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RASMUSSEN COLLEGE MATERNAL CHILD NURSING NUR 2513
NUR2513 EXAM 2 STUDY GUIDE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
RASMUSSEN COLLEGE 2025
- What is the normal fetal heart rate range during labor? a) 80–120 bpm b) 110–160 bpm c) 160–200 bpm d) 100–140 bpm b) 110–160 bpm The normal fetal heart rate typically ranges from 110 to 160 beats per minute.
- What is the primary purpose of administering oxytocin during labor? a) To reduce pain b) To induce or augment labor contractions c) To relax the uterus d) To prevent hemorrhage after delivery b) To induce or augment labor contractions Oxytocin stimulates uterine contractions to either start labor or strengthen weak contractions.
- Which stage of labor is characterized by complete cervical dilation and ends with delivery of the baby? a) First stage
b) Second stage c) Third stage d) Fourth stage b) Second stage The second stage of labor begins with full cervical dilation and ends with the birth of the baby.
- What is the priority nursing intervention immediately after delivery of the placenta? a) Administer pain medication b) Assess uterine tone and bleeding c) Begin breastfeeding d) Monitor fetal heart rate b) Assess uterine tone and bleeding Assessing uterine tone ensures the uterus is contracting properly to prevent hemorrhage.
- Which sign indicates potential placental abruption? a) Painless vaginal bleeding b) Bright red vaginal bleeding with no pain c) Sudden onset of severe abdominal pain with dark vaginal bleeding d) Gradual increase in contractions c) Sudden onset of severe abdominal pain with dark vaginal bleeding Placental abruption usually causes sudden pain and dark bleeding due to premature separation of the placenta.
c) Preeclampsia Preeclampsia involves high blood pressure and proteinuria after 20 weeks, with possible edema.
- What medication is typically given to prevent neonatal hemorrhagic disease? a) Vitamin C b) Vitamin D c) Vitamin K d) Iron supplement c) Vitamin K Vitamin K is administered to newborns to promote clotting and prevent hemorrhagic disease. 10.What is the most common site for intramuscular injections in infants? a) Deltoid b) Vastus lateralis c) Gluteus maximus d) Dorsogluteal b) Vastus lateralis The vastus lateralis is the preferred IM site for infants due to muscle development and safety. 11.Which reflex is assessed by stroking the infant’s cheek and observing head turning toward the stimulus? a) Moro reflex b) Rooting reflex
c) Babinski reflex d) Grasp reflex b) Rooting reflex The rooting reflex helps the infant locate the nipple for feeding. 12.What is the expected weight loss range for a healthy newborn in the first week of life? a) 10-15% of birth weight b) 20-25% of birth weight c) 3-7% of birth weight d) 30-35% of birth weight c) 3-7% of birth weight Newborns commonly lose up to 7% of birth weight due to fluid shifts but should regain it by 2 weeks. 13.Which hormone primarily maintains the uterine lining during early pregnancy? a) Estrogen b) Oxytocin c) Progesterone d) Prolactin c) Progesterone Progesterone maintains the endometrium and prevents uterine contractions during early pregnancy. 14.What is the most common cause of postpartum hemorrhage? a) Retained placenta
b) 10-20 minutes c) 30-45 minutes d) 1 hour a) 1-5 minutes The third stage (delivery of placenta) usually occurs within 5 minutes after the baby is born. 18.Which newborn assessment finding is abnormal and requires further evaluation? a) Heart rate 140 bpm b) Respiratory rate 40 breaths/min c) Central cyanosis d) Pink mucous membranes c) Central cyanosis Central cyanosis indicates inadequate oxygenation and requires immediate assessment. 19.What is the priority action when a newborn shows signs of respiratory distress? a) Swaddle the infant b) Provide supplemental oxygen c) Initiate breastfeeding d) Administer vitamin K b) Provide supplemental oxygen Supplemental oxygen is the priority to improve oxygenation in respiratory distress.
