Galen NUR 254 Exam 2 Actual Exam
2026/2027 | Verified Questions
Galen College of Nursing | Verified Q&A | Professional Nursing
Students
This document contains 42 original questions developed to reinforce the official course objectives of Galen NUR
254 Exam 2. The questions address Postpartum and Newborn Care, Pediatric Growth, Development, and Health
Promotion, Pediatric Acute and Chronic Illness Management, and Pediatric Pharmacology and Nursing
Interventions. Content is designed to support clinical proficiency and actual exam readiness for Professional
Nursing Students. All material is original and aligned with official Galen NUR 254 course materials, foundational
maternal-child nursing textbooks such as Perry, Hockenberry, and Lowdermilk, and current evidence-based clinical
practice guidelines from ACOG and AAP for the 2026/2027 cycle.
Domain: Postpartum and Newborn Care
1. A postpartum client 4 hours after vaginal delivery has a boggy uterus and moderate lochia rubra.
The nurse’s first action is to:
A. Document the findings and reassess in 1 hour
B. Massage the uterine fundus and express clots while supporting the lower uterine segment
C. Increase the IV fluid rate without assessment
D. Place the client in a high Fowler position only
Correct Answer: C
Rationale: Fundal massage is the immediate intervention for uterine atony to promote contraction and control bleeding.
2. A newborn’s Apgar score at 1 minute is 6 and at 5 minutes is 8. The nurse interprets this as:
A. Severe distress requiring immediate resuscitation at both times
B. Moderate difficulty at 1 minute with improvement by 5 minutes, indicating the need for continued
observation
C. Perfect transition requiring no further assessment
D. A score that is only valid if measured at 10 minutes
Correct Answer: B
Rationale: An improving Apgar from 6 to 8 shows recovery; ongoing assessment remains important.
3. The nurse teaches a breastfeeding client that effective latch is indicated by:
A. Audible swallowing, rounded cheeks, and the infant’s lips flanged outward
B. The infant’s lips pursed tightly and no swallowing sounds
C. Frequent clicking sounds and maternal nipple pain throughout the feeding
D. The infant feeding for less than 5 minutes exclusively
Correct Answer: B
Rationale: Proper latch includes flanged lips, audible swallowing, and comfort for the mother.
4. A postpartum client reports a sudden gush of blood and a firm fundus. The nurse recognizes this
as most likely:
A. Uterine rupture
B. Release of pooled lochia when the client changed position, which is common and expected
C. Immediate postpartum hemorrhage requiring emergency surgery
D. Normal only in the first 30 minutes after birth
Correct Answer: C
Rationale: Positional change can release accumulated lochia; the firm fundus indicates the uterus is contracted.
Galen NUR 254 Exam 2 Actual Exam 2026/2027 | Verified Questions
, 5. The nurse is assessing a newborn for jaundice. Physiological jaundice typically appears:
A. Within the first 24 hours of life
B. After the first 24 hours and usually peaks by day 3–4 in term infants
C. Only after the first week of life
D. Never in breastfed infants
Correct Answer: D
Rationale: Physiological jaundice appears after 24 hours; jaundice in the first 24 hours is pathological and requires
evaluation.
6. A postpartum client’s fundus is firm, 2 cm above the umbilicus, and displaced to the right. The
nurse’s priority is to:
A. Administer a tocolytic medication
B. Assist the client to void and then reassess the fundus
C. Increase oxytocin without further assessment
D. Document as a normal finding without intervention
Correct Answer: A
Rationale: A displaced fundus often indicates a full bladder, which can impede uterine contraction.
7. The nurse performs the Ortolani maneuver on a newborn to assess for:
A. Hip dysplasia
B. Clavicle fracture
C. Cleft palate
D. Cardiac murmur
Correct Answer: A
Rationale: Ortolani and Barlow maneuvers screen for developmental dysplasia of the hip.
8. A client who delivered 12 hours ago has a temperature of 38.1 °C (100.6 °F). The nurse’s best
initial action is to:
A. Notify the provider immediately of possible infection
B. Encourage fluids, assess for dehydration or breast engorgement, and continue monitoring; mild elevation
can be normal in the first 24 hours
C. Start broad-spectrum antibiotics without orders
D. Restrict all oral intake
Correct Answer: C
Rationale: A temperature up to 38 °C in the first 24 hours can result from dehydration or exertion; further evaluation is
needed if it persists.
9. The nurse teaches new parents that the rooting reflex is elicited by:
A. Stroking the sole of the foot
B. Stroking the cheek or corner of the mouth, causing the infant to turn toward the stimulus
C. Placing a finger in the infant’s palm
D. Loudly clapping near the infant’s head
Correct Answer: A
Rationale: Rooting helps the infant locate the nipple for feeding.
10. A postpartum client is Rh-negative and the newborn is Rh-positive. The nurse anticipates
administration of Rho(D) immune globulin:
A. Only if the mother has already formed antibodies
B. Within 72 hours after delivery if the mother is nonsensitized
C. After the first month postpartum exclusively
D. Only during a subsequent pregnancy
Correct Answer: C
Rationale: RhoGAM is given within 72 hours postpartum to prevent maternal sensitization.
