NSG 3500 Maternal Exam 1 | Questions and
Answers with Rationales | 2026/2027
Updated | 100% Correct - Galen College of
Nursing.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
95 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses foundational and applied knowledge in maternal-newborn nursing, including antepartum,
intrapartum, postpartum, and newborn care. It emphasizes physiologic adaptations, pharmacologic
interventions, fetal surveillance, and evidence-based nursing management of normal and complicated
pregnancies.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 77% (standard for Galen College of Nursing).
HIGHP - Page 1 of 31
,1. A pregnant client at 34 weeks' gestation reports a sudden gush of clear fluid from the
vagina. Which assessment finding best confirms rupture of membranes?
[ ] A. Fern test showing ferning pattern under microscopy
[ ] B. Nitrazine paper turning yellow
[ ] C. Presence of leukocytes on wet mount
[ ] D. Fundal height increase of 2 cm
CORRECT: A. Fern test showing ferning pattern under microscopy
The fern test detects amniotic fluid crystallization due to sodium chloride and proteins, producing a fern-like
pattern; it is a reliable confirmation of ROM. Nitrazine turns blue with alkaline amniotic fluid, not yellow.
Leukocytes indicate infection, not ROM. Fundal height changes are unrelated to membrane rupture.
2. A laboring client receiving oxytocin has a contraction lasting 95 seconds with a fetal
heart rate showing late decelerations. What is the nurse's priority action?
[ ] A. Increase oxytocin rate to strengthen contractions
[ ] B. Discontinue oxytocin and administer oxygen
[ ] C. Position client supine and monitor closely
[ ] D. Document findings and reassess in 30 minutes
CORRECT: B. Discontinue oxytocin and administer oxygen
Late decelerations with prolonged contractions indicate uteroplacental insufficiency; stopping oxytocin and
giving oxygen improves fetal oxygenation. Increasing oxytocin worsens the condition. Supine positioning can
cause supine hypotension. Delayed reassessment is unsafe.
3. Which statement by a postpartum client prescribed methylergonovine indicates a need
for further teaching?
[ ] A. I will report any severe cramping or headache.
[ ] B. I should avoid breastfeeding while taking this.
[ ] C. This medication helps prevent bleeding after delivery.
[ ] D. I will take it with food to reduce nausea.
CORRECT: B. I should avoid breastfeeding while taking this.
Methylergonovine is compatible with breastfeeding and does not require avoidance; it is used to prevent
postpartum hemorrhage. The other statements reflect correct understanding of side effects, purpose, and
administration.
4. A client at 36 weeks' gestation with severe preeclampsia is receiving magnesium
sulfate. Which assessment finding requires immediate intervention?
[ ] A. Respiratory rate of 12 breaths/min
[ ] B. Deep tendon reflexes 2+
HIGHP - Page 2 of 31
, [ ] C. Urine output of 20 mL/hr
[ ] D. Serum magnesium level of 4 mg/dL
CORRECT: C. Urine output of 20 mL/hr
Urine output <30 mL/hr indicates possible magnesium toxicity and requires stopping the infusion and
notifying the provider. Respiratory rate of 12 is acceptable, reflexes 2+ are normal, and a magnesium level of
4 mg/dL is therapeutic (normal 4-7 mg/dL).
5. A nurse is reviewing the electronic fetal monitor tracing and notes a pattern of variable
decelerations. Which intervention should the nurse implement first?
[ ] A. Administer a tocolytic agent
[ ] B. Change the client's position
[ ] C. Increase intravenous fluid rate
[ ] D. Prepare for immediate cesarean birth
CORRECT: B. Change the client's position
Variable decelerations are typically caused by umbilical cord compression; repositioning the client (e.g.,
side-lying, knee-chest) is the first-line intervention. Tocolytic agents are not indicated. IV fluids may help but
are not first. Cesarean is reserved for non-resolving patterns.
6. A client in the first trimester reports nausea and vomiting. Which recommendation is
most appropriate?
[ ] A. Eat three large meals daily
[ ] B. Consume dry crackers before rising
[ ] C. Drink fluids with meals
[ ] D. Avoid ginger-containing foods
CORRECT: B. Consume dry crackers before rising
Eating dry crackers before getting out of bed helps reduce morning nausea by stabilizing blood glucose.
Large meals, fluids with meals, and avoiding ginger (which can help) are not recommended.
7. Which finding in a newborn requires immediate nursing intervention?
[ ] A. Heart rate of 130 beats/min
[ ] B. Respiratory rate of 70 breaths/min
[ ] C. Axillary temperature of 36.8°C
[ ] D. Blood glucose of 50 mg/dL
CORRECT: B. Respiratory rate of 70 breaths/min
A respiratory rate >60 breaths/min in a newborn may indicate respiratory distress and requires immediate
evaluation. Heart rate of 130, temperature of 36.8°C, and glucose of 50 mg/dL are within normal limits.
