NUR 230 Final Exam: OB/Peds - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A nurse is assessing a client at 34 weeks of gestation who has a diagnosis of severe preeclampsia. Which
of the following findings should the nurse report to the provider immediately?
A. 1+ pitting edema in the lower extremities
B. Epigastric pain or RUQ tenderness
C. Blood pressure of 148/92 mmHg
D. Urinary output of 40 mL/hr
Correct Answer: B
Rationale: Epigastric pain in a preeclamptic client often indicates liver involvement and impending
seizure activity. This symptom suggests hepatic ischemia which can lead to HELLP syndrome or
eclampsia. The nurse must prioritize this finding as it represents a significant worsening of the patient’s
condition. Immediate notification of the provider is necessary to prevent maternal and fetal
complications. This assessment is a critical part of high-risk obstetric monitoring in nursing practice.
2. A newborn has a heart rate of 110 bpm, a slow/weak cry, some flexion of the extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 7
C. 6
D. 8
Correct Answer: C
,Rationale: The APGAR score is calculated by giving points for heart rate, respiratory effort, muscle tone,
reflex irritability, and color. In this scenario, the newborn gets 2 for heart rate, 1 for cry, 1 for flexion, 1
for grimace, and 1 for color. Adding these values results in a total score of 6, indicating moderate distress.
Standard neonatal care requires a repeat assessment at five minutes to track improvement. Accurate
scoring allows the medical team to determine the level of resuscitation or intervention required.
3. Which of the following interventions is the priority for a nurse caring for a client experiencing postpartum
hemorrhage due to uterine atony?
A. Administer oxygen via non-rebreather mask
B. Insert a second large-bore IV catheter
C. Perform a firm fundal massage
D. Notify the physician immediately
Correct Answer: C
Rationale: Fundal massage is the primary nursing intervention to stimulate uterine contractions and
stop bleeding from atony. By manually compressing the uterus, the nurse helps expel clots and promotes
vasoconstriction of the placental site. While notifying the provider and starting fluids are important,
stopping the source of blood loss is the immediate priority. The nurse should continue to monitor the
firmness of the fundus following the initial massage. This rapid response is essential to maintain
maternal hemodynamic stability in the postpartum period.
4. According to Piaget, a 4-year-old child who believes that their stuffed animal is alive and has feelings is
demonstrating which cognitive characteristic?
A. Object permanence
B. Conservation
,C. Egocentrism
D. Animism
Correct Answer: D
Rationale: Animism is the belief that inanimate objects possess lifelike qualities and intentions. This is a
hallmark of the preoperational stage of cognitive development in preschool-aged children. During this
phase, children use symbolic thinking but lack logic regarding physical laws. Understanding these
developmental milestones helps nurses communicate effectively with young patients through play.
Reassuring the child about their ‘friend’ can reduce anxiety during clinical procedures.
5. A nurse is teaching a parent about managing a child with mild croup at home. Which instruction should
be included?
A. Provide a warm, dry environment for the child
B. Take the child out into the cool night air if a coughing fit occurs
C. Administer over-the-counter cough suppressants
D. Restrict fluid intake to prevent aspiration
Correct Answer: B
Rationale: Cool air helps reduce the mucosal edema in the upper airway, easing the characteristic
barking cough of croup. Parents are often advised to use a cool-mist humidifier or take the child outdoors
briefly in cold weather. Cough suppressants are generally avoided because they can mask symptoms or
cause sedation. Monitoring for signs of respiratory distress, such as stridor at rest, is a vital teaching
point for safety. These simple home measures often resolve mild cases without the need for
hospitalization.
, 6. A child is diagnosed with Tetralogy of Fallot. Which of the following is one of the four heart defects
associated with this condition?
A. Atrial septal defect
B. Patent ductus arteriosus
C. Coarctation of the aorta
D. Ventricular septal defect
Correct Answer: D
Rationale: Tetralogy of Fallot consists of four defects: ventricular septal defect, pulmonary stenosis,
overriding aorta, and right ventricular hypertrophy. These anomalies lead to the shunting of
deoxygenated blood into the systemic circulation, causing cyanosis. Infants may experience ‘Tet spells’
during periods of agitation or feeding. Nurses should be prepared to place the infant in a knee-chest
position to increase systemic resistance. Surgical repair is eventually required to correct the structural
issues and improve oxygenation.
7. A pregnant client with Type 1 Diabetes Mellitus is in her second trimester. What should the nurse expect
regarding her insulin requirements?
A. Insulin needs will significantly decrease
B. Insulin will be discontinued and replaced by oral hypoglycemics
C. Insulin requirements will remain the same as pre-pregnancy
D. Insulin needs will increase due to placental hormones
Correct Answer: D
Rationale: In the second and third trimesters, placental hormones like human placental lactogen create
insulin resistance. This physiologic change increases the body’s demand for insulin to maintain normal
Updated and Latest Questions and Correct Answers with
Rationale
1. A nurse is assessing a client at 34 weeks of gestation who has a diagnosis of severe preeclampsia. Which
of the following findings should the nurse report to the provider immediately?
