NUR 3300 Exam 4 – Nursing Practice II – (2026) Actual Questions & Answers
(WPU
NUR 3300 Exam 4 – Nursing Practice II (2026)
William Paterson University – 200 Practice Questions with Answers & Rationales
Section A: Maternal-Newborn Nursing & Labor & Delivery (Questions 1-45)
Question 1
A client at 36 weeks' gestation presents to the OB unit reporting continuous,
heavy vaginal discharge and pelvic pressure. Assessment reveals no signs of labor
and a positive nitrazine test. What nursing intervention should the nurse prepare
to implement?
A) Prepare for immediate induction of labor
B) Teach the client Kegel exercises
C) Administer erythromycin IV
D) Discharge the client home with bed rest instructions
Answer: C
Rationale: A positive nitrazine test with heavy leaking suggests premature rupture
of membranes (PROM). At 36 weeks, IV antibiotics such as erythromycin are
administered to reduce the risk of ascending infection for both mother and fetus
while further care is planned .
,Question 2
The nurse is performing an assessment on a client in the immediate postpartum
period. Which assessment finding requires the nurse's priority attention?
A) Mild perineal discomfort
B) Fatigue and drowsiness
C) Hemorrhage
D) Mild afterpains
Answer: C
Rationale: Postpartum hemorrhage is the leading cause of maternal morbidity
and mortality and requires rapid recognition. Fundal tone, lochia amount, and
vital signs must be prioritized to detect excessive blood loss early .
Question 3
The healthcare provider has ordered cervical ripening overnight for a client being
admitted for induction of labor. Which teaching should the nurse prioritize for the
client and her partner?
,A) "This will make your contractions start immediately and very strongly."
B) "The cervix needs to be soft and thinning to be induced for labor; this helps
prepare it."
C) "Cervical ripening is only used if you are already fully dilated."
D) "This procedure will numb the cervix so you won't feel contractions."
Answer: B
Rationale: Cervical ripening softens and thins the cervix (effacement) to make it
more favorable for induction. This process typically occurs before active labor
begins and does not immediately cause strong contractions .
Question 4
The nurse is caring for a client receiving oxytocin for labor induction. The nurse
notes the client is dilated to 4 cm with contractions every 1 minute and increased
signs of fetal distress. What action should the nurse take?
A) Increase the oxytocin rate to establish adequate labor
B) Continue the current rate and observe for 30 more minutes
C) Stop the oxytocin infusion immediately
D) Encourage the client to ambulate in the hallway
, Answer: C
Rationale: Contractions occurring every minute indicate
tachysystole/hyperstimulation, which can compromise fetal oxygenation.
Oxytocin must be discontinued immediately, the maternal position changed, and
the provider notified .
Question 5
A G2P1 woman in labor attempting a VBAC (vaginal birth after cesarean) suddenly
complains of light-headedness and dizziness. An increase in pulse and decrease in
blood pressure is noted from vital signs obtained 15 minutes prior. The nurse
should investigate further for signs of which complication?
A) Placenta previa
B) Uterine rupture
C) Cord prolapse
D) Hyperemesis gravidarum
Answer: B
(WPU
NUR 3300 Exam 4 – Nursing Practice II (2026)
William Paterson University – 200 Practice Questions with Answers & Rationales
Section A: Maternal-Newborn Nursing & Labor & Delivery (Questions 1-45)
Question 1
A client at 36 weeks' gestation presents to the OB unit reporting continuous,
heavy vaginal discharge and pelvic pressure. Assessment reveals no signs of labor
and a positive nitrazine test. What nursing intervention should the nurse prepare
to implement?
A) Prepare for immediate induction of labor
B) Teach the client Kegel exercises
C) Administer erythromycin IV
D) Discharge the client home with bed rest instructions
Answer: C
Rationale: A positive nitrazine test with heavy leaking suggests premature rupture
of membranes (PROM). At 36 weeks, IV antibiotics such as erythromycin are
administered to reduce the risk of ascending infection for both mother and fetus
while further care is planned .
,Question 2
The nurse is performing an assessment on a client in the immediate postpartum
period. Which assessment finding requires the nurse's priority attention?
A) Mild perineal discomfort
B) Fatigue and drowsiness
C) Hemorrhage
D) Mild afterpains
Answer: C
Rationale: Postpartum hemorrhage is the leading cause of maternal morbidity
and mortality and requires rapid recognition. Fundal tone, lochia amount, and
vital signs must be prioritized to detect excessive blood loss early .
Question 3
The healthcare provider has ordered cervical ripening overnight for a client being
admitted for induction of labor. Which teaching should the nurse prioritize for the
client and her partner?
,A) "This will make your contractions start immediately and very strongly."
B) "The cervix needs to be soft and thinning to be induced for labor; this helps
prepare it."
C) "Cervical ripening is only used if you are already fully dilated."
D) "This procedure will numb the cervix so you won't feel contractions."
Answer: B
Rationale: Cervical ripening softens and thins the cervix (effacement) to make it
more favorable for induction. This process typically occurs before active labor
begins and does not immediately cause strong contractions .
Question 4
The nurse is caring for a client receiving oxytocin for labor induction. The nurse
notes the client is dilated to 4 cm with contractions every 1 minute and increased
signs of fetal distress. What action should the nurse take?
A) Increase the oxytocin rate to establish adequate labor
B) Continue the current rate and observe for 30 more minutes
C) Stop the oxytocin infusion immediately
D) Encourage the client to ambulate in the hallway
, Answer: C
Rationale: Contractions occurring every minute indicate
tachysystole/hyperstimulation, which can compromise fetal oxygenation.
Oxytocin must be discontinued immediately, the maternal position changed, and
the provider notified .
Question 5
A G2P1 woman in labor attempting a VBAC (vaginal birth after cesarean) suddenly
complains of light-headedness and dizziness. An increase in pulse and decrease in
blood pressure is noted from vital signs obtained 15 minutes prior. The nurse
should investigate further for signs of which complication?
A) Placenta previa
B) Uterine rupture
C) Cord prolapse
D) Hyperemesis gravidarum
Answer: B
