NUR 254 Exams 1, 2, 3 & 4 | Galen College |
Complete Maternal & Pediatric Nursing Bundle!!!Accurately
Answers and Verified Questions.
NUR 254 Exam 1 – Maternal Nursing: Antepartum & Intrapartum
1. A nurse is teaching a primigravida about physiological changes in pregnancy. Which
finding is considered normal?
A) Decreased respiratory rate
B) Blurred vision with headaches
C) Increased heart rate by 10–15 bpm
D) Decreased platelet count below 100,000
Answer: C – Increased heart rate by 10–15 bpm
Rationale: Cardiac output increases, leading to a mild tachycardia. Blurred vision + headache
suggests preeclampsia. Platelets <100,000 is abnormal.
2. A client at 38 weeks gestation reports a sudden gush of fluid from the vagina. The nurse
notes the fluid is green-tinged. What action is priority?
A) Assess fetal heart rate
B) Perform a Nitrazine test
C) Prepare for immediate cesarean
D) Administer oxygen to the mother
Answer: A – Assess fetal heart rate
Rationale: Green fluid indicates meconium, which can cause meconium aspiration
syndrome. Priority is fetal assessment.
,3. A nurse is caring for a patient with placenta previa. Which finding requires immediate
intervention?
A) Painless bright red vaginal bleeding
B) Intermittent contractions every 10 minutes
C) Fetal heart rate of 150 bpm
D) Cervical dilation of 2 cm
Answer: A – Painless bright red vaginal bleeding
Rationale: This is the hallmark sign of placenta previa; it can become life-threatening rapidly.
4. A patient in active labor requests an epidural. Which lab value must the nurse check
before placement?
A) Hemoglobin
B) Platelet count
C) Blood glucose
D) White blood cell count
Answer: B – Platelet count
Rationale: Low platelets increase the risk of epidural hematoma. Typically need >70,000–
100,000.
5. A nurse administers misoprostol (Cytotec) for cervical ripening. The patient now has a
single contraction lasting 3 minutes. What is the priority action?
A) Apply oxygen via face mask
B) Administer terbutaline
C) Notify the provider immediately
D) Reposition the patient on her left side
Answer: C – Notify the provider immediately
Rationale: Contraction lasting >90 seconds suggests tachysystole with risk of uterine rupture.
6. A G2P1 patient at 40 weeks has rupture of membranes with clear fluid. FHR is 140 with
moderate variability. The nurse notes a prolapsed cord on speculum exam. What is the
first action?
A) Push the presenting part off the cord
B) Place patient in Trendelenburg position
C) Administer tocolytics
, D) Start an IV of lactated Ringer’s
Answer: A – Push the presenting part off the cord
Rationale: Relieves cord compression. Then reposition, call for help, prepare for cesarean.
7. A nurse is assessing a patient with hyperemesis gravidarum. Which finding indicates
severe dehydration?
A) Ketones in urine
B) Dry mucous membranes
C) Orthostatic hypotension
D) Urine specific gravity >1.030
Answer: D – Urine specific gravity >1.030
Rationale: Concentrated urine indicates significant dehydration.
8. A patient with gestational diabetes is at 34 weeks. Which finding suggests poor glycemic
control affecting the fetus?
A) Polyhydramnios
B) Intrauterine growth restriction
C) Oligohydramnios
D) Microcephaly
Answer: A – Polyhydramnios
Rationale: Fetal hyperglycemia causes polyuria → polyhydramnios.
9. A nurse is assessing a patient’s Leopold maneuvers. Step 3 identifies the breech
presentation. Where is the head felt?
A) Fundus
B) Lower uterine segment
C) Right lateral
D) Left lateral
Answer: A – Fundus
Rationale: In breech, the head is at the fundus (hard, round, movable).
10. A patient in active labor requests pain medication. The nurse reviews her prenatal
record. Which condition would contraindicate an epidural?
A) Gestational hypertension
Complete Maternal & Pediatric Nursing Bundle!!!Accurately
Answers and Verified Questions.
NUR 254 Exam 1 – Maternal Nursing: Antepartum & Intrapartum
1. A nurse is teaching a primigravida about physiological changes in pregnancy. Which
finding is considered normal?
A) Decreased respiratory rate
B) Blurred vision with headaches
C) Increased heart rate by 10–15 bpm
D) Decreased platelet count below 100,000
Answer: C – Increased heart rate by 10–15 bpm
Rationale: Cardiac output increases, leading to a mild tachycardia. Blurred vision + headache
suggests preeclampsia. Platelets <100,000 is abnormal.
2. A client at 38 weeks gestation reports a sudden gush of fluid from the vagina. The nurse
notes the fluid is green-tinged. What action is priority?
A) Assess fetal heart rate
B) Perform a Nitrazine test
C) Prepare for immediate cesarean
D) Administer oxygen to the mother
Answer: A – Assess fetal heart rate
Rationale: Green fluid indicates meconium, which can cause meconium aspiration
syndrome. Priority is fetal assessment.
,3. A nurse is caring for a patient with placenta previa. Which finding requires immediate
intervention?
A) Painless bright red vaginal bleeding
B) Intermittent contractions every 10 minutes
C) Fetal heart rate of 150 bpm
D) Cervical dilation of 2 cm
Answer: A – Painless bright red vaginal bleeding
Rationale: This is the hallmark sign of placenta previa; it can become life-threatening rapidly.
4. A patient in active labor requests an epidural. Which lab value must the nurse check
before placement?
A) Hemoglobin
B) Platelet count
C) Blood glucose
D) White blood cell count
Answer: B – Platelet count
Rationale: Low platelets increase the risk of epidural hematoma. Typically need >70,000–
100,000.
5. A nurse administers misoprostol (Cytotec) for cervical ripening. The patient now has a
single contraction lasting 3 minutes. What is the priority action?
A) Apply oxygen via face mask
B) Administer terbutaline
C) Notify the provider immediately
D) Reposition the patient on her left side
Answer: C – Notify the provider immediately
Rationale: Contraction lasting >90 seconds suggests tachysystole with risk of uterine rupture.
6. A G2P1 patient at 40 weeks has rupture of membranes with clear fluid. FHR is 140 with
moderate variability. The nurse notes a prolapsed cord on speculum exam. What is the
first action?
A) Push the presenting part off the cord
B) Place patient in Trendelenburg position
C) Administer tocolytics
, D) Start an IV of lactated Ringer’s
Answer: A – Push the presenting part off the cord
Rationale: Relieves cord compression. Then reposition, call for help, prepare for cesarean.
7. A nurse is assessing a patient with hyperemesis gravidarum. Which finding indicates
severe dehydration?
A) Ketones in urine
B) Dry mucous membranes
C) Orthostatic hypotension
D) Urine specific gravity >1.030
Answer: D – Urine specific gravity >1.030
Rationale: Concentrated urine indicates significant dehydration.
8. A patient with gestational diabetes is at 34 weeks. Which finding suggests poor glycemic
control affecting the fetus?
A) Polyhydramnios
B) Intrauterine growth restriction
C) Oligohydramnios
D) Microcephaly
Answer: A – Polyhydramnios
Rationale: Fetal hyperglycemia causes polyuria → polyhydramnios.
9. A nurse is assessing a patient’s Leopold maneuvers. Step 3 identifies the breech
presentation. Where is the head felt?
A) Fundus
B) Lower uterine segment
C) Right lateral
D) Left lateral
Answer: A – Fundus
Rationale: In breech, the head is at the fundus (hard, round, movable).
10. A patient in active labor requests pain medication. The nurse reviews her prenatal
record. Which condition would contraindicate an epidural?
A) Gestational hypertension
