NSG 3500 Maternity Exam 4 Prep Document | 2026/2027
Edition | 250 Verified Questions
NSG 3500 Maternity Exam 4 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED
A+. 100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive test bank for NSG 3500 Maternity Exam 4 contains 250 verified questions and
answers, designed to help nursing students master maternal-newborn nursing concepts. The document
covers key topics such as antepartum care, intrapartum management, postpartum complications, and
neonatal assessment. Each question includes correct answers with rationales, ensuring a deep
understanding of evidence-based practice. Updated for the 2026/2027 academic year, this resource
reflects the latest clinical guidelines and exam standards.
Key Features:
Antepartum nursing care and risk assessment
Intrapartum fetal monitoring and labor management
Postpartum hemorrhage and infection prevention
Newborn transition and APGAR scoring
High-risk pregnancy conditions (preeclampsia, gestational diabetes)
Pharmacology for maternity nursing
Updates for 2026:
- Revised to include 2026 ACOG guidelines for gestational diabetes screening
- Updated neonatal resuscitation protocols per 2025 AAP guidelines
- Added new questions on COVID-19 in pregnancy and vaccination recommendations
- Enhanced rationales with current evidence-based practice references
- Expanded coverage of postpartum mental health screening tools
Abstract:
This test bank for NSG 3500 Maternity Exam 4 provides 250 rigorously verified questions that align with the latest
nursing curriculum and clinical standards. The content is organized into major content areas including
antepartum, intrapartum, postpartum, and newborn care, with a focus on high-risk conditions and evidence-based
interventions. Each question is accompanied by a detailed rationale that explains the correct answer and
distractor analysis, promoting critical thinking and application. The document is designed to simulate the actual
exam experience, with questions ranging from basic recall to complex clinical scenarios. Updated for the
2026/2027 academic year, it incorporates recent changes in obstetric guidelines and pharmacological treatments.
This resource is ideal for students seeking to achieve a grade of A+ on their maternity nursing exam.
Keywords:
NSG 3500, Maternity Exam 4, Galen, Test Bank, Maternal-Newborn Nursing, NCLEX-RN, 2026-2027, Verified
Questions
Answer Format:
Each question is followed by the correct answer in bold, with a detailed rationale explaining why it is correct and
why the other options are incorrect. Rationales include references to current clinical guidelines and nursing
textbooks to support learning.
Compliance Checklist:
All questions verified for accuracy against 2026-2027 curriculum
Answers graded A+ by nursing faculty
Rationales updated with latest evidence-based practice
Page 1
, Covers all major content areas for NSG 3500 Exam 4
Includes distractors that reflect common student misconceptions
Content Area Overview:
Content Area Questions Key Topics Weight
Antepartum Care 1-50 Prenatal assessments, risk factors, 20%
gestational diabetes, preeclampsia, multiple
gestation
Intrapartum Care 51-110 Labor stages, fetal monitoring, pain 24%
management, induction, operative delivery
Postpartum Care 111-170 Hemorrhage, infection, thromboembolism, 24%
breastfeeding, mental health
Newborn Care 171-220 APGAR, transition, jaundice, hypoglycemia, 20%
congenital anomalies
Pharmacology & Complications 221-250 Oxytocin, magnesium sulfate, antibiotics, 12%
antihypertensives, emergency drugs
Page 2
,Q1. A 28-week pregnant individual with no prenatal care presents with sudden onset of severe epigastric
pain, headache, and visual disturbances. Blood pressure is 180/120 mm Hg, and urine dipstick shows 3+
protein. Fetal heart rate is 140 bpm with minimal variability. Which intervention should the nurse prioritize
immediately after initiating seizure precautions?
A. Administer magnesium sulfate 4 g IV bolus over 20 minutes
B. Administer nifedipine 10 mg sublingual
C. Prepare for emergent cesarean delivery
D. Insert a urinary catheter for strict intake and output
Correct Answer: A. Administer magnesium sulfate 4 g IV bolus over 20 minutes
Rationale: Magnesium sulfate is the first-line anticonvulsant for severe preeclampsia with severe features (BP
160/110, proteinuria, symptoms). It reduces the risk of eclampsia and is prioritized over antihypertensives or
delivery until the mother is stabilized. Nifedipine may be used for BP control but not before seizure prophylaxis.
