,NUR254/NUR 254 Exam 2 | Maternal & Pediatric
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. The nurse is teaching a client with Type 1 diabetes who just delivered a healthy baby. Which of the
following information should the nurse include in the client's teaching?**
A) Change to oral hypoglycemic medications that will control sugar levels better than insulin
B) Urine should be checked for ketones every time the client voids
C) Due to hormonal changes after delivery, the need for insulin may decrease
D) Feed the baby formula since insulin received through breastfeeding may cause low blood sugar
Correct Answer: Due to hormonal changes after delivery, the need for insulin may decrease
Rationale: Postpartum hormonal shifts can reduce insulin resistance, leading to a decreased
requirement for exogenous insulin. Clients should be educated about this change to avoid hypoglycemia
and maintain appropriate glycemic control. Insulin requirements typically drop significantly after
delivery of the placenta.
**2. The nurse is caring for the following clients in the postpartum unit. Which client should the nurse
see first?**
A) Multipara mother who has saturated 2 perineal pads in one hour
B) Primipara mother who delivered 3 hours ago and is having difficulty getting the baby to latch on to
the breast
C) Primipara mother requesting help with repositioning her baby to decrease incisional pain from a
cesarean delivery
Correct Answer: Multipara mother who has saturated 2 perineal pads in one hour
Rationale: Saturating two perineal pads in one hour is a sign of postpartum hemorrhage and is the
priority. This client requires immediate assessment and intervention. The other clients have needs that,
while important, are not immediately life-threatening.
,**3. The nurse is assessing a client who is 24 hours postpartum. Which finding is most important for the
nurse to follow up?**
A) Voided 2125 mL of clear yellow urine in the last 24 hours
B) Fundus is slightly firm
C) White blood cell count of 8.5 mm
D) Perineal pad saturated
Correct Answer: Perineal pad saturated
Rationale: Saturated perineal pads may indicate hemorrhage and require immediate follow-up. A WBC
of 8.5 is within normal limits. While 2125 mL is a large urine output, it is not as immediately concerning
as a saturated pad. The fundus should be firm.
**4. A nurse is assessing a newborn who has just been delivered. Which of the following is the priority
physiological change?**
A) Successful feeding
B) Thermoregulation
C) Extra-uterine circulatory shift
D) Spontaneous respirations
Correct Answer: Spontaneous respirations
Rationale: The priority physiological change immediately after birth is the initiation of spontaneous
respirations. Without adequate respirations, the newborn cannot oxygenate, and all other physiological
adaptations depend on this.
**5. The nurse is caring for a newborn who was delivered 24 hours ago and is due to have an initial
bath. Which intervention should the nurse include?**
A) Place a hat on the newborn during bathing
B) Utilize a cleanser with a neutral pH during bathing
C) Make sure the newborn is placed in hot water
, D) Use warm 0.9% sodium chloride (normal saline) during bathing
Correct Answer: Utilize a cleanser with a neutral pH during bathing
Rationale: A neutral pH cleanser should be used to protect the newborn's delicate skin. Water should be
warm, not hot. A hat should be used after the bath to prevent heat loss, not during. Normal saline is not
typically used for bathing.
**6. A nurse is caring for a newborn who was born 30 minutes ago. Which finding is a probable sign of
respiratory distress?**
A) Chest retractions
B) Respirations of 58
C) Short periods of apnea lasting 8 to 10 seconds
D) Blue hands and feet
Correct Answer: Chest retractions
Rationale: Chest retractions indicate respiratory distress. Respirations of 58 are within normal range (30-
60). Short apnea (<15 seconds) is common in newborns. Acrocyanosis (blue hands and feet) is normal in
the first 24-48 hours.
