NUR 254 Exams 1 - 4 Actual Exam
2026/2027 | Galen College |
Complete Maternal & Pediatric
Nursing Bundle | Questions &
Answers | Pass Guaranteed - A+
Graded
EXAM 1 – Maternal Nursing: Antepartum & Intrapartum
Section A: Antepartum Care & Fetal Development
Q1: A nurse is providing prenatal education to a client who is 10 weeks pregnant. The
client asks about the purpose of taking folic acid supplements. Which response by the
nurse is best?
A. "It helps maintain your energy levels during the first trimester."
B. "It promotes the development of the baby's neural tube and prevents spinal defects."
[CORRECT]
C. "It assists with the absorption of calcium to build strong bones."
D. "It prevents iron-deficiency anemia which is common in early pregnancy."
Correct Answer: B
Rationale: Folic acid is crucial in the first trimester for neural tube formation (brain and
spinal cord); it helps prevent defects like spina bifida, making this the best answer, while
other options describe functions of different nutrients.
Q2: During a prenatal visit, a client at 28 weeks gestation reports occasional
lightheadedness when lying on her back. What teaching should the nurse provide to
address this discomfort?
A. "Limit your fluid intake to reduce blood pressure."
B. "Sleep on your left side to avoid compression of the vena cava." [CORRECT]
C. "Elevate your legs above heart level when lying down."
D. "Increase your intake of salty foods to boost blood volume."
Correct Answer: B
,Rationale: Lying supine can compress the vena cava by the gravid uterus, reducing
cardiac return and causing hypotension (supine hypotensive syndrome); left lateral
positioning relieves this pressure.
Q3: A nurse is calculating a client's expected date of birth (EDB) using Naegele’s rule.
The client reports her last menstrual period (LMP) started on January 3. What is the
estimated date of birth?
A. October 3
B. October 10
C. October 17
D. October 24
Correct Answer: B
Rationale: Using Naegele’s rule (LMP + 7 days - 3 months + 1 year), January 3 plus 7
days is January 10; subtracting 3 months gives October 10 of the following year.
Q4: A pregnant client at 24 weeks gestation asks about safe exercises. Which activity
should the nurse recommend?
A. Hot yoga
B. Snow skiing
C. Swimming [CORRECT]
D. Horseback riding
Correct Answer: C
Rationale: Swimming is a safe, low-impact exercise during pregnancy that relieves joint
pressure and prevents overheating, while contact sports and activities with high fall risks
or heat exposure are contraindicated.
Q5: The nurse is assessing a client who is 32 weeks pregnant and notes her blood
pressure is 135/85 mmHg. She states this is slightly higher than her baseline. What is
the nurse's priority action?
A. Prepare the client for immediate delivery.
B. Administer a dose of magnesium sulfate.
C. Assess for proteinuria and other signs of preeclampsia. [CORRECT]
D. Instruct the client to reduce her sodium intake strictly.
Correct Answer: C
Rationale: A blood pressure of 135/85 is elevated in pregnancy; the nurse must assess
for preeclampsia by checking for protein in the urine and other symptoms (headache,
visual changes) rather than jumping to treatment or discharge.
Q6: A client at 14 weeks gestation complains of nausea and vomiting ("morning
sickness"). Which dietary modification should the nurse suggest?
A. Drink a glass of milk with meals to coat the stomach.
,B. Eat dry, bland foods like crackers before getting out of bed. [CORRECT]
C. Skip breakfast to allow the stomach to rest.
D. Increase intake of citrus juices to stimulate digestion.
Correct Answer: B
Rationale: Eating dry, bland carbohydrates like crackers before rising in the morning
helps settle the stomach and absorb gastric acid, which is a standard intervention for
nausea.
Q7: A nurse is teaching a client about Rh immunoglobulin (RhoGam). When should the
client expect to receive this injection?
A. At 28 weeks and again within 72 hours after delivery if the baby is Rh-positive.
[CORRECT]
B. Only if the client experiences significant bleeding during pregnancy.
C. Immediately after the first prenatal visit regardless of blood type.
D. During the third trimester only if the father is Rh-negative.
Correct Answer: A
Rationale: Standard protocol for Rh-negative mothers is RhoGam at 28 weeks to
prevent sensitization and again within 72 hours postpartum if the infant is Rh-positive or
if the status is unknown.
Q8: During a prenatal visit, a client asks how the doctor can tell if the baby is growing
adequately. What is the best method the nurse should explain?
A. Measuring the client's fundal height at each visit. [CORRECT]
B. Monitoring the client's weight gain every week.
C. Listening to the fetal heart rate with a Doppler.
D. Assessing the client's appetite and energy level.
Correct Answer: A
Rationale: Fundal height measurement in centimeters generally corresponds to weeks
of gestation after 20 weeks and is the primary screening tool for fetal growth.
