,NSG 3500 Final Exam Nursing Practice – Maternal Health Questions
And Answers 2026/2027 Galen College
Q1. Which factor most directly stimulates the newborn's respiratory
center immediately after birth?
A) Decreased carbon dioxide levels
B) Increased maternal progesterone
C) Rising carbon dioxide levels combined with falling oxygen and pH
D) Increased fetal hemoglobin production
Correct Answer: C) Rising carbon dioxide levels combined with falling oxygen
and pH
Rationale: At birth, rising carbon dioxide, reduced oxygen, and decreasing
pH stimulate the medullary respiratory center and contribute to initiation of
breathing.
Q2. Which property of pulmonary surfactant is essential for
newborn respiratory adaptation?
A) It increases airway secretions.
B) It reduces alveolar surface tension and helps prevent collapse.
C) It closes the ductus arteriosus.
D) It increases pulmonary vascular resistance.
Correct Answer: B) It reduces alveolar surface tension and helps prevent
collapse.
Rationale: Surfactant lowers surface tension within the alveoli, helping keep
them open during expiration and supporting effective gas exchange.
Q3. What is the expected respiratory rate for a healthy term
newborn?
A) 10–20 breaths/min
B) 20–30 breaths/min
C) 30–60 breaths/min
D) 70–90 breaths/min
Correct Answer: C) 30–60 breaths/min
Rationale: A normal newborn respiratory rate is approximately 30–60
breaths per minute, although brief variations can occur.
,Q4. Which newborn breathing pattern should the nurse recognize as
abnormal?
A) Brief pauses followed by regular respirations
B) Periodic breathing with short pauses
C) Apnea lasting longer than expected and associated with color change
D) Irregular respirations during active sleep
Correct Answer: C) Apnea lasting longer than expected and associated with
color change
Rationale: Brief periodic pauses can occur normally, but prolonged apnea,
especially with bradycardia or cyanosis, indicates respiratory compromise.
Q5. Which cardiovascular change is necessary for transition from
fetal to neonatal circulation?
A) Increased right-to-left shunting
B) Functional closure of the fetal shunts
C) Continued dependence on placental circulation
D) Increased pulmonary vascular resistance
Correct Answer: B) Functional closure of the fetal shunts
Rationale: After birth, pulmonary blood flow increases and the foramen
ovale, ductus arteriosus, and ductus venosus undergo functional closure as
neonatal circulation is established.
Q6. Which fetal vessel connects the pulmonary artery with the
aorta?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Correct Answer: C) Ductus arteriosus
Rationale: The ductus arteriosus allows fetal blood to bypass the lungs by
connecting the pulmonary artery to the descending aorta.
Q7. What is the primary purpose of the foramen ovale during fetal
life?
A) To direct blood from the right atrium toward the left atrium
B) To connect the aorta to the pulmonary artery
, C) To bypass the fetal liver
D) To return blood from the placenta
Correct Answer: A) To direct blood from the right atrium toward the left
atrium
Rationale: The foramen ovale allows blood to move from the right atrium to
the left atrium, bypassing the nonfunctioning fetal lungs.
Q8. Which finding is generally expected during the first day of life?
A) Central cyanosis of the tongue
B) Acrocyanosis of the hands and feet
C) Persistent gray skin color
D) Severe circumoral cyanosis at rest
Correct Answer: B) Acrocyanosis of the hands and feet
Rationale: Peripheral cyanosis of the hands and feet can occur transiently
as peripheral circulation adjusts. Central cyanosis involving the lips or tongue
is abnormal.
Q9. Which finding indicates abnormal central oxygenation in a
newborn?
A) Bluish hands during the first hours
B) Pink trunk with cool feet
C) Blue tongue and oral mucosa
D) Mild mottling after exposure to cool air
Correct Answer: C) Blue tongue and oral mucosa
Rationale: Central cyanosis involving the tongue, lips, or mucous
membranes suggests inadequate oxygenation and requires immediate
assessment.
Q10. Which mechanism provides most of the newborn's heat
production immediately after birth?
