Page 1 of 68
NSG 3500 MATERNITY — EXAM 4 2026/2027 COMPLETE
(150) CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MATERNITY
Prepare effectively for the NSG 3500 (Galen) Maternity Exam 4 with this focused study
resource. It supports review of antepartum care, pregnancy and fetal development,
labor and delivery, maternal assessment, newborn care, and common maternity
complications. Use the material to reinforce your knowledge, review high-yield topics,
and identify areas that may require additional study. This resource is suited for Galen
nursing students, maternity nursing learners, and candidates preparing for the NSG
3500 Maternity Exam 1.
MULTIPLE CHOICE.
SECTION 1: NEWBORN TRANSITION & ASSESSMENT (Questions 1–25)
1. A nurse is teaching new parents about the factors that stimulate a
newborn's first breath. Which factor is considered the PRIMARY chemical
stimulus?
A. The drop in ambient temperature upon delivery
B. Hypoxia, hypercarbia, and acidosis from clamping of the umbilical cord
C. The thoracic squeeze during a vaginal birth
D. Tactile stimulation from drying the infant
Answer: B. Hypoxia, hypercarbia, and acidosis from 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.
, Page 2 of 68
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
Answer: B. 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 respiratory distress syndrome (RDS), not
TTN.
3. A 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
Answer: B. 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.
, Page 3 of 68
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
Answer: B. 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. A 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
Answer: B. 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. A nurse is assessing a newborn 1 minute after birth. The newborn has a
heart rate of 110/min, a slow/weak cry, some flexion of extremities,
grimace when stimulated, and a pink body with blue extremities. What is
the Apgar score?
, Page 4 of 68
A. 5
B. 7
C. 6
D. 8
Answer: C. 6
Rationale: Heart rate (110 = 2 points), Respiratory effort (slow/weak cry =
1), Muscle tone (some flexion = 1), Reflex irritability (grimace = 1), Color
(pink body/blue extremities = 1). Total score = 6.
7. What is the normal heart rate range for a term newborn?
A. 80–100 beats per minute
B. 100–140 beats per minute
C. 110–160 beats per minute
D. 140–180 beats per minute
Answer: C. 110–160 beats per minute
Rationale: The normal newborn heart rate is 110–160 beats per minute.
Tachycardia is defined as >160 bpm and bradycardia as <110 bpm. The
heart rate should be assessed at the apex (apical pulse) for a full minute.
8. A nurse is assessing a newborn's vital signs. Which respiratory rate
would be within the normal range for a term newborn?
A. 20 breaths per minute
B. 40 breaths per minute
C. 60 breaths per minute
D. 30–60 breaths per minute
Answer: D. 30–60 breaths per minute
Rationale: The normal respiratory rate for a newborn is 30–60 breaths per
NSG 3500 MATERNITY — EXAM 4 2026/2027 COMPLETE
(150) CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MATERNITY
Prepare effectively for the NSG 3500 (Galen) Maternity Exam 4 with this focused study
resource. It supports review of antepartum care, pregnancy and fetal development,
labor and delivery, maternal assessment, newborn care, and common maternity
complications. Use the material to reinforce your knowledge, review high-yield topics,
and identify areas that may require additional study. This resource is suited for Galen
nursing students, maternity nursing learners, and candidates preparing for the NSG
3500 Maternity Exam 1.
MULTIPLE CHOICE.
SECTION 1: NEWBORN TRANSITION & ASSESSMENT (Questions 1–25)
1. A nurse is teaching new parents about the factors that stimulate a
newborn's first breath. Which factor is considered the PRIMARY chemical
stimulus?
A. The drop in ambient temperature upon delivery
B. Hypoxia, hypercarbia, and acidosis from clamping of the umbilical cord
C. The thoracic squeeze during a vaginal birth
D. Tactile stimulation from drying the infant
Answer: B. Hypoxia, hypercarbia, and acidosis from 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.
, Page 2 of 68
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
Answer: B. 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 respiratory distress syndrome (RDS), not
TTN.
3. A 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
Answer: B. 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.
, Page 3 of 68
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
Answer: B. 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. A 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
Answer: B. 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. A nurse is assessing a newborn 1 minute after birth. The newborn has a
heart rate of 110/min, a slow/weak cry, some flexion of extremities,
grimace when stimulated, and a pink body with blue extremities. What is
the Apgar score?
, Page 4 of 68
A. 5
B. 7
C. 6
D. 8
Answer: C. 6
Rationale: Heart rate (110 = 2 points), Respiratory effort (slow/weak cry =
1), Muscle tone (some flexion = 1), Reflex irritability (grimace = 1), Color
(pink body/blue extremities = 1). Total score = 6.
7. What is the normal heart rate range for a term newborn?
A. 80–100 beats per minute
B. 100–140 beats per minute
C. 110–160 beats per minute
D. 140–180 beats per minute
Answer: C. 110–160 beats per minute
Rationale: The normal newborn heart rate is 110–160 beats per minute.
Tachycardia is defined as >160 bpm and bradycardia as <110 bpm. The
heart rate should be assessed at the apex (apical pulse) for a full minute.
8. A nurse is assessing a newborn's vital signs. Which respiratory rate
would be within the normal range for a term newborn?
A. 20 breaths per minute
B. 40 breaths per minute
C. 60 breaths per minute
D. 30–60 breaths per minute
Answer: D. 30–60 breaths per minute
Rationale: The normal respiratory rate for a newborn is 30–60 breaths per
