Galen NSG 3500 Exam 3 | Nursing Research & EBP (2026) Actual
Q&A PDF
1. A patient at 30 weeks gestation is receiving magnesium sulfate for severe preeclampsia.
Which finding indicates magnesium toxicity?
A) Deep tendon reflexes 2+
B) Respiratory rate of 10 breaths per minute
C) Urine output of 50 mL/hr
D) Blood pressure 150/100 mm Hg
Correct Answer: Respiratory rate of 10 breaths per minute
Rationale: Respiratory depression (<12 breaths/min) is a sign of magnesium toxicity, along with
absent deep tendon reflexes and oliguria. The nurse must stop the infusion, administer calcium
gluconate, and notify the provider. DTRs 2+ and urine output 50 mL/hr are reassuring.
2. A nurse is reviewing the lab results of a patient with severe preeclampsia. The platelet count
is 90,000/mm³. The nurse understands this finding indicates:
A) Normal pregnancy adaptation
B) Risk for bleeding and possible HELLP syndrome
C) Gestational diabetes
D) Anemia of pregnancy
Correct Answer: Risk for bleeding and possible HELLP syndrome
Rationale: Thrombocytopenia (<100,000/mm³) is a sign of severe preeclampsia and is part of
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets). It increases bleeding risk
and requires close monitoring. Delivery is the definitive treatment.
,3. A continuous trickle of bright red blood without clots and a firm uterus indicates which type
of postpartum hemorrhage?
A) Uterine atony
B) Unrepaired lacerations
C) Retained placental fragments
D) Uterine inversion
Correct Answer: Unrepaired lacerations
Rationale: A firm uterus usually rules out atony. Persistent bleeding despite a contracted uterus
suggests cervical, vaginal, or perineal lacerations that require surgical repair.
4. A patient complains of unrelieved pain or pressure in the perineal or vaginal area after a
forceps delivery. What is the most likely condition?
A) Endometritis
B) Hematoma
C) Uterine atony
D) Mastitis
Correct Answer: Hematoma
Rationale: Hematomas occur due to bleeding into soft tissues, presenting as severe pain or
pressure often disproportionate to findings on examination. They may expand rapidly and
require surgical intervention if large.
5. When does early postpartum hemorrhage (PPH) typically occur?
A) Within the first 4 hours after delivery
B) 24–48 hours after delivery
,C) 1 week after delivery
D) 2 weeks after delivery
Correct Answer: Within the first 4 hours after delivery
Rationale: Early postpartum hemorrhage occurs within 24 hours after delivery, with the majority
occurring within the first 4 hours due to uterine atony, trauma, or retained tissue.
6. A nurse is assessing a patient with hyperemesis gravidarum. Which laboratory finding is most
consistent with this condition?
A) Elevated hemoglobin
B) Metabolic alkalosis
C) Elevated liver enzymes and low platelets
D) Low serum potassium and elevated urine ketones
Correct Answer: Low serum potassium and elevated urine ketones
Rationale: Hyperemesis gravidarum leads to dehydration, electrolyte imbalances (hypokalemia,
hyponatremia), and starvation ketosis (ketonuria). Elevated liver enzymes and low platelets
suggest HELLP syndrome.
7. The nurse is caring for a patient in active labor. Which fetal heart rate (FHR) pattern requires
immediate intervention?
A) Baseline FHR of 130–145 bpm with moderate variability and accelerations
B) Baseline FHR of 165 bpm lasting for 45 minutes
C) Intermittent late decelerations occurring with 50% of contractions
D) Early decelerations with a nadir at the peak of the contraction
, Correct Answer: Intermittent late decelerations occurring with 50% of contractions
Rationale: Late decelerations indicate uteroplacental insufficiency and are considered a
non-reassuring fetal status requiring immediate intervention (position change, oxygen, IV
fluids). Baseline tachycardia is concerning but less urgent than intermittent late decelerations.
Early decelerations are benign.
8. A primigravida at 39 weeks gestation is admitted to the labor and delivery unit. Her cervical
examination reveals 3 cm dilation, 80% effacement, and -1 station. Which finding would indicate
the onset of the active phase of labor?
A) Cervical dilation of 4 cm
B) Effacement of 100%
C) Contractions every 2–3 minutes lasting 60 seconds
D) Fetal station 0
Correct Answer: Cervical dilation of 4 cm
Rationale: The active phase of the first stage of labor begins at 4–6 cm cervical dilation. In the
latent phase, cervical dilation is 0–3 cm. The active phase is characterized by more rapid cervical
change (1.2 cm/hour for nulliparas).
9. A nurse is assessing a postpartum patient who is 2 hours after a vaginal delivery. The fundus
is boggy and deviated to the right. What is the nurse's priority action?