Delivery is indicated after stabilization, not immediately. Catheterization is supportive but not the priority.
Why Wrong:
B - Nifedipine is an antihypertensive but does not prevent seizures; magnesium sulfate is the priority.
C - Delivery is indicated after maternal stabilization to prevent further deterioration, not immediately before
seizure prophylaxis.
D - Catheterization is important for monitoring output but does not address the immediate risk of eclampsia.
Reference: Cunningham, F.G., et al. (2022). Williams Obstetrics, 26th Ed., Ch. 40; ACOG Practice Bulletin No.
222, 2020.
Q2. During a postpartum hemorrhage, the nurse notes that the uterus is firm and midline, but bleeding
continues. Vital signs are stable. Which step should the nurse take next?
A. Perform fundal massage
B. Assess for retained placental fragments
C. Administer methylergonovine 0.2 mg IM
D. Insert a second large-bore IV catheter
Correct Answer: B. Assess for retained placental fragments
Rationale: A firm, midline uterus suggests adequate uterine tone; hemorrhage in this context is likely due to
retained placental fragments or genital tract trauma. Fundal massage is already effective if the uterus is firm.
Methylergonovine is indicated for uterine atony, not for a firm uterus. A second IV is supportive but does not
address the cause.
Why Wrong:
A - Fundal massage is appropriate for a boggy uterus; this uterus is firm, so massage is not indicated.
C - Methylergonovine treats uterine atony; here the uterus is firm, so it is not the cause of bleeding.
D - Additional IV access is important for resuscitation but does not identify or treat the source of hemorrhage.
Reference: ACOG Practice Bulletin No. 183, 2017; Lyndon, A., et al. (2020). AWHONN Postpartum Hemorrhage
Project.
Q3. Which finding in a newborn at 24 hours of life is most concerning and requires immediate intervention?
A. Axillary temperature 36.8°C (98.2°F)
B. Respiratory rate 62 breaths/min with slight nasal flaring
C. Heart rate 130 bpm while awake
D. Blood glucose 45 mg/dL via heel stick
Correct Answer: B. Respiratory rate 62 breaths/min with slight nasal flaring
Rationale: A respiratory rate of 62 with nasal flaring indicates respiratory distress; normal rate is 30-60, and
nasal flaring is a sign of increased work of breathing. Temperature 36.8°C is normal. Heart rate 130 is normal for
awake newborn. Blood glucose 45 mg/dL is within normal range (>40 mg/dL).
Page 3
, Why Wrong:
A - Axillary temperature 36.8°C is within normal range (36.5-37.5°C).
C - Heart rate 130 bpm is normal for an awake newborn (110-160 bpm).
D - Blood glucose 45 mg/dL is above the threshold for hypoglycemia (<40 mg/dL).
Reference: Gomella, T.L., & Cunningham, M.D. (2021). Neonatology: Management, Procedures, On-Call Problems, 8th Ed.,
Ch. 1.
Q4. A nurse is caring for a client receiving oxytocin for labor augmentation. The contraction pattern shows
contractions every 2 minutes, lasting 90 seconds, with intensity of 80 mm Hg by intrauterine pressure
catheter. Fetal heart rate shows recurrent late decelerations. What is the nurse's priority action?
A. Increase oxytocin rate to achieve adequate labor progress
B. Discontinue oxytocin and administer a tocolytic
C. Turn client on left side and administer oxygen via face mask
D. Prepare for immediate cesarean delivery
Correct Answer: C. Turn client on left side and administer oxygen via face mask
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority is to improve fetal oxygenation by
repositioning (left lateral) and administering oxygen. Oxytocin should be reduced or stopped, not increased.
Tocolytics may be considered for hyperstimulation but not first-line. Cesarean may be needed if decelerations
persist, but immediate intrauterine resuscitation is the priority.