A. 1+ pitting edema in the lower extremities
B. Epigastric pain or RUQ tenderness
C. Blood pressure of 148/92 mmHg
D. Urinary output of 40 mL/hr
Correct Answer: B
Rationale: Epigastric pain in a preeclamptic client often indicates liver involvement and impending
seizure activity. This symptom suggests hepatic ischemia which can lead to HELLP syndrome or
eclampsia. The nurse must prioritize this finding as it represents a significant worsening of the patient’s
condition. Immediate notification of the provider is necessary to prevent maternal and fetal
complications. This assessment is a critical part of high-risk obstetric monitoring in nursing practice.
2. A newborn has a heart rate of 110 bpm, a slow/weak cry, some flexion of the extremities, grimace when
stimulated, and a pink body with blue extremities. What is the APGAR score?
A. 5
B. 7
C. 6
D. 8
Correct Answer: C
,Rationale: The APGAR score is calculated by giving points for heart rate, respiratory effort, muscle tone,
reflex irritability, and color. In this scenario, the newborn gets 2 for heart rate, 1 for cry, 1 for flexion, 1
for grimace, and 1 for color. Adding these values results in a total score of 6, indicating moderate distress.
Standard neonatal care requires a repeat assessment at five minutes to track improvement. Accurate
scoring allows the medical team to determine the level of resuscitation or intervention required.
3. Which of the following interventions is the priority for a nurse caring for a client experiencing postpartum
hemorrhage due to uterine atony?
A. Administer oxygen via non-rebreather mask
B. Insert a second large-bore IV catheter
C. Perform a firm fundal massage
D. Notify the physician immediately
Correct Answer: C
Rationale: Fundal massage is the primary nursing intervention to stimulate uterine contractions and
stop bleeding from atony. By manually compressing the uterus, the nurse helps expel clots and promotes
vasoconstriction of the placental site. While notifying the provider and starting fluids are important,
stopping the source of blood loss is the immediate priority. The nurse should continue to monitor the
firmness of the fundus following the initial massage. This rapid response is essential to maintain
maternal hemodynamic stability in the postpartum period.
4. According to Piaget, a 4-year-old child who believes that their stuffed animal is alive and has feelings is
demonstrating which cognitive characteristic?
A. Object permanence
B. Conservation
,C. Egocentrism
D. Animism
Correct Answer: D
Rationale: Animism is the belief that inanimate objects possess lifelike qualities and intentions. This is a
hallmark of the preoperational stage of cognitive development in preschool-aged children. During this
phase, children use symbolic thinking but lack logic regarding physical laws. Understanding these
developmental milestones helps nurses communicate effectively with young patients through play.
Reassuring the child about their ‘friend’ can reduce anxiety during clinical procedures.
5. A nurse is teaching a parent about managing a child with mild croup at home. Which instruction should
be included?
A. Provide a warm, dry environment for the child
B. Take the child out into the cool night air if a coughing fit occurs
C. Administer over-the-counter cough suppressants
D. Restrict fluid intake to prevent aspiration
Correct Answer: B
Rationale: Cool air helps reduce the mucosal edema in the upper airway, easing the characteristic
barking cough of croup. Parents are often advised to use a cool-mist humidifier or take the child outdoors
briefly in cold weather. Cough suppressants are generally avoided because they can mask symptoms or
cause sedation. Monitoring for signs of respiratory distress, such as stridor at rest, is a vital teaching
point for safety. These simple home measures often resolve mild cases without the need for
hospitalization.
, 6. A child is diagnosed with Tetralogy of Fallot. Which of the following is one of the four heart defects
associated with this condition?
A. Atrial septal defect
B. Patent ductus arteriosus
C. Coarctation of the aorta
D. Ventricular septal defect
Correct Answer: D
Rationale: Tetralogy of Fallot consists of four defects: ventricular septal defect, pulmonary stenosis,
overriding aorta, and right ventricular hypertrophy. These anomalies lead to the shunting of
deoxygenated blood into the systemic circulation, causing cyanosis. Infants may experience ‘Tet spells’
during periods of agitation or feeding. Nurses should be prepared to place the infant in a knee-chest
position to increase systemic resistance. Surgical repair is eventually required to correct the structural
issues and improve oxygenation.
7. A pregnant client with Type 1 Diabetes Mellitus is in her second trimester. What should the nurse expect
regarding her insulin requirements?
A. Insulin needs will significantly decrease
B. Insulin will be discontinued and replaced by oral hypoglycemics
C. Insulin requirements will remain the same as pre-pregnancy
D. Insulin needs will increase due to placental hormones
Correct Answer: D
Rationale: In the second and third trimesters, placental hormones like human placental lactogen create
insulin resistance. This physiologic change increases the body’s demand for insulin to maintain normal
