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NUR 254 — MATERNAL AND PEDIATRIC NURSING EXAMS 1–4 -
2026 QUESTIONS WITH VERIFIED QUESTIONS DETAILED
RATIONALES GRADED A+
NUR 254 — Maternal and Pediatric Nursing: Exams 1–4 — Questions with Rationales
Summarized 10-Point Exam Coverage
Antepartum care — prenatal assessment, physiological changes of pregnancy, nutrition,
prenatal screening, and high-risk pregnancy.
Intrapartum care — labor stages, fetal monitoring, pain management, obstetric emergencies,
and delivery.
Postpartum care — fundal assessment, lochia, breastfeeding, complications, and postpartum
hemorrhage.
Newborn care — Apgar scoring, newborn assessment, reflexes, feeding, and common newborn
conditions.
Pediatric growth and development — developmental milestones, theories (Erikson, Piaget), and
age-specific nursing care.
Pediatric respiratory conditions — asthma, RSV, croup, epiglottitis, and cystic fibrosis.
Pediatric cardiovascular conditions — congenital heart defects, heart failure, and rheumatic
fever.
Pediatric neurologic and musculoskeletal conditions — seizures, cerebral palsy, spina bifida, and
fractures.
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Pediatric infectious diseases and immunizations — vaccine schedules, common childhood
illnesses, and isolation precautions.
Pediatric medication administration and emergency care — dosage calculation, safe medication
administration, and pediatric emergencies.
SECTION 1: EXAM 1 — Antepartum and Intrapartum Care (Questions 1–90)
Antepartum Care (Questions 1–45)
Q1. A nurse is assessing a client at her first prenatal visit. The client reports her last menstrual
period (LMP) was March 10, 2026. Using Naegele's rule, what is her estimated date of delivery
(EDD)?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. January 17, 2027
Correct Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP, then add 7 days.
March 10 – 3 months = December 10, then +7 days = December 17. The correct EDD is
December 17, 2026.
Q2. A nurse is educating a primigravida client about the physiological changes of pregnancy.
Which of the following is a normal finding in the second trimester?
A. Colostrum leakage from the breasts
B. Increased frequency of urination
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C. Decreased cardiac output
D. Decreased blood volume
Correct Answer: A
Rationale: Colostrum leakage from the breasts is a normal finding in the second trimester due
to hormonal changes. Urinary frequency is more common in the first and third trimesters.
Cardiac output and blood volume increase during pregnancy, not decrease.
Q3. A client at 32 weeks gestation is admitted with preterm labor. Which medication should
the nurse anticipate administering to promote fetal lung maturity?
A. Magnesium sulfate
B. Betamethasone
C. Terbutaline
D. Indomethacin
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to promote fetal lung maturity in
preterm labor. It is given in 2 doses, 24 hours apart. Magnesium sulfate and terbutaline are
tocolytics, and indomethacin is also a tocolytic but not used for lung maturity.
Q4. A client at 33 weeks' gestation presents with sudden onset of severe, constant abdominal
pain and dark vaginal bleeding. The uterus is firm and tender to palpation. Contractions are
every 2 minutes with high resting tone. Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Preterm labor
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Correct Answer: B
Rationale: The classic signs of placental abruption are painful, dark red bleeding, uterine
hypertonicity, and a rigid, tender uterus. Placenta previa typically presents with painless, bright
red bleeding and a soft uterus.
Q5. A client planning a pregnancy has no history of a neural tube defect. Which instruction
best lowers the fetal risk for a neural tube defect?
A. Begin folic acid supplementation at 0.4 mg daily before conception
B. Begin folic acid supplementation at 4 mg daily after conception
C. Avoid all dairy products during pregnancy
D. Increase vitamin A intake during pregnancy
Correct Answer: A
Rationale: Folic acid supplementation at 0.4 mg daily before conception significantly reduces
the risk of neural tube defects. Women with a history of neural tube defects may require higher
doses.
Q6. A nurse is assessing a client at 10 weeks gestation. Which finding would be considered a
normal physiological change of pregnancy?
A. Decreased heart rate
B. Increased blood pressure
C. Increased respiratory rate
D. Decreased blood volume
Correct Answer: A
Rationale: A decreased heart rate is not a normal finding. Normal physiological changes of
pregnancy include increased heart rate, increased blood volume, and decreased blood pressure.
Increased respiratory rate may occur due to increased oxygen demand.