11. The nurse notes a newborn has a respiratory rate of 72 breaths/min and mild nasal flaring 30
minutes after birth. The priority action is to:
A. Encourage the parents to begin rooming-in immediately without further assessment
B. Continue close observation, ensure airway clearance, and assess for other signs of respiratory distress
C. Feed the infant a full bottle immediately
D. Place the infant in a prone position only
Galen NUR 254 Exam 2 Actual Exam 2026/2027 | Verified Questions
2026/2027 | Verified Questions
Galen College of Nursing | Verified Q&A | Professional Nursing
Students
This document contains 42 original questions developed to reinforce the official course objectives of Galen NUR
254 Exam 2. The questions address Postpartum and Newborn Care, Pediatric Growth, Development, and Health
Promotion, Pediatric Acute and Chronic Illness Management, and Pediatric Pharmacology and Nursing
Interventions. Content is designed to support clinical proficiency and actual exam readiness for Professional
Nursing Students. All material is original and aligned with official Galen NUR 254 course materials, foundational
maternal-child nursing textbooks such as Perry, Hockenberry, and Lowdermilk, and current evidence-based clinical
practice guidelines from ACOG and AAP for the 2026/2027 cycle.
Domain: Postpartum and Newborn Care
1. A postpartum client 4 hours after vaginal delivery has a boggy uterus and moderate lochia rubra.
The nurse’s first action is to:
A. Document the findings and reassess in 1 hour
B. Massage the uterine fundus and express clots while supporting the lower uterine segment
C. Increase the IV fluid rate without assessment
D. Place the client in a high Fowler position only
Correct Answer: C
Rationale: Fundal massage is the immediate intervention for uterine atony to promote contraction and control bleeding.
2. A newborn’s Apgar score at 1 minute is 6 and at 5 minutes is 8. The nurse interprets this as:
A. Severe distress requiring immediate resuscitation at both times
B. Moderate difficulty at 1 minute with improvement by 5 minutes, indicating the need for continued
observation
C. Perfect transition requiring no further assessment
D. A score that is only valid if measured at 10 minutes
Correct Answer: B
Rationale: An improving Apgar from 6 to 8 shows recovery; ongoing assessment remains important.
3. The nurse teaches a breastfeeding client that effective latch is indicated by:
A. Audible swallowing, rounded cheeks, and the infant’s lips flanged outward
B. The infant’s lips pursed tightly and no swallowing sounds
C. Frequent clicking sounds and maternal nipple pain throughout the feeding
D. The infant feeding for less than 5 minutes exclusively
Correct Answer: B
Rationale: Proper latch includes flanged lips, audible swallowing, and comfort for the mother.
4. A postpartum client reports a sudden gush of blood and a firm fundus. The nurse recognizes this
as most likely:
A. Uterine rupture
B. Release of pooled lochia when the client changed position, which is common and expected
C. Immediate postpartum hemorrhage requiring emergency surgery
D. Normal only in the first 30 minutes after birth
Correct Answer: C
Rationale: Positional change can release accumulated lochia; the firm fundus indicates the uterus is contracted.
Galen NUR 254 Exam 2 Actual Exam 2026/2027 | Verified Questions
, 5. The nurse is assessing a newborn for jaundice. Physiological jaundice typically appears:
A. Within the first 24 hours of life
B. After the first 24 hours and usually peaks by day 3–4 in term infants
C. Only after the first week of life
D. Never in breastfed infants
Correct Answer: D
Rationale: Physiological jaundice appears after 24 hours; jaundice in the first 24 hours is pathological and requires
evaluation.
6. A postpartum client’s fundus is firm, 2 cm above the umbilicus, and displaced to the right. The
nurse’s priority is to:
A. Administer a tocolytic medication
B. Assist the client to void and then reassess the fundus
C. Increase oxytocin without further assessment
D. Document as a normal finding without intervention
Correct Answer: A
Rationale: A displaced fundus often indicates a full bladder, which can impede uterine contraction.
7. The nurse performs the Ortolani maneuver on a newborn to assess for:
A. Hip dysplasia
B. Clavicle fracture
C. Cleft palate
D. Cardiac murmur
Correct Answer: A
Rationale: Ortolani and Barlow maneuvers screen for developmental dysplasia of the hip.
8. A client who delivered 12 hours ago has a temperature of 38.1 °C (100.6 °F). The nurse’s best
initial action is to:
A. Notify the provider immediately of possible infection
B. Encourage fluids, assess for dehydration or breast engorgement, and continue monitoring; mild elevation
can be normal in the first 24 hours
C. Start broad-spectrum antibiotics without orders
D. Restrict all oral intake
Correct Answer: C
Rationale: A temperature up to 38 °C in the first 24 hours can result from dehydration or exertion; further evaluation is
needed if it persists.
9. The nurse teaches new parents that the rooting reflex is elicited by:
A. Stroking the sole of the foot
B. Stroking the cheek or corner of the mouth, causing the infant to turn toward the stimulus
C. Placing a finger in the infant’s palm
D. Loudly clapping near the infant’s head
Correct Answer: A
Rationale: Rooting helps the infant locate the nipple for feeding.
10. A postpartum client is Rh-negative and the newborn is Rh-positive. The nurse anticipates
administration of Rho(D) immune globulin:
A. Only if the mother has already formed antibodies
B. Within 72 hours after delivery if the mother is nonsensitized
C. After the first month postpartum exclusively
D. Only during a subsequent pregnancy
Correct Answer: C
Rationale: RhoGAM is given within 72 hours postpartum to prevent maternal sensitization.
11. The nurse notes a newborn has a respiratory rate of 72 breaths/min and mild nasal flaring 30
minutes after birth. The priority action is to:
A. Encourage the parents to begin rooming-in immediately without further assessment
B. Continue close observation, ensure airway clearance, and assess for other signs of respiratory distress
C. Feed the infant a full bottle immediately
D. Place the infant in a prone position only
Galen NUR 254 Exam 2 Actual Exam 2026/2027 | Verified Questions
