,Table of Contents
Content Area Questions Key Topics
NSG 432 2 Nursing CARE OF 1-34 Weeks, Gestation, Finding, Intervention, Postpartum
THE Childbearing Family
Higher Education Nursing
Curriculum 2026/2027
Academic YEAR 200 AND
WITH Evidence-based
Rationales Nursing CARE OF
THE Childbearing Family
Undergraduate YEAR 4 /
Pre-licensure BSN
Gestation 35-68 Weeks, Fetal, Labor, Finding, Appropriate
Finding 69-102 Weeks, Gestation, Fetal, Heart RATE, Intervention
Fetal 103-136 Weeks, Gestation, Intervention, Finding, Immediate
Intervention 137-170 Weeks, Gestation, Finding, Appropriate, Labor
Heart 171-200 Finding, Intervention, Fetal, Weeks, Heart RATE
TOTAL 200 All questions include answers and detailed rationales
,Section A - NSG 432 2 Nursing CARE OF THE Childbearing
Family Higher Education Nursing Curriculum 2026/2027
Academic YEAR 200 AND WITH Evidence-based Rationales
Nursing CARE OF THE Childbearing Family Undergraduate
YEAR 4 / Pre-licensure BSN
Q1.
A patient at 34 weeks gestation with preeclampsia with severe features is receiving
magnesium sulfate. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A. Respiratory rate of 12 breaths/min B. Deep tendon reflexes of 2+
C. Urine output of 30 mL/hr D. Serum magnesium level of 6.5 mEq/L
Correct: A - Respiratory rate of 12 breaths/min
Rationale:A respiratory rate below 12 breaths/min is a sign of magnesium toxicity, as
magnesium depresses the central nervous system and neuromuscular transmission. DTRs of
2+ are normal, urine output of 30 mL/hr is acceptable, and a magnesium level of 6.5 mEq/L is
within the therapeutic range (4.8-8.4 mEq/L).
Q2.
Which fetal heart rate pattern is most indicative of uteroplacental insufficiency and
requires immediate intervention?
A. Early decelerations with a mirror image to B. Variable decelerations with a U-shape
contractions and rapid onset
C. Late decelerations with minimal variability D. Accelerations with moderate variability
Correct: C - Late decelerations with minimal variability
Rationale:Late decelerations, especially with minimal variability, indicate uteroplacental
insufficiency and fetal hypoxemia. Early decelerations are benign and related to head
compression. Variable decelerations reflect cord compression. Accelerations with moderate
variability indicate fetal well-being.
Q3.
A postpartum patient who is Rh-negative and has an Rh-positive infant receives Rho(D)
immune globulin. What is the primary nursing consideration to ensure effectiveness?
A. Administer within 72 hours of delivery B. Confirm the infant is Rh-negative
Page 3
, Section A - NSG 432 2 Nursing CARE OF THE Childbearing Family Higher Education Nursing Curriculum 2026/2027 Academic YEAR 200 AND
WITH Evidence-based Rationales Nursing CARE OF THE Childbearing Family Undergraduate YEAR 4 / Pre-licensure BSN
C. Screen the mother for anti-D antibodies D. Administer the dose intramuscularly in
before administration the deltoid
Correct: A - Administer within 72 hours of delivery
Rationale:Rho(D) immune globulin must be given within 72 hours postpartum to prevent
maternal sensitization to Rh-positive fetal blood. The infant must be Rh-positive (not negative)
for administration. Screening for anti-D antibodies is done before administration, but the
timing is the critical factor. The deltoid is not the recommended site; the gluteal muscle is
preferred.
Q4.
A patient at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM).
Which parameter is most accurate for evaluating long-term glycemic control in this
patient?
A. Fasting blood glucose levels B. 2-hour postprandial glucose levels
C. Glycosylated hemoglobin (HbA1c) D. Daily fetal movement counts
Correct: C - Glycosylated hemoglobin (HbA1c)
Rationale:HbA1c reflects average glucose over the previous 8-12 weeks, making it useful for
long-term control, though in pregnancy it may be lower. However, for daily management,
fasting and postprandial levels are used. Fetal movement counts assess fetal well-being, not
glycemic control.
Q5.
During the active phase of labor, a patient requests an epidural. Which finding
contraindicates epidural placement?
A. Cervical dilation of 5 cm B. Platelet count of 80,000/mm³
C. Maternal temperature of 37.2°C D. Blood pressure of 120/80 mmHg
Correct: B - Platelet count of 80,000/mm³
Rationale:A platelet count below 100,000/mm³ is a contraindication to epidural placement
due to the risk of spinal epidural hematoma. Cervical dilation of 5 cm is fine, a temperature of
37.2°C is normal, and a blood pressure of 120/80 is acceptable.
Q6.
A newborn is exhibiting nasal flaring, grunting, and intercostal retractions. Which
condition is most likely, and what is the priority nursing action?