Q9: A client at 12 weeks gestation is concerned about darkening of the skin on her face
(melasma). What is the nurse's best response?
A. "This is a permanent change caused by hormonal shifts."
B. "You should avoid the sun and use sunscreen to prevent worsening." [CORRECT]
C. "This indicates a deficiency in Vitamin D that needs supplementation."
D. "It is usually a sign of liver dysfunction in pregnancy."
Correct Answer: B
Rationale: Melasma (chloasma) or "mask of pregnancy" is a common hormonal change;
while it fades postpartum, sun exposure worsens it, so sunscreen is the correct advice,
not alarming the client about permanent damage or liver failure.
, Q10: A nurse is performing a non-stress test (NST) on a client at 34 weeks. The results
show two accelerations of the fetal heart rate of 15 bpm lasting 20 seconds in a
20-minute period. How should the nurse document this result?
A. Non-reassuring
B. Reactive [CORRECT]
C. Negative
D. Positive
Correct Answer: B
Rationale: A reactive NST requires at least two accelerations of 15 bpm for at least 15
seconds (or 20 minutes depending on gestational age) within 20 minutes; this indicates
fetal well-being.
Q11: A client asks about the potential effects of smoking during pregnancy. Which
statement by the nurse is most accurate?
A. "Smoking primarily causes low birth weight and preterm labor." [CORRECT]
B. "It usually leads to macrosomia and larger than average babies."
C. "The effects are minimal if you cut down after the first trimester."
D. "It only affects the mother's lungs, not the placenta."
Correct Answer: A
Rationale: Smoking is a major risk factor for intrauterine growth restriction (low birth
weight), preterm birth, and placental issues, making this the priority teaching point over
incorrect minimization of risks.
Q12: A client at 28 weeks gestation reports feeling Braxton Hicks contractions. How
should the nurse differentiate these from true labor?
A. Braxton Hicks contractions are felt in the lower back and increase with activity.
B. Braxton Hicks contractions are irregular and stop with rest or hydration. [CORRECT]
C. Braxton Hicks contractions cause cervical dilation and effacement.
D. Braxton Hicks contractions become progressively more painful and frequent.
Correct Answer: B
Rationale: Braxton Hicks contractions are often described as "practice" contractions that
are irregular, infrequent, and typically resolve with comfort measures like rest or
hydration, unlike true labor which is regular and progressive.
Q13: A nurse is collecting data on a client with a history of heroin use who is pregnant.
The client states she has stopped using. For which complication is this client at highest
risk immediately after birth?
A. Postpartum hemorrhage
B. Neonatal abstinence syndrome (NAS) [CORRECT]
C. Hyperbilirubinemia
D. Postpartum depression
2026/2027 | Galen College |
Complete Maternal & Pediatric
Nursing Bundle | Questions &
Answers | Pass Guaranteed - A+
Graded
EXAM 1 – Maternal Nursing: Antepartum & Intrapartum
Section A: Antepartum Care & Fetal Development
Q1: A nurse is providing prenatal education to a client who is 10 weeks pregnant. The
client asks about the purpose of taking folic acid supplements. Which response by the
nurse is best?
A. "It helps maintain your energy levels during the first trimester."
B. "It promotes the development of the baby's neural tube and prevents spinal defects."
[CORRECT]
C. "It assists with the absorption of calcium to build strong bones."
D. "It prevents iron-deficiency anemia which is common in early pregnancy."
Correct Answer: B
Rationale: Folic acid is crucial in the first trimester for neural tube formation (brain and
spinal cord); it helps prevent defects like spina bifida, making this the best answer, while
other options describe functions of different nutrients.
Q2: During a prenatal visit, a client at 28 weeks gestation reports occasional
lightheadedness when lying on her back. What teaching should the nurse provide to
address this discomfort?
A. "Limit your fluid intake to reduce blood pressure."
B. "Sleep on your left side to avoid compression of the vena cava." [CORRECT]
C. "Elevate your legs above heart level when lying down."
D. "Increase your intake of salty foods to boost blood volume."
Correct Answer: B
,Rationale: Lying supine can compress the vena cava by the gravid uterus, reducing
cardiac return and causing hypotension (supine hypotensive syndrome); left lateral
positioning relieves this pressure.
Q3: A nurse is calculating a client's expected date of birth (EDB) using Naegele’s rule.
The client reports her last menstrual period (LMP) started on January 3. What is the
estimated date of birth?
A. October 3
B. October 10
C. October 17
D. October 24
Correct Answer: B
Rationale: Using Naegele’s rule (LMP + 7 days - 3 months + 1 year), January 3 plus 7
days is January 10; subtracting 3 months gives October 10 of the following year.
