NUR 254 Exams 1–4 (Latest 2026/2027 Update) Maternal
and Pediatrics, Questions and Answers - Galen College of
Nursing COMPREHENSIVE MATERNAL AND
PEDIATRICS EXAMINATION Practice Questions with
Answers and Rationales
1. 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.
2. 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: Cardiac output increases by 30-50% during pregnancy to meet the
metabolic demands of the mother and fetus. GI contractility decreases
(constipation), blood pressure typically decreases in the second trimester, and
respiratory rate remains relatively unchanged (though tidal volume increases).
,3. The nurse is teaching a client about symptoms to report during her
pregnancy. Which of the following statements by the client indicates a 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
evaluation. Increased urination and fatigue are common discomforts; nausea is
expected in the first trimester unless severe.
4. The nurse is teaching a client about the presumptive signs of pregnancy.
Which of the following is a presumptive sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate on Doppler
D) Ultrasound visualization of the fetus
Rationale: Presumptive signs are subjective changes experienced by the woman
(breast tenderness, nausea, fatigue, amenorrhea, urinary frequency, quickening).
Goodell sign is probable, FHR and ultrasound are positive signs.
5. A pregnant client asks the nurse about the expected weight gain during
pregnancy. The nurse correctly responds that the recommended weight gain
for a woman with a normal BMI is:
A) 11-20 pounds
B) 15-25 pounds
C) 25-35 pounds
D) 28-40 pounds
,Rationale: For women with a normal BMI (18.5-24.9), the recommended weight
gain is 25-35 pounds. Underweight women should gain 28-40 pounds, overweight
15-25 pounds, and obese 11-20 pounds.
6. The nurse is assessing a pregnant 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 of pregnancy
that can only be attributed to pregnancy. These include ultrasound visualization,
fetal heart tones, and fetal movement felt by the examiner.
7. 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%.
8. 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.
9. 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.
10. 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.
11. 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"
and Pediatrics, Questions and Answers - Galen College of
Nursing COMPREHENSIVE MATERNAL AND
PEDIATRICS EXAMINATION Practice Questions with
Answers and Rationales
1. 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.
2. 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: Cardiac output increases by 30-50% during pregnancy to meet the
metabolic demands of the mother and fetus. GI contractility decreases
(constipation), blood pressure typically decreases in the second trimester, and
respiratory rate remains relatively unchanged (though tidal volume increases).
,3. The nurse is teaching a client about symptoms to report during her
pregnancy. Which of the following statements by the client indicates a 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
evaluation. Increased urination and fatigue are common discomforts; nausea is
expected in the first trimester unless severe.
4. The nurse is teaching a client about the presumptive signs of pregnancy.
Which of the following is a presumptive sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate on Doppler
D) Ultrasound visualization of the fetus
Rationale: Presumptive signs are subjective changes experienced by the woman
(breast tenderness, nausea, fatigue, amenorrhea, urinary frequency, quickening).
Goodell sign is probable, FHR and ultrasound are positive signs.
5. A pregnant client asks the nurse about the expected weight gain during
pregnancy. The nurse correctly responds that the recommended weight gain
for a woman with a normal BMI is:
A) 11-20 pounds
B) 15-25 pounds
C) 25-35 pounds
D) 28-40 pounds
,Rationale: For women with a normal BMI (18.5-24.9), the recommended weight
gain is 25-35 pounds. Underweight women should gain 28-40 pounds, overweight
15-25 pounds, and obese 11-20 pounds.
6. The nurse is assessing a pregnant 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 of pregnancy
that can only be attributed to pregnancy. These include ultrasound visualization,
fetal heart tones, and fetal movement felt by the examiner.
7. 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%.
8. 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.
9. 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.
10. 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.
11. 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"
