NUR 254 Exam 1 Review – Alternate Set
Galen College of Nursing | Updated 2025–2026
Additional 150 Questions with Detailed Rationales
Section 1: Antepartum Assessment & Initial Prenatal Care (Questions
1–35)
Question 1: A client at her first prenatal visit asks the nurse about the accuracy of pregnancy tests.
Which statement is correct?
A) "Urine pregnancy tests are accurate immediately after conception"
B) "Serum hCG can detect pregnancy 8-10 days after ovulation"
C) "Home pregnancy tests are never accurate"
D) "Blood tests are less sensitive than urine tests"
Answer: B
Rationale: Serum hCG can detect pregnancy as early as 8-10 days after ovulation. Urine tests detect
hCG around the time of the missed period (12-14 days after ovulation). Both tests detect hCG, but
serum tests are more sensitive and quantitative.
Question 2: A client asks the nurse what happens during the first prenatal visit. The nurse explains that
the first visit typically includes:
A) Only a urine test for protein
B) A complete history, physical exam, lab tests, and establishing estimated due date
C) Only a pelvic exam
D) Administration of all vaccines at once
Answer: B
Rationale: The first prenatal visit is comprehensive: health history, physical exam (including pelvic
exam), baseline vital signs and weight, urine dipstick, blood tests (CBC, blood type, Rh, antibody
screen, rubella titer, syphilis, HIV, hepatitis B, GBS if indicated), and establishing EDB.
,Question 3: The nurse is teaching a client about the signs of pregnancy. Which finding is
a positive sign of pregnancy?
A) Nausea and vomiting
B) Visualization of the fetus on ultrasound
C) Positive pregnancy test
D) Chadwick sign
Answer: B
Rationale: Positive signs can have no other explanation and confirm pregnancy: visualization of the
fetus on ultrasound, auscultation of fetal heart tones, and palpation of fetal movements by an
examiner. Presumptive signs are subjective (nausea, breast tenderness, amenorrhea). Probable signs
are objective but not definitive (positive hCG, Goodell/Chadwick/Hegar signs).
Question 4: A client at 16 weeks gestation asks when she will likely begin to feel the baby move. What
is the nurse's best response?
A) "You should have felt movement by now"
B) "First-time mothers typically feel movement at 18-20 weeks"
C) "You will feel movement at 30-32 weeks"
D) "Only mothers who have had previous pregnancies feel movement"
Answer: B
Rationale: Quickening (first perception of fetal movement) typically occurs at 18-20 weeks in
primigravidas and 14-16 weeks in multigravidas. The nurse should reassure the client that this timeline
is normal.
Question 5: A client's last menstrual period (LMP) began on December 20. Using Naegele's rule, the
estimated date of birth is:
A) July 13
B) September 27
C) October 13
D) August 27
Answer: B
Rationale: Naegele's rule: subtract 3 months (December → September), add 7 days (20 + 7 = 27), add
1 year → September 27 of the following year.
,Question 6: The nurse is calculating the estimated date of birth for a client whose LMP was June 15.
What is the correct EDB?
A) March 8
B) March 15
C) March 22
D) April 15
Answer: C
Rationale: June 15 → subtract 3 months = March 15, add 7 days = March 22 of the following year.
Question 7: A client is 8 weeks pregnant. Her fundal height is palpable:
A) At the umbilicus
B) Just above the symphysis pubis
C) At the xiphoid process
D) Not palpable yet
Answer: B
Rationale: At 12 weeks, the fundus is just above the symphysis pubis. At 8 weeks, the uterus is still
within the pelvis and may not be palpable abdominally. Fundal height in cm equals weeks of gestation
from 20-34 weeks.
Question 8: The nurse is reviewing laboratory results for a client at 10 weeks gestation. Which finding
is concerning and requires notification of the provider?
