NUR 230 Maternal & Pediatric Nursing Final Exam Practice 2026
|Galen College
1. A nurse is assessing a client at 34 weeks gestation who reports a sudden
onset of bright red vaginal bleeding without pain. Which condition should the
nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. Abruptio placentae typically presents with painful, dark red bleeding.
2. Which of the following fetal heart rate patterns is an indication of
uteroplacental insufficiency?
A. Early decelerations
B. Late decelerations
C. Accelerations
D. Variable decelerations
Answer: B
Rationale: Late decelerations are caused by uteroplacental insufficiency and are
considered a non-reassuring sign that requires immediate intervention.
,3. A nurse is caring for a client in the first stage of labor. The nurse observes the
fetal heart rate (FHR) decrease after the peak of a contraction and return to
baseline well after the contraction has ended. Which action should the nurse
take first?
A. Change the client’s position to lateral
B. Increase the rate of the maintenance IV fluid
C. Perform a vaginal exam
D. Administer oxygen via face mask
Answer: A
Rationale: The pattern describes late decelerations. The priority intervention is to
improve placental perfusion by turning the client to a side-lying position.
4. Which medication is commonly administered to a neonate within 1 to 2 hours
of birth to prevent ophthalmia neonatorum?
A. Vitamin K
B. Nystatin
C. Hepatitis B vaccine
D. Erythromycin ointment
Answer: D
Rationale: Erythromycin ophthalmic ointment is administered prophylactically to prevent
blindness caused by gonorrhea or chlamydia infections acquired during birth.
5. A nurse is teaching a postpartum client about the characteristics of lochia.
Which sequence of lochia discharge should the nurse describe?
A. Lochia serosa, lochia rubra, lochia alba
B. Lochia rubra, lochia serosa, lochia alba
C. Lochia rubra, lochia alba, lochia serosa
D. Lochia alba, lochia serosa, lochia rubra
Answer: B
, Rationale: Lochia rubra occurs for the first 1-3 days, followed by lochia serosa (days 4-10),
and finally lochia alba (11 days to 6 weeks).
6. A nurse is assessing a newborn with a high-pitched cry, irritability, and poor
feeding. The mother admits to substance use during pregnancy. Which
condition does the nurse suspect?
A. Fetal alcohol syndrome
B. Neonatal abstinence syndrome
C. Hypoglycemia
D. Sepsis
Answer: B
Rationale: Neonatal abstinence syndrome (NAS) presents with central nervous system
irritability (high-pitched cry, tremors) and gastrointestinal dysfunction following
withdrawal from maternal drugs.
7. What is the therapeutic range for magnesium sulfate when treating a client
with preeclampsia?
A. 4 to 7 mEq/L
B. 1 to 3 mEq/L
C. 8 to 10 mEq/L
D. 12 to 15 mEq/L
Answer: A
Rationale: The therapeutic range for magnesium sulfate to prevent seizures in
preeclampsia is typically 4 to 7 mEq/L. Higher levels increase the risk of toxicity.
|Galen College
1. A nurse is assessing a client at 34 weeks gestation who reports a sudden
onset of bright red vaginal bleeding without pain. Which condition should the
nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Answer: A
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
third trimester. Abruptio placentae typically presents with painful, dark red bleeding.
2. Which of the following fetal heart rate patterns is an indication of
uteroplacental insufficiency?
A. Early decelerations
B. Late decelerations
C. Accelerations
D. Variable decelerations
Answer: B
Rationale: Late decelerations are caused by uteroplacental insufficiency and are
considered a non-reassuring sign that requires immediate intervention.
,3. A nurse is caring for a client in the first stage of labor. The nurse observes the
fetal heart rate (FHR) decrease after the peak of a contraction and return to
baseline well after the contraction has ended. Which action should the nurse
take first?
A. Change the client’s position to lateral
B. Increase the rate of the maintenance IV fluid
C. Perform a vaginal exam
D. Administer oxygen via face mask
Answer: A
Rationale: The pattern describes late decelerations. The priority intervention is to
improve placental perfusion by turning the client to a side-lying position.
4. Which medication is commonly administered to a neonate within 1 to 2 hours
of birth to prevent ophthalmia neonatorum?
A. Vitamin K
B. Nystatin
C. Hepatitis B vaccine
D. Erythromycin ointment
Answer: D
Rationale: Erythromycin ophthalmic ointment is administered prophylactically to prevent
blindness caused by gonorrhea or chlamydia infections acquired during birth.
5. A nurse is teaching a postpartum client about the characteristics of lochia.
Which sequence of lochia discharge should the nurse describe?
A. Lochia serosa, lochia rubra, lochia alba
B. Lochia rubra, lochia serosa, lochia alba
C. Lochia rubra, lochia alba, lochia serosa
D. Lochia alba, lochia serosa, lochia rubra
Answer: B
, Rationale: Lochia rubra occurs for the first 1-3 days, followed by lochia serosa (days 4-10),
and finally lochia alba (11 days to 6 weeks).
6. A nurse is assessing a newborn with a high-pitched cry, irritability, and poor
feeding. The mother admits to substance use during pregnancy. Which
condition does the nurse suspect?
A. Fetal alcohol syndrome
B. Neonatal abstinence syndrome
C. Hypoglycemia
D. Sepsis
Answer: B
Rationale: Neonatal abstinence syndrome (NAS) presents with central nervous system
irritability (high-pitched cry, tremors) and gastrointestinal dysfunction following
withdrawal from maternal drugs.
7. What is the therapeutic range for magnesium sulfate when treating a client
with preeclampsia?
A. 4 to 7 mEq/L
B. 1 to 3 mEq/L
C. 8 to 10 mEq/L
D. 12 to 15 mEq/L
Answer: A
Rationale: The therapeutic range for magnesium sulfate to prevent seizures in
preeclampsia is typically 4 to 7 mEq/L. Higher levels increase the risk of toxicity.
