,Galen NSG 3500 Exam 2 – Maternal Health
(2026) Actual Q&A PDF
1. The nurse is assessing a patient in the first stage of labor. The cervix is 5 cm dilated, and
contractions occur every 3 minutes, lasting 50 seconds. Which phase of labor is the patient in?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Active phase
Rationale: The active phase of the first stage of labor is defined by cervical dilation from 4 to 7 cm,
with contractions occurring every 2 to 5 minutes and lasting 45 to 60 seconds. The latent phase is 1 to
3 cm; the transition phase is 8 to 10 cm; the second stage begins at full dilation.
2. A patient at 39 weeks gestation reports irregular contractions that decrease when she walks. The
nurse recognizes these findings as:
A) True labor
B) False labor
C) Preterm labor
D) Precipitous labor
Correct Answer: False labor
Rationale: False labor is characterized by irregular contractions that do not intensify and often stop
with ambulation or rest. True labor contractions increase in frequency, duration, and intensity, and
are associated with progressive cervical dilation.
3. The nurse is reviewing a fetal heart rate tracing. The baseline is 145 bpm with moderate variability
and accelerations. No decelerations are noted. How should the nurse categorize this tracing?
,A) Category I (normal)
B) Category II (indeterminate)
C) Category III (abnormal)
D) Category IV (terminal)
Correct Answer: Category I (normal)
Rationale: A Category I tracing requires a baseline of 110 to 160 bpm, moderate variability, no late or
variable decelerations, and may have accelerations. This pattern is strongly predictive of normal fetal
acid‑base status and requires no intervention.
4. The nurse notes recurrent late decelerations with absent variability on the fetal monitor. What is
the priority nursing action?
A) Continue to monitor and document
B) Reposition the patient to the left side and administer oxygen
C) Increase the oxytocin infusion rate
D) Prepare the patient for discharge
Correct Answer: Reposition the patient to the left side and administer oxygen
Rationale: This is a Category III tracing indicating fetal hypoxemia. Immediate interventions include
lateral repositioning to improve uteroplacental perfusion, administering oxygen, stopping oxytocin,
and notifying the provider. Continuing to monitor or increasing oxytocin would worsen the situation.
5. A laboring patient’s membranes rupture spontaneously. The nurse notes a loop of umbilical cord
protruding from the vagina. What is the priority action?
A) Prepare for a vaginal delivery
B) Elevate the presenting part with a sterile gloved hand and call for help
C) Administer oxytocin to speed delivery
D) Place the patient in a supine position
, Correct Answer: Elevate the presenting part with a sterile gloved hand and call for help
Rationale: Umbilical cord prolapse is an obstetric emergency. The priority is to relieve cord
compression by elevating the presenting part off the cord, positioning the patient in knee‑chest or
Trendelenburg, and preparing for immediate cesarean delivery. Vaginal delivery and oxytocin are
contraindicated.
6. Which cervical ripening agent is a prostaglandin E1 analogue used to soften the cervix before
induction?
A) Oxytocin
B) Nifedipine
C) Misoprostol
D) Terbutaline
Correct Answer: Misoprostol
Rationale: Misoprostol (Cytotec) is a prostaglandin E1 analogue that ripens the cervix by promoting
softening and effacement. Oxytocin is not a ripening agent; it stimulates contractions. Nifedipine and
terbutaline are tocolytics.
7. The nurse is caring for a patient in the fourth stage of labor. The fundus is boggy and displaced to
the right. What should the nurse do first?
A) Massage the fundus vigorously
B) Assist the patient to void
C) Notify the provider
D) Administer oxytocin immediately
Correct Answer: Assist the patient to void
Rationale: A displaced, boggy fundus often indicates a full bladder, which prevents the uterus from
contracting effectively. The nurse should first assist the patient to void, then reassess the fundus. If it
remains boggy, massage and oxytocin may be needed.
(2026) Actual Q&A PDF
1. The nurse is assessing a patient in the first stage of labor. The cervix is 5 cm dilated, and
contractions occur every 3 minutes, lasting 50 seconds. Which phase of labor is the patient in?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Active phase
Rationale: The active phase of the first stage of labor is defined by cervical dilation from 4 to 7 cm,
with contractions occurring every 2 to 5 minutes and lasting 45 to 60 seconds. The latent phase is 1 to
3 cm; the transition phase is 8 to 10 cm; the second stage begins at full dilation.
2. A patient at 39 weeks gestation reports irregular contractions that decrease when she walks. The
nurse recognizes these findings as:
A) True labor
B) False labor
C) Preterm labor
D) Precipitous labor
Correct Answer: False labor
Rationale: False labor is characterized by irregular contractions that do not intensify and often stop
with ambulation or rest. True labor contractions increase in frequency, duration, and intensity, and
are associated with progressive cervical dilation.
3. The nurse is reviewing a fetal heart rate tracing. The baseline is 145 bpm with moderate variability
and accelerations. No decelerations are noted. How should the nurse categorize this tracing?
,A) Category I (normal)
B) Category II (indeterminate)
C) Category III (abnormal)
D) Category IV (terminal)
Correct Answer: Category I (normal)
Rationale: A Category I tracing requires a baseline of 110 to 160 bpm, moderate variability, no late or
variable decelerations, and may have accelerations. This pattern is strongly predictive of normal fetal
acid‑base status and requires no intervention.
4. The nurse notes recurrent late decelerations with absent variability on the fetal monitor. What is
the priority nursing action?
A) Continue to monitor and document
B) Reposition the patient to the left side and administer oxygen
C) Increase the oxytocin infusion rate
D) Prepare the patient for discharge
Correct Answer: Reposition the patient to the left side and administer oxygen
Rationale: This is a Category III tracing indicating fetal hypoxemia. Immediate interventions include
lateral repositioning to improve uteroplacental perfusion, administering oxygen, stopping oxytocin,
and notifying the provider. Continuing to monitor or increasing oxytocin would worsen the situation.
5. A laboring patient’s membranes rupture spontaneously. The nurse notes a loop of umbilical cord
protruding from the vagina. What is the priority action?
A) Prepare for a vaginal delivery
B) Elevate the presenting part with a sterile gloved hand and call for help
C) Administer oxytocin to speed delivery
D) Place the patient in a supine position
, Correct Answer: Elevate the presenting part with a sterile gloved hand and call for help
Rationale: Umbilical cord prolapse is an obstetric emergency. The priority is to relieve cord
compression by elevating the presenting part off the cord, positioning the patient in knee‑chest or
Trendelenburg, and preparing for immediate cesarean delivery. Vaginal delivery and oxytocin are
contraindicated.
6. Which cervical ripening agent is a prostaglandin E1 analogue used to soften the cervix before
induction?
A) Oxytocin
B) Nifedipine
C) Misoprostol
D) Terbutaline
Correct Answer: Misoprostol
Rationale: Misoprostol (Cytotec) is a prostaglandin E1 analogue that ripens the cervix by promoting
softening and effacement. Oxytocin is not a ripening agent; it stimulates contractions. Nifedipine and
terbutaline are tocolytics.
7. The nurse is caring for a patient in the fourth stage of labor. The fundus is boggy and displaced to
the right. What should the nurse do first?
A) Massage the fundus vigorously
B) Assist the patient to void
C) Notify the provider
D) Administer oxytocin immediately
Correct Answer: Assist the patient to void
Rationale: A displaced, boggy fundus often indicates a full bladder, which prevents the uterus from
contracting effectively. The nurse should first assist the patient to void, then reassess the fundus. If it
remains boggy, massage and oxytocin may be needed.
