NUR 230 Exam 2 – Galen OB/Peds (2026)
NUR 230 Exam 2 – Galen OB/Peds (2026 update)
Actual Questions & Answers | Guarantee Pass
70 Multiple Choice Questions with Rationales
1. A pregnant client at 28 weeks gestation reports decreased fetal movement over the
past 24 hours. What is the nurse's priority action?
A. Instruct the client to drink cold water and count kicks for 1 hour
B. Reassure the client that decreased movement is normal at this gestation
C. Schedule a nonstress test (NST) to evaluate fetal well-being
D. Auscultate the fetal heart rate with a Doppler device
Correct Answer: C
Rationale: Decreased fetal movement after 28 weeks may indicate fetal distress and
warrants further evaluation. A nonstress test (NST) is the appropriate initial
assessment to evaluate fetal well-being by monitoring the fetal heart rate response to
movement. While kick counts are useful for ongoing monitoring, a reported decrease
requires clinical evaluation rather than home reassessment alone. Reassuring the
client without assessment could delay identification of a compromised fetus.
2. A nurse is reviewing the laboratory results of a client at 36 weeks gestation. Which
finding should the nurse report immediately to the healthcare provider?
A. Hemoglobin 11.0 g/dL B. White blood cell count 12,000/mm3
C. Platelet count 90,000/mm3 D. Fibrinogen level 350 mg/dL
Correct Answer: C
Rationale: A platelet count of 90,000/mm3 is below the normal range of 150,000 to
400,000/mm3 and indicates thrombocytopenia. Thrombocytopenia in pregnancy may
signal HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), a life-
threatening complication of preeclampsia. This finding requires immediate provider
notification. Mild anemia (Hgb 11.0) is common in pregnancy due to hemodilution,
and a slightly elevated WBC is a normal physiological change. Fibrinogen levels
normally increase during pregnancy.
1
, NUR 230 Exam 2 – Galen OB/Peds (2026)
3. A client at 32 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which statement by the client indicates a need for further teaching?
A. I will monitor my blood glucose levels four times daily
B. I should limit my carbohydrate intake at each meal
C. Since I did not have diabetes before pregnancy, it will not affect my baby
D. I will need to track my baby's movements daily
Correct Answer: C
Rationale: Gestational diabetes mellitus, even when it develops only during
pregnancy, can significantly affect the fetus. Poorly controlled blood glucose can
lead to macrosomia, hypoglycemia in the newborn, respiratory distress syndrome,
and birth injuries. The client must understand that GDM requires careful
management to prevent complications. Monitoring blood glucose, managing
carbohydrates, and performing daily kick counts are all appropriate actions for a
client with GDM.
4. A pregnant client at 35 weeks gestation has a blood pressure of 150/100 mmHg
and 2+ proteinuria. The nurse recognizes these findings as indicative of which
condition?
A. Gestational B. Preeclampsia C. Eclampsia D. Chronic
hypertension hypertension
Correct Answer: B
Rationale: Preeclampsia is diagnosed when a pregnant woman develops
hypertension (blood pressure of 140/90 mmHg or higher after 20 weeks)
accompanied by proteinuria (1+ or greater on dipstick). This client meets both
criteria. Gestational hypertension involves elevated blood pressure without
proteinuria. Eclampsia includes seizures in addition to preeclampsia criteria.
Chronic hypertension predates pregnancy. Early recognition and management of
preeclampsia are essential to prevent progression to severe disease and eclampsia.
5. A nurse is teaching a group of pregnant clients about warning signs in pregnancy
that require immediate medical attention. Which sign should be included?
A. Mild ankle edema in the evening B. Vaginal bleeding in the second or
third trimester
C. Intermittent nausea after meals D. Frequency of urination increasing at
30 weeks
Correct Answer: B
2
, NUR 230 Exam 2 – Galen OB/Peds (2026)
Rationale: Vaginal bleeding during the second or third trimester is never considered
normal and requires immediate evaluation. It may indicate placenta previa, placental
abruption, or preterm labor, all of which can be life-threatening to the mother and
fetus. Mild ankle edema is common in pregnancy due to venous compression.