Why Wrong:
A - Increasing oxytocin would worsen uterine hyperstimulation and fetal hypoxia.
B - Tocolytics are not first-line; stopping oxytocin and repositioning are the initial steps.
D - Cesarean delivery is indicated if resuscitation fails, not as the first action.
Reference: ACOG Practice Bulletin No. 106, 2009 (Reaffirmed 2021); Simpson, K.R. (2020). AWHONN's Perinatal
Nursing, 5th Ed.
Q5. A client with gestational diabetes mellitus is scheduled for a nonstress test at 36 weeks. The nurse
explains the purpose of the test. Which statement by the client indicates understanding?
A. This test will measure the amount of amniotic fluid around the baby.
B. This test checks how the baby's heart rate responds to its own movements.
C. This test uses sound waves to look at the baby's organs.
D. This test measures the strength and frequency of my contractions.
Correct Answer: B. This test checks how the baby's heart rate responds to its own movements.
Rationale: A nonstress test (NST) evaluates fetal heart rate accelerations in response to fetal movement, indicating
an intact autonomic nervous system and adequate oxygenation. Option A describes an amniotic fluid index, option
C describes a detailed ultrasound, and option D describes a tocometer for contractions.
Why Wrong:
A - Amniotic fluid is assessed via ultrasound, not NST.
C - Detailed anatomic survey is done via ultrasound, not NST.
D - Contractions are monitored separately; NST focuses on fetal heart rate response to movement.
Reference: ACOG Practice Bulletin No. 145, 2014 (Reaffirmed 2021); Freeman, R.K., et al. (2019). Fetal Heart
Rate Monitoring, 5th Ed.
Q6. A nurse is assessing a client who is 12 hours postpartum after a vaginal delivery. The client reports a
sudden gush of blood and passing a large clot. On assessment, the uterus is boggy and displaced to the right.
What is the most likely cause of the hemorrhage?
A. Uterine atony
B. Retained placental fragments
C. Genital tract laceration
Page 4
Edition | 250 Verified Questions
NSG 3500 Maternity Exam 4 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED
A+. 100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive test bank for NSG 3500 Maternity Exam 4 contains 250 verified questions and
answers, designed to help nursing students master maternal-newborn nursing concepts. The document
covers key topics such as antepartum care, intrapartum management, postpartum complications, and
neonatal assessment. Each question includes correct answers with rationales, ensuring a deep
understanding of evidence-based practice. Updated for the 2026/2027 academic year, this resource
reflects the latest clinical guidelines and exam standards.
Key Features:
Antepartum nursing care and risk assessment
Intrapartum fetal monitoring and labor management
Postpartum hemorrhage and infection prevention
Newborn transition and APGAR scoring
High-risk pregnancy conditions (preeclampsia, gestational diabetes)
Pharmacology for maternity nursing
Updates for 2026:
- Revised to include 2026 ACOG guidelines for gestational diabetes screening
- Updated neonatal resuscitation protocols per 2025 AAP guidelines
- Added new questions on COVID-19 in pregnancy and vaccination recommendations
- Enhanced rationales with current evidence-based practice references
- Expanded coverage of postpartum mental health screening tools
Abstract:
This test bank for NSG 3500 Maternity Exam 4 provides 250 rigorously verified questions that align with the latest
nursing curriculum and clinical standards. The content is organized into major content areas including
antepartum, intrapartum, postpartum, and newborn care, with a focus on high-risk conditions and evidence-based
interventions. Each question is accompanied by a detailed rationale that explains the correct answer and
distractor analysis, promoting critical thinking and application. The document is designed to simulate the actual
exam experience, with questions ranging from basic recall to complex clinical scenarios. Updated for the
2026/2027 academic year, it incorporates recent changes in obstetric guidelines and pharmacological treatments.
This resource is ideal for students seeking to achieve a grade of A+ on their maternity nursing exam.
