NUR 254 Exams 1 - 4 | Galen College | (2026/2027) Complete
Maternal & Pediatric Nursing Bundle COMPREHENSIVE
MATERNAL AND PEDIATRIC NURSING
EXAMINATION Practice Questions with Answers and
Detailed Rationales
1. The nurse is teaching a client about symptoms to report during pregnancy.
Which of the following statements by the client indicates correct
understanding of the teaching?
A) "If I have any fluid leaking from my vagina, I must call the clinic
immediately"
B) "I'll report increased frequency of urination"
C) "Nausea should be reported immediately"
D) "If I feel tired after resting, I should report it immediately"
Rationale: Sudden or continuous leakage of fluid may indicate rupture of
membranes, increasing the risk for infection or preterm labor, and requires prompt
medical attention. Increased urination, nausea, and fatigue are common
discomforts of pregnancy.
2. The charge nurse is discussing probable signs of pregnancy with a newly
hired nurse. The newly hired nurse correctly identifies which of the following
as a probable sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate (FHR) detected on Doppler
D) Negative serum pregnancy test
Rationale: A probable sign of pregnancy is an objective finding strongly
suggestive of pregnancy. Goodell sign (softening of the cervix) is a classic
probable sign. Breast tenderness is a presumptive sign, FHR detection is a positive
sign, and a negative pregnancy test rules out pregnancy.
,3. The nurse is preparing to teach a client about the physiological changes that
occur during pregnancy. Which of the following should the nurse teach as an
increased physiological change?
A) Gastrointestinal (GI) contractility
B) Blood Pressure
C) Cardiac output
D) Respiratory rate
Rationale: During pregnancy, there is a significant increase in maternal cardiac
output to meet the metabolic demands of the mother and the developing fetus. This
physiological adaptation begins early in the first trimester, peaks in the second
trimester, and remains elevated until term. GI contractility typically decreases
(constipation), and blood pressure decreases due to decreased systemic vascular
resistance.
4. The nurse has provided dietary teaching for a pregnant client with iron
deficiency anemia. Which of the following meal options indicates the client
understood the teaching?
A) Chicken salad sandwich with almonds and raisins
B) Toasted cheese sandwich with celery sticks
C) Red beans with whole-grain rice and mixed greens
D) Oatmeal, whole wheat toast and jelly
Rationale: Red beans and mixed greens are rich sources of non-heme iron.
Combining iron-rich foods with vitamin C enhances absorption. This meal
provides iron, folate, and other essential nutrients. Almonds and raisins also
contain iron, but red beans and greens are more concentrated sources.
5. The nurse is assessing a client at 12 weeks gestation. Which finding would
be considered a positive sign of pregnancy?
A) Chadwick's sign
B) Goodell's sign
C) Ultrasound visualization of the fetus
D) Positive pregnancy test
,Rationale: Positive signs of pregnancy are objective, definitive signs that can only
be attributed to pregnancy. These include ultrasound visualization, audible fetal
heart tones, and fetal movement felt by the examiner.
6. The nurse is teaching a prenatal class about the physiological changes in
pregnancy. Which statement about cardiovascular changes is correct?
A) Blood pressure increases significantly during the second trimester
B) The heart is displaced upward and to the left
C) Heart rate decreases by 10-15 beats per minute
D) Cardiac output remains unchanged
Rationale: The enlarging uterus displaces the heart upward and to the left. Blood
pressure typically decreases in the second trimester, heart rate increases by 10-15
bpm, and cardiac output increases by 30-50%.
7. A client at 20 weeks gestation asks the nurse about quickening. The nurse
correctly explains that quickening is:
A) The first fetal movements felt by the mother
B) The first fetal heartbeat heard on Doppler
C) The descent of the fetal head into the pelvis
D) The engagement of the fetal presenting part
Rationale: Quickening refers to the first perception of fetal movement by the
mother, typically felt between 16-20 weeks gestation in primigravidas and earlier
in multigravidas.
8. The nurse is assessing a client at 8 weeks gestation who reports breast
tenderness and nausea. The nurse documents these findings as which of the
following?
A) Positive signs of pregnancy
B) Presumptive signs of pregnancy
C) Probable signs of pregnancy
D) Diagnostic signs of pregnancy
, Rationale: Breast tenderness and nausea are presumptive signs—subjective
symptoms experienced by the woman. They are not definitive but suggest
pregnancy.
9. A pregnant client with a BMI of 32 is concerned about appropriate weight
gain. The nurse correctly advises a weight gain of:
A) 25-35 pounds
B) 15-25 pounds
C) 11-20 pounds
D) 28-40 pounds
Rationale: For obese women (BMI ≥ 30), the recommended weight gain is 11-20
pounds to minimize pregnancy complications.
10. The nurse is teaching a client about discomforts of pregnancy. Which
statement indicates the client understands the management of nausea and
vomiting?
A) "I should eat large meals to prevent nausea"
B) "I should avoid an empty stomach by eating small, frequent meals"
C) "I should lie flat immediately after eating"
D) "I should drink fluids with all meals"
Rationale: Eating small, frequent meals and avoiding an empty stomach help
manage nausea. Dry crackers before rising, ginger, and vitamin B6 may also help.
Severe vomiting (hyperemesis gravidarum) should be reported.
11. The nurse is assessing a client for signs of preeclampsia. Which blood
pressure reading requires further evaluation in a pregnant client at 28 weeks?
