NUR 254 Exams 1–4 Maternal Pediatric
Nursing Galen 2026/2027 – Questions and
Answers | 100% Verified | Detailed Rationales
– Pass Guaranteed – A+ Graded
NUR 254 Exams 1–4 Practice Exam
Maternal & Pediatric Nursing | Galen College of Nursing | 2026/2027 Edition
SECTION 1: Prenatal Care & Maternity Foundations
1. A nurse is assessing a client at her first prenatal visit. The client reports her last
menstrual period (LMP) was March 10, 2026. Using Naegele's rule, what is her
estimated date of delivery (EDD)?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. January 17, 2027
Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP, then
add 7 days. March 10 - 3 months = December 10, then +7 days = December 17 .
2. The first day of a client's last menstrual period was September 14. Using
Naegele's rule, which estimated birth date should the nurse calculate?
,A. June 7
B. May 7
C. June 21
D. July 21
Answer: C
Rationale: Naegele's rule adds seven days to the first day of the LMP and
subtracts three months. September 14 becomes September 21, then June 21 .
3. A client planning a pregnancy has no history of a neural tube defect. Which
instruction best lowers the fetal risk for a neural tube defect?
A. Begin 50 micrograms of folic acid only after fetal movement is felt
B. Take 4 milligrams of folic acid only during the final month of pregnancy
C. Take 400 to 800 micrograms of folic acid daily, beginning before conception
D. Avoid folic acid when the diet contains fortified grains
Answer: C
Rationale: Adequate folate must be present during very early neural tube
formation, often before pregnancy is recognized. A daily intake of 400 to 800
micrograms is appropriate for most clients without a prior affected pregnancy .
4. Which finding is a positive sign of pregnancy?
A. A positive urine human chorionic gonadotropin result
B. Fetal cardiac activity visualized by ultrasound
C. Amenorrhea for two menstrual cycles
D. Bluish discoloration of the cervix
Answer: B
Rationale: Direct visualization of fetal cardiac activity confirms the presence of a
fetus. Amenorrhea is presumptive, while cervical color change and a human
chorionic gonadotropin result are probable rather than positive signs .
,5. Which early-pregnancy action of human chorionic gonadotropin is most
important for maintaining the pregnancy?
A. It directly causes fetal lung surfactant production
B. It closes the fetal ductus arteriosus
C. It initiates maternal milk ejection during the first trimester
D. It sustains the corpus luteum so progesterone production continues
Answer: D
Rationale: Human chorionic gonadotropin preserves the corpus luteum early in
gestation, maintaining progesterone until placental hormone production is
sufficient. Progesterone supports the endometrium and limits uterine
contractility .
6. A healthy pregnant client has a mildly reduced hematocrit with no symptoms.
Which physiologic change best explains this finding?
A. Red blood cell destruction accelerates throughout pregnancy
B. The placenta removes maternal erythrocytes from circulation
C. Plasma volume expands more than red blood cell mass
D. Maternal blood volume steadily decreases after implantation
Answer: C
Rationale: Pregnancy expands both plasma volume and red blood cell mass, but
plasma volume rises proportionally more. The resulting hemodilution produces
the expected physiologic anemia of pregnancy .
7. A client at 28 weeks gestation reports feeling dizzy when lying on her back.
What should the nurse do first?
A. Encourage the client to bear down with each breath
B. Turn the client onto the left side
, C. Place the client in a high-Fowler position with legs dependent
D. Administer oxygen via face mask
Answer: B
Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava in the supine position, reducing venous return
and causing dizziness. The immediate intervention is to position her on her left
side to restore circulation .
8. A nurse is teaching a pregnant client about nutrition. Which statement by the
client indicates understanding?
A. "I should gain 25-35 pounds during pregnancy."
B. "I need to double my calorie intake now."
C. "I can continue drinking 2 cups of coffee daily."
D. "I should avoid all fish during pregnancy."
Answer: A
Rationale: For a client with normal pre-pregnancy BMI, a weight gain of 25-35
lbs is recommended. Caloric needs increase by only ~300 kcal/day in 2nd/3rd
trimesters (not double). Caffeine should be limited to <200mg/day (~1 cup
coffee). Fish low in mercury (e.g., salmon) are encouraged 2-3 servings/week for
omega-3s .
9. A patient at 12 weeks gestation reports morning sickness. Which
recommendation should the nurse prioritize?
