NUR 254 Exam 1 – Maternal and Pediatric
Nursing (Antepartum, Intrapartum, and
Postpartum) Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
1. A client at 10 weeks gestation reports nausea every morning. Which instruction
should the nurse provide?
A. Drink orange juice before getting out of bed
B. Eat dry crackers before rising from bed
C. Avoid eating until after noon
D. Drink fluids with every meal
Answer in italic bold: B. Eat dry crackers before rising from bed.
Rationale in italic: Dry crackers or toast before getting out of bed help stabilize
blood sugar and reduce morning sickness. Fluids with meals can cause early
satiety and worsen nausea.
2. The nurse is assessing a client at 16 weeks gestation. Which finding is considered a
presumptive sign of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones audible by Doppler
C. Quickening
D. Palpable fetal outline
Answer in italic bold: C. Quickening.
Rationale in italic: Quickening (fetal movement felt by the mother) is a
presumptive sign. Positive pregnancy test, fetal heart tones, and fetal outline
are probable or positive signs.
3. A client's GTPAL is G3 T1 P1 A1 L2. How many preterm births has this client
experienced?
A. 1
B. 2
C. 3
D. 0
Answer in italic bold: A. 1.
Rationale in italic: The P in GTPAL represents preterm births (20-36 weeks). T is
, term births, A is abortions, and L is living children. A G3 T1 P1 A1 L2 indicates
one preterm birth.
4. A nurse is teaching a client about nutrition during pregnancy. Which statement by
the client indicates understanding?
A. "I need to eat twice as much food now."
B. "I should increase my calories by about 300-350 per day."
C. "I can skip breakfast if I eat a large dinner."
D. "I need to avoid all carbohydrates."
*Answer in italic bold: B. "I should increase my calories by about 300-350 per
day." *
Rationale in italic: During the second and third trimesters, the recommended
increase is approximately 300-350 additional calories per day. Quality of food
is more important than quantity.
5. A client at 32 weeks gestation is diagnosed with preeclampsia. What is the defining
characteristic of this condition?
A. Hypotension and bradycardia
B. Hypertension and proteinuria after 20 weeks
C. Hypertension and seizures
D. Proteinuria only
Answer in italic bold: B. Hypertension and proteinuria after 20 weeks.
Rationale in italic: Preeclampsia is defined as new-onset hypertension and
proteinuria after 20 weeks gestation. Seizures indicate eclampsia, which is a
complication of preeclampsia.
6. Which laboratory finding is most concerning in a client with preeclampsia?
A. Hemoglobin 12 g/dL
B. Platelet count 90,000/mcL
C. White blood cell count 8,000/mcL
D. Serum creatinine 0.8 mg/dL
Answer in italic bold: B. Platelet count 90,000/mcL.
Rationale in italic: Thrombocytopenia (platelets <100,000/mcL) is a sign of
severe preeclampsia/HELLP syndrome and indicates worsening disease. This
requires immediate intervention.
7. A client with gestational diabetes is receiving dietary teaching. Which snack is most
appropriate?
A. Fruit juice and a candy bar
B. Crackers with peanut butter
C. Sugary cereal with milk
D. A donut and coffee
Answer in italic bold: B. Crackers with peanut butter.
Rationale in italic: A snack combining complex carbohydrates with protein
helps maintain stable blood glucose levels. Sugary foods cause rapid spikes and
drops in blood sugar.
,8. A client at 28 weeks gestation is Rh-negative and her partner is Rh-positive. What
intervention is required?
A. Administer RhoGAM at 28 weeks and within 72 hours of birth
B. Administer RhoGAM at 32 weeks only
C. Administer RhoGAM at delivery only
D. No intervention is required if this is her first pregnancy
Answer in italic bold: A. Administer RhoGAM at 28 weeks and within 72 hours
of birth.
Rationale in italic: RhoGAM is given at 28 weeks and again within 72 hours
after birth to prevent Rh isoimmunization in future pregnancies.
9. A nurse is assessing a client in the first trimester who reports fatigue. What should
the nurse tell the client?
A. "This is abnormal and needs further testing."
B. "Fatigue is common due to increased metabolic demands."
C. "You must have an iron deficiency."
D. "You should sleep for 12 hours each night."
*Answer in italic bold: B. "Fatigue is common due to increased metabolic
demands." *
Rationale in italic: Fatigue is a common complaint in the first trimester due to
hormonal changes and increased metabolic demands. It typically improves in
the second trimester.
10. A client at 20 weeks gestation presents with painless vaginal bleeding. The nurse
should first suspect which condition?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Cervical laceration
Answer in italic bold: A. Placenta previa.
Rationale in italic: Painless vaginal bleeding in the second or third trimester is
the hallmark of placenta previa. Abruptio placentae typically presents with
painful bleeding.
11. A client at 35 weeks gestation reports a sudden gush of fluid from her vagina. The
nurse notes the fluid is clear and has a fern-like pattern when dried on a slide. What
is the priority intervention?
