesium sulfate for preeclampsia has a serum magnesium level
of 8.5 mg/dL. Which assessment finding is most indicative of magnesium toxicity?
[ ] A. Blood pressure 140/90 mm Hg
[ ] B. Respiratory rate of 10 breaths/min
[ ] C. Deep tendon reflexes 2+
[ ] D. Urine output of 50 mL/hr
CORRECT: B. Respiratory rate of 10 breaths/min
A respiratory rate below 12 breaths/min is an early sign of magnesium toxicity, which can progress to
respiratory depression and cardiac arrest. Therapeutic magnesium levels range from 4 to 7 mg/dL; levels
above 8 mg/dL require close monitoring. Blood pressure, reflexes, and urine output are not primary indicators
of magnesium toxicity.
6. A patient at 28 weeks' gestation with gestational diabetes asks about fetal surveillance.
Which test is most appropriate to assess fetal well-being at this gestational age?
[ ] A. Nonstress test (NST) weekly
[ ] B. Contraction stress test (CST)
[ ] C. Biophysical profile (BPP) twice weekly
[ ] D. Amniocentesis for fetal lung maturity
CORRECT: A. Nonstress test (NST) weekly
For gestational diabetes, weekly nonstress testing typically begins at 28-32 weeks to monitor fetal
oxygenation and heart rate reactivity. Contraction stress testing is generally avoided before 32 weeks due to
risks of preterm labor. Biophysical profile is often reserved for higher-risk conditions, and amniocentesis for
lung maturity is not indicated at 28 weeks.
HIGHP - Page 3 of 18
Answers with Rationales | 2026/2027
Updated | 100% Correct - Galen College.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
50 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses nursing knowledge of high-risk maternal and newborn conditions, including hypertensive
disorders of pregnancy, gestational diabetes, preterm labor, fetal monitoring, labor complications, postpartum
hemorrhage, and newborn transition. Content aligns with the latest ACOG, AWHONN, and NRP guidelines for
safe maternal-newborn care.
STUDY GUIDE
Recommended duration: 2.5 hours. Passing target: 75%.
HIGHP - Page 1 of 18
,1. A patient at 34 weeks' gestation is admitted with severe preeclampsia. Which prescribed
intervention should the nurse question?
[ ] A. Administer magnesium sulfate IV per protocol.
[ ] B. Initiate continuous fetal monitoring.
[ ] C. Administer betamethasone IM for fetal lung maturity.
[ ] D. Restrict oral fluids to 1,000 mL per 24 hours.
CORRECT: D. Restrict oral fluids to 1,000 mL per 24 hours.
Fluid restriction is not recommended in severe preeclampsia and may worsen hemoconcentration and
placental perfusion; maintenance IV fluids are typically given. Magnesium sulfate is standard for seizure
prophylaxis, fetal monitoring is required, and betamethasone is indicated for fetal lung maturity between 24
and 34 weeks. Therefore, option D is the prescription the nurse should question.
2. A patient with type 1 diabetes is in the first stage of labor. Which finding requires
immediate intervention?
[ ] A. Maternal blood glucose 110 mg/dL
[ ] B. Fetal heart rate baseline 140 bpm
[ ] C. Maternal blood glucose 45 mg/dL
[ ] D. Contractions every 3 minutes lasting 50 seconds
CORRECT: C. Maternal blood glucose 45 mg/dL
Maternal hypoglycemia (blood glucose <60 mg/dL) during labor can lead to maternal seizures, altered
consciousness, and fetal compromise; it requires immediate treatment with IV dextrose. A glucose of 110
mg/dL, a baseline FHR of 140 bpm, and the described contraction pattern are within normal limits and do not
require immediate intervention.
3. A patient at 32 weeks' gestation presents with painless, bright red vaginal bleeding.
Which assessment finding is most concerning for placental abruption rather than placenta
previa?
[ ] A. Uterine tenderness and board-like rigidity
[ ] B. Soft, non-tender uterus
[ ] C. Fetal heart rate baseline of 150 bpm
[ ] D. Fundal height appropriate for gestation
CORRECT: A. Uterine tenderness and board-like rigidity
Placental abruption typically presents with painful vaginal bleeding, uterine tenderness, and a rigid or
board-like abdomen due to retroplacental blood accumulation. Placenta previa classically presents with
painless bleeding and a soft, non-tender uterus. The other findings are non-specific and do not differentiate
between the two conditions.
HIGHP - Page 2 of 18
, 4. A laboring patient at 41 weeks' gestation has a fetal heart rate tracing showing recurrent
late decelerations. Which action should the nurse take first?
[ ] A. Increase the oxytocin infusion rate to augment labor.
[ ] B. Reposition the patient to a left lateral position.
[ ] C. Prepare for an immediate cesarean delivery.
[ ] D. Document the finding and continue monitoring.
CORRECT: B. Reposition the patient to a left lateral position.
Late decelerations indicate uteroplacental insufficiency; the first nursing action is to improve placental
perfusion by repositioning the patient laterally, administering oxygen, and increasing IV fluids. Increasing
oxytocin would worsen the insufficiency, cesarean delivery is not the first action, and documentation alone
would delay necessary intervention.
5. A patient receiving magnesium sulfate for preeclampsia has a serum magnesium level
of 8.5 mg/dL. Which assessment finding is most indicative of magnesium toxicity?
[ ] A. Blood pressure 140/90 mm Hg
[ ] B. Respiratory rate of 10 breaths/min
[ ] C. Deep tendon reflexes 2+
[ ] D. Urine output of 50 mL/hr
CORRECT: B. Respiratory rate of 10 breaths/min
A respiratory rate below 12 breaths/min is an early sign of magnesium toxicity, which can progress to
respiratory depression and cardiac arrest. Therapeutic magnesium levels range from 4 to 7 mg/dL; levels
above 8 mg/dL require close monitoring. Blood pressure, reflexes, and urine output are not primary indicators
of magnesium toxicity.
6. A patient at 28 weeks' gestation with gestational diabetes asks about fetal surveillance.
Which test is most appropriate to assess fetal well-being at this gestational age?
[ ] A. Nonstress test (NST) weekly
[ ] B. Contraction stress test (CST)
[ ] C. Biophysical profile (BPP) twice weekly
[ ] D. Amniocentesis for fetal lung maturity
CORRECT: A. Nonstress test (NST) weekly
For gestational diabetes, weekly nonstress testing typically begins at 28-32 weeks to monitor fetal
oxygenation and heart rate reactivity. Contraction stress testing is generally avoided before 32 weeks due to
risks of preterm labor. Biophysical profile is often reserved for higher-risk conditions, and amniocentesis for
lung maturity is not indicated at 28 weeks.
HIGHP - Page 3 of 18
