NUR 254 Exams 1, 2, 3 & 4 (Latest
2026/2027 Update) Maternal and
Pediatrics, Questions and Answers|A+
Guaranteed Pass (M0ST RECENT !!!)
Exam 1: Antepartum & Prenatal Care
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
Correct Answer: B
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) 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
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,C) Take 400 to 800 micrograms of folic acid daily, beginning before conception
D) Avoid folic acid when the diet contains fortified grains
Correct Answer: C
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 .
3) 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
Correct Answer: B
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 .
4) 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
Correct Answer: C
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 .
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, 5) 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
Correct Answer: B
Supine hypotensive syndrome occurs when the gravid uterus compresses the inferior
vena cava. Turning the client onto her left side relieves the compression and restores
circulation .
6) A client at 32 weeks gestation presents with a blood pressure of 148/92 mmHg and
3+ proteinuria. Which condition should the nurse suspect?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Supine hypotensive syndrome
Correct Answer: B
Preeclampsia is defined as new-onset hypertension (≥140/90 mmHg) after 20 weeks'
gestation with proteinuria (≥300 mg/24 hours) or other signs of end-organ dysfunction.
This client meets the criteria .
7) A client at 36 weeks gestation reports painless, bright red vaginal bleeding. What is
the priority nursing action?
A) Immediate sterile vaginal exam
B) Ultrasound to locate placenta before any digital exam
C) Oxytocin induction
D) Amniotomy
Correct Answer: B
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2026/2027 Update) Maternal and
Pediatrics, Questions and Answers|A+
Guaranteed Pass (M0ST RECENT !!!)
Exam 1: Antepartum & Prenatal Care
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
Correct Answer: B
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) 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
Page|1
,C) Take 400 to 800 micrograms of folic acid daily, beginning before conception
D) Avoid folic acid when the diet contains fortified grains
Correct Answer: C
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 .
3) 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
Correct Answer: B
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 .
4) 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
Correct Answer: C
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 .
Page|2
, 5) 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
Correct Answer: B
Supine hypotensive syndrome occurs when the gravid uterus compresses the inferior
vena cava. Turning the client onto her left side relieves the compression and restores
circulation .
6) A client at 32 weeks gestation presents with a blood pressure of 148/92 mmHg and
3+ proteinuria. Which condition should the nurse suspect?
A) Gestational hypertension
B) Preeclampsia
C) Chronic hypertension
D) Supine hypotensive syndrome
Correct Answer: B
Preeclampsia is defined as new-onset hypertension (≥140/90 mmHg) after 20 weeks'
gestation with proteinuria (≥300 mg/24 hours) or other signs of end-organ dysfunction.
This client meets the criteria .
7) A client at 36 weeks gestation reports painless, bright red vaginal bleeding. What is
the priority nursing action?
A) Immediate sterile vaginal exam
B) Ultrasound to locate placenta before any digital exam
C) Oxytocin induction
D) Amniotomy
Correct Answer: B
Page|3
