,Galen NSG 3500 Exam 4 – Maternal Health (2026) Actual Q&A PDF
1. The nurse is teaching new parents about the factors that stimulate a newborn’s first breath. Which factor is considered chemical?
A) The drop in ambient temperature upon delivery
B) Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
C) The thoracic squeeze during a vaginal birth
D) Tactile stimulation from drying the infant
Correct Answer: Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
Rationale: Chemical factors are the most critical stimulants for the first breath. Falling oxygen levels (hypoxia), rising carbon dioxide (hypercarbia), and falling pH
(acidosis) stimulate the medullary respiratory center. The other options are thermal, mechanical, and sensory factors, respectively.
2. A term newborn delivered by elective cesarean section is at increased risk for transient tachypnea of the newborn (TTN). The nurse understands this is
primarily due to:
A) Immature surfactant production
B) Lack of the mechanical thoracic squeeze during passage through the birth canal
C) Maternal diabetes during pregnancy
D) Meconium aspiration during delivery
Correct Answer: Lack of the mechanical thoracic squeeze during passage through the birth canal
Rationale: During vaginal delivery, the fetal chest is compressed, expelling lung fluid. This “thoracic squeeze” is absent in cesarean deliveries, leading to delayed
clearance of fetal lung fluid and TTN. Surfactant deficiency causes RDS, not TTN.
3. The nurse is assessing a newborn 2 hours after birth. The hands and feet are bluish, but the trunk and mucous membranes are pink. The nurse documents this
finding as:
A) Central cyanosis
B) Acrocyanosis
C) Mottling
,D) Pallor
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a normal, benign finding in the first hours of life caused by vasomotor instability and sluggish peripheral circulation. Central cyanosis
involves the trunk and mucous membranes and is always abnormal. No intervention is needed for acrocyanosis.
4. A newborn’s head has a soft, edematous swelling that crosses the sagittal suture line. The nurse identifies this as:
A) Cephalohematoma
B) Caput succedaneum
C) Molding
D) Craniosynostosis
Correct Answer: Caput succedaneum
Rationale: Caput succedaneum is soft tissue edema of the scalp that crosses suture lines, caused by pressure during delivery. It resolves in a few days.
Cephalohematoma is a subperiosteal hemorrhage that does not cross sutures and resolves over weeks.
5. The nurse is observing a newborn’s respiratory pattern. The newborn has pauses in breathing lasting 10 seconds without any change in heart rate or skin
color. The nurse documents this as:
A) Apnea
B) Periodic breathing
C) Respiratory distress
D) Bradypnea
Correct Answer: Periodic breathing
Rationale: Periodic breathing consists of brief pauses (5‑15 seconds) in respiration without cyanosis or bradycardia. It is a common, benign pattern due to an
immature respiratory center. Apnea is a pause >20 seconds or accompanied by bradycardia/cyanosis and is abnormal.
, 6. The nurse is teaching parents about preventing sudden infant death syndrome (SIDS). Which statement by the parents indicates correct understanding?
A) “We will place our baby on the stomach to sleep.”
B) “We will put our baby to sleep on the back.”
C) “We will use a soft, fluffy mattress for comfort.”
D) “We will place several stuffed animals in the crib.”
Correct Answer: “We will put our baby to sleep on the back.”
Rationale: The “Back to Sleep” recommendation—placing infants supine on a firm mattress with no loose bedding—significantly reduces the risk of SIDS. Prone
and side‑lying positions, soft mattresses, and stuffed animals increase risk.
7. The nurse is caring for a newborn with gastroschisis. The intestines are protruding outside the abdominal wall without a covering membrane. What is the
priority nursing action?
A) Place the infant in a prone position
B) Cover the exposed bowel with sterile, saline‑moistened gauze
C) Begin immediate formula feedings
D) Apply a dry, tight abdominal binder
Correct Answer: Cover the exposed bowel with sterile, saline‑moistened gauze
Rationale: The exposed bowel must be protected from trauma, infection, and heat/fluid loss. A sterile, non‑adherent, saline‑moistened dressing (or a clear
bowel bag) is applied. Feedings are withheld; the infant is positioned supine to avoid kinking.
8. A newborn is diagnosed with a diaphragmatic hernia. Which assessment finding would the nurse expect?
A) A scaphoid (sunken) abdomen and bowel sounds auscultated in the chest
B) A distended, firm abdomen
C) A high‑pitched, shrill cry
D) Projectile vomiting after every feeding
Correct Answer: A scaphoid (sunken) abdomen and bowel sounds auscultated in the chest
1. The nurse is teaching new parents about the factors that stimulate a newborn’s first breath. Which factor is considered chemical?