Page 4
Content Area Questions Key Topics
NSG 432 2 Nursing CARE OF 1-34 Weeks, Gestation, Finding, Intervention, Postpartum
THE Childbearing Family
Higher Education Nursing
Curriculum 2026/2027
Academic YEAR 200 AND
WITH Evidence-based
Rationales Nursing CARE OF
THE Childbearing Family
Undergraduate YEAR 4 /
Pre-licensure BSN
Gestation 35-68 Weeks, Fetal, Labor, Finding, Appropriate
Finding 69-102 Weeks, Gestation, Fetal, Heart RATE, Intervention
Fetal 103-136 Weeks, Gestation, Intervention, Finding, Immediate
Intervention 137-170 Weeks, Gestation, Finding, Appropriate, Labor
Heart 171-200 Finding, Intervention, Fetal, Weeks, Heart RATE
TOTAL 200 All questions include answers and detailed rationales
,Section A - NSG 432 2 Nursing CARE OF THE Childbearing
Family Higher Education Nursing Curriculum 2026/2027
Academic YEAR 200 AND WITH Evidence-based Rationales
Nursing CARE OF THE Childbearing Family Undergraduate
YEAR 4 / Pre-licensure BSN
Q1.
A patient at 34 weeks gestation with preeclampsia with severe features is receiving
magnesium sulfate. Which assessment finding indicates magnesium toxicity requiring
immediate intervention?
A. Respiratory rate of 12 breaths/min B. Deep tendon reflexes of 2+
C. Urine output of 30 mL/hr D. Serum magnesium level of 6.5 mEq/L
Correct: A - Respiratory rate of 12 breaths/min
Rationale:A respiratory rate below 12 breaths/min is a sign of magnesium toxicity, as
magnesium depresses the central nervous system and neuromuscular transmission. DTRs of
2+ are normal, urine output of 30 mL/hr is acceptable, and a magnesium level of 6.5 mEq/L is
within the therapeutic range (4.8-8.4 mEq/L).
Q2.
Which fetal heart rate pattern is most indicative of uteroplacental insufficiency and
requires immediate intervention?
A. Early decelerations with a mirror image to B. Variable decelerations with a U-shape
contractions and rapid onset
C. Late decelerations with minimal variability D. Accelerations with moderate variability
Correct: C - Late decelerations with minimal variability
Rationale:Late decelerations, especially with minimal variability, indicate uteroplacental
insufficiency and fetal hypoxemia. Early decelerations are benign and related to head
compression. Variable decelerations reflect cord compression. Accelerations with moderate
variability indicate fetal well-being.
Q3.
A postpartum patient who is Rh-negative and has an Rh-positive infant receives Rho(D)
immune globulin. What is the primary nursing consideration to ensure effectiveness?
A. Administer within 72 hours of delivery B. Confirm the infant is Rh-negative
Page 3
, Section A - NSG 432 2 Nursing CARE OF THE Childbearing Family Higher Education Nursing Curriculum 2026/2027 Academic YEAR 200 AND
WITH Evidence-based Rationales Nursing CARE OF THE Childbearing Family Undergraduate YEAR 4 / Pre-licensure BSN
C. Screen the mother for anti-D antibodies D. Administer the dose intramuscularly in
before administration the deltoid
Correct: A - Administer within 72 hours of delivery
Rationale:Rho(D) immune globulin must be given within 72 hours postpartum to prevent
maternal sensitization to Rh-positive fetal blood. The infant must be Rh-positive (not negative)
for administration. Screening for anti-D antibodies is done before administration, but the
timing is the critical factor. The deltoid is not the recommended site; the gluteal muscle is
preferred.
Q4.
A patient at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM).
Which parameter is most accurate for evaluating long-term glycemic control in this
patient?
A. Fasting blood glucose levels B. 2-hour postprandial glucose levels
C. Glycosylated hemoglobin (HbA1c) D. Daily fetal movement counts
Correct: C - Glycosylated hemoglobin (HbA1c)
Rationale:HbA1c reflects average glucose over the previous 8-12 weeks, making it useful for
long-term control, though in pregnancy it may be lower. However, for daily management,
fasting and postprandial levels are used. Fetal movement counts assess fetal well-being, not
glycemic control.
Q5.
During the active phase of labor, a patient requests an epidural. Which finding
contraindicates epidural placement?
A. Cervical dilation of 5 cm B. Platelet count of 80,000/mm³
C. Maternal temperature of 37.2°C D. Blood pressure of 120/80 mmHg
Correct: B - Platelet count of 80,000/mm³
Rationale:A platelet count below 100,000/mm³ is a contraindication to epidural placement
due to the risk of spinal epidural hematoma. Cervical dilation of 5 cm is fine, a temperature of
37.2°C is normal, and a blood pressure of 120/80 is acceptable.
Q6.
A newborn is exhibiting nasal flaring, grunting, and intercostal retractions. Which
condition is most likely, and what is the priority nursing action?
Page 4
