NSG 3500 Exam 4 – Nursing Practice:
Maternal Health (Galen College of Nursing)
2025–2026 | Verified Q&A Review with
Clinical Focus
1. A nurse is caring for a client at 36 weeks gestation who reports severe right upper
quadrant pain and visual disturbances. Which condition should the nurse suspect?
✅
A. Placenta previa
B. Preeclampsia with severe features
C. HELLP syndrome
D. Ectopic pregnancy
🩺 Rationale:
● Correct: Preeclampsia with severe features presents with RUQ/epigastric pain due to
liver involvement, visual changes, and hypertension.
● Color Code:
○ 🟩 Key symptom: RUQ pain + vision issues → liver involvement.
○ 🟥 Incorrect: Placenta previa = painless bleeding; HELLP = lab-confirmed (low
platelets, hemolysis).
2. During labor, a fetal heart rate shows late decelerations. What is the nurse’s first
action?
✅
A. Increase Pitocin
B. Turn the client to her left side
, C. Apply scalp electrode
D. Notify the provider immediately
🩺 Rationale:
● Correct: Repositioning improves uteroplacental blood flow.
● Follow-up: Stop oxytocin, administer O₂, increase IV fluids.
● 🟩 Late decels = placental insufficiency → priority is maternal repositioning.
3. A client in active labor requests an epidural. Which assessment must be verified
before the procedure?
✅
A. Fetal heart rate baseline
B. Maternal platelet count
C. Cervical dilation
D. Presence of contractions
🩺 Rationale:
● Correct: Epidurals are contraindicated if platelets <100,000 (risk for epidural
hematoma).
● 🟩 Check coagulation status first.
4. A postpartum client complains of persistent perineal pain unrelieved by analgesics.
The nurse notes firm uterus and no vaginal bleeding. Which finding is suspected?
✅
A. Uterine atony
B. Vaginal hematoma
C. Endometritis
D. Lochia rubra
🩺 Rationale:
● Correct: Firm fundus + pain + minimal bleeding = hematoma.
● 🟥 Uterine atony → boggy uterus + heavy bleeding.
Maternal Health (Galen College of Nursing)
2025–2026 | Verified Q&A Review with
Clinical Focus
1. A nurse is caring for a client at 36 weeks gestation who reports severe right upper
quadrant pain and visual disturbances. Which condition should the nurse suspect?
✅
A. Placenta previa
B. Preeclampsia with severe features
C. HELLP syndrome
D. Ectopic pregnancy
🩺 Rationale:
● Correct: Preeclampsia with severe features presents with RUQ/epigastric pain due to
liver involvement, visual changes, and hypertension.
● Color Code:
○ 🟩 Key symptom: RUQ pain + vision issues → liver involvement.
○ 🟥 Incorrect: Placenta previa = painless bleeding; HELLP = lab-confirmed (low
platelets, hemolysis).
2. During labor, a fetal heart rate shows late decelerations. What is the nurse’s first
action?
✅
A. Increase Pitocin
B. Turn the client to her left side
, C. Apply scalp electrode
D. Notify the provider immediately
🩺 Rationale:
● Correct: Repositioning improves uteroplacental blood flow.
● Follow-up: Stop oxytocin, administer O₂, increase IV fluids.
● 🟩 Late decels = placental insufficiency → priority is maternal repositioning.
3. A client in active labor requests an epidural. Which assessment must be verified
before the procedure?
✅
A. Fetal heart rate baseline
B. Maternal platelet count
C. Cervical dilation
D. Presence of contractions
🩺 Rationale:
● Correct: Epidurals are contraindicated if platelets <100,000 (risk for epidural
hematoma).
● 🟩 Check coagulation status first.
4. A postpartum client complains of persistent perineal pain unrelieved by analgesics.
The nurse notes firm uterus and no vaginal bleeding. Which finding is suspected?
✅
A. Uterine atony
B. Vaginal hematoma
C. Endometritis
D. Lochia rubra
🩺 Rationale:
● Correct: Firm fundus + pain + minimal bleeding = hematoma.
● 🟥 Uterine atony → boggy uterus + heavy bleeding.
