NUR 418 Exam 2 Q&A Childbearing Family Nursing –
Concordia St. Paul (2026/2027)
Childbearing Family Nursing | Key Domains: Intrapartum Care & Pain Management, Postpartum
Adaptation & Complications, Newborn Transition & Immediate Care, High-Risk Childbearing
(Preeclampsia, Preterm Labor, etc.), Newborn Nutrition (Breastfeeding/Bottle-feeding), Postpartum
Psychological Adjustments, and Family Education & Discharge Planning | Expert-Aligned Structure |
Exam-Ready Format
Introduction
This structured NUR 418 Exam 2 for Concordia University, St. Paul for 2026/2027 provides a
focused set of high-quality exam-style questions with correct answers and rationales. It emphasizes
the nursing care of the family during and immediately after childbirth, including the management of
labor, the physiological and psychological transition to parenthood, the care of the normal and
high-risk newborn, and the promotion of family wellness.
Exam Structure:
• Exam 2: (55 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological principle of labor or postpartum recovery, the priority intervention for
a maternal or newborn complication, the key teaching point for breastfeeding or newborn care, and
why alternative options are incorrect, contraindicated, or not the highest priority for the
childbearing family.
1. A client in active labor requests pain relief. She is 6 cm dilated, 100% effaced, and the fetus
is at +1 station. Which method provides pain relief without slowing labor?
A. Epidural anesthesia
B. IV meperidine
C. Nitrous oxide inhalation
D. Pudendal block
,C. Nitrous oxide inhalation
Nitrous oxide provides rapid-onset, self-administered analgesia that does not interfere with uterine
contractions or fetal descent. Epidurals (A) can slow labor and require fetal monitoring. Meperidine
(B) crosses the placenta and may cause neonatal respiratory depression. Pudendal block (D) is used
only for episiotomy or delivery, not labor pain.
2. A postpartum client’s fundus is boggy and located 2 cm above the umbilicus 1 hour after
birth. What is the nurse’s priority action?
A. Administer oxytocin as prescribed
B. Massage the fundus until firm
C. Assess for a full bladder
D. Increase IV fluid rate
B. Massage the fundus until firm
A boggy fundus indicates uterine atony, the leading cause of early postpartum hemorrhage. Immediate
fundal massage stimulates contractions to reduce bleeding. Oxytocin (A) is given after massage if
atony persists. Bladder assessment (C) is done if the fundus is deviated, but firmness is the immediate
concern.
3. A newborn at 1 hour of life has a heart rate of 130 bpm, is crying vigorously, has flexed
extremities, pink body with blue hands/feet, and grimaces to suction. What is the 1-minute
APGAR score?
A. 7
B. 8
C. 9
D. 10
C. 9
, APGAR scoring: Heart rate >100 = 2; Respiratory effort (crying) = 2; Muscle tone (flexed) = 2; Reflex
irritability (grimace) = 2; Color (acrocyanosis) = 1. Total = 9. Acrocyanosis (blue hands/feet) is normal
in newborns and scores 1.
4. A client at 36 weeks’ gestation reports regular contractions every 5 minutes, lower back
pain, and pelvic pressure. What is the priority nursing action?
A. Encourage ambulation to strengthen contractions
B. Assess cervical dilation and fetal fibronectin
C. Administer terbutaline to stop contractions
D. Provide comfort measures and monitor fetal heart rate
B. Assess cervical dilation and fetal fibronectin
These are signs of preterm labor. The priority is to confirm cervical change (≥2 cm dilation) and
consider fetal fibronectin testing (negative test rules out delivery in 7–14 days). Ambulation (A) may
worsen labor. Terbutaline (C) is no longer recommended due to cardiac risks. Comfort measures (D)
are supportive but not diagnostic.
5. A breastfeeding mother reports sore nipples after 3 days of nursing. What is the best
teaching intervention?
A. “Apply lanolin cream after each feeding.”
B. “Ensure the baby’s mouth covers the areola, not just the nipple.”
C. “Switch to bottle-feeding for 24 hours to let nipples heal.”
D. “Use soap to clean nipples before feeding.”
B. “Ensure the baby’s mouth covers the areola, not just the nipple.”
Sore nipples are usually due to poor latch. A proper latch includes the nipple and areola, reducing
friction and trauma. Lanolin (A) soothes but doesn’t fix the cause. Switching to bottles (C) reduces milk
supply. Soap (D) dries the skin and is unnecessary—water is sufficient.
