NUR 254 MIDTERM PRACTICE EXAM: Maternal & Pediatric
Nursing – Galen College of Nursing Questions with Correct
Answers and Explanations in Italics.
Section 1: Antepartum Nursing (Pregnancy & Prenatal Care)
Q1. A pregnant patient's last normal menstrual period (LNMP) began on May 4th. Using
Naegele’s rule, what is the estimated date of delivery (EDD)?
A) February 1st
B) February 11th
C) January 28th
D) February 18th
Answer: B) February 11th
*Rationale: Naegele’s rule: Subtract 3 months from the first day of the LNMP and add 7
days (and add 1 year if crossing the year boundary). May 4 minus 3 months = February
4. February 4 plus 7 days = February 11.*
Q2. A nurse is assessing a pregnant patient at 12 weeks gestation. Which of the
following is a presumptive (possible) sign of pregnancy?
A) Chadwick's sign
B) Positive pregnancy test
C) Hegar's sign
D) Breast tenderness and fatigue
Answer: D) Breast tenderness and fatigue
Rationale: Presumptive signs are subjective changes felt by the patient (amenorrhea,
nausea, fatigue, breast tenderness). Probable signs are objective findings observed by the
examiner (Chadwick's sign, Hegar's sign, positive pregnancy test). Positive signs confirm
pregnancy.
,Q3. A pregnant patient asks the nurse, "When will I start to feel the baby move?" The
nurse knows that quickening is typically felt by a primigravida at:
A) 12–14 weeks
B) 16–20 weeks
C) 24–26 weeks
D) 28–30 weeks
Answer: B) 16–20 weeks
Rationale: Quickening is typically felt by a primigravida at 16–20 weeks. A multigravida
may feel it earlier, around 14–16 weeks, because they recognize the sensation.
Q4. A patient at 28 weeks gestation is scheduled for a 1-hour glucose tolerance test
(GCT). Which instruction should the nurse provide?
A) "Fast for 12 hours before the test."
B) "Eat a high-protein meal right before the test."
C) "Drink the glucose solution within 5 minutes, and your blood will be drawn 1 hour
later."
D) "You will need to have your blood drawn four times."
Answer: C) "Drink the glucose solution within 5 minutes, and your blood will be
drawn 1 hour later."
*Rationale: The 1-hour glucose challenge test does NOT require fasting. The patient
drinks a 50g glucose solution, and blood is drawn exactly 1 hour later. Fasting and
multiple blood draws (over 3 hours) are required only if the 1-hour test is abnormal.*
Q5. A patient at 32 weeks reports experiencing occasional, irregular, painless uterine
contractions. The nurse explains that these are:
A) True labor contractions
B) Braxton Hicks contractions
C) Preterm labor
D) Placental abruption
Answer: B) Braxton Hicks contractions
Rationale: Braxton Hicks contractions are irregular, painless (or mild), "practice"
, contractions that do not cause cervical dilation. They are most commonly felt in the third
trimester.
Q6. Which immunization is CONTRAINDICATED during pregnancy because it contains
a live attenuated virus?
A) Tetanus, diphtheria, and pertussis (Tdap)
B) Inactivated influenza vaccine
C) Measles, mumps, and rubella (MMR)
D) Hepatitis B
Answer: C) Measles, mumps, and rubella (MMR)
Rationale: Live attenuated vaccines (MMR, varicella, intranasal flu) are contraindicated
during pregnancy due to the theoretical risk of causing the disease in the fetus. Tdap,
inactivated flu, and Hep B are safe and recommended.
Q7. A nurse is teaching a pregnant woman about danger signs in pregnancy that
require immediate notification of the provider. Which of the following should be
included?
A) Fetal movement
B) Occasional ankle swelling at the end of the day
C) Vaginal bleeding or fluid leaking
D) Mild backache
Answer: C) Vaginal bleeding or fluid leaking
Rationale: Danger signs include vaginal bleeding, rupture of membranes (fluid leaking),
severe headaches, visual changes, epigastric pain, severe abdominal pain, and decreased
fetal movement.
Q8. Which hormone is responsible for maintaining the corpus luteum during early
pregnancy and is the hormone detected in pregnancy tests?