A) 120/80 mmHg
B) 140/90 mmHg
C) 110/70 mmHg
D) 130/82 mmHg
Maternal & Pediatric Nursing Bundle COMPREHENSIVE
MATERNAL AND PEDIATRIC NURSING
EXAMINATION Practice Questions with Answers and
Detailed Rationales
1. The nurse is teaching a client about symptoms to report during pregnancy.
Which of the following statements by the client indicates correct
understanding of the teaching?
A) "If I have any fluid leaking from my vagina, I must call the clinic
immediately"
B) "I'll report increased frequency of urination"
C) "Nausea should be reported immediately"
D) "If I feel tired after resting, I should report it immediately"
Rationale: Sudden or continuous leakage of fluid may indicate rupture of
membranes, increasing the risk for infection or preterm labor, and requires prompt
medical attention. Increased urination, nausea, and fatigue are common
discomforts of pregnancy.
2. The charge nurse is discussing probable signs of pregnancy with a newly
hired nurse. The newly hired nurse correctly identifies which of the following
as a probable sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate (FHR) detected on Doppler
D) Negative serum pregnancy test
Rationale: A probable sign of pregnancy is an objective finding strongly
suggestive of pregnancy. Goodell sign (softening of the cervix) is a classic
probable sign. Breast tenderness is a presumptive sign, FHR detection is a positive
sign, and a negative pregnancy test rules out pregnancy.
,3. The nurse is preparing to teach a client about the physiological changes that
occur during pregnancy. Which of the following should the nurse teach as an
increased physiological change?
A) Gastrointestinal (GI) contractility
B) Blood Pressure
C) Cardiac output
D) Respiratory rate
Rationale: During pregnancy, there is a significant increase in maternal cardiac
output to meet the metabolic demands of the mother and the developing fetus. This
physiological adaptation begins early in the first trimester, peaks in the second
trimester, and remains elevated until term. GI contractility typically decreases
(constipation), and blood pressure decreases due to decreased systemic vascular
resistance.
4. The nurse has provided dietary teaching for a pregnant client with iron
deficiency anemia. Which of the following meal options indicates the client
understood the teaching?
A) Chicken salad sandwich with almonds and raisins
B) Toasted cheese sandwich with celery sticks
C) Red beans with whole-grain rice and mixed greens
D) Oatmeal, whole wheat toast and jelly
Rationale: Red beans and mixed greens are rich sources of non-heme iron.
Combining iron-rich foods with vitamin C enhances absorption. This meal
provides iron, folate, and other essential nutrients. Almonds and raisins also
contain iron, but red beans and greens are more concentrated sources.
5. The nurse is assessing a client at 12 weeks gestation. Which finding would
be considered a positive sign of pregnancy?
A) Chadwick's sign
B) Goodell's sign
C) Ultrasound visualization of the fetus
D) Positive pregnancy test
,Rationale: Positive signs of pregnancy are objective, definitive signs that can only
be attributed to pregnancy. These include ultrasound visualization, audible fetal
heart tones, and fetal movement felt by the examiner.
6. The nurse is teaching a prenatal class about the physiological changes in
pregnancy. Which statement about cardiovascular changes is correct?
A) Blood pressure increases significantly during the second trimester
B) The heart is displaced upward and to the left
C) Heart rate decreases by 10-15 beats per minute
D) Cardiac output remains unchanged
Rationale: The enlarging uterus displaces the heart upward and to the left. Blood
pressure typically decreases in the second trimester, heart rate increases by 10-15
bpm, and cardiac output increases by 30-50%.
7. A client at 20 weeks gestation asks the nurse about quickening. The nurse
correctly explains that quickening is:
A) The first fetal movements felt by the mother
B) The first fetal heartbeat heard on Doppler
C) The descent of the fetal head into the pelvis
D) The engagement of the fetal presenting part
Rationale: Quickening refers to the first perception of fetal movement by the
mother, typically felt between 16-20 weeks gestation in primigravidas and earlier
in multigravidas.
8. The nurse is assessing a client at 8 weeks gestation who reports breast
tenderness and nausea. The nurse documents these findings as which of the
following?
A) Positive signs of pregnancy
B) Presumptive signs of pregnancy
C) Probable signs of pregnancy
D) Diagnostic signs of pregnancy
, Rationale: Breast tenderness and nausea are presumptive signs—subjective
symptoms experienced by the woman. They are not definitive but suggest
pregnancy.
9. A pregnant client with a BMI of 32 is concerned about appropriate weight
gain. The nurse correctly advises a weight gain of:
A) 25-35 pounds
B) 15-25 pounds
C) 11-20 pounds
D) 28-40 pounds
Rationale: For obese women (BMI ≥ 30), the recommended weight gain is 11-20
pounds to minimize pregnancy complications.
10. The nurse is teaching a client about discomforts of pregnancy. Which
statement indicates the client understands the management of nausea and
vomiting?
A) "I should eat large meals to prevent nausea"
B) "I should avoid an empty stomach by eating small, frequent meals"
C) "I should lie flat immediately after eating"
D) "I should drink fluids with all meals"
Rationale: Eating small, frequent meals and avoiding an empty stomach help
manage nausea. Dry crackers before rising, ginger, and vitamin B6 may also help.
Severe vomiting (hyperemesis gravidarum) should be reported.
11. The nurse is assessing a client for signs of preeclampsia. Which blood
pressure reading requires further evaluation in a pregnant client at 28 weeks?
A) 120/80 mmHg
B) 140/90 mmHg
C) 110/70 mmHg
D) 130/82 mmHg
