,NUR254/NUR 254 Exam 1 | Maternal & Pediatric
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. A nurse is teaching a group of pregnant women about physiological changes during pregnancy.
Which finding would the nurse explain as a normal change?**
A) Decreased heart rate
B) Increased anterior-posterior chest diameter
C) Decreased tidal volume
D) Decreased oxygen consumption
Correct Answer: Increased anterior-posterior chest diameter
Rationale: Progesterone causes relaxation of ligaments, increasing the anterior-posterior chest diameter
during pregnancy. Heart rate increases (not decreases), tidal volume increases, and oxygen consumption
increases in pregnancy. These physiological adaptations support the growing fetus and prepare the
mother for labor.
**2. A nurse is reviewing the medical record of a pregnant client. The client's gravida and para are
documented as G4 P2. Which interpretation is correct?**
A) The client is pregnant for the fourth time and has had two births
B) The client is pregnant for the second time and has had four births
C) The client has had four pregnancies and two miscarriages
D) The client has had two pregnancies and four births
Correct Answer: The client is pregnant for the fourth time and has had two births
Rationale: Gravida refers to the total number of pregnancies a woman has had, regardless of outcome.
Para refers to the number of pregnancies that have reached viability (typically 20 weeks or more). G4 P2
means the client is pregnant for the fourth time and has had two births.
,**3. A client who is 20 weeks gestation asks the nurse where the top of the uterus should be felt. The
nurse should palpate the fundus at which location?**
A) Symphysis pubis
B) Umbilicus
C) Xiphoid process
D) Midway between the symphysis and umbilicus
Correct Answer: Umbilicus
Rationale: At 20 weeks gestation, the fundal height is typically at the level of the umbilicus. Fundal
height corresponds to the number of weeks of gestation (within a few centimeters). By 12 weeks, the
fundus is at the symphysis pubis; by 36 weeks, it reaches the xiphoid process.
**4. A nurse is assessing a client in the first trimester of pregnancy. Which finding is considered a
presumptive sign of pregnancy?**
A) Positive pregnancy test
B) Fetal heart tones audible by Doppler
C) Goodell's sign
D) Breast tenderness
Correct Answer: Breast tenderness
Rationale: Presumptive signs of pregnancy are subjective changes reported by the client and can be
caused by conditions other than pregnancy. These include amenorrhea, breast tenderness, nausea,
vomiting, and fatigue. Positive pregnancy test, Goodell's sign, and fetal heart tones are probable or
positive signs.
**5. A pregnant client tells the nurse she has been experiencing pica during this pregnancy. The nurse
should assess the client for which potential complication?**
A) Hypercalcemia
B) Iron deficiency anemia
C) Gestational diabetes
, D) Preeclampsia
Correct Answer: Iron deficiency anemia
Rationale: Pica is the craving for non-food substances such as clay, dirt, or ice. It is often associated with
iron deficiency anemia. The nurse should assess for signs of anemia and recommend iron
supplementation if indicated. Pica can also lead to gastrointestinal obstruction or lead poisoning.
**6. A nurse is providing teaching about prenatal nutrition. Which client statement indicates the need
for additional teaching?**
A) "I will take a folic acid supplement daily."
B) "I should increase my calcium intake."
C) "I can continue to eat sushi with raw fish."
D) "I will avoid alcohol completely."
Correct Answer: "I can continue to eat sushi with raw fish."
Rationale: Raw fish should be avoided during pregnancy due to the risk of foodborne illness and
potential exposure to harmful bacteria and parasites. Clients should be instructed to avoid raw or
undercooked seafood, deli meats, and unpasteurized dairy products. Folic acid, calcium, and alcohol
avoidance are appropriate teachings.
**7. A nurse is caring for a client who has just been diagnosed with gestational diabetes. Which of the
following is a priority nursing intervention?**
A) Administer insulin immediately
B) Teach the client about dietary modifications and blood glucose monitoring
C) Prepare the client for an induction of labor
D) Restrict all carbohydrate intake
Correct Answer: Teach the client about dietary modifications and blood glucose monitoring
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. A nurse is teaching a group of pregnant women about physiological changes during pregnancy.