A) Progesterone
B) Estrogen
Nursing – Galen College of Nursing Questions with Correct
Answers and Explanations in Italics.
Section 1: Antepartum Nursing (Pregnancy & Prenatal Care)
Q1. A pregnant patient's last normal menstrual period (LNMP) began on May 4th. Using
Naegele’s rule, what is the estimated date of delivery (EDD)?
A) February 1st
B) February 11th
C) January 28th
D) February 18th
Answer: B) February 11th
*Rationale: Naegele’s rule: Subtract 3 months from the first day of the LNMP and add 7
days (and add 1 year if crossing the year boundary). May 4 minus 3 months = February
4. February 4 plus 7 days = February 11.*
Q2. A nurse is assessing a pregnant patient at 12 weeks gestation. Which of the
following is a presumptive (possible) sign of pregnancy?
A) Chadwick's sign
B) Positive pregnancy test
C) Hegar's sign
D) Breast tenderness and fatigue
Answer: D) Breast tenderness and fatigue
Rationale: Presumptive signs are subjective changes felt by the patient (amenorrhea,
nausea, fatigue, breast tenderness). Probable signs are objective findings observed by the
examiner (Chadwick's sign, Hegar's sign, positive pregnancy test). Positive signs confirm
pregnancy.
,Q3. A pregnant patient asks the nurse, "When will I start to feel the baby move?" The
nurse knows that quickening is typically felt by a primigravida at:
A) 12–14 weeks
B) 16–20 weeks
C) 24–26 weeks
D) 28–30 weeks
Answer: B) 16–20 weeks
Rationale: Quickening is typically felt by a primigravida at 16–20 weeks. A multigravida
may feel it earlier, around 14–16 weeks, because they recognize the sensation.
Q4. A patient at 28 weeks gestation is scheduled for a 1-hour glucose tolerance test
(GCT). Which instruction should the nurse provide?
A) "Fast for 12 hours before the test."
B) "Eat a high-protein meal right before the test."
C) "Drink the glucose solution within 5 minutes, and your blood will be drawn 1 hour
later."
D) "You will need to have your blood drawn four times."
Answer: C) "Drink the glucose solution within 5 minutes, and your blood will be
drawn 1 hour later."
*Rationale: The 1-hour glucose challenge test does NOT require fasting. The patient
drinks a 50g glucose solution, and blood is drawn exactly 1 hour later. Fasting and
multiple blood draws (over 3 hours) are required only if the 1-hour test is abnormal.*
Q5. A patient at 32 weeks reports experiencing occasional, irregular, painless uterine
contractions. The nurse explains that these are:
A) True labor contractions
B) Braxton Hicks contractions
C) Preterm labor
D) Placental abruption
Answer: B) Braxton Hicks contractions
Rationale: Braxton Hicks contractions are irregular, painless (or mild), "practice"
, contractions that do not cause cervical dilation. They are most commonly felt in the third
trimester.
Q6. Which immunization is CONTRAINDICATED during pregnancy because it contains
a live attenuated virus?
A) Tetanus, diphtheria, and pertussis (Tdap)
B) Inactivated influenza vaccine
C) Measles, mumps, and rubella (MMR)
D) Hepatitis B
Answer: C) Measles, mumps, and rubella (MMR)
Rationale: Live attenuated vaccines (MMR, varicella, intranasal flu) are contraindicated
during pregnancy due to the theoretical risk of causing the disease in the fetus. Tdap,
inactivated flu, and Hep B are safe and recommended.
Q7. A nurse is teaching a pregnant woman about danger signs in pregnancy that
require immediate notification of the provider. Which of the following should be
included?
A) Fetal movement
B) Occasional ankle swelling at the end of the day
C) Vaginal bleeding or fluid leaking
D) Mild backache
Answer: C) Vaginal bleeding or fluid leaking
Rationale: Danger signs include vaginal bleeding, rupture of membranes (fluid leaking),
severe headaches, visual changes, epigastric pain, severe abdominal pain, and decreased
fetal movement.
Q8. Which hormone is responsible for maintaining the corpus luteum during early
pregnancy and is the hormone detected in pregnancy tests?
A) Progesterone
B) Estrogen