Keywords:
NSG 3500, Maternity Exam 4, Galen, Test Bank, Maternal-Newborn Nursing, NCLEX-RN, 2026-2027, Verified
Questions
Answer Format:
Each question is followed by the correct answer in bold, with a detailed rationale explaining why it is correct and
why the other options are incorrect. Rationales include references to current clinical guidelines and nursing
textbooks to support learning.
Compliance Checklist:
All questions verified for accuracy against 2026-2027 curriculum
Answers graded A+ by nursing faculty
Rationales updated with latest evidence-based practice
Page 1
, Covers all major content areas for NSG 3500 Exam 4
Includes distractors that reflect common student misconceptions
Content Area Overview:
Content Area Questions Key Topics Weight
Antepartum Care 1-50 Prenatal assessments, risk factors, 20%
gestational diabetes, preeclampsia, multiple
gestation
Intrapartum Care 51-110 Labor stages, fetal monitoring, pain 24%
management, induction, operative delivery
Postpartum Care 111-170 Hemorrhage, infection, thromboembolism, 24%
breastfeeding, mental health
Newborn Care 171-220 APGAR, transition, jaundice, hypoglycemia, 20%
congenital anomalies
Pharmacology & Complications 221-250 Oxytocin, magnesium sulfate, antibiotics, 12%
antihypertensives, emergency drugs
Page 2
,Q1. A 28-week pregnant individual with no prenatal care presents with sudden onset of severe epigastric
pain, headache, and visual disturbances. Blood pressure is 180/120 mm Hg, and urine dipstick shows 3+
protein. Fetal heart rate is 140 bpm with minimal variability. Which intervention should the nurse prioritize
immediately after initiating seizure precautions?
A. Administer magnesium sulfate 4 g IV bolus over 20 minutes
B. Administer nifedipine 10 mg sublingual
C. Prepare for emergent cesarean delivery
D. Insert a urinary catheter for strict intake and output
Correct Answer: A. Administer magnesium sulfate 4 g IV bolus over 20 minutes
Rationale: Magnesium sulfate is the first-line anticonvulsant for severe preeclampsia with severe features (BP
160/110, proteinuria, symptoms). It reduces the risk of eclampsia and is prioritized over antihypertensives or
delivery until the mother is stabilized. Nifedipine may be used for BP control but not before seizure prophylaxis.
Delivery is indicated after stabilization, not immediately. Catheterization is supportive but not the priority.
Why Wrong:
B - Nifedipine is an antihypertensive but does not prevent seizures; magnesium sulfate is the priority.
C - Delivery is indicated after maternal stabilization to prevent further deterioration, not immediately before
seizure prophylaxis.
D - Catheterization is important for monitoring output but does not address the immediate risk of eclampsia.
Reference: Cunningham, F.G., et al. (2022). Williams Obstetrics, 26th Ed., Ch. 40; ACOG Practice Bulletin No.
222, 2020.
Q2. During a postpartum hemorrhage, the nurse notes that the uterus is firm and midline, but bleeding
continues. Vital signs are stable. Which step should the nurse take next?
A. Perform fundal massage
B. Assess for retained placental fragments
C. Administer methylergonovine 0.2 mg IM
D. Insert a second large-bore IV catheter
Correct Answer: B. Assess for retained placental fragments
Rationale: A firm, midline uterus suggests adequate uterine tone; hemorrhage in this context is likely due to
retained placental fragments or genital tract trauma. Fundal massage is already effective if the uterus is firm.
Methylergonovine is indicated for uterine atony, not for a firm uterus. A second IV is supportive but does not
address the cause.
Why Wrong:
A - Fundal massage is appropriate for a boggy uterus; this uterus is firm, so massage is not indicated.
C - Methylergonovine treats uterine atony; here the uterus is firm, so it is not the cause of bleeding.
D - Additional IV access is important for resuscitation but does not identify or treat the source of hemorrhage.
Reference: ACOG Practice Bulletin No. 183, 2017; Lyndon, A., et al. (2020). AWHONN Postpartum Hemorrhage
Project.
Q3. Which finding in a newborn at 24 hours of life is most concerning and requires immediate intervention?