A) Hgb 11.0 g/dL
B) Platelets 80,000/mm³
C) WBC 12,000/mm³
D) Blood type A positive
Answer: B
Rationale: Normal platelet count in pregnancy is 150,000-400,000. A count of 80,000 is
thrombocytopenia, which may indicate HELLP syndrome, immune thrombocytopenia, or other
conditions. Hgb 11.0 is within normal range for pregnancy (>11.0 in first trimester). WBC up to 15,000
can be normal in pregnancy.
Question 9: A client at 36 weeks gestation reports she has been having irregular, painless contractions.
The nurse documents these as:
, A) Braxton-Hicks contractions
B) True labor contractions
C) Preterm labor
D) Placental abruption
Answer: A
Rationale: Braxton-Hicks contractions are irregular, painless, and do not cause cervical change. They
are normal in the third trimester. True labor contractions are regular, become stronger over time,
increase in frequency, and cause cervical dilation/effacement.
Question 10: The nurse is teaching a client about the difference between Braxton-Hicks contractions
and true labor contractions. Which statement by the client indicates understanding?
A) "Braxton-Hicks contractions get closer together over time"
B) "Braxton-Hicks contractions often stop with walking or position change"
C) "True labor contractions are irregular"
D) "Braxton-Hicks contractions cause cervical dilation"
Answer: B
Rationale: Braxton-Hicks contractions often stop with activity or position change; true labor
contractions continue and intensify. True labor contractions become regular, closer together, and
cause cervical change.
Question 11: A client at 28 weeks gestation asks about the pattern of weight gain during pregnancy.
What is the expected pattern?
A) 5 pounds in the first trimester, 1 pound per week thereafter
B) 1-2 pounds per month in first trimester, then 0.5-1 pound per week in second/third trimesters
C) 10 pounds per trimester
D) No weight gain until second trimester
Answer: B
Rationale: Expected weight gain pattern: first trimester (0-5 lbs total, about 1-2 lbs per month), second
and third trimesters (0.5-1 lb per week). Total gain depends on prepregnancy BMI.
Question 12: A client with a prepregnancy BMI of 32 kg/m² is at her first prenatal visit. The nurse
should advise her that the recommended total weight gain is:
Galen College of Nursing | Updated 2025–2026
Additional 150 Questions with Detailed Rationales
Section 1: Antepartum Assessment & Initial Prenatal Care (Questions
1–35)
Question 1: A client at her first prenatal visit asks the nurse about the accuracy of pregnancy tests.
Which statement is correct?
A) "Urine pregnancy tests are accurate immediately after conception"
B) "Serum hCG can detect pregnancy 8-10 days after ovulation"
C) "Home pregnancy tests are never accurate"
D) "Blood tests are less sensitive than urine tests"
Answer: B
Rationale: Serum hCG can detect pregnancy as early as 8-10 days after ovulation. Urine tests detect
hCG around the time of the missed period (12-14 days after ovulation). Both tests detect hCG, but
serum tests are more sensitive and quantitative.
Question 2: A client asks the nurse what happens during the first prenatal visit. The nurse explains that
the first visit typically includes:
A) Only a urine test for protein
B) A complete history, physical exam, lab tests, and establishing estimated due date
C) Only a pelvic exam
D) Administration of all vaccines at once
Answer: B
Rationale: The first prenatal visit is comprehensive: health history, physical exam (including pelvic
exam), baseline vital signs and weight, urine dipstick, blood tests (CBC, blood type, Rh, antibody
screen, rubella titer, syphilis, HIV, hepatitis B, GBS if indicated), and establishing EDB.
,Question 3: The nurse is teaching a client about the signs of pregnancy. Which finding is
a positive sign of pregnancy?
A) Nausea and vomiting
B) Visualization of the fetus on ultrasound
C) Positive pregnancy test
D) Chadwick sign
Answer: B
Rationale: Positive signs can have no other explanation and confirm pregnancy: visualization of the
fetus on ultrasound, auscultation of fetal heart tones, and palpation of fetal movements by an
examiner. Presumptive signs are subjective (nausea, breast tenderness, amenorrhea). Probable signs
are objective but not definitive (positive hCG, Goodell/Chadwick/Hegar signs).
