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NUR 254 EXAMS 1, 2, 3 & 4 EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
NUR 254 Exams 1, 2, 3 & 4 – Maternal and Pediatric Nursing
SECTION 1: ANTEPARTUM & PRENATAL CARE (Exam 1: Questions 1–65)
Question 1. The nurse is teaching a client who is in the 10th week of pregnancy about morning
sickness. Which of the following should the nurse include in the teaching?
A) Avoid all fluids during meals to prevent nausea
B) Eat small, frequent meals throughout the day
C) Increase intake of spicy and fatty foods to settle the stomach
D) Take antiemetic medication immediately upon waking
Answer: B
Rationale: Eating small, frequent meals helps maintain blood glucose levels and prevents an
empty stomach, which can exacerbate nausea. Avoiding all fluids can lead to dehydration. Spicy
and fatty foods can worsen nausea. Antiemetics should be used as prescribed, not immediately
upon waking without provider guidance.
Question 2. A nurse is assessing a client at 10 weeks' gestation who reports occasional spotting
with mild cramping. Which action should the nurse take first?
A) Reassure the client that spotting is normal in early pregnancy
B) Assess the character and quantity of the bleeding and notify the provider
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C) Instruct the client to increase fluid intake
D) Schedule the client for a routine ultrasound in one week
Answer: B
Rationale: Bleeding in early pregnancy may indicate miscarriage, ectopic pregnancy, or other
complications. The nurse must assess the bleeding (color, amount, presence of tissue/clots) and
notify the provider promptly. While some spotting can occur with implantation, it must be
evaluated rather than assumed benign.
Question 3. A nurse is teaching a pregnant client about nutrition. Which statement by the client
indicates correct understanding?
A) "I should double my calorie intake throughout pregnancy."
B) "I need about 300 extra calories per day during the second and third trimesters."
C) "I should avoid all fish during pregnancy."
D) "I only need to take folic acid after the first trimester."
Answer: B
Rationale: Pregnancy requires approximately 300 additional calories per day in the second and
third trimesters. Folic acid is critical in the first trimester for neural tube development and
should ideally be started before conception. Fish low in mercury (e.g., salmon, sardines) is
encouraged.
Question 4. 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
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Answer: B
Rationale: 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.
Gestational hypertension lacks proteinuria. Supine hypotensive syndrome causes hypotension,
not hypertension.
Question 5. A client at 36 weeks' gestation reports painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A) Abruptio placentae
B) Placenta previa
C) Uterine rupture
D) Cervical dilation
Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding in the
second or third trimester. Abruptio placentae typically causes painful bleeding with a rigid,
board-like abdomen. Uterine rupture is associated with severe pain and fetal distress.
Question 6. The charge nurse is discussing probable signs of pregnancy with a newly hired
nurse. Which finding is a probable sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate detected on Doppler
D) Negative serum pregnancy test
Answer: A
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
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presumptive sign, FHR detection is a positive sign, and a negative pregnancy test rules out
pregnancy.
Question 7. 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
Answer: C
Rationale: During pregnancy, there is a significant increase in maternal cardiac output to meet
the metabolic demands of the mother and the developing fetus. GI contractility decreases,
leading to constipation, and blood pressure remains the same or decreases slightly due to
decreased systemic vascular resistance.
Question 8. The nurse is caring for a client who is pregnant and recently diagnosed with pica.
Which hemoglobin (Hgb) level should the nurse expect to find in the client's chart?
A) 12 g/dL
B) 13.5 g/dL
C) 9 g/dL
D) 11 g/dL
Answer: C
Rationale: Pica, the ingestion of non-nutritive substances, is often associated with iron
deficiency anemia. A hemoglobin level of 9 g/dL is below normal limits during pregnancy and
consistent with moderate anemia, which aligns with findings in clients exhibiting pica.