NUR 254 — MATERNAL AND PEDIATRIC NURSING EXAMS 1–4 -
2026 QUESTIONS WITH VERIFIED QUESTIONS DETAILED
RATIONALES GRADED A+
NUR 254 — Maternal and Pediatric Nursing: Exams 1–4 — Questions with Rationales
Summarized 10-Point Exam Coverage
Antepartum care — prenatal assessment, physiological changes of pregnancy, nutrition,
prenatal screening, and high-risk pregnancy.
Intrapartum care — labor stages, fetal monitoring, pain management, obstetric emergencies,
and delivery.
Postpartum care — fundal assessment, lochia, breastfeeding, complications, and postpartum
hemorrhage.
Newborn care — Apgar scoring, newborn assessment, reflexes, feeding, and common newborn
conditions.
Pediatric growth and development — developmental milestones, theories (Erikson, Piaget), and
age-specific nursing care.
Pediatric respiratory conditions — asthma, RSV, croup, epiglottitis, and cystic fibrosis.
Pediatric cardiovascular conditions — congenital heart defects, heart failure, and rheumatic
fever.
Pediatric neurologic and musculoskeletal conditions — seizures, cerebral palsy, spina bifida, and
fractures.
,Page 2 of 131
Pediatric infectious diseases and immunizations — vaccine schedules, common childhood
illnesses, and isolation precautions.
Pediatric medication administration and emergency care — dosage calculation, safe medication
administration, and pediatric emergencies.
SECTION 1: EXAM 1 — Antepartum and Intrapartum Care (Questions 1–90)
Antepartum Care (Questions 1–45)
Q1. A nurse is assessing a client at her first prenatal visit. The client reports her last menstrual
period (LMP) was March 10, 2026. Using Naegele's rule, what is her estimated date of delivery
(EDD)?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. January 17, 2027
Correct Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP, then add 7 days.
March 10 – 3 months = December 10, then +7 days = December 17. The correct EDD is
December 17, 2026.
Q2. A nurse is educating a primigravida client about the physiological changes of pregnancy.
Which of the following is a normal finding in the second trimester?
A. Colostrum leakage from the breasts
B. Increased frequency of urination
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C. Decreased cardiac output
D. Decreased blood volume
Correct Answer: A
Rationale: Colostrum leakage from the breasts is a normal finding in the second trimester due
to hormonal changes. Urinary frequency is more common in the first and third trimesters.
Cardiac output and blood volume increase during pregnancy, not decrease.
Q3. A client at 32 weeks gestation is admitted with preterm labor. Which medication should
the nurse anticipate administering to promote fetal lung maturity?
A. Magnesium sulfate
B. Betamethasone
C. Terbutaline
D. Indomethacin
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to promote fetal lung maturity in
preterm labor. It is given in 2 doses, 24 hours apart. Magnesium sulfate and terbutaline are
tocolytics, and indomethacin is also a tocolytic but not used for lung maturity.
Q4. A client at 33 weeks' gestation presents with sudden onset of severe, constant abdominal
pain and dark vaginal bleeding. The uterus is firm and tender to palpation. Contractions are
every 2 minutes with high resting tone. Which condition is most likely?
A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Preterm labor
, Page 4 of 131
Correct Answer: B
Rationale: The classic signs of placental abruption are painful, dark red bleeding, uterine
hypertonicity, and a rigid, tender uterus. Placenta previa typically presents with painless, bright
red bleeding and a soft uterus.
Q5. A client planning a pregnancy has no history of a neural tube defect. Which instruction
best lowers the fetal risk for a neural tube defect?
A. Begin folic acid supplementation at 0.4 mg daily before conception
B. Begin folic acid supplementation at 4 mg daily after conception
C. Avoid all dairy products during pregnancy
D. Increase vitamin A intake during pregnancy
Correct Answer: A
Rationale: Folic acid supplementation at 0.4 mg daily before conception significantly reduces
the risk of neural tube defects. Women with a history of neural tube defects may require higher
doses.
Q6. A nurse is assessing a client at 10 weeks gestation. Which finding would be considered a
normal physiological change of pregnancy?
A. Decreased heart rate
B. Increased blood pressure
C. Increased respiratory rate
D. Decreased blood volume
Correct Answer: A
Rationale: A decreased heart rate is not a normal finding. Normal physiological changes of
pregnancy include increased heart rate, increased blood volume, and decreased blood pressure.
Increased respiratory rate may occur due to increased oxygen demand.
