NUR 254 Exams 1 - 4 | Galen College |
(2026/2027) Complete Maternal &
Pediatric Nursing Bundle Questions and
Ansẉers with rationales
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────
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EXAM 1: Maternal Nursing (Antepartum & Intrapartum)
1. A nurse is assessing a pregnant client at 12 weeks gestation.
Which finding should the nurse consider normal?
A) Blood pressure of 150/90 mmHg
B) Heart rate of 55 bpm
C) Hemoglobin of 11.2 g/dL
D) Fetal heart rate of 80 bpm
Answer: C
Rationale: During pregnancy, plasma volume increases more than
red blood cell mass, causing physiologic anemia of pregnancy
(hemodilution). A hemoglobin of 11.2 g/dL is normal in the first
trimester. BP should not exceed 140/90, HR should be 60-100, and
the fetal heart rate at 12 weeks should be 110-160 bpm.
2. A client at 8 weeks gestation asks the nurse about taking a
prenatal vitamin. Which supplement is most critical during the first
trimester to prevent neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin C
Answer: C
Rationale: Folic acid (at least 400-800 mcg daily) is crucial during
early pregnancy to prevent neural tube defects like spina bifida and
anencephaly, which occur in the first 4 weeks of gestation.
3. A pregnant client presents with severe, persistent vomiting. The
nurse notes elevated ketones in the urine. Which condition is the
client likely experiencing?
,A) Hyperemesis gravidarum
B) Gestational diabetes
C) Preeclampsia
D) Placenta previa
Answer: A
Rationale: Hyperemesis gravidarum is characterized by severe,
persistent vomiting leading to dehydration, electrolyte imbalances,
and ketonuria. It requires medical intervention, often IV fluids and
antiemetics.
4. A nurse is teaching a client about the signs of preterm labor.
Which statement by the client indicates a need for further teaching?
A) "I should call the doctor if I have contractions every 10 minutes."
B) "I should report any fluid leaking from my vagina."
C) "Mild, occasional cramping like a period is normal and I shouldn't
worry."
D) "Pelvic pressure that feels like the baby is pushing down is a
warning sign."
Answer: C
Rationale: Mild cramping can be a sign of preterm labor and should
be reported. All other options are correct indications of potential
preterm labor that require provider notification.
5. At 16 weeks gestation, a client asks when they will feel fetal
movement. The nurse should respond that quickening typically
occurs between:
A) 8 and 10 weeks
B) 12 and 14 weeks
C) 16 and 20 weeks
D) 24 and 28 weeks
Answer: C
Rationale: Quickening, the first perception of fetal movement, is
typically felt by the mother between 16 and 20 weeks of gestation.
, 6. A nurse is monitoring a client receiving oxytocin for labor
induction. The fetal heart rate (FHR) shows late decelerations. What
is the nurse's priority action?
A) Increase the oxytocin rate
B) Turn the client to a lateral position
C) Administer terbutaline
D) Assess maternal temperature
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency.
The priority is to improve blood flow to the placenta by stopping the
oxytocin and repositioning the client to a lateral position.
Terbutaline may be given if contractions are tetanic, but
repositioning and stopping the oxytocin are first.
7. Which of the following is the primary physiological cause of
supine hypotension during pregnancy?
A) Increased blood volume
B) Compression of the inferior vena cava
C) Increased cardiac output
D) Elevated diaphragm
Answer: B
Rationale: Supine hypotension (aortocaval compression) occurs
when the gravid uterus compresses the inferior vena cava in the
supine position, reducing venous return and cardiac output. It is
relieved by left lateral positioning.
8. A pregnant client is diagnosed with gestational diabetes. The
nurse understands that the primary goal of treatment is:
A) Preventing macrosomia and neonatal hypoglycemia
B) Inducing labor at 37 weeks
C) Maintaining bed rest until delivery
D) Administering insulin at every meal
Answer: A
(2026/2027) Complete Maternal &
Pediatric Nursing Bundle Questions and
Ansẉers with rationales
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────
─────────
EXAM 1: Maternal Nursing (Antepartum & Intrapartum)
1. A nurse is assessing a pregnant client at 12 weeks gestation.
Which finding should the nurse consider normal?