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NUR 254 EXAMS 1, 2, 3 & 4 EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
NUR 254 Exams 1, 2, 3 & 4 – Maternal and Pediatric Nursing
SECTION 1: ANTEPARTUM & PRENATAL CARE (Exam 1: Questions 1–65)
Question 1. The nurse is teaching a client who is in the 10th week of pregnancy about morning
sickness. Which of the following should the nurse include in the teaching?
A) Avoid all fluids during meals to prevent nausea
B) Eat small, frequent meals throughout the day
C) Increase intake of spicy and fatty foods to settle the stomach
D) Take antiemetic medication immediately upon waking
Answer: B
Rationale: Eating small, frequent meals helps maintain blood glucose levels and prevents an
empty stomach, which can exacerbate nausea. Avoiding all fluids can lead to dehydration. Spicy
and fatty foods can worsen nausea. Antiemetics should be used as prescribed, not immediately
upon waking without provider guidance.
Question 2. A nurse is assessing a client at 10 weeks' gestation who reports occasional spotting
with mild cramping. Which action should the nurse take first?
A) Reassure the client that spotting is normal in early pregnancy
B) Assess the character and quantity of the bleeding and notify the provider
1|Page
,Page 2 of 98
C) Instruct the client to increase fluid intake
D) Schedule the client for a routine ultrasound in one week
Answer: B
Rationale: Bleeding in early pregnancy may indicate miscarriage, ectopic pregnancy, or other
complications. The nurse must assess the bleeding (color, amount, presence of tissue/clots) and
notify the provider promptly. While some spotting can occur with implantation, it must be
evaluated rather than assumed benign.
Question 3. A nurse is teaching a pregnant client about nutrition. Which statement by the client
indicates correct understanding?
A) "I should double my calorie intake throughout pregnancy."
B) "I need about 300 extra calories per day during the second and third trimesters."
C) "I should avoid all fish during pregnancy."
D) "I only need to take folic acid after the first trimester."
Answer: B
Rationale: Pregnancy requires approximately 300 additional calories per day in the second and
third trimesters. Folic acid is critical in the first trimester for neural tube development and
should ideally be started before conception. Fish low in mercury (e.g., salmon, sardines) is
encouraged.
Question 4. 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
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,Page 3 of 98
Answer: B
Rationale: 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.
Gestational hypertension lacks proteinuria. Supine hypotensive syndrome causes hypotension,
not hypertension.
Question 5. A client at 36 weeks' gestation reports painless, bright red vaginal bleeding. Which
condition should the nurse suspect?
A) Abruptio placentae
B) Placenta previa
C) Uterine rupture
D) Cervical dilation
Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding in the
second or third trimester. Abruptio placentae typically causes painful bleeding with a rigid,
board-like abdomen. Uterine rupture is associated with severe pain and fetal distress.
Question 6. The charge nurse is discussing probable signs of pregnancy with a newly hired
nurse. Which finding is a probable sign of pregnancy?
A) Goodell sign
B) Breast tenderness
C) Fetal heart rate detected on Doppler
D) Negative serum pregnancy test
Answer: A
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
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presumptive sign, FHR detection is a positive sign, and a negative pregnancy test rules out
pregnancy.
Question 7. 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
Answer: C
Rationale: During pregnancy, there is a significant increase in maternal cardiac output to meet
the metabolic demands of the mother and the developing fetus. GI contractility decreases,
leading to constipation, and blood pressure remains the same or decreases slightly due to
decreased systemic vascular resistance.
Question 8. The nurse is caring for a client who is pregnant and recently diagnosed with pica.
Which hemoglobin (Hgb) level should the nurse expect to find in the client's chart?
A) 12 g/dL
B) 13.5 g/dL
C) 9 g/dL
D) 11 g/dL
Answer: C
Rationale: Pica, the ingestion of non-nutritive substances, is often associated with iron
deficiency anemia. A hemoglobin level of 9 g/dL is below normal limits during pregnancy and
consistent with moderate anemia, which aligns with findings in clients exhibiting pica.
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