Question 4: A client at 16 weeks gestation asks when she will likely begin to feel the baby move. What
is the nurse's best response?
A) "You should have felt movement by now"
B) "First-time mothers typically feel movement at 18-20 weeks"
C) "You will feel movement at 30-32 weeks"
D) "Only mothers who have had previous pregnancies feel movement"
Answer: B
Rationale: Quickening (first perception of fetal movement) typically occurs at 18-20 weeks in
primigravidas and 14-16 weeks in multigravidas. The nurse should reassure the client that this timeline
is normal.
Question 5: A client's last menstrual period (LMP) began on December 20. Using Naegele's rule, the
estimated date of birth is:
A) July 13
B) September 27
C) October 13
D) August 27
Answer: B
Rationale: Naegele's rule: subtract 3 months (December → September), add 7 days (20 + 7 = 27), add
1 year → September 27 of the following year.
,Question 6: The nurse is calculating the estimated date of birth for a client whose LMP was June 15.
What is the correct EDB?
A) March 8
B) March 15
C) March 22
D) April 15
Answer: C
Rationale: June 15 → subtract 3 months = March 15, add 7 days = March 22 of the following year.
Question 7: A client is 8 weeks pregnant. Her fundal height is palpable:
A) At the umbilicus
B) Just above the symphysis pubis
C) At the xiphoid process
D) Not palpable yet
Answer: B
Rationale: At 12 weeks, the fundus is just above the symphysis pubis. At 8 weeks, the uterus is still
within the pelvis and may not be palpable abdominally. Fundal height in cm equals weeks of gestation
from 20-34 weeks.
Question 8: The nurse is reviewing laboratory results for a client at 10 weeks gestation. Which finding
is concerning and requires notification of the provider?
A) Hgb 11.0 g/dL
B) Platelets 80,000/mm³
C) WBC 12,000/mm³
D) Blood type A positive
Answer: B
Rationale: Normal platelet count in pregnancy is 150,000-400,000. A count of 80,000 is
thrombocytopenia, which may indicate HELLP syndrome, immune thrombocytopenia, or other
conditions. Hgb 11.0 is within normal range for pregnancy (>11.0 in first trimester). WBC up to 15,000
can be normal in pregnancy.
Question 9: A client at 36 weeks gestation reports she has been having irregular, painless contractions.
The nurse documents these as:
, A) Braxton-Hicks contractions
B) True labor contractions
C) Preterm labor
D) Placental abruption
Answer: A
Rationale: Braxton-Hicks contractions are irregular, painless, and do not cause cervical change. They
are normal in the third trimester. True labor contractions are regular, become stronger over time,
increase in frequency, and cause cervical dilation/effacement.
Question 10: The nurse is teaching a client about the difference between Braxton-Hicks contractions
and true labor contractions. Which statement by the client indicates understanding?
A) "Braxton-Hicks contractions get closer together over time"
B) "Braxton-Hicks contractions often stop with walking or position change"
C) "True labor contractions are irregular"
D) "Braxton-Hicks contractions cause cervical dilation"
Answer: B
Rationale: Braxton-Hicks contractions often stop with activity or position change; true labor
contractions continue and intensify. True labor contractions become regular, closer together, and
cause cervical change.
Question 11: A client at 28 weeks gestation asks about the pattern of weight gain during pregnancy.
What is the expected pattern?
A) 5 pounds in the first trimester, 1 pound per week thereafter
B) 1-2 pounds per month in first trimester, then 0.5-1 pound per week in second/third trimesters
C) 10 pounds per trimester
D) No weight gain until second trimester
Answer: B
Rationale: Expected weight gain pattern: first trimester (0-5 lbs total, about 1-2 lbs per month), second
and third trimesters (0.5-1 lb per week). Total gain depends on prepregnancy BMI.
Question 12: A client with a prepregnancy BMI of 32 kg/m² is at her first prenatal visit. The nurse
should advise her that the recommended total weight gain is:
