NSG 3500 Maternal Exam 2 Review |
Questions and Answers | 2026/27 Updated
Complete - Galen College.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
88 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 the intrapartum and postpartum periods, including fetal monitoring,
labor management, obstetric emergencies, postpartum complications, and newborn transition. Questions
emphasize clinical judgment, prioritization, and evidence-based maternal-newborn care aligned with current
ACOG, AWHONN, and NRP standards.
STUDY GUIDE
Recommended duration: 90 minutes. Passing target: 75%.
HIGHP - Page 1 of 30
,1. A laboring patient at 6 cm dilation suddenly has a fetal heart rate pattern showing a
prolonged deceleration to 80 bpm lasting 90 seconds. Which action should the nurse take
first?
[ ] A. Administer oxygen at 10 L/min via nonrebreather mask.
[ ] B. Reposition the patient to left lateral and stop oxytocin infusion.
[ ] C. Notify the provider and prepare for immediate cesarean birth.
[ ] D. Perform a sterile vaginal exam to assess for cord prolapse.
CORRECT: B. Reposition the patient to left lateral and stop oxytocin infusion.
The priority is to restore uteroplacental perfusion by relieving cord compression or uterine hyperstimulation;
repositioning and stopping oxytocin are first-line intrauterine resuscitation measures. Oxygen and provider
notification follow, and vaginal exam is indicated only if cord prolapse is suspected after initial repositioning.
2. Which statement by a postpartum patient indicates a need for further teaching about
prevention of venous thromboembolism after cesarean birth?
[ ] A. I will ambulate as soon as I am able.
[ ] B. I will drink plenty of fluids throughout the day.
[ ] C. I will sit with my legs crossed for comfort.
[ ] D. I will perform ankle pumps while in bed.
CORRECT: C. I will sit with my legs crossed for comfort.
Crossing the legs impedes venous return and increases VTE risk; it should be avoided. Ambulation,
hydration, and ankle exercises are all appropriate preventive measures after cesarean birth.
3. A patient receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep tendon reflexes. Which action should the nurse anticipate?
[ ] A. Increase the magnesium sulfate infusion rate.
[ ] B. Administer calcium gluconate intravenously.
[ ] C. Prepare for immediate delivery.
[ ] D. Administer oxytocin to augment labor.
CORRECT: B. Administer calcium gluconate intravenously.
Respiratory depression and loss of deep tendon reflexes indicate magnesium toxicity; the antidote is calcium
gluconate. Increasing the infusion would worsen toxicity, and delivery or oxytocin do not address the toxicity.
4. Which finding in a newborn at 1 hour of life requires immediate nursing intervention?
[ ] A. Heart rate 130 bpm
[ ] B. Respiratory rate 70 breaths/min
[ ] C. Axillary temperature 36.8°C
HIGHP - Page 2 of 30
, [ ] D. Blood glucose 50 mg/dL
CORRECT: B. Respiratory rate 70 breaths/min
A respiratory rate above 60 breaths/min in a newborn may indicate respiratory distress and requires
immediate evaluation. The other findings are within normal newborn ranges.
5. A patient is experiencing a postpartum hemorrhage after vaginal delivery. The uterus is
boggy, and the bladder is distended. Which action should the nurse take first?
[ ] A. Perform fundal massage and empty the bladder.
[ ] B. Administer methylergonovine intramuscularly.
[ ] C. Prepare for blood transfusion.
[ ] D. Insert a large-bore IV line for fluid resuscitation.
CORRECT: A. Perform fundal massage and empty the bladder.
Uterine atony is the most common cause of postpartum hemorrhage; fundal massage and bladder emptying
are the first-line interventions. Medications and IV access are important but follow initial massage and bladder
emptying.
6. Which assessment finding in a patient 24 hours after cesarean birth should the nurse
report to the provider immediately?
[ ] A. Incisional pain rated 4/10
[ ] B. Temperature 38.2°C
[ ] C. Serosanguineous lochia rubra
[ ] D. Shallow breathing due to pain
CORRECT: B. Temperature 38.2°C
A temperature above 38°C after 24 hours may indicate infection and should be reported. Incisional pain,
lochia rubra, and shallow breathing are expected findings that require nursing management but not
immediate provider notification.
7. Which statement by a patient at 28 weeks gestation indicates understanding of warning
signs that require immediate reporting?
[ ] A. I should report a sudden gush of fluid from my vagina.
[ ] B. I should report occasional heartburn after meals.
[ ] C. I should report mild ankle swelling in the evening.
[ ] D. I should report Braxton Hicks contractions that stop with rest.
CORRECT: A. I should report a sudden gush of fluid from my vagina.
A sudden gush of fluid may indicate premature rupture of membranes and requires immediate evaluation.
