NUR 230 Maternal & Pediatric Nursing Week 7 Study Guide 2026
|Galen College
1. A nurse is assessing a client 2 hours postpartum and notes the fundus is
boggy and displaced to the right. What is the priority nursing action?
A. Assist the client to empty her bladder
B. Massage the fundus until firm
C. Administer oxytocin IV
D. Notify the provider immediately
Answer: A
Rationale: A displaced fundus to the right is usually a sign of a full bladder, which prevents
the uterus from contracting. Emptying the bladder is the first step.
2. Which of the following findings is considered a sign of respiratory distress in a
newborn?
A. Acrocyanosis
B. Abdominal breathing
C. Nasal flaring
D. Heart rate of 140 bpm
Answer: C
Rationale: Nasal flaring, grunting, and retractions are clinical signs of respiratory distress
in a neonate.
,3. According to Erikson, which developmental task is primary for an infant (birth
to 1 year)?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: C
Rationale: Trust vs. Mistrust is the first stage of Erikson’s psychosocial development,
focusing on the infant’s basic needs being met by caregivers.
4. A client with preeclampsia is receiving Magnesium Sulfate. Which finding
should the nurse report to the provider?
A. Respiratory rate of 10 breaths/min
B. Deep tendon reflexes of 2+
C. Urine output of 40 mL/hr
D. Feeling of warmth and flushing
Answer: A
Rationale: Magnesium toxicity can lead to respiratory depression (rate <12). This is a
critical finding requiring immediate intervention.
5. What is the most common cause of postpartum hemorrhage?
A. Retained placental fragments
B. Coagulopathies
C. Lacerations of the birth canal
D. Uterine atony
Answer: D
Rationale: Uterine atony, or failure of the uterus to contract effectively, is the leading cause
of PPH.
, 6. At what age does an infant typically double their birth weight?
A. 4 months
B. 6 months
C. 9 months
D. 12 months
Answer: B
Rationale: Generally, an infant doubles their birth weight by 6 months and triples it by 1
year.
7. Which immunization is typically given at birth?
A. Hepatitis B
B. Rotavirus
C. Inactivated Poliovirus (IPV)
D. Measles, Mumps, Rubella (MMR)
Answer: A
Rationale: The Hepatitis B vaccine is the only immunization recommended to be given
within the first 24 hours of life.
8. A mother notices her 18-month-old is playing with blocks next to another
child but not with them. This is known as:
A. Parallel play
B. Onlooker play
C. Associative play
D. Cooperative play
Answer: A
Rationale: Parallel play is characteristic of toddlers who play beside others but do not
interact directly.
|Galen College
1. A nurse is assessing a client 2 hours postpartum and notes the fundus is
boggy and displaced to the right. What is the priority nursing action?
A. Assist the client to empty her bladder
B. Massage the fundus until firm
C. Administer oxytocin IV
D. Notify the provider immediately
Answer: A
Rationale: A displaced fundus to the right is usually a sign of a full bladder, which prevents
the uterus from contracting. Emptying the bladder is the first step.
2. Which of the following findings is considered a sign of respiratory distress in a
newborn?
A. Acrocyanosis
B. Abdominal breathing
C. Nasal flaring
D. Heart rate of 140 bpm
Answer: C
Rationale: Nasal flaring, grunting, and retractions are clinical signs of respiratory distress
in a neonate.
,3. According to Erikson, which developmental task is primary for an infant (birth
to 1 year)?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: C
Rationale: Trust vs. Mistrust is the first stage of Erikson’s psychosocial development,
focusing on the infant’s basic needs being met by caregivers.
4. A client with preeclampsia is receiving Magnesium Sulfate. Which finding
should the nurse report to the provider?
A. Respiratory rate of 10 breaths/min
B. Deep tendon reflexes of 2+
C. Urine output of 40 mL/hr
D. Feeling of warmth and flushing
Answer: A
Rationale: Magnesium toxicity can lead to respiratory depression (rate <12). This is a
critical finding requiring immediate intervention.
5. What is the most common cause of postpartum hemorrhage?
A. Retained placental fragments
B. Coagulopathies
C. Lacerations of the birth canal
D. Uterine atony
Answer: D
Rationale: Uterine atony, or failure of the uterus to contract effectively, is the leading cause
of PPH.
, 6. At what age does an infant typically double their birth weight?
A. 4 months
B. 6 months
C. 9 months
D. 12 months
Answer: B
Rationale: Generally, an infant doubles their birth weight by 6 months and triples it by 1
year.
7. Which immunization is typically given at birth?
A. Hepatitis B
B. Rotavirus
C. Inactivated Poliovirus (IPV)
D. Measles, Mumps, Rubella (MMR)
Answer: A
Rationale: The Hepatitis B vaccine is the only immunization recommended to be given
within the first 24 hours of life.
8. A mother notices her 18-month-old is playing with blocks next to another
child but not with them. This is known as:
A. Parallel play
B. Onlooker play
C. Associative play
D. Cooperative play
Answer: A
Rationale: Parallel play is characteristic of toddlers who play beside others but do not
interact directly.
