NUR 254 Complete Exam Bundle 2026/2027 |
Exams 1, 2, 3 & 4 | Maternal & Pediatric
Nursing | Galen College | 200 Practice
Questions & Verified Answers | Just
Released This Year PDF | Updated This Year
NUR 254 MATERNAL & PEDIATRIC NURSING EXAM BUNDLE 2026/2027 Galen
College Complete Practice Exam
• Document Features: 200 comprehensive practice questions covering maternal
health, prenatal care, labor/delivery, postpartum care, newborn assessment,
pediatric growth & development, and common pediatric conditions with verified
answers
• Study Guidance: Work through all questions systematically, review rationales for
both correct and incorrect answers, identify weak areas, and use this as your final
preparation tool before the actual examination
1. A primigravida client at 28 weeks gestation presents to the clinic for a
routine prenatal visit. The nurse notes the client has gained 12 pounds since
the last visit 4 weeks ago. What is the most appropriate nursing action?
A) Restrict the client's caloric intake immediately
B) Refer the client to the healthcare provider for further assessment
C) Advise the client to increase physical activity without healthcare provider
consultation
D) Document the finding and schedule a follow-up appointment in 2 weeks
E) Recommend the client purchase a weight loss supplement
✓ CORRECT ANSWER: B
Rationale: A weight gain of 12 pounds in 4 weeks (approximately 3 pounds per
week) is excessive during the second trimester and may indicate gestational
diabetes, preeclampsia, or other complications. While normal second trimester
,weight gain is approximately 0.5-1 pound per week, this client's gain warrants
provider evaluation. Referral to the healthcare provider is the appropriate initial
action as it allows for proper assessment and investigation of potential
complications. Restricting calories or recommending weight loss supplements is
contraindicated in pregnancy as adequate nutrition is essential for fetal
development.
2. A nurse is educating a pregnant client about folic acid supplementation.
Which statement by the client indicates a need for further teaching?
A) "I should take folic acid throughout my entire pregnancy"
B) "Folic acid helps prevent neural tube defects in my baby"
C) "I can stop taking folic acid after the first trimester since the baby's spine is
already formed"
D) "Folic acid is especially important in the first few weeks of pregnancy"
E) "Taking folic acid reduces the risk of spina bifida"
✓ CORRECT ANSWER: C
Rationale: The statement indicating a need for further teaching is that folic acid
can be stopped after the first trimester. Folic acid supplementation should continue
throughout the entire pregnancy and ideally into the postpartum period, especially
if breastfeeding. While neural tube defects occur early in pregnancy (during the first
28 days), folic acid continues to be important for overall maternal health and fetal
development throughout pregnancy. The other statements are accurate: folic acid
does prevent neural tube defects, is crucial in early pregnancy, and specifically
reduces the risk of spina bifida.
3. A client in the first trimester reports experiencing severe nausea and
vomiting that is interfering with her ability to eat and drink. She has lost 5
pounds since her last visit. What is the priority nursing intervention?
A) Encourage the client to eat small, frequent meals and sip ginger tea
,B) Assess for signs of hyperemesis gravidarum and notify the healthcare provider
C) Recommend the client increase fluid intake by 2 liters daily
D) Suggest the client rest more frequently throughout the day
E) Advise the client that this is normal and will resolve on its own
✓ CORRECT ANSWER: B
Rationale: While mild nausea and vomiting are common in early pregnancy, this
client's presentation of severe nausea/vomiting with weight loss (5 pounds) raises
concern for hyperemesis gravidarum, a serious condition that can lead to
dehydration, electrolyte imbalances, and nutritional deficiencies. Assessment for
hyperemesis gravidarum and provider notification is the priority intervention. This
may require further testing, possible antiemetic medications, or even
hospitalization if the client is significantly dehydrated. While ginger tea and small
meals are supportive measures, they are not sufficient as the primary intervention
for this clinical presentation.
4. During a prenatal visit, a client at 32 weeks gestation reports a sudden
onset of severe headache, right upper quadrant pain, and blurred vision.
What is the nurse's most appropriate action?
