NUR 230 Maternal & Pediatric Nursing Final Exam 2026 |Galen
College
1. A nurse is calculating the GTPAL for a client who is pregnant, has a 5-year-old
born at 39 weeks, a 3-year-old born at 34 weeks, and had one miscarriage at 12
weeks. What is the correct GTPAL?
A. G3, T2, P0, A1, L2
B. G4, T1, P1, A1, L2
C. G4, T2, P1, A0, L2
D. G3, T1, P1, A1, L2
Answer: B
Rationale: The client is currently pregnant (G4), had one full-term birth (T1), one preterm
birth (P1), one miscarriage (A1), and has two living children (L2).
2. Which fetal heart rate pattern is most indicative of uteroplacental
insufficiency?
A. Early decelerations
B. Accelerations
C. Variable decelerations
D. Late decelerations
Answer: D
Rationale: Late decelerations are caused by uteroplacental insufficiency and require
immediate intervention to improve fetal oxygenation.
,3. A client at 32 weeks gestation is admitted with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Ectopic pregnancy
C. Placenta previa
D. Molar pregnancy
Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester.
4. What is the primary medication used to prevent seizures in a client with
preeclampsia?
A. Magnesium sulfate
B. Terbutaline
C. Oxytocin
D. Calcium gluconate
Answer: A
Rationale: Magnesium sulfate is the drug of choice for seizure prophylaxis in preeclampsia
by depressing the central nervous system.
5. The nurse is assessing a client receiving Magnesium Sulfate. Which finding
indicates toxicity?
A. Presence of deep tendon reflexes
B. Urinary output of 50 mL/hr
C. Blood pressure of 140/90 mmHg
D. Respiratory rate of 10 breaths/min
Answer: D
Rationale: Signs of magnesium toxicity include a respiratory rate below 12/min, loss of
deep tendon reflexes, and decreased urinary output.
, 6. What is the priority nursing intervention for a client with umbilical cord
prolapse?
A. Apply pressure to the presenting part to lift it off the cord
B. Administer oxygen via face mask
C. Begin an oxytocin infusion
D. Perform a fundal massage
Answer: A
Rationale: Relieving pressure on the prolapsed cord is the priority to maintain fetal
oxygenation until an emergency C-section can be performed.
7. A newborn has a heart rate of 110, a strong cry, some flexion of extremities,
sneezes when stimulated, and a pink body with blue extremities. What is the
Apgar score?
A. 7
B. 8
C. 9
D. 10
Answer: B
Rationale: HR=2, Cry=2, Flexion=1, Sneeze=2, Color=1. Total = 8.
8. Which medication is routinely administered to newborns within 1 hour of
birth to prevent ophthalmia neonatorum?
A. Erythromycin ophthalmic ointment
B. Hepatitis B vaccine
C. Vitamin K
D. Nystatin
Answer: A
Rationale: Erythromycin ointment prevents eye infections caused by gonorrhea or
chlamydia during delivery.
College
1. A nurse is calculating the GTPAL for a client who is pregnant, has a 5-year-old
born at 39 weeks, a 3-year-old born at 34 weeks, and had one miscarriage at 12
weeks. What is the correct GTPAL?
A. G3, T2, P0, A1, L2
B. G4, T1, P1, A1, L2
C. G4, T2, P1, A0, L2
D. G3, T1, P1, A1, L2
Answer: B
Rationale: The client is currently pregnant (G4), had one full-term birth (T1), one preterm
birth (P1), one miscarriage (A1), and has two living children (L2).
2. Which fetal heart rate pattern is most indicative of uteroplacental
insufficiency?
A. Early decelerations
B. Accelerations
C. Variable decelerations
D. Late decelerations
Answer: D
Rationale: Late decelerations are caused by uteroplacental insufficiency and require
immediate intervention to improve fetal oxygenation.
,3. A client at 32 weeks gestation is admitted with painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Ectopic pregnancy
C. Placenta previa
D. Molar pregnancy
Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding in the
second or third trimester.
4. What is the primary medication used to prevent seizures in a client with
preeclampsia?
A. Magnesium sulfate
B. Terbutaline
C. Oxytocin
D. Calcium gluconate
Answer: A
Rationale: Magnesium sulfate is the drug of choice for seizure prophylaxis in preeclampsia
by depressing the central nervous system.
5. The nurse is assessing a client receiving Magnesium Sulfate. Which finding
indicates toxicity?
A. Presence of deep tendon reflexes
B. Urinary output of 50 mL/hr
C. Blood pressure of 140/90 mmHg
D. Respiratory rate of 10 breaths/min
Answer: D
Rationale: Signs of magnesium toxicity include a respiratory rate below 12/min, loss of
deep tendon reflexes, and decreased urinary output.
, 6. What is the priority nursing intervention for a client with umbilical cord
prolapse?
A. Apply pressure to the presenting part to lift it off the cord
B. Administer oxygen via face mask
C. Begin an oxytocin infusion
D. Perform a fundal massage
Answer: A
Rationale: Relieving pressure on the prolapsed cord is the priority to maintain fetal
oxygenation until an emergency C-section can be performed.
7. A newborn has a heart rate of 110, a strong cry, some flexion of extremities,
sneezes when stimulated, and a pink body with blue extremities. What is the
Apgar score?
A. 7
B. 8
C. 9
D. 10
Answer: B
Rationale: HR=2, Cry=2, Flexion=1, Sneeze=2, Color=1. Total = 8.
8. Which medication is routinely administered to newborns within 1 hour of
birth to prevent ophthalmia neonatorum?
A. Erythromycin ophthalmic ointment
B. Hepatitis B vaccine
C. Vitamin K
D. Nystatin
Answer: A
Rationale: Erythromycin ointment prevents eye infections caused by gonorrhea or
chlamydia during delivery.
