NUR 230: Maternal & Pediatric Nursing Exam 3 Comprehensive Study
Guide 2026 |Galen College
1. A nurse is caring for a child with epiglottitis. Which of the following actions
should the nurse take first?
A. Obtain a throat culture
B. Prepare for nasotracheal intubation
C. Initiate IV access
D. Apply a warm compress to the neck
Answer: B
Rationale: Epiglottitis is a medical emergency. The priority is maintaining a patent airway.
Preparing for intubation is critical before the airway becomes completely obstructed.
Throat cultures are contraindicated as they can trigger laryngospasm.
2. A postpartum nurse is assessing a client 2 hours after delivery. The client’s
fundus is boggy and displaced to the right. Which action is appropriate?
A. Assist the client to the bathroom to void
B. Administer oxytocin IV bolus
C. Massage the fundus until firm
D. Place the client in Trendelenburg position
Answer: A
Rationale: A fundus displaced to the right usually indicates a distended bladder. Assisting
the client to void allows the uterus to return to the midline and contract effectively.
,3. A 4-year-old child is admitted with Tetralogy of Fallot. The child suddenly
becomes cyanotic and dyspneic. Which position should the nurse place the child
in?
A. Knee-chest
B. Semi-Fowler’s
C. High-Fowler’s
D. Supine
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which
decreases the right-to-left shunt and improves oxygenation during a ‘tet spell’.
4. A client at 34 weeks gestation is receiving magnesium sulfate for
preeclampsia. The nurse notes a respiratory rate of 10/min and absent deep
tendon reflexes. Which medication should be available?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity, which is
characterized by respiratory depression and loss of deep tendon reflexes.
5. A nurse is teaching the parents of a child with cystic fibrosis about nutrition.
Which instruction is most important?
A. Restrict sodium intake
B. Limit fluid intake during meals
C. Provide a low-fat, low-calorie diet
D. Administer pancreatic enzymes with all meals and snacks
Answer: D
, Rationale: Children with CF require pancreatic enzymes to assist with the digestion and
absorption of fats and proteins due to pancreatic insufficiency.
6. A newborn has an Apgar score of 9 at 1 minute. Which of the following is the
most likely reason for the missing point?
A. Heart rate of 110/min
B. Slow respirations
C. Weak cry
D. Acrocyanosis
Answer: D
Rationale: Acrocyanosis (blue extremities with a pink trunk) is common in newborns and
results in a score of 1 for color, making the total Apgar 9 instead of 10.
7. Which clinical manifestation is a classic sign of pyloric stenosis in an infant?
A. Projectile vomiting
B. Currant jelly-like stools
C. Bile-stained emesis
D. Steatorrhea
Answer: A
Rationale: Projectile vomiting after feedings is the hallmark sign of hypertrophic pyloric
stenosis due to the obstruction of the gastric outlet.
8. A nurse is assessing a child with suspected intussusception. Which finding
should the nurse expect?
A. Ribbon-like stools
B. Absence of bowel sounds
C. Constant, dull abdominal pain
D. Palpable sausage-shaped mass in the upper right quadrant
Answer: D
Guide 2026 |Galen College
1. A nurse is caring for a child with epiglottitis. Which of the following actions
should the nurse take first?
A. Obtain a throat culture
B. Prepare for nasotracheal intubation
C. Initiate IV access
D. Apply a warm compress to the neck
Answer: B
Rationale: Epiglottitis is a medical emergency. The priority is maintaining a patent airway.
Preparing for intubation is critical before the airway becomes completely obstructed.
Throat cultures are contraindicated as they can trigger laryngospasm.
2. A postpartum nurse is assessing a client 2 hours after delivery. The client’s
fundus is boggy and displaced to the right. Which action is appropriate?
A. Assist the client to the bathroom to void
B. Administer oxytocin IV bolus
C. Massage the fundus until firm
D. Place the client in Trendelenburg position
Answer: A
Rationale: A fundus displaced to the right usually indicates a distended bladder. Assisting
the client to void allows the uterus to return to the midline and contract effectively.
,3. A 4-year-old child is admitted with Tetralogy of Fallot. The child suddenly
becomes cyanotic and dyspneic. Which position should the nurse place the child
in?
A. Knee-chest
B. Semi-Fowler’s
C. High-Fowler’s
D. Supine
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which
decreases the right-to-left shunt and improves oxygenation during a ‘tet spell’.
4. A client at 34 weeks gestation is receiving magnesium sulfate for
preeclampsia. The nurse notes a respiratory rate of 10/min and absent deep
tendon reflexes. Which medication should be available?
A. Naloxone
B. Calcium gluconate
C. Terbutaline
D. Hydralazine
Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity, which is
characterized by respiratory depression and loss of deep tendon reflexes.
5. A nurse is teaching the parents of a child with cystic fibrosis about nutrition.
Which instruction is most important?
A. Restrict sodium intake
B. Limit fluid intake during meals
C. Provide a low-fat, low-calorie diet
D. Administer pancreatic enzymes with all meals and snacks
Answer: D
, Rationale: Children with CF require pancreatic enzymes to assist with the digestion and
absorption of fats and proteins due to pancreatic insufficiency.
6. A newborn has an Apgar score of 9 at 1 minute. Which of the following is the
most likely reason for the missing point?
A. Heart rate of 110/min
B. Slow respirations
C. Weak cry
D. Acrocyanosis
Answer: D
Rationale: Acrocyanosis (blue extremities with a pink trunk) is common in newborns and
results in a score of 1 for color, making the total Apgar 9 instead of 10.
7. Which clinical manifestation is a classic sign of pyloric stenosis in an infant?
A. Projectile vomiting
B. Currant jelly-like stools
C. Bile-stained emesis
D. Steatorrhea
Answer: A
Rationale: Projectile vomiting after feedings is the hallmark sign of hypertrophic pyloric
stenosis due to the obstruction of the gastric outlet.
8. A nurse is assessing a child with suspected intussusception. Which finding
should the nurse expect?
A. Ribbon-like stools
B. Absence of bowel sounds
C. Constant, dull abdominal pain
D. Palpable sausage-shaped mass in the upper right quadrant
Answer: D