A. Send the client home with bed rest instructions
B. Assess for umbilical cord prolapse and prepare for delivery
C. Administer oral antibiotics
D. Reassure the client that this is normal discharge
Answer in italic bold: B. Assess for umbilical cord prolapse and prepare for
delivery.
Rationale in italic: The fern test positive indicates amniotic fluid (rupture of
membranes). The priority is to assess for cord prolapse, monitor for infection,
and prepare for possible delivery, especially if preterm.
, 12. Which of the following is a positive sign of pregnancy?
A. Goodell's sign
B. Chadwick's sign
C. Visualization of the fetus on ultrasound
D. Braxton Hicks contractions
Answer in italic bold: C. Visualization of the fetus on ultrasound.
Rationale in italic: Positive signs of pregnancy include ultrasound visualization
of the fetus, fetal heart tones, and fetal movements felt by the examiner.
Goodell's and Chadwick's signs are probable signs.
13. A client at 12 weeks gestation has a hemoglobin of 10.5 g/dL. The nurse recognizes
this is consistent with what?
A. Normal first-trimester finding
B. Iron deficiency anemia
C. Polycythemia
D. Gestational diabetes
Answer in italic bold: B. Iron deficiency anemia.
Rationale in italic: Hemoglobin below 11 g/dL in the first trimester suggests
anemia, most commonly due to iron deficiency. The client may require iron
supplementation.
14. A client at 18 weeks gestation is scheduled for alpha-fetoprotein (AFP) screening.
What is the primary purpose of this test?
A. Diagnose gestational diabetes
B. Screen for neural tube defects and chromosomal abnormalities
C. Assess fetal lung maturity
D. Determine fetal sex
Answer in italic bold: B. Screen for neural tube defects and chromosomal
abnormalities.
Rationale in italic: AFP screening is a maternal serum marker used to screen for
neural tube defects (elevated levels) and chromosomal abnormalities such as
Down syndrome (decreased levels).
15. A client at 30 weeks gestation develops gestational hypertension without proteinuria.
The nurse should monitor for progression to which condition?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Hyperemesis gravidarum
Answer in italic bold: B. Preeclampsia.
Rationale in italic: Gestational hypertension (hypertension without proteinuria)
can progress to preeclampsia if proteinuria develops. Close monitoring of blood
pressure, urine protein, and symptoms is essential.
16. What is the primary nursing intervention for a client diagnosed with hyperemesis
gravidarum?
A. Encourage high-fat foods
Nursing (Antepartum, Intrapartum, and
Postpartum) Questions And Well Graded
Solutions With Rationales Updated 2026-
2027
1. A client at 10 weeks gestation reports nausea every morning. Which instruction
should the nurse provide?
A. Drink orange juice before getting out of bed
B. Eat dry crackers before rising from bed
C. Avoid eating until after noon
D. Drink fluids with every meal
Answer in italic bold: B. Eat dry crackers before rising from bed.
Rationale in italic: Dry crackers or toast before getting out of bed help stabilize
blood sugar and reduce morning sickness. Fluids with meals can cause early
satiety and worsen nausea.
2. The nurse is assessing a client at 16 weeks gestation. Which finding is considered a
presumptive sign of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones audible by Doppler
C. Quickening
D. Palpable fetal outline
Answer in italic bold: C. Quickening.
Rationale in italic: Quickening (fetal movement felt by the mother) is a
presumptive sign. Positive pregnancy test, fetal heart tones, and fetal outline
are probable or positive signs.
3. A client's GTPAL is G3 T1 P1 A1 L2. How many preterm births has this client
experienced?
A. 1
B. 2
C. 3
D. 0
Answer in italic bold: A. 1.
Rationale in italic: The P in GTPAL represents preterm births (20-36 weeks). T is
, term births, A is abortions, and L is living children. A G3 T1 P1 A1 L2 indicates
one preterm birth.
4. A nurse is teaching a client about nutrition during pregnancy. Which statement by
the client indicates understanding?
A. "I need to eat twice as much food now."
B. "I should increase my calories by about 300-350 per day."
C. "I can skip breakfast if I eat a large dinner."
D. "I need to avoid all carbohydrates."
*Answer in italic bold: B. "I should increase my calories by about 300-350 per
day." *
Rationale in italic: During the second and third trimesters, the recommended
increase is approximately 300-350 additional calories per day. Quality of food
is more important than quantity.
5. A client at 32 weeks gestation is diagnosed with preeclampsia. What is the defining
characteristic of this condition?
A. Hypotension and bradycardia
B. Hypertension and proteinuria after 20 weeks
C. Hypertension and seizures
D. Proteinuria only
Answer in italic bold: B. Hypertension and proteinuria after 20 weeks.
Rationale in italic: Preeclampsia is defined as new-onset hypertension and
proteinuria after 20 weeks gestation. Seizures indicate eclampsia, which is a
complication of preeclampsia.
