Page 1 of 58
NUR 254 MATERNAL AND PEDIATRIC NURSING EXAM 2
COMPLETE (140) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURSING
Prepare effectively for the NUR 254 Maternal and Pediatric Nursing Exam 2 with this
focused study resource. It supports review of maternal health, pregnancy, labor and
delivery, newborn care, pediatric growth and development, and essential nursing
interventions. Use the material to reinforce your understanding, review key topics, and
identify areas that may require additional study. This resource is suited for nursing
students, maternal-child health learners, and candidates preparing for the NUR 254
examination.
MULTIPLE CHOICE.
DOMAIN 1 — Antepartum Nursing (Questions 1–14)
1. A pregnant patient at 36 weeks gestation calls the clinic and reports a
sudden onset of painless vaginal bleeding. What is the priority action by
the nurse?
A. Advise the patient to come to the clinic for a routine appointment
B. Instruct the patient to go to the emergency department immediately
C. Advise the patient to rest in bed and take acetaminophen
D. Schedule a non-stress test for the next day
Answer: B. Instruct the patient to go to the emergency department
immediately
Rationale: Painless vaginal bleeding in the third trimester is a hallmark sign of
placenta previa. This is a medical emergency that requires immediate
evaluation. The patient should be transported to the emergency department
without vaginal examinations or aggressive cervical checks, which could
precipitate massive hemorrhage.
, Page 2 of 58
2. A patient at 24 weeks gestation is diagnosed with gestational diabetes.
The nurse should prioritize teaching about:
A. Increasing carbohydrate intake to support fetal growth
B. Monitoring blood glucose levels and following a controlled carbohydrate
meal plan
C. Avoiding all exercise during pregnancy
D. Taking oral hypoglycemic medications
Answer: B. Monitoring blood glucose levels and following a controlled
carbohydrate meal plan
Rationale: Management of gestational diabetes centers on blood glucose
monitoring and dietary modifications to control carbohydrate intake. Insulin is
the medication of choice if diet and exercise are insufficient. Exercise is
encouraged, not avoided, unless contraindicated.
3. A patient at 32 weeks gestation presents with elevated blood pressure,
proteinuria, and edema. What is the most likely diagnosis?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Ectopic pregnancy
Answer: B. Preeclampsia
Rationale: Preeclampsia is characterized by new-onset hypertension
(≥140/90 mmHg) after 20 weeks gestation with proteinuria or other signs of
end-organ dysfunction. The triad of hypertension, proteinuria, and edema is a
classic presentation.
4. Which of the following is a sign of magnesium sulfate toxicity?
A. Respiratory rate of 14 breaths/min
B. Urine output of 50 mL in 2 hours
, Page 3 of 58
C. Loss of deep tendon reflexes
D. Blood pressure of 140/90 mmHg
Answer: C. Loss of deep tendon reflexes
Rationale: Magnesium sulfate is used to prevent seizures in preeclampsia
and eclampsia. Toxicity manifests with loss of deep tendon reflexes,
respiratory depression, and oliguria. The therapeutic range is 4-8 mEq/L. The
antidote is calcium gluconate.
5. The nurse is assessing a patient with preeclampsia who is receiving
magnesium sulfate. Which finding requires immediate intervention?
A. Reflexes 2+
B. Respiratory rate 10 breaths/min
C. Urine output 40 mL/hour
D. Blood pressure 150/90 mmHg
Answer: B. Respiratory rate 10 breaths/min
Rationale: Magnesium sulfate toxicity causes respiratory depression. A
respiratory rate below 12 breaths/min is a sign of toxicity and requires
stopping the infusion and administering calcium gluconate. Reflexes should
be 1-2+; urine output should be >30 mL/hour.
6. The nurse is teaching a prenatal class about nutrition. Which statement
indicates a need for further teaching?
A. "I should increase my intake of calcium and iron during pregnancy."
B. "I should take a folic acid supplement of 400-800 mcg daily."
C. "I should avoid all fish during pregnancy due to mercury concerns."
D. "I should increase my caloric intake by about 300-450 calories per day."
Answer: C. "I should avoid all fish during pregnancy due to mercury
concerns."
, Page 4 of 58
Rationale: Some fish are high in mercury (e.g., shark, swordfish, king
mackerel, tilefish) and should be avoided. However, low-mercury fish
(salmon, shrimp, canned light tuna) are encouraged for their omega-3 fatty
acids, which support fetal brain development.
7. A patient at 28 weeks gestation reports painless vaginal bleeding after a
vaginal exam at the clinic. The nurse suspects:
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Rupture of membranes
Answer: B. Placenta previa
Rationale: Placenta previa is characterized by painless, bright red vaginal
bleeding. Bleeding can be precipitated by cervical exams or contractions.
Vaginal exams should be avoided if placenta previa is suspected. Placental
abruption presents with painful, dark bleeding and uterine rigidity.
8. The nurse is caring for a patient who is Rh-negative and is 28 weeks
pregnant. What is the priority intervention?
A. Administer Rh immune globulin (RhoGAM) at 28 weeks gestation
B. Administer Rh immune globulin at delivery only
C. Check the father's blood type
D. No intervention is needed
Answer: A. Administer Rh immune globulin (RhoGAM) at 28 weeks
gestation
Rationale: Rh-negative patients should receive Rh immune globulin
(RhoGAM) at 28 weeks gestation to prevent sensitization. It is also given within
72 hours of delivery if the infant is Rh-positive.
9. The nurse is performing a fetal assessment. Which finding indicates
fetal well-being on a non-stress test (NST)?