Which finding would the nurse explain as a normal change?**
A) Decreased heart rate
B) Increased anterior-posterior chest diameter
C) Decreased tidal volume
D) Decreased oxygen consumption
Correct Answer: Increased anterior-posterior chest diameter
Rationale: Progesterone causes relaxation of ligaments, increasing the anterior-posterior chest diameter
during pregnancy. Heart rate increases (not decreases), tidal volume increases, and oxygen consumption
increases in pregnancy. These physiological adaptations support the growing fetus and prepare the
mother for labor.
**2. A nurse is reviewing the medical record of a pregnant client. The client's gravida and para are
documented as G4 P2. Which interpretation is correct?**
A) The client is pregnant for the fourth time and has had two births
B) The client is pregnant for the second time and has had four births
C) The client has had four pregnancies and two miscarriages
D) The client has had two pregnancies and four births
Correct Answer: The client is pregnant for the fourth time and has had two births
Rationale: Gravida refers to the total number of pregnancies a woman has had, regardless of outcome.
Para refers to the number of pregnancies that have reached viability (typically 20 weeks or more). G4 P2
means the client is pregnant for the fourth time and has had two births.
,**3. A client who is 20 weeks gestation asks the nurse where the top of the uterus should be felt. The
nurse should palpate the fundus at which location?**
A) Symphysis pubis
B) Umbilicus
C) Xiphoid process
D) Midway between the symphysis and umbilicus
Correct Answer: Umbilicus
Rationale: At 20 weeks gestation, the fundal height is typically at the level of the umbilicus. Fundal
height corresponds to the number of weeks of gestation (within a few centimeters). By 12 weeks, the
fundus is at the symphysis pubis; by 36 weeks, it reaches the xiphoid process.
**4. A nurse is assessing a client in the first trimester of pregnancy. Which finding is considered a
presumptive sign of pregnancy?**
A) Positive pregnancy test
B) Fetal heart tones audible by Doppler
C) Goodell's sign
D) Breast tenderness
Correct Answer: Breast tenderness
Rationale: Presumptive signs of pregnancy are subjective changes reported by the client and can be
caused by conditions other than pregnancy. These include amenorrhea, breast tenderness, nausea,
vomiting, and fatigue. Positive pregnancy test, Goodell's sign, and fetal heart tones are probable or
positive signs.
**5. A pregnant client tells the nurse she has been experiencing pica during this pregnancy. The nurse
should assess the client for which potential complication?**
A) Hypercalcemia
B) Iron deficiency anemia
C) Gestational diabetes
, D) Preeclampsia
Correct Answer: Iron deficiency anemia
Rationale: Pica is the craving for non-food substances such as clay, dirt, or ice. It is often associated with
iron deficiency anemia. The nurse should assess for signs of anemia and recommend iron
supplementation if indicated. Pica can also lead to gastrointestinal obstruction or lead poisoning.
**6. A nurse is providing teaching about prenatal nutrition. Which client statement indicates the need
for additional teaching?**
A) "I will take a folic acid supplement daily."
B) "I should increase my calcium intake."
C) "I can continue to eat sushi with raw fish."
D) "I will avoid alcohol completely."
Correct Answer: "I can continue to eat sushi with raw fish."
Rationale: Raw fish should be avoided during pregnancy due to the risk of foodborne illness and
potential exposure to harmful bacteria and parasites. Clients should be instructed to avoid raw or
undercooked seafood, deli meats, and unpasteurized dairy products. Folic acid, calcium, and alcohol
avoidance are appropriate teachings.
**7. A nurse is caring for a client who has just been diagnosed with gestational diabetes. Which of the
following is a priority nursing intervention?**
A) Administer insulin immediately
B) Teach the client about dietary modifications and blood glucose monitoring
C) Prepare the client for an induction of labor
D) Restrict all carbohydrate intake
Correct Answer: Teach the client about dietary modifications and blood glucose monitoring