**7. The nurse is caring for a newborn immediately following birth. After ensuring a patent airway,
which action is the priority?**
A) Dry the skin
B) Administer eye prophylaxis
C) Administer vitamin K
D) Place an identification bracelet
Correct Answer: Dry the skin
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. The nurse is teaching a client with Type 1 diabetes who just delivered a healthy baby. Which of the
following information should the nurse include in the client's teaching?**
A) Change to oral hypoglycemic medications that will control sugar levels better than insulin
B) Urine should be checked for ketones every time the client voids
C) Due to hormonal changes after delivery, the need for insulin may decrease
D) Feed the baby formula since insulin received through breastfeeding may cause low blood sugar
Correct Answer: Due to hormonal changes after delivery, the need for insulin may decrease
Rationale: Postpartum hormonal shifts can reduce insulin resistance, leading to a decreased
requirement for exogenous insulin. Clients should be educated about this change to avoid hypoglycemia
and maintain appropriate glycemic control. Insulin requirements typically drop significantly after
delivery of the placenta.
**2. The nurse is caring for the following clients in the postpartum unit. Which client should the nurse
see first?**
A) Multipara mother who has saturated 2 perineal pads in one hour
B) Primipara mother who delivered 3 hours ago and is having difficulty getting the baby to latch on to
the breast
C) Primipara mother requesting help with repositioning her baby to decrease incisional pain from a
cesarean delivery
Correct Answer: Multipara mother who has saturated 2 perineal pads in one hour
Rationale: Saturating two perineal pads in one hour is a sign of postpartum hemorrhage and is the
priority. This client requires immediate assessment and intervention. The other clients have needs that,
while important, are not immediately life-threatening.
,**3. The nurse is assessing a client who is 24 hours postpartum. Which finding is most important for the
nurse to follow up?**
A) Voided 2125 mL of clear yellow urine in the last 24 hours
B) Fundus is slightly firm
C) White blood cell count of 8.5 mm
D) Perineal pad saturated
Correct Answer: Perineal pad saturated
Rationale: Saturated perineal pads may indicate hemorrhage and require immediate follow-up. A WBC
of 8.5 is within normal limits. While 2125 mL is a large urine output, it is not as immediately concerning
as a saturated pad. The fundus should be firm.
**4. A nurse is assessing a newborn who has just been delivered. Which of the following is the priority
physiological change?**
A) Successful feeding
B) Thermoregulation
C) Extra-uterine circulatory shift
D) Spontaneous respirations
Correct Answer: Spontaneous respirations
Rationale: The priority physiological change immediately after birth is the initiation of spontaneous
respirations. Without adequate respirations, the newborn cannot oxygenate, and all other physiological
adaptations depend on this.
**5. The nurse is caring for a newborn who was delivered 24 hours ago and is due to have an initial
bath. Which intervention should the nurse include?**
A) Place a hat on the newborn during bathing
B) Utilize a cleanser with a neutral pH during bathing
C) Make sure the newborn is placed in hot water
, D) Use warm 0.9% sodium chloride (normal saline) during bathing
Correct Answer: Utilize a cleanser with a neutral pH during bathing
Rationale: A neutral pH cleanser should be used to protect the newborn's delicate skin. Water should be
warm, not hot. A hat should be used after the bath to prevent heat loss, not during. Normal saline is not
typically used for bathing.
**6. A nurse is caring for a newborn who was born 30 minutes ago. Which finding is a probable sign of
respiratory distress?**
A) Chest retractions
B) Respirations of 58
C) Short periods of apnea lasting 8 to 10 seconds
D) Blue hands and feet
Correct Answer: Chest retractions
Rationale: Chest retractions indicate respiratory distress. Respirations of 58 are within normal range (30-
60). Short apnea (<15 seconds) is common in newborns. Acrocyanosis (blue hands and feet) is normal in
the first 24-48 hours.
**7. The nurse is caring for a newborn immediately following birth. After ensuring a patent airway,
which action is the priority?**
A) Dry the skin
B) Administer eye prophylaxis
C) Administer vitamin K
D) Place an identification bracelet
Correct Answer: Dry the skin