A) The drop in ambient temperature upon delivery
B) Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
C) The thoracic squeeze during a vaginal birth
D) Tactile stimulation from drying the infant
Correct Answer: Hypoxia, hypercarbia, and acidosis from the clamping of the umbilical cord
Rationale: Chemical factors are the most critical stimulants for the first breath. Falling oxygen levels (hypoxia), rising carbon dioxide (hypercarbia), and falling pH
(acidosis) stimulate the medullary respiratory center. The other options are thermal, mechanical, and sensory factors, respectively.
2. A term newborn delivered by elective cesarean section is at increased risk for transient tachypnea of the newborn (TTN). The nurse understands this is
primarily due to:
A) Immature surfactant production
B) Lack of the mechanical thoracic squeeze during passage through the birth canal
C) Maternal diabetes during pregnancy
D) Meconium aspiration during delivery
Correct Answer: Lack of the mechanical thoracic squeeze during passage through the birth canal
Rationale: During vaginal delivery, the fetal chest is compressed, expelling lung fluid. This “thoracic squeeze” is absent in cesarean deliveries, leading to delayed
clearance of fetal lung fluid and TTN. Surfactant deficiency causes RDS, not TTN.
3. The nurse is assessing a newborn 2 hours after birth. The hands and feet are bluish, but the trunk and mucous membranes are pink. The nurse documents this
finding as:
A) Central cyanosis
B) Acrocyanosis
C) Mottling
,D) Pallor
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a normal, benign finding in the first hours of life caused by vasomotor instability and sluggish peripheral circulation. Central cyanosis
involves the trunk and mucous membranes and is always abnormal. No intervention is needed for acrocyanosis.
4. A newborn’s head has a soft, edematous swelling that crosses the sagittal suture line. The nurse identifies this as:
A) Cephalohematoma
B) Caput succedaneum
C) Molding
D) Craniosynostosis
Correct Answer: Caput succedaneum
Rationale: Caput succedaneum is soft tissue edema of the scalp that crosses suture lines, caused by pressure during delivery. It resolves in a few days.
Cephalohematoma is a subperiosteal hemorrhage that does not cross sutures and resolves over weeks.
5. The nurse is observing a newborn’s respiratory pattern. The newborn has pauses in breathing lasting 10 seconds without any change in heart rate or skin
color. The nurse documents this as:
A) Apnea
B) Periodic breathing
C) Respiratory distress
D) Bradypnea
Correct Answer: Periodic breathing
Rationale: Periodic breathing consists of brief pauses (5‑15 seconds) in respiration without cyanosis or bradycardia. It is a common, benign pattern due to an
immature respiratory center. Apnea is a pause >20 seconds or accompanied by bradycardia/cyanosis and is abnormal.
, 6. The nurse is teaching parents about preventing sudden infant death syndrome (SIDS). Which statement by the parents indicates correct understanding?
A) “We will place our baby on the stomach to sleep.”
B) “We will put our baby to sleep on the back.”
C) “We will use a soft, fluffy mattress for comfort.”
D) “We will place several stuffed animals in the crib.”
Correct Answer: “We will put our baby to sleep on the back.”
Rationale: The “Back to Sleep” recommendation—placing infants supine on a firm mattress with no loose bedding—significantly reduces the risk of SIDS. Prone
and side‑lying positions, soft mattresses, and stuffed animals increase risk.
7. The nurse is caring for a newborn with gastroschisis. The intestines are protruding outside the abdominal wall without a covering membrane. What is the
priority nursing action?
A) Place the infant in a prone position
B) Cover the exposed bowel with sterile, saline‑moistened gauze
C) Begin immediate formula feedings
D) Apply a dry, tight abdominal binder
Correct Answer: Cover the exposed bowel with sterile, saline‑moistened gauze
Rationale: The exposed bowel must be protected from trauma, infection, and heat/fluid loss. A sterile, non‑adherent, saline‑moistened dressing (or a clear
bowel bag) is applied. Feedings are withheld; the infant is positioned supine to avoid kinking.
8. A newborn is diagnosed with a diaphragmatic hernia. Which assessment finding would the nurse expect?
A) A scaphoid (sunken) abdomen and bowel sounds auscultated in the chest
B) A distended, firm abdomen
C) A high‑pitched, shrill cry
D) Projectile vomiting after every feeding
Correct Answer: A scaphoid (sunken) abdomen and bowel sounds auscultated in the chest
