, Exam Information
Course: NUR 254 Maternal and Pediatric Nursing
Target Audience: Nursing students at Galen College of Nursing
Core Domains Covered:
o Exam 1: Antepartum care, maternal physiologic changes, prenatal nutrition, GTPAL,
Naegele's rule, presumptive/probable/positive signs of pregnancy, high-risk factors
o Exam 2: Intrapartum labor, fetal monitoring, maternal complications during labor, pain
management, and delivery
o Exam 3: Postpartum care, newborn assessment, APGAR scoring, breastfeeding, and
neonatal jaundice
o Exam 4: Pediatric growth and development, pain scales, pediatric nursing interventions,
and high-acuity pediatric conditions
Question Format: Multiple-choice, with answers and detailed rationales
Total Questions: 230 (approximately 57-58 questions per exam)
EXAM 1: ANTEPARTUM & FOUNDATIONAL MATERNAL NURSING (Questions 1-60)
1. A nurse is calculating the GTPAL for a client who is currently pregnant with twins.
The client has had one previous miscarriage at 10 weeks gestation, one full-term
, delivery of a healthy infant, and one preterm delivery at 32 weeks gestation. What is
the GTPAL?
A) G=3, T=1, P=1, A=1, L=2
B) G=4, T=1, P=1, A=1, L=2
C) G=3, T=1, P=0, A=2, L=2
D) G=4, T=0, P=1, A=2, L=2
Answer: A. GTPAL is calculated as: G (Gravida) = total number of pregnancies including
current (3 previous + 1 current = 4? Wait, let's recalculate). The current pregnancy counts in
gravida. The client has had 1 previous miscarriage, 1 full-term, and 1 preterm = 3 previous
pregnancies + 1 current = G=4. T (Term) = number of term births (37+ weeks) = 1. P
(Preterm) = number of preterm births (20-37 weeks) = 1. A (Abortions) = number of
spontaneous or therapeutic abortions before 20 weeks = 1. L (Living) = number of living
children = 2 (twins count as 2). However, the current pregnancy is not yet delivered, so L=2.
So G=4, T=1, P=1, A=1, L=2. The correct answer is B.
2. A nurse is teaching a group of pregnant women about the presumptive signs of
pregnancy. Which of the following should the nurse include?
A) Positive pregnancy test
B) Fetal heartbeat heard on Doppler
, C) Amenorrhea
D) Fetal movement felt by the examiner
Answer: C. Amenorrhea is a presumptive sign of pregnancy. Positive pregnancy test, fetal
heartbeat, and fetal movement felt by the examiner are positive signs.
3. A client at 8 weeks gestation asks the nurse about expected weight gain. What is
the recommended weight gain for a client with a normal BMI during the first
trimester?
A) 1-2 lbs total
B) 2.2 - 4.4 lbs total
C) 5-10 lbs total
D) 15-20 lbs total
Answer: B. The recommended weight gain for a client with a normal BMI during the first
trimester is 2.2 - 4.4 lbs (1-2 kg) total. Total weight gain for a normal BMI pregnancy is 25-
35 lbs.
4. A nurse is assessing a pregnant client at 12 weeks gestation. Which of the
following are probable signs of pregnancy? (Select all that apply.)
A) Chadwick's sign
B) Goodell's sign
Course: NUR 254 Maternal and Pediatric Nursing
Target Audience: Nursing students at Galen College of Nursing
Core Domains Covered:
o Exam 1: Antepartum care, maternal physiologic changes, prenatal nutrition, GTPAL,
Naegele's rule, presumptive/probable/positive signs of pregnancy, high-risk factors
o Exam 2: Intrapartum labor, fetal monitoring, maternal complications during labor, pain
management, and delivery
o Exam 3: Postpartum care, newborn assessment, APGAR scoring, breastfeeding, and
neonatal jaundice
o Exam 4: Pediatric growth and development, pain scales, pediatric nursing interventions,
and high-acuity pediatric conditions
Question Format: Multiple-choice, with answers and detailed rationales
Total Questions: 230 (approximately 57-58 questions per exam)
EXAM 1: ANTEPARTUM & FOUNDATIONAL MATERNAL NURSING (Questions 1-60)
1. A nurse is calculating the GTPAL for a client who is currently pregnant with twins.
The client has had one previous miscarriage at 10 weeks gestation, one full-term
, delivery of a healthy infant, and one preterm delivery at 32 weeks gestation. What is
the GTPAL?
A) G=3, T=1, P=1, A=1, L=2
B) G=4, T=1, P=1, A=1, L=2
C) G=3, T=1, P=0, A=2, L=2
D) G=4, T=0, P=1, A=2, L=2
Answer: A. GTPAL is calculated as: G (Gravida) = total number of pregnancies including
current (3 previous + 1 current = 4? Wait, let's recalculate). The current pregnancy counts in
gravida. The client has had 1 previous miscarriage, 1 full-term, and 1 preterm = 3 previous
pregnancies + 1 current = G=4. T (Term) = number of term births (37+ weeks) = 1. P
(Preterm) = number of preterm births (20-37 weeks) = 1. A (Abortions) = number of
spontaneous or therapeutic abortions before 20 weeks = 1. L (Living) = number of living
children = 2 (twins count as 2). However, the current pregnancy is not yet delivered, so L=2.
So G=4, T=1, P=1, A=1, L=2. The correct answer is B.
2. A nurse is teaching a group of pregnant women about the presumptive signs of
pregnancy. Which of the following should the nurse include?
A) Positive pregnancy test
B) Fetal heartbeat heard on Doppler
, C) Amenorrhea
D) Fetal movement felt by the examiner
Answer: C. Amenorrhea is a presumptive sign of pregnancy. Positive pregnancy test, fetal
heartbeat, and fetal movement felt by the examiner are positive signs.
3. A client at 8 weeks gestation asks the nurse about expected weight gain. What is
the recommended weight gain for a client with a normal BMI during the first
trimester?
A) 1-2 lbs total
B) 2.2 - 4.4 lbs total
C) 5-10 lbs total
D) 15-20 lbs total
Answer: B. The recommended weight gain for a client with a normal BMI during the first
trimester is 2.2 - 4.4 lbs (1-2 kg) total. Total weight gain for a normal BMI pregnancy is 25-
35 lbs.
4. A nurse is assessing a pregnant client at 12 weeks gestation. Which of the
following are probable signs of pregnancy? (Select all that apply.)
A) Chadwick's sign
B) Goodell's sign