A) Schedule a follow-up appointment for the next week
B) Recommend over-the-counter pain relievers and rest
C) Immediately assess blood pressure and notify the healthcare provider of
possible preeclampsia/eclampsia
D) Advise the client to drink more water and monitor symptoms
E) Document findings and monitor the client during routine follow-up
✓ CORRECT ANSWER: C
Rationale: The client's presentation of severe headache, right upper quadrant pain,
and blurred vision are classic signs of severe preeclampsia or eclampsia, which are
life-threatening emergencies in pregnancy. These symptoms suggest possible liver
, involvement and visual changes associated with increased intracranial pressure.
Blood pressure assessment is critical, and immediate provider notification is
required. This situation demands urgent evaluation and possible delivery as the
definitive treatment. Delaying care or recommending conservative measures could
result in maternal and fetal morbidity or mortality.
5. A nurse is preparing a client for labor induction with oxytocin (Pitocin).
Which nursing assessment is most important before starting the infusion?
A) Verify that the client has eaten within the past 2 hours
B) Confirm fetal heart rate is within normal range and assess cervical status
C) Ensure the client has signed a general consent form
D) Check that the client's blood pressure is above 140/90 mmHg
E) Document the client's favorite position for labor
✓ CORRECT ANSWER: B
Rationale: Before initiating oxytocin induction, the nurse must confirm fetal well-
being (normal fetal heart rate) and assess cervical status (cervical ripeness and
dilation). Oxytocin is contraindicated in certain situations such as placenta previa,
cord prolapse, or unfavorable cervix without prior ripening. Baseline fetal heart rate
and cervical assessment ensure appropriate candidate selection and help predict
induction success. A specific consent for induction/labor management is needed
(not just general consent). While other assessments are helpful, fetal well-being and
cervical status are most critical before starting oxytocin.
6. A laboring client at 6 cm dilation requests an epidural. After placement, the
client reports inability to move her lower extremities. What is the most
appropriate nursing action?
A) Notify the anesthesiologist immediately as this may indicate improper catheter
placement or spinal injection
Exams 1, 2, 3 & 4 | Maternal & Pediatric
Nursing | Galen College | 200 Practice
Questions & Verified Answers | Just
Released This Year PDF | Updated This Year
NUR 254 MATERNAL & PEDIATRIC NURSING EXAM BUNDLE 2026/2027 Galen
College Complete Practice Exam
• Document Features: 200 comprehensive practice questions covering maternal
health, prenatal care, labor/delivery, postpartum care, newborn assessment,
pediatric growth & development, and common pediatric conditions with verified
answers
• Study Guidance: Work through all questions systematically, review rationales for
both correct and incorrect answers, identify weak areas, and use this as your final
preparation tool before the actual examination
1. A primigravida client at 28 weeks gestation presents to the clinic for a
routine prenatal visit. The nurse notes the client has gained 12 pounds since
the last visit 4 weeks ago. What is the most appropriate nursing action?
A) Restrict the client's caloric intake immediately
B) Refer the client to the healthcare provider for further assessment
C) Advise the client to increase physical activity without healthcare provider
consultation
D) Document the finding and schedule a follow-up appointment in 2 weeks
E) Recommend the client purchase a weight loss supplement
✓ CORRECT ANSWER: B
Rationale: A weight gain of 12 pounds in 4 weeks (approximately 3 pounds per
week) is excessive during the second trimester and may indicate gestational
diabetes, preeclampsia, or other complications. While normal second trimester
,weight gain is approximately 0.5-1 pound per week, this client's gain warrants
provider evaluation. Referral to the healthcare provider is the appropriate initial
action as it allows for proper assessment and investigation of potential
complications. Restricting calories or recommending weight loss supplements is
contraindicated in pregnancy as adequate nutrition is essential for fetal
development.
2. A nurse is educating a pregnant client about folic acid supplementation.
Which statement by the client indicates a need for further teaching?