A. Eat three large meals per day
B. Drink fluids mainly with meals
C. Eat dry crackers before arising
D. Increase spicy food intake
Answer: C
Rationale: Dry crackers before rising help stabilize blood sugar and reduce
Nursing Galen 2026/2027 – Questions and
Answers | 100% Verified | Detailed Rationales
– Pass Guaranteed – A+ Graded
NUR 254 Exams 1–4 Practice Exam
Maternal & Pediatric Nursing | Galen College of Nursing | 2026/2027 Edition
SECTION 1: Prenatal Care & Maternity Foundations
1. A nurse is assessing a client at her first prenatal visit. The client reports her last
menstrual period (LMP) was March 10, 2026. Using Naegele's rule, what is her
estimated date of delivery (EDD)?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. January 17, 2027
Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP, then
add 7 days. March 10 - 3 months = December 10, then +7 days = December 17 .
2. The first day of a client's last menstrual period was September 14. Using
Naegele's rule, which estimated birth date should the nurse calculate?
,A. June 7
B. May 7
C. June 21
D. July 21
Answer: C
Rationale: Naegele's rule adds seven days to the first day of the LMP and
subtracts three months. September 14 becomes September 21, then June 21 .
3. A client planning a pregnancy has no history of a neural tube defect. Which
instruction best lowers the fetal risk for a neural tube defect?
A. Begin 50 micrograms of folic acid only after fetal movement is felt
B. Take 4 milligrams of folic acid only during the final month of pregnancy
C. Take 400 to 800 micrograms of folic acid daily, beginning before conception
D. Avoid folic acid when the diet contains fortified grains
Answer: C
Rationale: Adequate folate must be present during very early neural tube
formation, often before pregnancy is recognized. A daily intake of 400 to 800
micrograms is appropriate for most clients without a prior affected pregnancy .
4. Which finding is a positive sign of pregnancy?
A. A positive urine human chorionic gonadotropin result
B. Fetal cardiac activity visualized by ultrasound
C. Amenorrhea for two menstrual cycles
D. Bluish discoloration of the cervix
Answer: B
Rationale: Direct visualization of fetal cardiac activity confirms the presence of a
fetus. Amenorrhea is presumptive, while cervical color change and a human
chorionic gonadotropin result are probable rather than positive signs .
,5. Which early-pregnancy action of human chorionic gonadotropin is most
important for maintaining the pregnancy?
A. It directly causes fetal lung surfactant production
B. It closes the fetal ductus arteriosus
C. It initiates maternal milk ejection during the first trimester
D. It sustains the corpus luteum so progesterone production continues
Answer: D
Rationale: Human chorionic gonadotropin preserves the corpus luteum early in
gestation, maintaining progesterone until placental hormone production is
sufficient. Progesterone supports the endometrium and limits uterine
contractility .
6. A healthy pregnant client has a mildly reduced hematocrit with no symptoms.
Which physiologic change best explains this finding?
A. Red blood cell destruction accelerates throughout pregnancy
B. The placenta removes maternal erythrocytes from circulation
C. Plasma volume expands more than red blood cell mass
D. Maternal blood volume steadily decreases after implantation
Answer: C
Rationale: Pregnancy expands both plasma volume and red blood cell mass, but
plasma volume rises proportionally more. The resulting hemodilution produces
the expected physiologic anemia of pregnancy .
7. A client at 28 weeks gestation reports feeling dizzy when lying on her back.
What should the nurse do first?
A. Encourage the client to bear down with each breath
B. Turn the client onto the left side
, C. Place the client in a high-Fowler position with legs dependent
D. Administer oxygen via face mask
Answer: B
Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava in the supine position, reducing venous return
and causing dizziness. The immediate intervention is to position her on her left
side to restore circulation .
8. A nurse is teaching a pregnant client about nutrition. Which statement by the
client indicates understanding?
A. "I should gain 25-35 pounds during pregnancy."
B. "I need to double my calorie intake now."
C. "I can continue drinking 2 cups of coffee daily."
D. "I should avoid all fish during pregnancy."
Answer: A
Rationale: For a client with normal pre-pregnancy BMI, a weight gain of 25-35
lbs is recommended. Caloric needs increase by only ~300 kcal/day in 2nd/3rd
trimesters (not double). Caffeine should be limited to <200mg/day (~1 cup
coffee). Fish low in mercury (e.g., salmon) are encouraged 2-3 servings/week for
omega-3s .
9. A patient at 12 weeks gestation reports morning sickness. Which
recommendation should the nurse prioritize?
A. Eat three large meals per day
B. Drink fluids mainly with meals
C. Eat dry crackers before arising
D. Increase spicy food intake
Answer: C
Rationale: Dry crackers before rising help stabilize blood sugar and reduce