Intermittent nausea and increased urinary frequency are normal pregnancy
discomforts. The nurse must emphasize that any bleeding after the first trimester
warrants urgent medical assessment.
6. A client at 24 weeks gestation asks the nurse about the purpose of the glucose
challenge test (GCT). What is the best response by the nurse?
A. It screens for gestational diabetes mellitus between 24 and 28 weeks
B. It determines if the baby has a congenital heart defect
C. It evaluates how well the placenta is functioning
D. It checks the mother's ability to metabolize iron during pregnancy
Correct Answer: A
Rationale: The glucose challenge test (GCT) is a screening tool for gestational
diabetes mellitus (GDM) performed between 24 and 28 weeks gestation. The client
consumes a 50-gram glucose solution, and blood glucose is measured after 1 hour. If
the result exceeds the threshold (typically 140 mg/dL), a diagnostic 3-hour oral
glucose tolerance test (OGTT) is ordered. GDM affects approximately 2-10% of
pregnancies and is associated with increased maternal and fetal risks when
uncontrolled.
7. A pregnant client with Rh-negative blood type asks why she needs Rho(D)
immune globulin (RhoGAM). Which explanation by the nurse is most accurate?
A. It prevents the mother from developing antibodies against Rh-positive fetal
blood cells
B. It treats existing anemia caused by Rh incompatibility
C. It boosts the mother's immune system to fight infections during pregnancy
D. It converts the mother's Rh-negative blood to Rh-positive
Correct Answer: A
Rationale: Rho(D) immune globulin (RhoGAM) is administered to Rh-negative
mothers at 28 weeks gestation and within 72 hours after delivery of an Rh-positive
infant. It prevents maternal sensitization by destroying any fetal Rh-positive red
blood cells that have entered the maternal circulation, thereby preventing the mother
from producing anti-Rh antibodies. If sensitization occurs, future Rh-positive
3
, NUR 230 Exam 2 – Galen OB/Peds (2026)
pregnancies are at risk for hemolytic disease of the fetus and newborn (HDFN).
RhoGAM does not treat anemia, boost immunity, or change blood type.
8. A nurse is assessing a client at 12 weeks gestation. Which finding would the nurse
expect during this trimester?
A. Braxton Hicks contractions B. Fetal heart rate audible with a
Doppler
C. Quickening (fetal movement felt by D. Cervical dilation of 1-2 cm
the mother)
Correct Answer: B
Rationale: At 12 weeks gestation, the fetal heart rate can typically be detected with a
Doppler device. Quickening (maternal perception of fetal movement) usually occurs
between 16 and 20 weeks for nulliparous women and 14-16 weeks for multiparous
women. Braxton Hicks contractions begin in the second trimester but are more
commonly felt after 20 weeks. Cervical dilation is not a normal finding at 12 weeks
and would be concerning for cervical insufficiency or preterm labor.
9. A client at 30 weeks gestation is receiving terbutaline (Brethine) for preterm labor.
Which side effect should the nurse monitor for?
A. Hypotension and B. Tachycardia and C. Drowsiness and D. Hyperglycemia
bradycardia tremors dry mouth and weight gain
Correct Answer: B
Rationale: Terbutaline is a beta-2 adrenergic agonist used as a tocolytic to suppress
preterm labor. Common side effects include maternal tachycardia, palpitations,
tremors, nervousness, and hypokalemia. These occur because beta-2 agonists also
have some beta-1 activity, stimulating the heart. The nurse should monitor the
maternal heart rate, assess for tremors, and ensure the client is well-hydrated.
Hypotension and bradycardia are not expected with terbutaline; it typically causes
tachycardia, not bradycardia.
10. A nurse is conducting a prenatal class on nutrition during pregnancy. Which
statement by a participant indicates understanding of the teaching?
