NUR 418 Exams 1-3 & Final Q&A Childbearing Family –
Concordia St. Paul (2026/2027)
Comprehensive Childbearing Family Nursing | Key Domains: Reproductive Health & Antepartum
Care (Exam 1), Intrapartum & Postpartum Care (Exam 2), Newborn Care & High-Risk Conditions
(Exam 3), and Integrated Family Care & Complications (Final Exam) | Expert-Aligned Structure |
Complete Course Exam Bank Format
Introduction
This structured NUR 418 Complete Exam Bank for Concordia University, St. Paul for 2026/2027
provides question sets for all major assessments (Exams 1-3 and the Final) with correct answers
and rationales. It encompasses the full spectrum of nursing care for the childbearing family, from
preconception through postpartum and newborn adaptation, including the management of
common and high-risk conditions.
Exam Bank Structure:
• Exam 1: Reproductive & Antepartum: (60 QUESTIONS)
• Exam 2: Intrapartum & Postpartum: (55 QUESTIONS)
• Exam 3: Newborn & High-Risk: (50 QUESTIONS)
• Final Exam: Comprehensive: (75 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological principle, the priority nursing assessment or intervention for a given
stage or complication, key patient education, and why alternative options are incorrect,
contraindicated, or not the highest priority for the childbearing family.
Exam 1: Reproductive & Antepartum Care (Questions 1–60)
1. A client is seeking contraception that is “hormone-free and long-lasting.” Which option is
most appropriate?
A. Combined oral contraceptive pill
B. Levonorgestrel intrauterine device (IUD)
C. Copper IUD
, D. Depo-Provera injection
C. Copper IUD
The copper IUD (e.g., Paragard) is a non-hormonal, long-acting reversible contraceptive (LARC)
effective for up to 10–12 years. Levonorgestrel IUD (B) contains progestin. Pills (A) and Depo (D) are
hormonal and require ongoing use.
2. A pregnant woman’s last menstrual period (LMP) began on March 10. Using Nagele’s rule,
what is her estimated due date?
A. December 3
B. December 17
C. November 3
D. January 17
B. December 17
Nagele’s Rule: March 10 minus 3 months = December 10; add 7 days = December 17.
3. A client at 28 weeks’ gestation has a blood pressure of 142/92 mm Hg and 1+ proteinuria
on dipstick. What condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
B. Preeclampsia
,Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks plus proteinuria or
end-organ dysfunction. Gestational hypertension (A) has no proteinuria. Eclampsia (D) includes
seizures.
Exam 2: Intrapartum & Postpartum Care (Questions 61–115)
61. 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. Meperidine (B) crosses the placenta and
may cause neonatal respiratory depression. Pudendal block (D) is used only for delivery, not labor
pain.
62. 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.
, 63. A postpartum client on day 2 says, “I feel like I can’t do this. I’m so tired and
overwhelmed.” What is the best nursing response?
A. “All new moms feel that way—just push through.”
B. “Would you like to talk about what’s overwhelming you?”
C. “Your baby is healthy; you should be grateful.”
D. “Take a sleeping pill and rest.”
B. “Would you like to talk about what’s overwhelming you?”
This open-ended, supportive response validates the mother’s feelings and screens for postpartum
adjustment difficulties or depression. Dismissing (A, C) or medicating (D) without assessment is
inappropriate.
Exam 3: Newborn Care & High-Risk Conditions (Questions 116–165)
116. 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.
117. A newborn exhibits jitteriness, poor feeding, and a blood glucose of 38 mg/dL at 2 hours
of life. What is the priority intervention?
Concordia St. Paul (2026/2027)
Comprehensive Childbearing Family Nursing | Key Domains: Reproductive Health & Antepartum
Care (Exam 1), Intrapartum & Postpartum Care (Exam 2), Newborn Care & High-Risk Conditions
(Exam 3), and Integrated Family Care & Complications (Final Exam) | Expert-Aligned Structure |
Complete Course Exam Bank Format
Introduction
This structured NUR 418 Complete Exam Bank for Concordia University, St. Paul for 2026/2027
provides question sets for all major assessments (Exams 1-3 and the Final) with correct answers
and rationales. It encompasses the full spectrum of nursing care for the childbearing family, from
preconception through postpartum and newborn adaptation, including the management of
common and high-risk conditions.
Exam Bank Structure:
• Exam 1: Reproductive & Antepartum: (60 QUESTIONS)
• Exam 2: Intrapartum & Postpartum: (55 QUESTIONS)
• Exam 3: Newborn & High-Risk: (50 QUESTIONS)
• Final Exam: Comprehensive: (75 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the physiological principle, the priority nursing assessment or intervention for a given
stage or complication, key patient education, and why alternative options are incorrect,
contraindicated, or not the highest priority for the childbearing family.
Exam 1: Reproductive & Antepartum Care (Questions 1–60)
1. A client is seeking contraception that is “hormone-free and long-lasting.” Which option is
most appropriate?
A. Combined oral contraceptive pill
B. Levonorgestrel intrauterine device (IUD)
C. Copper IUD
, D. Depo-Provera injection
C. Copper IUD
The copper IUD (e.g., Paragard) is a non-hormonal, long-acting reversible contraceptive (LARC)
effective for up to 10–12 years. Levonorgestrel IUD (B) contains progestin. Pills (A) and Depo (D) are
hormonal and require ongoing use.
2. A pregnant woman’s last menstrual period (LMP) began on March 10. Using Nagele’s rule,
what is her estimated due date?
A. December 3
B. December 17
C. November 3
D. January 17
B. December 17
Nagele’s Rule: March 10 minus 3 months = December 10; add 7 days = December 17.
3. A client at 28 weeks’ gestation has a blood pressure of 142/92 mm Hg and 1+ proteinuria
on dipstick. What condition is suspected?
A. Gestational hypertension
B. Preeclampsia
C. Chronic hypertension
D. Eclampsia
B. Preeclampsia
,Preeclampsia is defined as new-onset hypertension (≥140/90) after 20 weeks plus proteinuria or
end-organ dysfunction. Gestational hypertension (A) has no proteinuria. Eclampsia (D) includes
seizures.
Exam 2: Intrapartum & Postpartum Care (Questions 61–115)
61. 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. Meperidine (B) crosses the placenta and
may cause neonatal respiratory depression. Pudendal block (D) is used only for delivery, not labor
pain.
62. 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.
, 63. A postpartum client on day 2 says, “I feel like I can’t do this. I’m so tired and
overwhelmed.” What is the best nursing response?
A. “All new moms feel that way—just push through.”
B. “Would you like to talk about what’s overwhelming you?”
C. “Your baby is healthy; you should be grateful.”
D. “Take a sleeping pill and rest.”
B. “Would you like to talk about what’s overwhelming you?”
This open-ended, supportive response validates the mother’s feelings and screens for postpartum
adjustment difficulties or depression. Dismissing (A, C) or medicating (D) without assessment is
inappropriate.
Exam 3: Newborn Care & High-Risk Conditions (Questions 116–165)
116. 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.
117. A newborn exhibits jitteriness, poor feeding, and a blood glucose of 38 mg/dL at 2 hours
of life. What is the priority intervention?
