Page 1 of 159
NUR 254 Exams 1 - 4 Galen College Complete Maternal &
Pediatric Nursing EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
NUR 254 Exams 1 - 4 | Galen College Complete Maternal & Pediatric Nursing
10-LINE EXAM COVERAGE IN POINTS FORM
1. Antepartum Nursing & Prenatal Care – Normal physiological changes, fundal height
assessment, nutritional needs including folic acid and iron supplementation, common
discomforts of pregnancy, and signs of normal vs. abnormal findings requiring provider
notification .
2. High-Risk Antepartum Complications – Gestational diabetes screening and
management, preeclampsia recognition and magnesium sulfate therapy, placental
abnormalities (previa vs. abruption), ectopic pregnancy risk factors, and Rh
isoimmunization prevention with RhoGAM .
3. Intrapartum Nursing & Labor Management – Stages of labor including transition phase
assessment, electronic fetal monitoring interpretation (late, early, variable
decelerations), oxytocin induction, pain management options, and nursing interventions
for labor complications .
4. Fetal Assessment & Diagnostic Testing – Nonstress test (NST) interpretation (reactive vs.
non-reactive), biophysical profile components, amniotic fluid analysis, glucose challenge
test (GCT) and 3-hour oral glucose tolerance test (OGTT), alpha-fetoprotein (AFP)
screening, and ultrasound findings .
5. Postpartum Nursing Care – Postpartum assessment of uterine involution, lochia
progression, vital signs, breastfeeding support, postpartum hemorrhage prevention,
perineal care, and signs of postpartum complications including infection and
thromboembolism .
6. Newborn Assessment & Transition – Apgar scoring, newborn reflexes, transitional
period adaptations (thermoregulation, respiratory, cardiovascular), gestational age
assessment, newborn screening tests, and identification of common newborn
complications .
7. Newborn Complications & Interventions – Neonatal hypoglycemia, hyperbilirubinemia,
respiratory distress syndrome, meconium aspiration, sepsis risk factors, congenital
anomalies, and neonatal resuscitation priorities .
8. Pediatric Growth & Development – Developmental milestones by age, age-appropriate
nursing interventions, immunization schedules, nutrition and safety considerations,
family-centered care principles, and anticipatory guidance for pediatric clients .
, Page 2 of 159
9. Common Pediatric Disorders – Respiratory (asthma, bronchiolitis), gastrointestinal
(gastroenteritis, dehydration), neurological (meningitis, seizures), hematological (sickle
cell disease), infectious diseases, and pediatric emergency management .
10. Pediatric Nursing Care & Pharmacology – Medication administration and dosage
calculation in children, pain assessment and management, pediatric assessment
techniques, family teaching, discharge planning, and end-of-life care considerations for
pediatric clients .
250 NGN-STYLE MATERNAL & PEDIATRIC NURSING MULTIPLE CHOICE QUESTIONS WITH
RATIONALES
QUESTION 1
A nurse is assessing a pregnant client at 12 weeks gestation. Which finding should the nurse
identify as a normal physiological change of pregnancy?
A) Blood pressure reading of 150/90 mm Hg reflecting hypertension requiring immediate
intervention
B) Heart rate of 55 beats per minute indicating bradycardia requiring cardiac evaluation
C) Hemoglobin level of 11.2 g/dL reflecting physiological anemia of pregnancy due to
hemodilution
D) Fetal heart rate of 80 beats per minute indicating fetal distress requiring further assessment
Correct Answer: C
Rationale: During pregnancy, plasma volume increases more than red blood cell mass, causing
physiologic anemia of pregnancy (hemodilution). A hemoglobin of 11.2 g/dL is considered
normal in the first trimester. Blood pressure should not exceed 140/90 mm Hg; heart rate
typically increases slightly, not decreases to 55 bpm; and fetal heart rate should be 110-160
, Page 3 of 159
bpm by 12 weeks gestation. The physiological changes of pregnancy require understanding of
normal parameters to distinguish from abnormal findings .
QUESTION 2
A client at 8 weeks gestation asks the nurse about taking prenatal vitamins. Which supplement
is most critical during the first trimester for prevention of neural tube defects?
