NUR 254 Final Exam: Maternal
and Pediatrics - Galen College of
Nursing Updated and Latest
Questions and Correct Answers
with Rationale
1. A nurse is assessing a client at 34 weeks of gestation who presents with painless, bright red vaginal
bleeding. Which of the following conditions should the nurse suspect?
A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Uterine rupture
Correct Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding during the second or
third trimester. In contrast, abruptio placentae typically presents with painful bleeding and abdominal
rigidity. The nurse must avoid performing a vaginal exam until ultrasound confirms the placental
location. Monitoring fetal heart rates and maternal vital signs is the priority for safety. Ensuring the client
remains on bed rest helps prevent further bleeding episodes.
2. Which of the following interventions is a priority for a toddler experiencing a ‘tet spell’ due to Tetralogy
of Fallot?
A. Administer high-flow oxygen via mask
,B. Prepare for immediate surgical intervention
C. Administer intravenous morphine sulfate
D. Place the child in a knee-chest position
Correct Answer: D
Rationale: Placing the toddler in the knee-chest position increases systemic vascular resistance which
reduces the right-to-left shunt. This intervention helps improve pulmonary blood flow and increases
oxygen saturation during a cyanotic episode. It is the immediate nursing action required before
pharmacological interventions are initiated. The nurse should also remain calm to avoid further
distressing the child. Supplemental oxygen can be provided after the position is secured to support
oxygenation.
3. A pregnant client is receiving magnesium sulfate for preeclampsia. Which assessment finding indicates
magnesium toxicity?
A. Hyperactive deep tendon reflexes
B. Respiratory rate of 10 breaths per minute
C. Increased urine output
D. Fetal tachycardia
Correct Answer: B
Rationale: A respiratory rate below 12 breaths per minute is a critical indicator of magnesium sulfate
toxicity. Other signs include the loss of deep tendon reflexes and decreased urinary output. The nurse
must monitor these parameters closely to prevent respiratory or cardiac arrest. If toxicity is suspected,
the infusion should be discontinued immediately. Calcium gluconate serves as the pharmacological
antidote and must be readily available.
, 4. A nurse is caring for an infant with pyloric stenosis. Which clinical manifestation should the nurse expect
to find?
A. Currant jelly-like stools
B. Bile-stained emesis
C. Sausage-shaped mass in the right upper quadrant
D. Projectile vomiting after feedings
Correct Answer: D
Rationale: Projectile vomiting after feeding is the classic sign of hypertrophic pyloric stenosis in infants.
The emesis is typically non-bilious because the obstruction is proximal to the bile duct. An olive-shaped
mass may also be palpable in the right upper quadrant of the abdomen. Currant jelly stools are instead
associated with intussusception. Nurses must prioritize assessing for dehydration and metabolic
alkalosis in these patients.
5. What is the primary goal of care for a child hospitalized with Sickle Cell Crisis?
A. Promoting vigorous exercise to improve circulation
B. Restricting fluid intake to prevent edema
C. Administering oral anticoagulants
D. Pain management and aggressive hydration
Correct Answer: D
Rationale: Managing severe pain and providing intravenous hydration are the cornerstones of sickle cell
crisis treatment. Hydration helps reduce blood viscosity and prevents further sickling of red blood cells.
Oxygen therapy may also be used if the child is hypoxic to support tissue perfusion. Bed rest is
and Pediatrics - Galen College of
Nursing Updated and Latest
Questions and Correct Answers
with Rationale
1. A nurse is assessing a client at 34 weeks of gestation who presents with painless, bright red vaginal
bleeding. Which of the following conditions should the nurse suspect?
A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Uterine rupture
Correct Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding during the second or
third trimester. In contrast, abruptio placentae typically presents with painful bleeding and abdominal
rigidity. The nurse must avoid performing a vaginal exam until ultrasound confirms the placental
location. Monitoring fetal heart rates and maternal vital signs is the priority for safety. Ensuring the client
remains on bed rest helps prevent further bleeding episodes.
2. Which of the following interventions is a priority for a toddler experiencing a ‘tet spell’ due to Tetralogy
of Fallot?
A. Administer high-flow oxygen via mask
,B. Prepare for immediate surgical intervention
C. Administer intravenous morphine sulfate
D. Place the child in a knee-chest position
Correct Answer: D
Rationale: Placing the toddler in the knee-chest position increases systemic vascular resistance which
reduces the right-to-left shunt. This intervention helps improve pulmonary blood flow and increases
oxygen saturation during a cyanotic episode. It is the immediate nursing action required before
pharmacological interventions are initiated. The nurse should also remain calm to avoid further
distressing the child. Supplemental oxygen can be provided after the position is secured to support
oxygenation.
3. A pregnant client is receiving magnesium sulfate for preeclampsia. Which assessment finding indicates
magnesium toxicity?
A. Hyperactive deep tendon reflexes
B. Respiratory rate of 10 breaths per minute
C. Increased urine output
D. Fetal tachycardia
Correct Answer: B
Rationale: A respiratory rate below 12 breaths per minute is a critical indicator of magnesium sulfate
toxicity. Other signs include the loss of deep tendon reflexes and decreased urinary output. The nurse
must monitor these parameters closely to prevent respiratory or cardiac arrest. If toxicity is suspected,
the infusion should be discontinued immediately. Calcium gluconate serves as the pharmacological
antidote and must be readily available.
, 4. A nurse is caring for an infant with pyloric stenosis. Which clinical manifestation should the nurse expect
to find?
A. Currant jelly-like stools
B. Bile-stained emesis
C. Sausage-shaped mass in the right upper quadrant
D. Projectile vomiting after feedings
Correct Answer: D
Rationale: Projectile vomiting after feeding is the classic sign of hypertrophic pyloric stenosis in infants.
The emesis is typically non-bilious because the obstruction is proximal to the bile duct. An olive-shaped
mass may also be palpable in the right upper quadrant of the abdomen. Currant jelly stools are instead
associated with intussusception. Nurses must prioritize assessing for dehydration and metabolic
alkalosis in these patients.
5. What is the primary goal of care for a child hospitalized with Sickle Cell Crisis?
A. Promoting vigorous exercise to improve circulation
B. Restricting fluid intake to prevent edema
C. Administering oral anticoagulants
D. Pain management and aggressive hydration
Correct Answer: D
Rationale: Managing severe pain and providing intravenous hydration are the cornerstones of sickle cell
crisis treatment. Hydration helps reduce blood viscosity and prevents further sickling of red blood cells.
Oxygen therapy may also be used if the child is hypoxic to support tissue perfusion. Bed rest is