A) Shivering
B) Brown-fat metabolism
C) Increased skeletal-muscle activity
D) Voluntary movement
Correct Answer: B) Brown-fat metabolism
And Answers 2026/2027 Galen College
Q1. Which factor most directly stimulates the newborn's respiratory
center immediately after birth?
A) Decreased carbon dioxide levels
B) Increased maternal progesterone
C) Rising carbon dioxide levels combined with falling oxygen and pH
D) Increased fetal hemoglobin production
Correct Answer: C) Rising carbon dioxide levels combined with falling oxygen
and pH
Rationale: At birth, rising carbon dioxide, reduced oxygen, and decreasing
pH stimulate the medullary respiratory center and contribute to initiation of
breathing.
Q2. Which property of pulmonary surfactant is essential for
newborn respiratory adaptation?
A) It increases airway secretions.
B) It reduces alveolar surface tension and helps prevent collapse.
C) It closes the ductus arteriosus.
D) It increases pulmonary vascular resistance.
Correct Answer: B) It reduces alveolar surface tension and helps prevent
collapse.
Rationale: Surfactant lowers surface tension within the alveoli, helping keep
them open during expiration and supporting effective gas exchange.
Q3. What is the expected respiratory rate for a healthy term
newborn?
A) 10–20 breaths/min
B) 20–30 breaths/min
C) 30–60 breaths/min
D) 70–90 breaths/min
Correct Answer: C) 30–60 breaths/min
Rationale: A normal newborn respiratory rate is approximately 30–60
breaths per minute, although brief variations can occur.
,Q4. Which newborn breathing pattern should the nurse recognize as
abnormal?
A) Brief pauses followed by regular respirations
B) Periodic breathing with short pauses
C) Apnea lasting longer than expected and associated with color change
D) Irregular respirations during active sleep
Correct Answer: C) Apnea lasting longer than expected and associated with
color change
Rationale: Brief periodic pauses can occur normally, but prolonged apnea,
especially with bradycardia or cyanosis, indicates respiratory compromise.
Q5. Which cardiovascular change is necessary for transition from
fetal to neonatal circulation?
A) Increased right-to-left shunting
B) Functional closure of the fetal shunts
C) Continued dependence on placental circulation
D) Increased pulmonary vascular resistance
Correct Answer: B) Functional closure of the fetal shunts
Rationale: After birth, pulmonary blood flow increases and the foramen
ovale, ductus arteriosus, and ductus venosus undergo functional closure as
neonatal circulation is established.
Q6. Which fetal vessel connects the pulmonary artery with the
aorta?
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical vein
Correct Answer: C) Ductus arteriosus
Rationale: The ductus arteriosus allows fetal blood to bypass the lungs by
connecting the pulmonary artery to the descending aorta.
Q7. What is the primary purpose of the foramen ovale during fetal
life?
A) To direct blood from the right atrium toward the left atrium
B) To connect the aorta to the pulmonary artery
, C) To bypass the fetal liver
D) To return blood from the placenta
Correct Answer: A) To direct blood from the right atrium toward the left
atrium
Rationale: The foramen ovale allows blood to move from the right atrium to
the left atrium, bypassing the nonfunctioning fetal lungs.
Q8. Which finding is generally expected during the first day of life?
A) Central cyanosis of the tongue
B) Acrocyanosis of the hands and feet
C) Persistent gray skin color
D) Severe circumoral cyanosis at rest
Correct Answer: B) Acrocyanosis of the hands and feet
Rationale: Peripheral cyanosis of the hands and feet can occur transiently
as peripheral circulation adjusts. Central cyanosis involving the lips or tongue
is abnormal.
Q9. Which finding indicates abnormal central oxygenation in a
newborn?
A) Bluish hands during the first hours
B) Pink trunk with cool feet
C) Blue tongue and oral mucosa
D) Mild mottling after exposure to cool air
Correct Answer: C) Blue tongue and oral mucosa
Rationale: Central cyanosis involving the tongue, lips, or mucous
membranes suggests inadequate oxygenation and requires immediate
assessment.
Q10. Which mechanism provides most of the newborn's heat
production immediately after birth?
A) Shivering
B) Brown-fat metabolism
C) Increased skeletal-muscle activity
D) Voluntary movement
Correct Answer: B) Brown-fat metabolism