A. Axillary temperature 36.8°C (98.2°F)
B. Respiratory rate 62 breaths/min with slight nasal flaring
C. Heart rate 130 bpm while awake
D. Blood glucose 45 mg/dL via heel stick
Correct Answer: B. Respiratory rate 62 breaths/min with slight nasal flaring
Rationale: A respiratory rate of 62 with nasal flaring indicates respiratory distress; normal rate is 30-60, and
nasal flaring is a sign of increased work of breathing. Temperature 36.8°C is normal. Heart rate 130 is normal for
awake newborn. Blood glucose 45 mg/dL is within normal range (>40 mg/dL).
Page 3
, Why Wrong:
A - Axillary temperature 36.8°C is within normal range (36.5-37.5°C).
C - Heart rate 130 bpm is normal for an awake newborn (110-160 bpm).
D - Blood glucose 45 mg/dL is above the threshold for hypoglycemia (<40 mg/dL).
Reference: Gomella, T.L., & Cunningham, M.D. (2021). Neonatology: Management, Procedures, On-Call Problems, 8th Ed.,
Ch. 1.
Q4. A nurse is caring for a client receiving oxytocin for labor augmentation. The contraction pattern shows
contractions every 2 minutes, lasting 90 seconds, with intensity of 80 mm Hg by intrauterine pressure
catheter. Fetal heart rate shows recurrent late decelerations. What is the nurse's priority action?
A. Increase oxytocin rate to achieve adequate labor progress
B. Discontinue oxytocin and administer a tocolytic
C. Turn client on left side and administer oxygen via face mask
D. Prepare for immediate cesarean delivery
Correct Answer: C. Turn client on left side and administer oxygen via face mask
Rationale: Late decelerations indicate uteroplacental insufficiency. The priority is to improve fetal oxygenation by
repositioning (left lateral) and administering oxygen. Oxytocin should be reduced or stopped, not increased.
Tocolytics may be considered for hyperstimulation but not first-line. Cesarean may be needed if decelerations
persist, but immediate intrauterine resuscitation is the priority.
Why Wrong:
A - Increasing oxytocin would worsen uterine hyperstimulation and fetal hypoxia.
B - Tocolytics are not first-line; stopping oxytocin and repositioning are the initial steps.
D - Cesarean delivery is indicated if resuscitation fails, not as the first action.
Reference: ACOG Practice Bulletin No. 106, 2009 (Reaffirmed 2021); Simpson, K.R. (2020). AWHONN's Perinatal
Nursing, 5th Ed.
Q5. A client with gestational diabetes mellitus is scheduled for a nonstress test at 36 weeks. The nurse
explains the purpose of the test. Which statement by the client indicates understanding?
A. This test will measure the amount of amniotic fluid around the baby.
B. This test checks how the baby's heart rate responds to its own movements.
C. This test uses sound waves to look at the baby's organs.
D. This test measures the strength and frequency of my contractions.
Correct Answer: B. This test checks how the baby's heart rate responds to its own movements.
Rationale: A nonstress test (NST) evaluates fetal heart rate accelerations in response to fetal movement, indicating
an intact autonomic nervous system and adequate oxygenation. Option A describes an amniotic fluid index, option
C describes a detailed ultrasound, and option D describes a tocometer for contractions.
Why Wrong:
A - Amniotic fluid is assessed via ultrasound, not NST.
C - Detailed anatomic survey is done via ultrasound, not NST.
D - Contractions are monitored separately; NST focuses on fetal heart rate response to movement.
Reference: ACOG Practice Bulletin No. 145, 2014 (Reaffirmed 2021); Freeman, R.K., et al. (2019). Fetal Heart
Rate Monitoring, 5th Ed.
Q6. A nurse is assessing a client who is 12 hours postpartum after a vaginal delivery. The client reports a
sudden gush of blood and passing a large clot. On assessment, the uterus is boggy and displaced to the right.
What is the most likely cause of the hemorrhage?
A. Uterine atony
B. Retained placental fragments
C. Genital tract laceration
Page 4