6. Which laboratory finding is most concerning in a client with preeclampsia?
A. Hemoglobin 12 g/dL
B. Platelet count 90,000/mcL
C. White blood cell count 8,000/mcL
D. Serum creatinine 0.8 mg/dL
Answer in italic bold: B. Platelet count 90,000/mcL.
Rationale in italic: Thrombocytopenia (platelets <100,000/mcL) is a sign of
severe preeclampsia/HELLP syndrome and indicates worsening disease. This
requires immediate intervention.
7. A client with gestational diabetes is receiving dietary teaching. Which snack is most
appropriate?
A. Fruit juice and a candy bar
B. Crackers with peanut butter
C. Sugary cereal with milk
D. A donut and coffee
Answer in italic bold: B. Crackers with peanut butter.
Rationale in italic: A snack combining complex carbohydrates with protein
helps maintain stable blood glucose levels. Sugary foods cause rapid spikes and
drops in blood sugar.
,8. A client at 28 weeks gestation is Rh-negative and her partner is Rh-positive. What
intervention is required?
A. Administer RhoGAM at 28 weeks and within 72 hours of birth
B. Administer RhoGAM at 32 weeks only
C. Administer RhoGAM at delivery only
D. No intervention is required if this is her first pregnancy
Answer in italic bold: A. Administer RhoGAM at 28 weeks and within 72 hours
of birth.
Rationale in italic: RhoGAM is given at 28 weeks and again within 72 hours
after birth to prevent Rh isoimmunization in future pregnancies.
9. A nurse is assessing a client in the first trimester who reports fatigue. What should
the nurse tell the client?
A. "This is abnormal and needs further testing."
B. "Fatigue is common due to increased metabolic demands."
C. "You must have an iron deficiency."
D. "You should sleep for 12 hours each night."
*Answer in italic bold: B. "Fatigue is common due to increased metabolic
demands." *
Rationale in italic: Fatigue is a common complaint in the first trimester due to
hormonal changes and increased metabolic demands. It typically improves in
the second trimester.
10. A client at 20 weeks gestation presents with painless vaginal bleeding. The nurse
should first suspect which condition?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Cervical laceration
Answer in italic bold: A. Placenta previa.
Rationale in italic: Painless vaginal bleeding in the second or third trimester is
the hallmark of placenta previa. Abruptio placentae typically presents with
painful bleeding.
11. A client at 35 weeks gestation reports a sudden gush of fluid from her vagina. The
nurse notes the fluid is clear and has a fern-like pattern when dried on a slide. What
is the priority intervention?
A. Send the client home with bed rest instructions
B. Assess for umbilical cord prolapse and prepare for delivery
C. Administer oral antibiotics
D. Reassure the client that this is normal discharge
Answer in italic bold: B. Assess for umbilical cord prolapse and prepare for
delivery.
Rationale in italic: The fern test positive indicates amniotic fluid (rupture of
membranes). The priority is to assess for cord prolapse, monitor for infection,
and prepare for possible delivery, especially if preterm.
, 12. Which of the following is a positive sign of pregnancy?
A. Goodell's sign
B. Chadwick's sign
C. Visualization of the fetus on ultrasound
D. Braxton Hicks contractions
Answer in italic bold: C. Visualization of the fetus on ultrasound.
Rationale in italic: Positive signs of pregnancy include ultrasound visualization
of the fetus, fetal heart tones, and fetal movements felt by the examiner.
Goodell's and Chadwick's signs are probable signs.
13. A client at 12 weeks gestation has a hemoglobin of 10.5 g/dL. The nurse recognizes
this is consistent with what?
A. Normal first-trimester finding
B. Iron deficiency anemia
C. Polycythemia
D. Gestational diabetes
Answer in italic bold: B. Iron deficiency anemia.
Rationale in italic: Hemoglobin below 11 g/dL in the first trimester suggests
anemia, most commonly due to iron deficiency. The client may require iron
supplementation.
14. A client at 18 weeks gestation is scheduled for alpha-fetoprotein (AFP) screening.
What is the primary purpose of this test?
A. Diagnose gestational diabetes
B. Screen for neural tube defects and chromosomal abnormalities
C. Assess fetal lung maturity
D. Determine fetal sex
Answer in italic bold: B. Screen for neural tube defects and chromosomal
abnormalities.
Rationale in italic: AFP screening is a maternal serum marker used to screen for
neural tube defects (elevated levels) and chromosomal abnormalities such as
Down syndrome (decreased levels).
15. A client at 30 weeks gestation develops gestational hypertension without proteinuria.
The nurse should monitor for progression to which condition?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Hyperemesis gravidarum
Answer in italic bold: B. Preeclampsia.
Rationale in italic: Gestational hypertension (hypertension without proteinuria)
can progress to preeclampsia if proteinuria develops. Close monitoring of blood
pressure, urine protein, and symptoms is essential.
16. What is the primary nursing intervention for a client diagnosed with hyperemesis
gravidarum?
A. Encourage high-fat foods