20.What does the term "lochia" refer to? a) Fetal movements b) Vaginal discharge after delivery c) Uterine contractions d) Breast milk production b) Vaginal discharge after delivery Lochia is the vaginal bleeding and discharge following childbirth as the uterus heals. 21.Which dietary component is essential to prevent neural tube defects during pregnancy? a) Vitamin A b) Folic acid c) Calcium d) Iron b) Folic acid Folic acid supplementation before and during pregnancy reduces neural tube defects risk. 22.How often should a woman in active labor be assessed for fetal heart tones? a) Every 5 minutes b) Every 15-30 minutes c) Every hour d) Every 4 hours
a) Breech presentation A breech presentation often requires cesarean delivery for safety. 26.Which medication is contraindicated during pregnancy? a) Acetaminophen b) Ibuprofen in the third trimester c) Prenatal vitamins d) Folic acid supplements b) Ibuprofen in the third trimester Ibuprofen is avoided in late pregnancy due to risks of premature closure of the ductus arteriosus. 27.What is the main function of surfactant in the newborn lungs? a) Prevent infection b) Facilitate oxygen transport c) Reduce surface tension to keep alveoli open d) Stimulate respiratory rate c) Reduce surface tension to keep alveoli open Surfactant prevents alveolar collapse by reducing surface tension in the lungs. 28.Which sign indicates effective breastfeeding? a) Infant is sleepy and uninterested in feeding b) Audible swallowing during feeding c) Nipple pain lasting throughout feeding d) Infant refuses to latch b) Audible swallowing during feeding Swallowing sounds indicate the infant is actively feeding and swallowing milk.
29.What should the nurse monitor to detect early signs of preeclampsia? a) Blood glucose b) Blood pressure and urine protein c) Heart rate d) Respiratory rate b) Blood pressure and urine protein Elevated BP and proteinuria are hallmark signs of preeclampsia. 30.What is the appropriate action if a newborn's temperature drops below 36.5°C (97.7°F)? a) Place under radiant warmer or skin-to-skin contact b) Give cold bath c) Delay feeding d) Increase room ventilation a) Place under radiant warmer or skin-to-skin contact Hypothermia requires warming measures to maintain body temperature. 31.Which statement about rubella vaccination is correct? a) It can be given safely during pregnancy b) It is given postpartum if the mother is nonimmune c) It is unnecessary if the mother had rubella in childhood d) It prevents gestational diabetes b) It is given postpartum if the mother is nonimmune Rubella vaccine is contraindicated during pregnancy but recommended postpartum to protect future pregnancies.
a) Every 15 minutes b) Every 30 minutes c) Every hour d) Every 4 hours a) Every 15 minutes Frequent monitoring post-delivery helps detect complications early. 36.What is the expected finding in a newborn with physiologic jaundice? a) Jaundice within first 24 hours b) Jaundice appearing after 24 hours, peaking around day 3- 4 c) Jaundice lasting several weeks d) Severe anemia b) Jaundice appearing after 24 hours, peaking around day 3- 4 Physiologic jaundice is common and typically appears after the first day. 37.Which contraceptive method is safe during breastfeeding? a) Combined oral contraceptives b) Progestin-only contraceptives c) Estrogen-only contraceptives d) Diaphragm b) Progestin-only contraceptives Progestin-only methods do not affect milk production and are preferred during breastfeeding. 38.What is the priority nursing intervention if a newborn has a low Apgar score at 1 minute? a) Continue routine care
b) Initiate resuscitation measures as needed c) Call social services d) Delay feeding b) Initiate resuscitation measures as needed Low Apgar requires immediate evaluation and intervention to support breathing and circulation. 39.Which condition increases the risk of preterm labor? a) Multiparity b) Maternal smoking c) Post-term pregnancy d) Gestational diabetes b) Maternal smoking Smoking is a known risk factor for preterm labor due to vascular effects. 40.What is the first sign of labor? a) Regular painful contractions b) Bloody show or loss of mucus plug c) Rupture of membranes d) Increase in fetal movement b) Bloody show or loss of mucus plug The mucus plug may be expelled as labor approaches. 41.How is gestational diabetes diagnosed? a) Random blood glucose test b) Oral glucose tolerance test between 24-28 weeks