Heartburn, mild ankle swelling, and Braxton Hicks contractions that resolve are common discomforts of
HIGHP - Page 3 of 30
Questions and Answers | 2026/27 Updated
Complete - Galen College.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
88 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 the intrapartum and postpartum periods, including fetal monitoring,
labor management, obstetric emergencies, postpartum complications, and newborn transition. Questions
emphasize clinical judgment, prioritization, and evidence-based maternal-newborn care aligned with current
ACOG, AWHONN, and NRP standards.
STUDY GUIDE
Recommended duration: 90 minutes. Passing target: 75%.
HIGHP - Page 1 of 30
,1. A laboring patient at 6 cm dilation suddenly has a fetal heart rate pattern showing a
prolonged deceleration to 80 bpm lasting 90 seconds. Which action should the nurse take
first?
[ ] A. Administer oxygen at 10 L/min via nonrebreather mask.
[ ] B. Reposition the patient to left lateral and stop oxytocin infusion.
[ ] C. Notify the provider and prepare for immediate cesarean birth.
[ ] D. Perform a sterile vaginal exam to assess for cord prolapse.
CORRECT: B. Reposition the patient to left lateral and stop oxytocin infusion.
The priority is to restore uteroplacental perfusion by relieving cord compression or uterine hyperstimulation;
repositioning and stopping oxytocin are first-line intrauterine resuscitation measures. Oxygen and provider
notification follow, and vaginal exam is indicated only if cord prolapse is suspected after initial repositioning.
2. Which statement by a postpartum patient indicates a need for further teaching about
prevention of venous thromboembolism after cesarean birth?
[ ] A. I will ambulate as soon as I am able.
[ ] B. I will drink plenty of fluids throughout the day.
[ ] C. I will sit with my legs crossed for comfort.
[ ] D. I will perform ankle pumps while in bed.
CORRECT: C. I will sit with my legs crossed for comfort.
Crossing the legs impedes venous return and increases VTE risk; it should be avoided. Ambulation,
hydration, and ankle exercises are all appropriate preventive measures after cesarean birth.
3. A patient receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep tendon reflexes. Which action should the nurse anticipate?
[ ] A. Increase the magnesium sulfate infusion rate.
[ ] B. Administer calcium gluconate intravenously.
[ ] C. Prepare for immediate delivery.
[ ] D. Administer oxytocin to augment labor.
CORRECT: B. Administer calcium gluconate intravenously.
Respiratory depression and loss of deep tendon reflexes indicate magnesium toxicity; the antidote is calcium
gluconate. Increasing the infusion would worsen toxicity, and delivery or oxytocin do not address the toxicity.
4. Which finding in a newborn at 1 hour of life requires immediate nursing intervention?
[ ] A. Heart rate 130 bpm
[ ] B. Respiratory rate 70 breaths/min
[ ] C. Axillary temperature 36.8°C
HIGHP - Page 2 of 30
, [ ] D. Blood glucose 50 mg/dL
CORRECT: B. Respiratory rate 70 breaths/min
A respiratory rate above 60 breaths/min in a newborn may indicate respiratory distress and requires
immediate evaluation. The other findings are within normal newborn ranges.
5. A patient is experiencing a postpartum hemorrhage after vaginal delivery. The uterus is
boggy, and the bladder is distended. Which action should the nurse take first?
[ ] A. Perform fundal massage and empty the bladder.
[ ] B. Administer methylergonovine intramuscularly.
[ ] C. Prepare for blood transfusion.
[ ] D. Insert a large-bore IV line for fluid resuscitation.
CORRECT: A. Perform fundal massage and empty the bladder.
Uterine atony is the most common cause of postpartum hemorrhage; fundal massage and bladder emptying
are the first-line interventions. Medications and IV access are important but follow initial massage and bladder
emptying.
6. Which assessment finding in a patient 24 hours after cesarean birth should the nurse
report to the provider immediately?
[ ] A. Incisional pain rated 4/10
[ ] B. Temperature 38.2°C
[ ] C. Serosanguineous lochia rubra
[ ] D. Shallow breathing due to pain
CORRECT: B. Temperature 38.2°C
A temperature above 38°C after 24 hours may indicate infection and should be reported. Incisional pain,
lochia rubra, and shallow breathing are expected findings that require nursing management but not
immediate provider notification.
7. Which statement by a patient at 28 weeks gestation indicates understanding of warning
signs that require immediate reporting?
[ ] A. I should report a sudden gush of fluid from my vagina.
[ ] B. I should report occasional heartburn after meals.
[ ] C. I should report mild ankle swelling in the evening.
[ ] D. I should report Braxton Hicks contractions that stop with rest.
CORRECT: A. I should report a sudden gush of fluid from my vagina.
A sudden gush of fluid may indicate premature rupture of membranes and requires immediate evaluation.
Heartburn, mild ankle swelling, and Braxton Hicks contractions that resolve are common discomforts of
HIGHP - Page 3 of 30
