NUR 254
Maternal and Pediatric Nursing
Exams 1–4 Questions and Answers|
Galen College of Nursing
NUR 254 Exam 1
1. A client's last menstrual period began on January 10. Using
Naegele's rule, what is her estimated date of delivery?
A. November 17
B. September 17
C. October 17
D. October 10
Answer: C
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP
and add 7 days (Jan 10 → Oct 10 → Oct 17).
NUR 254 Exams | Page 1
,2. A client is pregnant. She has one child born at 39 weeks and had
one miscarriage at 10 weeks. Which gravida/para notation is correct?
A. G3 P1-1-0-1
B. G3 P2-0-0-1
C. G2 P1-0-1-1
D. G3 P1-0-1-1
Answer: D
Rationale: Gravida counts all pregnancies including the current one (3).
Para-TPAL: 1 term, 0 preterm, 1 abortion, 1 living child.
3. Which finding is classified as a PROBABLE sign of pregnancy?
A. Chadwick's sign (bluish cervix)
B. Visualization of the fetus on ultrasound
C. Fetal heart tones by Doppler
D. Fetal movement felt by the examiner
Answer: A
Rationale: Chadwick's sign is a probable sign. Positive signs (FHR,
ultrasound visualization, fetal movement felt by examiner) can only be
caused by a fetus.
4. Which is a presumptive sign of pregnancy?
A. Positive hCG urine test
B. Hegar's sign
C. Fetal heart tones
D. Nausea and breast tenderness
Answer: D
Rationale: Presumptive signs are subjective symptoms the woman
reports (nausea, fatigue, breast changes, quickening). Hegar's sign and
hCG are probable; FHR is positive.
NUR 254 Exams | Page 2
,5. A nurse teaches a woman planning pregnancy about folic acid.
Which statement shows correct understanding?
A. "It prevents gestational diabetes."
B. "I should take 400 mcg daily to help prevent neural tube defects."
C. "It prevents Down syndrome."
D. "I only need it after the first trimester."
Answer: B
Rationale: Folic acid (at least 400 mcg/day, started before conception)
reduces neural tube defects such as spina bifida, which form in the first
weeks of gestation.
6. A client with a normal pre-pregnancy BMI asks about expected
weight gain. What is the recommended total gain?
A. 15–25 lb
B. 25–35 lb (11.5–16 kg)
C. 10–15 lb
D. 40–50 lb
Answer: B
Rationale: For normal BMI (18.5–24.9), recommended gain is 25–35 lb.
Underweight women gain more; overweight and obese women gain less.
NUR 254 Exams | Page 3
, 7. A client at 8 weeks reports morning nausea. Which teaching is
most appropriate?
A. Eat three large meals daily
B. Lie down immediately after eating
C. Drink large amounts of fluid with meals
D. Eat dry crackers before rising and small, frequent meals
Answer: D
Rationale: Dry carbohydrates before rising and small frequent meals help
stabilize blood sugar and reduce nausea. Large meals and fluids with
meals worsen it.
8. A pregnant client at 30 weeks reports leg cramps at night. What
should the nurse instruct?
A. Restrict fluids in the evening
B. Dorsiflex the foot with the knee extended
C. Point the toes and massage the calf
D. Avoid all calcium-containing foods
Answer: B
Rationale: Straightening the leg and dorsiflexing the foot stretches the
gastrocnemius and relieves the cramp. Plantar flexion worsens it.
NUR 254 Exams | Page 4
Maternal and Pediatric Nursing
Exams 1–4 Questions and Answers|
Galen College of Nursing
NUR 254 Exam 1
1. A client's last menstrual period began on January 10. Using
Naegele's rule, what is her estimated date of delivery?
A. November 17
B. September 17
C. October 17
D. October 10
Answer: C
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP
and add 7 days (Jan 10 → Oct 10 → Oct 17).
NUR 254 Exams | Page 1
,2. A client is pregnant. She has one child born at 39 weeks and had
one miscarriage at 10 weeks. Which gravida/para notation is correct?
A. G3 P1-1-0-1
B. G3 P2-0-0-1
C. G2 P1-0-1-1
D. G3 P1-0-1-1
Answer: D
Rationale: Gravida counts all pregnancies including the current one (3).
Para-TPAL: 1 term, 0 preterm, 1 abortion, 1 living child.
3. Which finding is classified as a PROBABLE sign of pregnancy?
A. Chadwick's sign (bluish cervix)
B. Visualization of the fetus on ultrasound
C. Fetal heart tones by Doppler
D. Fetal movement felt by the examiner
Answer: A
Rationale: Chadwick's sign is a probable sign. Positive signs (FHR,
ultrasound visualization, fetal movement felt by examiner) can only be
caused by a fetus.
4. Which is a presumptive sign of pregnancy?
A. Positive hCG urine test
B. Hegar's sign
C. Fetal heart tones
D. Nausea and breast tenderness
Answer: D
Rationale: Presumptive signs are subjective symptoms the woman
reports (nausea, fatigue, breast changes, quickening). Hegar's sign and
hCG are probable; FHR is positive.
NUR 254 Exams | Page 2
,5. A nurse teaches a woman planning pregnancy about folic acid.
Which statement shows correct understanding?
A. "It prevents gestational diabetes."
B. "I should take 400 mcg daily to help prevent neural tube defects."
C. "It prevents Down syndrome."
D. "I only need it after the first trimester."
Answer: B
Rationale: Folic acid (at least 400 mcg/day, started before conception)
reduces neural tube defects such as spina bifida, which form in the first
weeks of gestation.
6. A client with a normal pre-pregnancy BMI asks about expected
weight gain. What is the recommended total gain?
A. 15–25 lb
B. 25–35 lb (11.5–16 kg)
C. 10–15 lb
D. 40–50 lb
Answer: B
Rationale: For normal BMI (18.5–24.9), recommended gain is 25–35 lb.
Underweight women gain more; overweight and obese women gain less.
NUR 254 Exams | Page 3
, 7. A client at 8 weeks reports morning nausea. Which teaching is
most appropriate?
A. Eat three large meals daily
B. Lie down immediately after eating
C. Drink large amounts of fluid with meals
D. Eat dry crackers before rising and small, frequent meals
Answer: D
Rationale: Dry carbohydrates before rising and small frequent meals help
stabilize blood sugar and reduce nausea. Large meals and fluids with
meals worsen it.
8. A pregnant client at 30 weeks reports leg cramps at night. What
should the nurse instruct?
A. Restrict fluids in the evening
B. Dorsiflex the foot with the knee extended
C. Point the toes and massage the calf
D. Avoid all calcium-containing foods
Answer: B
Rationale: Straightening the leg and dorsiflexing the foot stretches the
gastrocnemius and relieves the cramp. Plantar flexion worsens it.
NUR 254 Exams | Page 4