A) Blood pressure of 150/90 mmHg
B) Heart rate of 55 bpm
C) Hemoglobin of 11.2 g/dL
D) Fetal heart rate of 80 bpm
Answer: C
Rationale: During pregnancy, plasma volume increases more than
red blood cell mass, causing physiologic anemia of pregnancy
(hemodilution). A hemoglobin of 11.2 g/dL is normal in the first
trimester. BP should not exceed 140/90, HR should be 60-100, and
the fetal heart rate at 12 weeks should be 110-160 bpm.
2. A client at 8 weeks gestation asks the nurse about taking a
prenatal vitamin. Which supplement is most critical during the first
trimester to prevent neural tube defects?
A) Iron
B) Calcium
C) Folic acid
D) Vitamin C
Answer: C
Rationale: Folic acid (at least 400-800 mcg daily) is crucial during
early pregnancy to prevent neural tube defects like spina bifida and
anencephaly, which occur in the first 4 weeks of gestation.
3. A pregnant client presents with severe, persistent vomiting. The
nurse notes elevated ketones in the urine. Which condition is the
client likely experiencing?
,A) Hyperemesis gravidarum
B) Gestational diabetes
C) Preeclampsia
D) Placenta previa
Answer: A
Rationale: Hyperemesis gravidarum is characterized by severe,
persistent vomiting leading to dehydration, electrolyte imbalances,
and ketonuria. It requires medical intervention, often IV fluids and
antiemetics.
4. A nurse is teaching a client about the signs of preterm labor.
Which statement by the client indicates a need for further teaching?
A) "I should call the doctor if I have contractions every 10 minutes."
B) "I should report any fluid leaking from my vagina."
C) "Mild, occasional cramping like a period is normal and I shouldn't
worry."
D) "Pelvic pressure that feels like the baby is pushing down is a
warning sign."
Answer: C
Rationale: Mild cramping can be a sign of preterm labor and should
be reported. All other options are correct indications of potential
preterm labor that require provider notification.
5. At 16 weeks gestation, a client asks when they will feel fetal
movement. The nurse should respond that quickening typically
occurs between:
A) 8 and 10 weeks
B) 12 and 14 weeks
C) 16 and 20 weeks
D) 24 and 28 weeks
Answer: C
Rationale: Quickening, the first perception of fetal movement, is
typically felt by the mother between 16 and 20 weeks of gestation.
, 6. A nurse is monitoring a client receiving oxytocin for labor
induction. The fetal heart rate (FHR) shows late decelerations. What
is the nurse's priority action?
A) Increase the oxytocin rate
B) Turn the client to a lateral position
C) Administer terbutaline
D) Assess maternal temperature
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency.
The priority is to improve blood flow to the placenta by stopping the
oxytocin and repositioning the client to a lateral position.
Terbutaline may be given if contractions are tetanic, but
repositioning and stopping the oxytocin are first.
7. Which of the following is the primary physiological cause of
supine hypotension during pregnancy?
A) Increased blood volume
B) Compression of the inferior vena cava
C) Increased cardiac output
D) Elevated diaphragm
Answer: B
Rationale: Supine hypotension (aortocaval compression) occurs
when the gravid uterus compresses the inferior vena cava in the
supine position, reducing venous return and cardiac output. It is
relieved by left lateral positioning.
8. A pregnant client is diagnosed with gestational diabetes. The
nurse understands that the primary goal of treatment is:
A) Preventing macrosomia and neonatal hypoglycemia
B) Inducing labor at 37 weeks
C) Maintaining bed rest until delivery
D) Administering insulin at every meal
Answer: A