c) Measuring fundal height d) Assessing fetal movements b) Palpation of the fetus bouncing back after pushing Ballottement is a technique to feel the fetus rebound within the uterus. 45.Which vaccine is contraindicated during pregnancy? a) Influenza (inactivated) vaccine b) Tdap vaccine c) Live attenuated vaccines (e.g., MMR) d) Hepatitis B vaccine c) Live attenuated vaccines (e.g., MMR) Live vaccines are avoided during pregnancy due to risk to the fetus. 46.What is the priority action for a mother reporting decreased fetal movement? a) Immediate non-stress test or further fetal monitoring b) Advise rest and hydration only c) Schedule routine prenatal visit next week d) No action needed if no other symptoms a) Immediate non-stress test or further fetal monitoring Decreased fetal movement may indicate fetal distress and requires prompt evaluation. 47.Which newborn screening test is mandatory in most states? a) Hearing screening b) Newborn metabolic screening (PKU and others)
c) Vision screening d) Cognitive assessment b) Newborn metabolic screening (PKU and others) Metabolic screening detects rare but treatable disorders early. 48.What is the correct nursing action for a perineal hematoma postpartum? a) Ice packs and pain management b) Immediate surgical intervention in all cases c) Avoid perineal care d) Encourage ambulation only a) Ice packs and pain management Small hematomas can be managed conservatively with ice and analgesics. 49.When should Rh immune globulin be administered? a) At 28 weeks gestation and within 72 hours postpartum if baby is Rh- positive b) Only postpartum c) Only during first trimester d) Not necessary if mother is Rh-positive a) At 28 weeks gestation and within 72 hours postpartum if baby is Rh-positive Rh immune globulin prevents sensitization in Rh-negative mothers. 50.What is a normal blood glucose range for a newborn? a) 20-30 mg/dL b) 45-90 mg/dL c) 100-150 mg/dL d) 200-250 mg/dL
c) Breech presentation d) Transverse lie a) Left occiput anterior (LOA) LOA position allows the smallest fetal diameter to pass through the pelvis easily. 54.Which finding indicates potential shoulder dystocia during delivery? a) Rapid descent of the head b) Turtle sign (retraction of the fetal head after crowning) c) Early rupture of membranes d) Prolonged labor b) Turtle sign (retraction of the fetal head after crowning) The turtle sign suggests the anterior shoulder is stuck behind the pubic bone. 55.What is the expected urine output for a postpartum woman to indicate adequate hydration? a) 10-20 mL/hr b) 30-50 mL/hr c) 60-80 mL/hr d) 100-120 mL/hr b) 30-50 mL/hr Urine output less than 30 mL/hr may indicate dehydration or hypovolemia. 56.When assessing a neonate's respiratory status, which pattern is considered normal? a) Consistent respiratory rate of 60 breaths per minute b) Periodic breathing with pauses less than 20 seconds
c) Continuous grunting with retractions d) Nasal flaring and cyanosis b) Periodic breathing with pauses less than 20 seconds Periodic breathing is normal in newborns; pauses longer than 20 seconds require evaluation. 57.What is a common side effect of magnesium sulfate therapy in preeclampsia? a) Hypertension b) Respiratory depression c) Hyperreflexia d) Tachycardia b) Respiratory depression Magnesium sulfate can depress the respiratory center, requiring close monitoring. 58.Which is the earliest sign of fetal hypoxia on fetal heart monitoring? a) Early decelerations b) Late decelerations c) Variable decelerations d) Tachycardia d) Tachycardia An increased baseline fetal heart rate is an early sign of fetal hypoxia. 59.What is the correct needle gauge for an intramuscular injection in a newborn? a) 16-18 gauge