HIGHP - Page 3 of 31
, 8. A postpartum client is diagnosed with endometritis. Which assessment finding is most
consistent with this condition?
[ ] A. Fundus firm at the umbilicus
[ ] B. Foul-smelling lochia and fever
[ ] C. Bilateral breast engorgement
[ ] D. Painful, reddened calf area
CORRECT: B. Foul-smelling lochia and fever
Endometritis presents with fever, uterine tenderness, and foul-smelling lochia. A firm fundus is normal. Breast
engorgement indicates breast fullness. Calf pain suggests deep vein thrombosis.
9. A nurse is teaching a client about preconception health. Which statement indicates
correct understanding?
[ ] A. I should take folic acid 400 mcg daily.
[ ] B. I can continue my isotretinoin for acne.
[ ] C. I need to avoid all exercise.
[ ] D. I should double my caffeine intake.
CORRECT: A. I should take folic acid 400 mcg daily.
Folic acid 400 mcg daily is recommended to prevent neural tube defects. Isotretinoin is teratogenic and must
be discontinued. Moderate exercise is encouraged. Caffeine should be limited, not increased.
10. A client at 10 weeks' gestation reports severe nausea and vomiting, and the provider
suspects hyperemesis gravidarum. Which laboratory finding would the nurse anticipate as
most consistent with this diagnosis?
[ ] A. Elevated serum potassium with metabolic alkalosis
[ ] B. Decreased urine specific gravity with hypernatremia
[ ] C. Elevated urine ketones with hypokalemia and metabolic alkalosis
[ ] D. Elevated hemoglobin with respiratory acidosis
CORRECT: C. Elevated urine ketones with hypokalemia and metabolic alkalosis
Hyperemesis gravidarum causes prolonged vomiting leading to dehydration, starvation ketosis (elevated
urine ketones), loss of gastric hydrochloric acid (hypochloremic metabolic alkalosis), and potassium loss
(hypokalemia). Elevated potassium, hypernatremia, and respiratory acidosis are not characteristic findings of
this condition.
11. Which physiologic adaptation of pregnancy increases a client's risk for supine
hypotensive syndrome during the second and third trimesters?
[ ] A. Increased glomerular filtration rate
[ ] B. Compression of the inferior vena cava by the gravid uterus
HIGHP - Page 4 of 31
Answers with Rationales | 2026/2027
Updated | 100% Correct - Galen College of
Nursing.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
95 exam-style multiple-choice questions. Each question includes the correct answer and a complete rationale
for focused revision.
COVERAGE
This exam assesses foundational and applied knowledge in maternal-newborn nursing, including antepartum,
intrapartum, postpartum, and newborn care. It emphasizes physiologic adaptations, pharmacologic
interventions, fetal surveillance, and evidence-based nursing management of normal and complicated
pregnancies.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 77% (standard for Galen College of Nursing).
HIGHP - Page 1 of 31
,1. A pregnant client at 34 weeks' gestation reports a sudden gush of clear fluid from the
vagina. Which assessment finding best confirms rupture of membranes?
[ ] A. Fern test showing ferning pattern under microscopy
[ ] B. Nitrazine paper turning yellow
[ ] C. Presence of leukocytes on wet mount
[ ] D. Fundal height increase of 2 cm
CORRECT: A. Fern test showing ferning pattern under microscopy
The fern test detects amniotic fluid crystallization due to sodium chloride and proteins, producing a fern-like
pattern; it is a reliable confirmation of ROM. Nitrazine turns blue with alkaline amniotic fluid, not yellow.
Leukocytes indicate infection, not ROM. Fundal height changes are unrelated to membrane rupture.
2. A laboring client receiving oxytocin has a contraction lasting 95 seconds with a fetal
heart rate showing late decelerations. What is the nurse's priority action?
[ ] A. Increase oxytocin rate to strengthen contractions
[ ] B. Discontinue oxytocin and administer oxygen
[ ] C. Position client supine and monitor closely
[ ] D. Document findings and reassess in 30 minutes
CORRECT: B. Discontinue oxytocin and administer oxygen
Late decelerations with prolonged contractions indicate uteroplacental insufficiency; stopping oxytocin and
giving oxygen improves fetal oxygenation. Increasing oxytocin worsens the condition. Supine positioning can
cause supine hypotension. Delayed reassessment is unsafe.
3. Which statement by a postpartum client prescribed methylergonovine indicates a need
for further teaching?
[ ] A. I will report any severe cramping or headache.
[ ] B. I should avoid breastfeeding while taking this.
[ ] C. This medication helps prevent bleeding after delivery.
[ ] D. I will take it with food to reduce nausea.
CORRECT: B. I should avoid breastfeeding while taking this.