A. I should increase my caloric intake by approximately 300-500 calories per day
B. I need to avoid all fish during pregnancy due to mercury risk
C. I should double my iron intake to prevent anemia
D. Caffeine is completely prohibited during pregnancy
Correct Answer: A
4
NUR 230 Exam 2 – Galen OB/Peds (2026 update)
Actual Questions & Answers | Guarantee Pass
70 Multiple Choice Questions with Rationales
1. A pregnant client at 28 weeks gestation reports decreased fetal movement over the
past 24 hours. What is the nurse's priority action?
A. Instruct the client to drink cold water and count kicks for 1 hour
B. Reassure the client that decreased movement is normal at this gestation
C. Schedule a nonstress test (NST) to evaluate fetal well-being
D. Auscultate the fetal heart rate with a Doppler device
Correct Answer: C
Rationale: Decreased fetal movement after 28 weeks may indicate fetal distress and
warrants further evaluation. A nonstress test (NST) is the appropriate initial
assessment to evaluate fetal well-being by monitoring the fetal heart rate response to
movement. While kick counts are useful for ongoing monitoring, a reported decrease
requires clinical evaluation rather than home reassessment alone. Reassuring the
client without assessment could delay identification of a compromised fetus.
2. A nurse is reviewing the laboratory results of a client at 36 weeks gestation. Which
finding should the nurse report immediately to the healthcare provider?
A. Hemoglobin 11.0 g/dL B. White blood cell count 12,000/mm3
C. Platelet count 90,000/mm3 D. Fibrinogen level 350 mg/dL
Correct Answer: C
Rationale: A platelet count of 90,000/mm3 is below the normal range of 150,000 to
400,000/mm3 and indicates thrombocytopenia. Thrombocytopenia in pregnancy may
signal HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), a life-
threatening complication of preeclampsia. This finding requires immediate provider
notification. Mild anemia (Hgb 11.0) is common in pregnancy due to hemodilution,
and a slightly elevated WBC is a normal physiological change. Fibrinogen levels
normally increase during pregnancy.
1
, NUR 230 Exam 2 – Galen OB/Peds (2026)
3. A client at 32 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which statement by the client indicates a need for further teaching?
A. I will monitor my blood glucose levels four times daily
B. I should limit my carbohydrate intake at each meal
C. Since I did not have diabetes before pregnancy, it will not affect my baby
D. I will need to track my baby's movements daily
Correct Answer: C
Rationale: Gestational diabetes mellitus, even when it develops only during
pregnancy, can significantly affect the fetus. Poorly controlled blood glucose can
lead to macrosomia, hypoglycemia in the newborn, respiratory distress syndrome,
and birth injuries. The client must understand that GDM requires careful
management to prevent complications. Monitoring blood glucose, managing
carbohydrates, and performing daily kick counts are all appropriate actions for a
client with GDM.
4. A pregnant client at 35 weeks gestation has a blood pressure of 150/100 mmHg
and 2+ proteinuria. The nurse recognizes these findings as indicative of which
condition?
A. Gestational B. Preeclampsia C. Eclampsia D. Chronic
hypertension hypertension
Correct Answer: B
Rationale: Preeclampsia is diagnosed when a pregnant woman develops
hypertension (blood pressure of 140/90 mmHg or higher after 20 weeks)
accompanied by proteinuria (1+ or greater on dipstick). This client meets both
criteria. Gestational hypertension involves elevated blood pressure without
proteinuria. Eclampsia includes seizures in addition to preeclampsia criteria.
Chronic hypertension predates pregnancy. Early recognition and management of
preeclampsia are essential to prevent progression to severe disease and eclampsia.
5. A nurse is teaching a group of pregnant clients about warning signs in pregnancy
that require immediate medical attention. Which sign should be included?
A. Mild ankle edema in the evening B. Vaginal bleeding in the second or
third trimester
C. Intermittent nausea after meals D. Frequency of urination increasing at
30 weeks
Correct Answer: B
2
, NUR 230 Exam 2 – Galen OB/Peds (2026)
Rationale: Vaginal bleeding during the second or third trimester is never considered
normal and requires immediate evaluation. It may indicate placenta previa, placental
abruption, or preterm labor, all of which can be life-threatening to the mother and
fetus. Mild ankle edema is common in pregnancy due to venous compression.