NUR 254 MATERNAL AND PEDIATRIC NURSING EXAM 2
COMPLETE (140) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NURSING
Prepare effectively for the NUR 254 Maternal and Pediatric Nursing Exam 2 with this
focused study resource. It supports review of maternal health, pregnancy, labor and
delivery, newborn care, pediatric growth and development, and essential nursing
interventions. Use the material to reinforce your understanding, review key topics, and
identify areas that may require additional study. This resource is suited for nursing
students, maternal-child health learners, and candidates preparing for the NUR 254
examination.
MULTIPLE CHOICE.
DOMAIN 1 — Antepartum Nursing (Questions 1–14)
1. A pregnant patient at 36 weeks gestation calls the clinic and reports a
sudden onset of painless vaginal bleeding. What is the priority action by
the nurse?
A. Advise the patient to come to the clinic for a routine appointment
B. Instruct the patient to go to the emergency department immediately
C. Advise the patient to rest in bed and take acetaminophen
D. Schedule a non-stress test for the next day
Answer: B. Instruct the patient to go to the emergency department
immediately
Rationale: Painless vaginal bleeding in the third trimester is a hallmark sign of
placenta previa. This is a medical emergency that requires immediate
evaluation. The patient should be transported to the emergency department
without vaginal examinations or aggressive cervical checks, which could
precipitate massive hemorrhage.
, Page 2 of 58
2. A patient at 24 weeks gestation is diagnosed with gestational diabetes.
The nurse should prioritize teaching about:
A. Increasing carbohydrate intake to support fetal growth
B. Monitoring blood glucose levels and following a controlled carbohydrate
meal plan
C. Avoiding all exercise during pregnancy
D. Taking oral hypoglycemic medications
Answer: B. Monitoring blood glucose levels and following a controlled
carbohydrate meal plan
Rationale: Management of gestational diabetes centers on blood glucose
monitoring and dietary modifications to control carbohydrate intake. Insulin is
the medication of choice if diet and exercise are insufficient. Exercise is
encouraged, not avoided, unless contraindicated.
3. A patient at 32 weeks gestation presents with elevated blood pressure,
proteinuria, and edema. What is the most likely diagnosis?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Ectopic pregnancy
Answer: B. Preeclampsia
Rationale: Preeclampsia is characterized by new-onset hypertension
(≥140/90 mmHg) after 20 weeks gestation with proteinuria or other signs of
end-organ dysfunction. The triad of hypertension, proteinuria, and edema is a
classic presentation.
4. Which of the following is a sign of magnesium sulfate toxicity?
A. Respiratory rate of 14 breaths/min
B. Urine output of 50 mL in 2 hours
, Page 3 of 58
C. Loss of deep tendon reflexes
D. Blood pressure of 140/90 mmHg
Answer: C. Loss of deep tendon reflexes
Rationale: Magnesium sulfate is used to prevent seizures in preeclampsia
and eclampsia. Toxicity manifests with loss of deep tendon reflexes,
respiratory depression, and oliguria. The therapeutic range is 4-8 mEq/L. The
antidote is calcium gluconate.
5. The nurse is assessing a patient with preeclampsia who is receiving
magnesium sulfate. Which finding requires immediate intervention?
A. Reflexes 2+
B. Respiratory rate 10 breaths/min
C. Urine output 40 mL/hour
D. Blood pressure 150/90 mmHg
Answer: B. Respiratory rate 10 breaths/min
Rationale: Magnesium sulfate toxicity causes respiratory depression. A
respiratory rate below 12 breaths/min is a sign of toxicity and requires
stopping the infusion and administering calcium gluconate. Reflexes should
be 1-2+; urine output should be >30 mL/hour.
6. The nurse is teaching a prenatal class about nutrition. Which statement
indicates a need for further teaching?
A. "I should increase my intake of calcium and iron during pregnancy."
B. "I should take a folic acid supplement of 400-800 mcg daily."
C. "I should avoid all fish during pregnancy due to mercury concerns."
D. "I should increase my caloric intake by about 300-450 calories per day."
Answer: C. "I should avoid all fish during pregnancy due to mercury
concerns."
, Page 4 of 58
Rationale: Some fish are high in mercury (e.g., shark, swordfish, king
mackerel, tilefish) and should be avoided. However, low-mercury fish
(salmon, shrimp, canned light tuna) are encouraged for their omega-3 fatty
acids, which support fetal brain development.
7. A patient at 28 weeks gestation reports painless vaginal bleeding after a
vaginal exam at the clinic. The nurse suspects:
A. Placental abruption
B. Placenta previa
C. Preterm labor
D. Rupture of membranes
Answer: B. Placenta previa
Rationale: Placenta previa is characterized by painless, bright red vaginal
bleeding. Bleeding can be precipitated by cervical exams or contractions.
Vaginal exams should be avoided if placenta previa is suspected. Placental
abruption presents with painful, dark bleeding and uterine rigidity.
8. The nurse is caring for a patient who is Rh-negative and is 28 weeks
pregnant. What is the priority intervention?
A. Administer Rh immune globulin (RhoGAM) at 28 weeks gestation
B. Administer Rh immune globulin at delivery only
C. Check the father's blood type
D. No intervention is needed
Answer: A. Administer Rh immune globulin (RhoGAM) at 28 weeks
gestation
Rationale: Rh-negative patients should receive Rh immune globulin
(RhoGAM) at 28 weeks gestation to prevent sensitization. It is also given within
72 hours of delivery if the infant is Rh-positive.
9. The nurse is performing a fetal assessment. Which finding indicates
fetal well-being on a non-stress test (NST)?