A) "I should take folic acid throughout my entire pregnancy"
B) "Folic acid helps prevent neural tube defects in my baby"
C) "I can stop taking folic acid after the first trimester since the baby's spine is
already formed"
D) "Folic acid is especially important in the first few weeks of pregnancy"
E) "Taking folic acid reduces the risk of spina bifida"
✓ CORRECT ANSWER: C
Rationale: The statement indicating a need for further teaching is that folic acid
can be stopped after the first trimester. Folic acid supplementation should continue
throughout the entire pregnancy and ideally into the postpartum period, especially
if breastfeeding. While neural tube defects occur early in pregnancy (during the first
28 days), folic acid continues to be important for overall maternal health and fetal
development throughout pregnancy. The other statements are accurate: folic acid
does prevent neural tube defects, is crucial in early pregnancy, and specifically
reduces the risk of spina bifida.
3. A client in the first trimester reports experiencing severe nausea and
vomiting that is interfering with her ability to eat and drink. She has lost 5
pounds since her last visit. What is the priority nursing intervention?
A) Encourage the client to eat small, frequent meals and sip ginger tea
,B) Assess for signs of hyperemesis gravidarum and notify the healthcare provider
C) Recommend the client increase fluid intake by 2 liters daily
D) Suggest the client rest more frequently throughout the day
E) Advise the client that this is normal and will resolve on its own
✓ CORRECT ANSWER: B
Rationale: While mild nausea and vomiting are common in early pregnancy, this
client's presentation of severe nausea/vomiting with weight loss (5 pounds) raises
concern for hyperemesis gravidarum, a serious condition that can lead to
dehydration, electrolyte imbalances, and nutritional deficiencies. Assessment for
hyperemesis gravidarum and provider notification is the priority intervention. This
may require further testing, possible antiemetic medications, or even
hospitalization if the client is significantly dehydrated. While ginger tea and small
meals are supportive measures, they are not sufficient as the primary intervention
for this clinical presentation.
4. During a prenatal visit, a client at 32 weeks gestation reports a sudden
onset of severe headache, right upper quadrant pain, and blurred vision.
What is the nurse's most appropriate action?
A) Schedule a follow-up appointment for the next week
B) Recommend over-the-counter pain relievers and rest
C) Immediately assess blood pressure and notify the healthcare provider of
possible preeclampsia/eclampsia
D) Advise the client to drink more water and monitor symptoms
E) Document findings and monitor the client during routine follow-up
✓ CORRECT ANSWER: C
Rationale: The client's presentation of severe headache, right upper quadrant pain,
and blurred vision are classic signs of severe preeclampsia or eclampsia, which are
life-threatening emergencies in pregnancy. These symptoms suggest possible liver
, involvement and visual changes associated with increased intracranial pressure.
Blood pressure assessment is critical, and immediate provider notification is
required. This situation demands urgent evaluation and possible delivery as the
definitive treatment. Delaying care or recommending conservative measures could
result in maternal and fetal morbidity or mortality.
5. A nurse is preparing a client for labor induction with oxytocin (Pitocin).
Which nursing assessment is most important before starting the infusion?
A) Verify that the client has eaten within the past 2 hours
B) Confirm fetal heart rate is within normal range and assess cervical status
C) Ensure the client has signed a general consent form
D) Check that the client's blood pressure is above 140/90 mmHg
E) Document the client's favorite position for labor
✓ CORRECT ANSWER: B
Rationale: Before initiating oxytocin induction, the nurse must confirm fetal well-
being (normal fetal heart rate) and assess cervical status (cervical ripeness and
dilation). Oxytocin is contraindicated in certain situations such as placenta previa,
cord prolapse, or unfavorable cervix without prior ripening. Baseline fetal heart rate
and cervical assessment ensure appropriate candidate selection and help predict
induction success. A specific consent for induction/labor management is needed
(not just general consent). While other assessments are helpful, fetal well-being and
cervical status are most critical before starting oxytocin.
6. A laboring client at 6 cm dilation requests an epidural. After placement, the
client reports inability to move her lower extremities. What is the most
appropriate nursing action?
A) Notify the anesthesiologist immediately as this may indicate improper catheter
placement or spinal injection