A) Notify the healthcare provider
B) Massage the fundus and assist the patient to void
C) Administer oxytocin
D) Document the finding and continue monitoring
Correct Answer: Massage the fundus and assist the patient to void
Q&A PDF
1. A patient at 30 weeks gestation is receiving magnesium sulfate for severe preeclampsia.
Which finding indicates magnesium toxicity?
A) Deep tendon reflexes 2+
B) Respiratory rate of 10 breaths per minute
C) Urine output of 50 mL/hr
D) Blood pressure 150/100 mm Hg
Correct Answer: Respiratory rate of 10 breaths per minute
Rationale: Respiratory depression (<12 breaths/min) is a sign of magnesium toxicity, along with
absent deep tendon reflexes and oliguria. The nurse must stop the infusion, administer calcium
gluconate, and notify the provider. DTRs 2+ and urine output 50 mL/hr are reassuring.
2. A nurse is reviewing the lab results of a patient with severe preeclampsia. The platelet count
is 90,000/mm³. The nurse understands this finding indicates:
A) Normal pregnancy adaptation
B) Risk for bleeding and possible HELLP syndrome
C) Gestational diabetes
D) Anemia of pregnancy
Correct Answer: Risk for bleeding and possible HELLP syndrome
Rationale: Thrombocytopenia (<100,000/mm³) is a sign of severe preeclampsia and is part of
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets). It increases bleeding risk
and requires close monitoring. Delivery is the definitive treatment.
,3. A continuous trickle of bright red blood without clots and a firm uterus indicates which type
of postpartum hemorrhage?
A) Uterine atony
B) Unrepaired lacerations
C) Retained placental fragments
D) Uterine inversion
Correct Answer: Unrepaired lacerations
Rationale: A firm uterus usually rules out atony. Persistent bleeding despite a contracted uterus
suggests cervical, vaginal, or perineal lacerations that require surgical repair.
4. A patient complains of unrelieved pain or pressure in the perineal or vaginal area after a
forceps delivery. What is the most likely condition?
A) Endometritis
B) Hematoma
C) Uterine atony
D) Mastitis
Correct Answer: Hematoma
Rationale: Hematomas occur due to bleeding into soft tissues, presenting as severe pain or
pressure often disproportionate to findings on examination. They may expand rapidly and
require surgical intervention if large.
5. When does early postpartum hemorrhage (PPH) typically occur?
A) Within the first 4 hours after delivery
B) 24–48 hours after delivery
,C) 1 week after delivery
D) 2 weeks after delivery
Correct Answer: Within the first 4 hours after delivery
Rationale: Early postpartum hemorrhage occurs within 24 hours after delivery, with the majority
occurring within the first 4 hours due to uterine atony, trauma, or retained tissue.
6. A nurse is assessing a patient with hyperemesis gravidarum. Which laboratory finding is most
consistent with this condition?
A) Elevated hemoglobin
B) Metabolic alkalosis
C) Elevated liver enzymes and low platelets
D) Low serum potassium and elevated urine ketones
Correct Answer: Low serum potassium and elevated urine ketones
Rationale: Hyperemesis gravidarum leads to dehydration, electrolyte imbalances (hypokalemia,
hyponatremia), and starvation ketosis (ketonuria). Elevated liver enzymes and low platelets
suggest HELLP syndrome.
7. The nurse is caring for a patient in active labor. Which fetal heart rate (FHR) pattern requires
immediate intervention?
A) Baseline FHR of 130–145 bpm with moderate variability and accelerations
B) Baseline FHR of 165 bpm lasting for 45 minutes
C) Intermittent late decelerations occurring with 50% of contractions
D) Early decelerations with a nadir at the peak of the contraction
, Correct Answer: Intermittent late decelerations occurring with 50% of contractions
Rationale: Late decelerations indicate uteroplacental insufficiency and are considered a
non-reassuring fetal status requiring immediate intervention (position change, oxygen, IV
fluids). Baseline tachycardia is concerning but less urgent than intermittent late decelerations.
Early decelerations are benign.
8. A primigravida at 39 weeks gestation is admitted to the labor and delivery unit. Her cervical
examination reveals 3 cm dilation, 80% effacement, and -1 station. Which finding would indicate
the onset of the active phase of labor?
A) Cervical dilation of 4 cm
B) Effacement of 100%
C) Contractions every 2–3 minutes lasting 60 seconds
D) Fetal station 0
Correct Answer: Cervical dilation of 4 cm
Rationale: The active phase of the first stage of labor begins at 4–6 cm cervical dilation. In the
latent phase, cervical dilation is 0–3 cm. The active phase is characterized by more rapid cervical
change (1.2 cm/hour for nulliparas).
9. A nurse is assessing a postpartum patient who is 2 hours after a vaginal delivery. The fundus
is boggy and deviated to the right. What is the nurse's priority action?
A) Notify the healthcare provider
B) Massage the fundus and assist the patient to void
C) Administer oxytocin
D) Document the finding and continue monitoring
Correct Answer: Massage the fundus and assist the patient to void
