NUR 230 Maternal & Pediatric Nursing Exam 4 2026 |Galen College
1. Which assessment finding is most indicative of uterine atony in a patient who
is two hours postpartum?
A. A soft, boggy fundus upon palpation
B. A firm, midline fundus
C. Lochia rubra with small clots
D. Pulse rate of 80 beats per minute
Answer: A
Rationale: Uterine atony refers to a lack of muscle tone in the uterus, making it feel soft or
boggy, which is the leading cause of early postpartum hemorrhage.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for
preeclampsia. Which finding requires immediate intervention?
A. Presence of a mild headache
B. Deep tendon reflexes of 2+
C. Urinary output of 40 mL per hour
D. Respiratory rate of 10 breaths per minute
Answer: D
Rationale: Magnesium Sulfate toxicity can cause respiratory depression. A rate below 12
breaths per minute is a critical indicator of toxicity.
,3. Which fetal heart rate pattern is most associated with uteroplacental
insufficiency?
A. Early decelerations
B. Late decelerations
C. Variable decelerations
D. Accelerations
Answer: B
Rationale: Late decelerations are caused by uteroplacental insufficiency and require
immediate nursing intervention to improve fetal oxygenation.
4. When assessing a 6-month-old infant, which developmental milestone should
the nurse expect the child to have achieved?
A. Rolling from back to abdomen
B. Sitting steadily without support
C. Walking with support
D. Speaking three to five words
Answer: A
Rationale: By 6 months, infants typically can roll from their back to their abdomen and
abdomen to back.
5. A mother brings her toddler to the clinic for a suspected case of croup. Which
clinical manifestation is most characteristic of this condition?
A. A high-pitched wheeze on expiration
B. A barking, brassy cough
C. A productive cough with green mucus
D. Difficulty swallowing with drooling
Answer: B
Rationale: Croup is characterized by edema of the larynx and trachea, resulting in a
distinct ‘seal-like’ barking cough.
, 6. What is the priority nursing action for a patient experiencing a prolapsed
umbilical cord?
A. Place the patient in a Trendelenburg or knee-chest position
B. Administer oxygen via nasal cannula at 2L
C. Perform a vaginal exam to assess dilation
D. Start an IV infusion of normal saline
Answer: A
Rationale: Relieving pressure on the cord is the priority. Gravity-dependent positions like
Trendelenburg help keep the fetal head off the cord.
7. A nurse is caring for a newborn with neonatal abstinence syndrome (NAS).
Which intervention is most appropriate?
A. Place the newborn in a brightly lit room for stimulation
B. Avoid swaddling to allow for free movement
C. Vigorously rock the infant to soothe crying
D. Provide frequent, small feedings with high-calorie formula
Answer: D
Rationale: Infants with NAS often have poor feeding and high metabolic rates, requiring
high-calorie intake and a quiet, low-stimulus environment.
8. Which laboratory value is expected in a patient diagnosed with HELLP
syndrome?
A. Elevated hemoglobin
B. Increased platelet count
C. Elevated liver enzymes (AST and ALT)
D. Decreased serum creatinine
Answer: C
Rationale: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets.
1. Which assessment finding is most indicative of uterine atony in a patient who
is two hours postpartum?
A. A soft, boggy fundus upon palpation
B. A firm, midline fundus
C. Lochia rubra with small clots
D. Pulse rate of 80 beats per minute
Answer: A
Rationale: Uterine atony refers to a lack of muscle tone in the uterus, making it feel soft or
boggy, which is the leading cause of early postpartum hemorrhage.
2. A nurse is monitoring a patient receiving Magnesium Sulfate for
preeclampsia. Which finding requires immediate intervention?
A. Presence of a mild headache
B. Deep tendon reflexes of 2+
C. Urinary output of 40 mL per hour
D. Respiratory rate of 10 breaths per minute
Answer: D
Rationale: Magnesium Sulfate toxicity can cause respiratory depression. A rate below 12
breaths per minute is a critical indicator of toxicity.
,3. Which fetal heart rate pattern is most associated with uteroplacental
insufficiency?
A. Early decelerations
B. Late decelerations
C. Variable decelerations
D. Accelerations
Answer: B
Rationale: Late decelerations are caused by uteroplacental insufficiency and require
immediate nursing intervention to improve fetal oxygenation.
4. When assessing a 6-month-old infant, which developmental milestone should
the nurse expect the child to have achieved?
A. Rolling from back to abdomen
B. Sitting steadily without support
C. Walking with support
D. Speaking three to five words
Answer: A
Rationale: By 6 months, infants typically can roll from their back to their abdomen and
abdomen to back.
5. A mother brings her toddler to the clinic for a suspected case of croup. Which
clinical manifestation is most characteristic of this condition?
A. A high-pitched wheeze on expiration
B. A barking, brassy cough
C. A productive cough with green mucus
D. Difficulty swallowing with drooling
Answer: B
Rationale: Croup is characterized by edema of the larynx and trachea, resulting in a
distinct ‘seal-like’ barking cough.
, 6. What is the priority nursing action for a patient experiencing a prolapsed
umbilical cord?
A. Place the patient in a Trendelenburg or knee-chest position
B. Administer oxygen via nasal cannula at 2L
C. Perform a vaginal exam to assess dilation
D. Start an IV infusion of normal saline
Answer: A
Rationale: Relieving pressure on the cord is the priority. Gravity-dependent positions like
Trendelenburg help keep the fetal head off the cord.
7. A nurse is caring for a newborn with neonatal abstinence syndrome (NAS).
Which intervention is most appropriate?
A. Place the newborn in a brightly lit room for stimulation
B. Avoid swaddling to allow for free movement
C. Vigorously rock the infant to soothe crying
D. Provide frequent, small feedings with high-calorie formula
Answer: D
Rationale: Infants with NAS often have poor feeding and high metabolic rates, requiring
high-calorie intake and a quiet, low-stimulus environment.
8. Which laboratory value is expected in a patient diagnosed with HELLP
syndrome?
A. Elevated hemoglobin
B. Increased platelet count
C. Elevated liver enzymes (AST and ALT)
D. Decreased serum creatinine
Answer: C
Rationale: HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets.