Methylergonovine is compatible with breastfeeding and does not require avoidance; it is used to prevent
postpartum hemorrhage. The other statements reflect correct understanding of side effects, purpose, and
administration.
4. A client at 36 weeks' gestation with severe preeclampsia is receiving magnesium
sulfate. Which assessment finding requires immediate intervention?
[ ] A. Respiratory rate of 12 breaths/min
[ ] B. Deep tendon reflexes 2+
HIGHP - Page 2 of 31
, [ ] C. Urine output of 20 mL/hr
[ ] D. Serum magnesium level of 4 mg/dL
CORRECT: C. Urine output of 20 mL/hr
Urine output <30 mL/hr indicates possible magnesium toxicity and requires stopping the infusion and
notifying the provider. Respiratory rate of 12 is acceptable, reflexes 2+ are normal, and a magnesium level of
4 mg/dL is therapeutic (normal 4-7 mg/dL).
5. A nurse is reviewing the electronic fetal monitor tracing and notes a pattern of variable
decelerations. Which intervention should the nurse implement first?
[ ] A. Administer a tocolytic agent
[ ] B. Change the client's position
[ ] C. Increase intravenous fluid rate
[ ] D. Prepare for immediate cesarean birth
CORRECT: B. Change the client's position
Variable decelerations are typically caused by umbilical cord compression; repositioning the client (e.g.,
side-lying, knee-chest) is the first-line intervention. Tocolytic agents are not indicated. IV fluids may help but
are not first. Cesarean is reserved for non-resolving patterns.
6. A client in the first trimester reports nausea and vomiting. Which recommendation is
most appropriate?
[ ] A. Eat three large meals daily
[ ] B. Consume dry crackers before rising
[ ] C. Drink fluids with meals
[ ] D. Avoid ginger-containing foods
CORRECT: B. Consume dry crackers before rising
Eating dry crackers before getting out of bed helps reduce morning nausea by stabilizing blood glucose.
Large meals, fluids with meals, and avoiding ginger (which can help) are not recommended.
7. Which finding in a newborn requires immediate nursing intervention?
[ ] A. Heart rate of 130 beats/min
[ ] B. Respiratory rate of 70 breaths/min
[ ] C. Axillary temperature of 36.8°C
[ ] D. Blood glucose of 50 mg/dL
CORRECT: B. Respiratory rate of 70 breaths/min
A respiratory rate >60 breaths/min in a newborn may indicate respiratory distress and requires immediate
evaluation. Heart rate of 130, temperature of 36.8°C, and glucose of 50 mg/dL are within normal limits.
HIGHP - Page 3 of 31
, 8. A postpartum client is diagnosed with endometritis. Which assessment finding is most
consistent with this condition?
[ ] A. Fundus firm at the umbilicus
[ ] B. Foul-smelling lochia and fever
[ ] C. Bilateral breast engorgement
[ ] D. Painful, reddened calf area
CORRECT: B. Foul-smelling lochia and fever
Endometritis presents with fever, uterine tenderness, and foul-smelling lochia. A firm fundus is normal. Breast
engorgement indicates breast fullness. Calf pain suggests deep vein thrombosis.
9. A nurse is teaching a client about preconception health. Which statement indicates
correct understanding?
[ ] A. I should take folic acid 400 mcg daily.
[ ] B. I can continue my isotretinoin for acne.
[ ] C. I need to avoid all exercise.
[ ] D. I should double my caffeine intake.
CORRECT: A. I should take folic acid 400 mcg daily.
Folic acid 400 mcg daily is recommended to prevent neural tube defects. Isotretinoin is teratogenic and must
be discontinued. Moderate exercise is encouraged. Caffeine should be limited, not increased.
10. A client at 10 weeks' gestation reports severe nausea and vomiting, and the provider
suspects hyperemesis gravidarum. Which laboratory finding would the nurse anticipate as
most consistent with this diagnosis?
[ ] A. Elevated serum potassium with metabolic alkalosis
[ ] B. Decreased urine specific gravity with hypernatremia
[ ] C. Elevated urine ketones with hypokalemia and metabolic alkalosis
[ ] D. Elevated hemoglobin with respiratory acidosis
CORRECT: C. Elevated urine ketones with hypokalemia and metabolic alkalosis
Hyperemesis gravidarum causes prolonged vomiting leading to dehydration, starvation ketosis (elevated
urine ketones), loss of gastric hydrochloric acid (hypochloremic metabolic alkalosis), and potassium loss
(hypokalemia). Elevated potassium, hypernatremia, and respiratory acidosis are not characteristic findings of
this condition.
11. Which physiologic adaptation of pregnancy increases a client's risk for supine
hypotensive syndrome during the second and third trimesters?
[ ] A. Increased glomerular filtration rate
[ ] B. Compression of the inferior vena cava by the gravid uterus
HIGHP - Page 4 of 31