A) Iron supplementation to prevent maternal anemia and support fetal oxygenation
B) Calcium supplementation to support fetal bone and tooth development
C) Folic acid supplementation to prevent neural tube defects like spina bifida
D) Vitamin C supplementation to enhance iron absorption and immune function
Correct Answer: C
Rationale: Folic acid (at least 400-800 mcg daily) is crucial during early pregnancy to prevent
neural tube defects such as spina bifida and anencephaly, which occur in the first 4 weeks of
gestation before many women know they are pregnant. Iron, calcium, and vitamin C are also
important but are not specifically associated with neural tube defect prevention. The nurse
should emphasize folic acid supplementation as a priority in early pregnancy education .
QUESTION 3
A pregnant client presents with severe, persistent vomiting and is unable to keep food or fluids
down. The nurse notes elevated ketones in the urine. Which condition is the client most likely
experiencing?
, Page 4 of 159
A) Normal morning sickness that will resolve by 12-14 weeks gestation
B) Hyperemesis gravidarum requiring fluid and electrolyte replacement therapy
C) Gastroenteritis requiring antibiotic therapy and isolation precautions
D) Gastric ulcer requiring medication therapy and dietary modifications
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe, persistent vomiting that leads to
dehydration, electrolyte imbalances, and ketonuria. It requires medical intervention including IV
fluid replacement, electrolyte monitoring, and antiemetic therapy. This is more severe than
typical morning sickness and requires hospitalization in severe cases to prevent complications
such as Wernicke's encephalopathy. The nurse should not dismiss this as normal morning
sickness .
QUESTION 4
A nurse is monitoring a client receiving oxytocin for labor induction. The fetal heart rate (FHR)
monitor shows late decelerations. What is the nurse's priority action based on this finding?
A) Increase the oxytocin infusion rate to expedite delivery of the fetus
B) Turn the client to a lateral position and stop the oxytocin infusion
C) Administer terbutaline to stop uterine contractions immediately
D) Assess maternal temperature for signs of intrauterine infection
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia. The priority
NUR 254 Exams 1 - 4 Galen College Complete Maternal &
Pediatric Nursing EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
NUR 254 Exams 1 - 4 | Galen College Complete Maternal & Pediatric Nursing
10-LINE EXAM COVERAGE IN POINTS FORM
1. Antepartum Nursing & Prenatal Care – Normal physiological changes, fundal height
assessment, nutritional needs including folic acid and iron supplementation, common
discomforts of pregnancy, and signs of normal vs. abnormal findings requiring provider
notification .
2. High-Risk Antepartum Complications – Gestational diabetes screening and
management, preeclampsia recognition and magnesium sulfate therapy, placental
abnormalities (previa vs. abruption), ectopic pregnancy risk factors, and Rh
isoimmunization prevention with RhoGAM .
3. Intrapartum Nursing & Labor Management – Stages of labor including transition phase
assessment, electronic fetal monitoring interpretation (late, early, variable
decelerations), oxytocin induction, pain management options, and nursing interventions
for labor complications .
4. Fetal Assessment & Diagnostic Testing – Nonstress test (NST) interpretation (reactive vs.
non-reactive), biophysical profile components, amniotic fluid analysis, glucose challenge
test (GCT) and 3-hour oral glucose tolerance test (OGTT), alpha-fetoprotein (AFP)
screening, and ultrasound findings .
5. Postpartum Nursing Care – Postpartum assessment of uterine involution, lochia
progression, vital signs, breastfeeding support, postpartum hemorrhage prevention,
perineal care, and signs of postpartum complications including infection and
thromboembolism .
6. Newborn Assessment & Transition – Apgar scoring, newborn reflexes, transitional
period adaptations (thermoregulation, respiratory, cardiovascular), gestational age
assessment, newborn screening tests, and identification of common newborn
complications .
7. Newborn Complications & Interventions – Neonatal hypoglycemia, hyperbilirubinemia,
respiratory distress syndrome, meconium aspiration, sepsis risk factors, congenital
anomalies, and neonatal resuscitation priorities .