Intermittent nausea and increased urinary frequency are normal pregnancy
discomforts. The nurse must emphasize that any bleeding after the first trimester
warrants urgent medical assessment.
6. A client at 24 weeks gestation asks the nurse about the purpose of the glucose
challenge test (GCT). What is the best response by the nurse?
A. It screens for gestational diabetes mellitus between 24 and 28 weeks
B. It determines if the baby has a congenital heart defect
C. It evaluates how well the placenta is functioning
D. It checks the mother's ability to metabolize iron during pregnancy
Correct Answer: A
Rationale: The glucose challenge test (GCT) is a screening tool for gestational
diabetes mellitus (GDM) performed between 24 and 28 weeks gestation. The client
consumes a 50-gram glucose solution, and blood glucose is measured after 1 hour. If
the result exceeds the threshold (typically 140 mg/dL), a diagnostic 3-hour oral
glucose tolerance test (OGTT) is ordered. GDM affects approximately 2-10% of
pregnancies and is associated with increased maternal and fetal risks when
uncontrolled.
7. A pregnant client with Rh-negative blood type asks why she needs Rho(D)
immune globulin (RhoGAM). Which explanation by the nurse is most accurate?
A. It prevents the mother from developing antibodies against Rh-positive fetal
blood cells
B. It treats existing anemia caused by Rh incompatibility
C. It boosts the mother's immune system to fight infections during pregnancy
D. It converts the mother's Rh-negative blood to Rh-positive
Correct Answer: A
Rationale: Rho(D) immune globulin (RhoGAM) is administered to Rh-negative
mothers at 28 weeks gestation and within 72 hours after delivery of an Rh-positive
infant. It prevents maternal sensitization by destroying any fetal Rh-positive red
blood cells that have entered the maternal circulation, thereby preventing the mother
from producing anti-Rh antibodies. If sensitization occurs, future Rh-positive
3
, NUR 230 Exam 2 – Galen OB/Peds (2026)
pregnancies are at risk for hemolytic disease of the fetus and newborn (HDFN).
RhoGAM does not treat anemia, boost immunity, or change blood type.
8. A nurse is assessing a client at 12 weeks gestation. Which finding would the nurse
expect during this trimester?
A. Braxton Hicks contractions B. Fetal heart rate audible with a
Doppler
C. Quickening (fetal movement felt by D. Cervical dilation of 1-2 cm
the mother)
Correct Answer: B
Rationale: At 12 weeks gestation, the fetal heart rate can typically be detected with a
Doppler device. Quickening (maternal perception of fetal movement) usually occurs
between 16 and 20 weeks for nulliparous women and 14-16 weeks for multiparous
women. Braxton Hicks contractions begin in the second trimester but are more
commonly felt after 20 weeks. Cervical dilation is not a normal finding at 12 weeks
and would be concerning for cervical insufficiency or preterm labor.
9. A client at 30 weeks gestation is receiving terbutaline (Brethine) for preterm labor.
Which side effect should the nurse monitor for?
A. Hypotension and B. Tachycardia and C. Drowsiness and D. Hyperglycemia
bradycardia tremors dry mouth and weight gain
Correct Answer: B
Rationale: Terbutaline is a beta-2 adrenergic agonist used as a tocolytic to suppress
preterm labor. Common side effects include maternal tachycardia, palpitations,
tremors, nervousness, and hypokalemia. These occur because beta-2 agonists also
have some beta-1 activity, stimulating the heart. The nurse should monitor the
maternal heart rate, assess for tremors, and ensure the client is well-hydrated.
Hypotension and bradycardia are not expected with terbutaline; it typically causes
tachycardia, not bradycardia.
10. A nurse is conducting a prenatal class on nutrition during pregnancy. Which
statement by a participant indicates understanding of the teaching?
A. I should increase my caloric intake by approximately 300-500 calories per day
B. I need to avoid all fish during pregnancy due to mercury risk
C. I should double my iron intake to prevent anemia
D. Caffeine is completely prohibited during pregnancy
Correct Answer: A
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