Concordia St. Paul (2026/2027)
Childbearing Family Nursing | Key Domains: Intrapartum Care & Pain Management, Postpartum
Adaptation & Complications, Newborn Transition & Immediate Care, High-Risk Childbearing
(Preeclampsia, Preterm Labor, etc.), Newborn Nutrition (Breastfeeding/Bottle-feeding), Postpartum
Psychological Adjustments, and Family Education & Discharge Planning | Expert-Aligned Structure |
Exam-Ready Format
Introduction
This structured NUR 418 Exam 2 for Concordia University, St. Paul for 2026/2027 provides a
focused set of high-quality exam-style questions with correct answers and rationales. It emphasizes
the nursing care of the family during and immediately after childbirth, including the management of
labor, the physiological and psychological transition to parenthood, the care of the normal and
high-risk newborn, and the promotion of family wellness.
Exam Structure:
• Exam 2: (55 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological principle of labor or postpartum recovery, the priority intervention for
a maternal or newborn complication, the key teaching point for breastfeeding or newborn care, and
why alternative options are incorrect, contraindicated, or not the highest priority for the
childbearing family.
1. A client in active labor requests pain relief. She is 6 cm dilated, 100% effaced, and the fetus
is at +1 station. Which method provides pain relief without slowing labor?
A. Epidural anesthesia
B. IV meperidine
C. Nitrous oxide inhalation
D. Pudendal block
,C. Nitrous oxide inhalation
Nitrous oxide provides rapid-onset, self-administered analgesia that does not interfere with uterine
contractions or fetal descent. Epidurals (A) can slow labor and require fetal monitoring. Meperidine
(B) crosses the placenta and may cause neonatal respiratory depression. Pudendal block (D) is used
only for episiotomy or delivery, not labor pain.
2. A postpartum client’s fundus is boggy and located 2 cm above the umbilicus 1 hour after
birth. What is the nurse’s priority action?
A. Administer oxytocin as prescribed
B. Massage the fundus until firm
C. Assess for a full bladder
D. Increase IV fluid rate
B. Massage the fundus until firm
A boggy fundus indicates uterine atony, the leading cause of early postpartum hemorrhage. Immediate
fundal massage stimulates contractions to reduce bleeding. Oxytocin (A) is given after massage if
atony persists. Bladder assessment (C) is done if the fundus is deviated, but firmness is the immediate
concern.
3. A newborn at 1 hour of life has a heart rate of 130 bpm, is crying vigorously, has flexed
extremities, pink body with blue hands/feet, and grimaces to suction. What is the 1-minute
APGAR score?
A. 7
B. 8
C. 9
D. 10
C. 9
, APGAR scoring: Heart rate >100 = 2; Respiratory effort (crying) = 2; Muscle tone (flexed) = 2; Reflex
irritability (grimace) = 2; Color (acrocyanosis) = 1. Total = 9. Acrocyanosis (blue hands/feet) is normal
in newborns and scores 1.
4. A client at 36 weeks’ gestation reports regular contractions every 5 minutes, lower back
pain, and pelvic pressure. What is the priority nursing action?
A. Encourage ambulation to strengthen contractions
B. Assess cervical dilation and fetal fibronectin
C. Administer terbutaline to stop contractions
D. Provide comfort measures and monitor fetal heart rate
B. Assess cervical dilation and fetal fibronectin
These are signs of preterm labor. The priority is to confirm cervical change (≥2 cm dilation) and
consider fetal fibronectin testing (negative test rules out delivery in 7–14 days). Ambulation (A) may
worsen labor. Terbutaline (C) is no longer recommended due to cardiac risks. Comfort measures (D)
are supportive but not diagnostic.
5. A breastfeeding mother reports sore nipples after 3 days of nursing. What is the best
teaching intervention?
A. “Apply lanolin cream after each feeding.”
B. “Ensure the baby’s mouth covers the areola, not just the nipple.”
C. “Switch to bottle-feeding for 24 hours to let nipples heal.”
D. “Use soap to clean nipples before feeding.”
B. “Ensure the baby’s mouth covers the areola, not just the nipple.”
Sore nipples are usually due to poor latch. A proper latch includes the nipple and areola, reducing
friction and trauma. Lanolin (A) soothes but doesn’t fix the cause. Switching to bottles (C) reduces milk
supply. Soap (D) dries the skin and is unnecessary—water is sufficient.