8. Pediatric Growth & Development – Developmental milestones by age, age-appropriate
nursing interventions, immunization schedules, nutrition and safety considerations,
family-centered care principles, and anticipatory guidance for pediatric clients .
, Page 2 of 159
9. Common Pediatric Disorders – Respiratory (asthma, bronchiolitis), gastrointestinal
(gastroenteritis, dehydration), neurological (meningitis, seizures), hematological (sickle
cell disease), infectious diseases, and pediatric emergency management .
10. Pediatric Nursing Care & Pharmacology – Medication administration and dosage
calculation in children, pain assessment and management, pediatric assessment
techniques, family teaching, discharge planning, and end-of-life care considerations for
pediatric clients .
250 NGN-STYLE MATERNAL & PEDIATRIC NURSING MULTIPLE CHOICE QUESTIONS WITH
RATIONALES
QUESTION 1
A nurse is assessing a pregnant client at 12 weeks gestation. Which finding should the nurse
identify as a normal physiological change of pregnancy?
A) Blood pressure reading of 150/90 mm Hg reflecting hypertension requiring immediate
intervention
B) Heart rate of 55 beats per minute indicating bradycardia requiring cardiac evaluation
C) Hemoglobin level of 11.2 g/dL reflecting physiological anemia of pregnancy due to
hemodilution
D) Fetal heart rate of 80 beats per minute indicating fetal distress requiring further assessment
Correct Answer: C
Rationale: During pregnancy, plasma volume increases more than red blood cell mass, causing
physiologic anemia of pregnancy (hemodilution). A hemoglobin of 11.2 g/dL is considered
normal in the first trimester. Blood pressure should not exceed 140/90 mm Hg; heart rate
typically increases slightly, not decreases to 55 bpm; and fetal heart rate should be 110-160
, Page 3 of 159
bpm by 12 weeks gestation. The physiological changes of pregnancy require understanding of
normal parameters to distinguish from abnormal findings .
QUESTION 2
A client at 8 weeks gestation asks the nurse about taking prenatal vitamins. Which supplement
is most critical during the first trimester for prevention of neural tube defects?
A) Iron supplementation to prevent maternal anemia and support fetal oxygenation
B) Calcium supplementation to support fetal bone and tooth development
C) Folic acid supplementation to prevent neural tube defects like spina bifida
D) Vitamin C supplementation to enhance iron absorption and immune function
Correct Answer: C
Rationale: Folic acid (at least 400-800 mcg daily) is crucial during early pregnancy to prevent
neural tube defects such as spina bifida and anencephaly, which occur in the first 4 weeks of
gestation before many women know they are pregnant. Iron, calcium, and vitamin C are also
important but are not specifically associated with neural tube defect prevention. The nurse
should emphasize folic acid supplementation as a priority in early pregnancy education .
QUESTION 3
A pregnant client presents with severe, persistent vomiting and is unable to keep food or fluids
down. The nurse notes elevated ketones in the urine. Which condition is the client most likely
experiencing?
, Page 4 of 159
A) Normal morning sickness that will resolve by 12-14 weeks gestation
B) Hyperemesis gravidarum requiring fluid and electrolyte replacement therapy
C) Gastroenteritis requiring antibiotic therapy and isolation precautions
D) Gastric ulcer requiring medication therapy and dietary modifications
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe, persistent vomiting that leads to
dehydration, electrolyte imbalances, and ketonuria. It requires medical intervention including IV
fluid replacement, electrolyte monitoring, and antiemetic therapy. This is more severe than
typical morning sickness and requires hospitalization in severe cases to prevent complications
such as Wernicke's encephalopathy. The nurse should not dismiss this as normal morning
sickness .
QUESTION 4
A nurse is monitoring a client receiving oxytocin for labor induction. The fetal heart rate (FHR)
monitor shows late decelerations. What is the nurse's priority action based on this finding?
A) Increase the oxytocin infusion rate to expedite delivery of the fetus
B) Turn the client to a lateral position and stop the oxytocin infusion
C) Administer terbutaline to stop uterine contractions immediately
D) Assess maternal temperature for signs of intrauterine infection
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal hypoxia. The priority