Q4: A pregnant client at 24 weeks gestation asks about safe exercises. Which activity
should the nurse recommend?
A. Hot yoga
B. Snow skiing
C. Swimming [CORRECT]
D. Horseback riding
Correct Answer: C
Rationale: Swimming is a safe, low-impact exercise during pregnancy that relieves joint
pressure and prevents overheating, while contact sports and activities with high fall risks
or heat exposure are contraindicated.
Q5: The nurse is assessing a client who is 32 weeks pregnant and notes her blood
pressure is 135/85 mmHg. She states this is slightly higher than her baseline. What is
the nurse's priority action?
A. Prepare the client for immediate delivery.
B. Administer a dose of magnesium sulfate.
C. Assess for proteinuria and other signs of preeclampsia. [CORRECT]
D. Instruct the client to reduce her sodium intake strictly.
Correct Answer: C
Rationale: A blood pressure of 135/85 is elevated in pregnancy; the nurse must assess
for preeclampsia by checking for protein in the urine and other symptoms (headache,
visual changes) rather than jumping to treatment or discharge.
Q6: A client at 14 weeks gestation complains of nausea and vomiting ("morning
sickness"). Which dietary modification should the nurse suggest?
A. Drink a glass of milk with meals to coat the stomach.
,B. Eat dry, bland foods like crackers before getting out of bed. [CORRECT]
C. Skip breakfast to allow the stomach to rest.
D. Increase intake of citrus juices to stimulate digestion.
Correct Answer: B
Rationale: Eating dry, bland carbohydrates like crackers before rising in the morning
helps settle the stomach and absorb gastric acid, which is a standard intervention for
nausea.
Q7: A nurse is teaching a client about Rh immunoglobulin (RhoGam). When should the
client expect to receive this injection?
A. At 28 weeks and again within 72 hours after delivery if the baby is Rh-positive.
[CORRECT]
B. Only if the client experiences significant bleeding during pregnancy.
C. Immediately after the first prenatal visit regardless of blood type.
D. During the third trimester only if the father is Rh-negative.
Correct Answer: A
Rationale: Standard protocol for Rh-negative mothers is RhoGam at 28 weeks to
prevent sensitization and again within 72 hours postpartum if the infant is Rh-positive or
if the status is unknown.
Q8: During a prenatal visit, a client asks how the doctor can tell if the baby is growing
adequately. What is the best method the nurse should explain?
A. Measuring the client's fundal height at each visit. [CORRECT]
B. Monitoring the client's weight gain every week.
C. Listening to the fetal heart rate with a Doppler.
D. Assessing the client's appetite and energy level.
Correct Answer: A
Rationale: Fundal height measurement in centimeters generally corresponds to weeks
of gestation after 20 weeks and is the primary screening tool for fetal growth.
Q9: A client at 12 weeks gestation is concerned about darkening of the skin on her face
(melasma). What is the nurse's best response?
A. "This is a permanent change caused by hormonal shifts."
B. "You should avoid the sun and use sunscreen to prevent worsening." [CORRECT]
C. "This indicates a deficiency in Vitamin D that needs supplementation."
D. "It is usually a sign of liver dysfunction in pregnancy."
Correct Answer: B
Rationale: Melasma (chloasma) or "mask of pregnancy" is a common hormonal change;
while it fades postpartum, sun exposure worsens it, so sunscreen is the correct advice,
not alarming the client about permanent damage or liver failure.
, Q10: A nurse is performing a non-stress test (NST) on a client at 34 weeks. The results
show two accelerations of the fetal heart rate of 15 bpm lasting 20 seconds in a
20-minute period. How should the nurse document this result?
A. Non-reassuring
B. Reactive [CORRECT]
C. Negative
D. Positive
Correct Answer: B
Rationale: A reactive NST requires at least two accelerations of 15 bpm for at least 15
seconds (or 20 minutes depending on gestational age) within 20 minutes; this indicates
fetal well-being.
Q11: A client asks about the potential effects of smoking during pregnancy. Which
statement by the nurse is most accurate?
A. "Smoking primarily causes low birth weight and preterm labor." [CORRECT]
B. "It usually leads to macrosomia and larger than average babies."
C. "The effects are minimal if you cut down after the first trimester."
D. "It only affects the mother's lungs, not the placenta."
Correct Answer: A
Rationale: Smoking is a major risk factor for intrauterine growth restriction (low birth
weight), preterm birth, and placental issues, making this the priority teaching point over
incorrect minimization of risks.
Q12: A client at 28 weeks gestation reports feeling Braxton Hicks contractions. How
should the nurse differentiate these from true labor?
A. Braxton Hicks contractions are felt in the lower back and increase with activity.
B. Braxton Hicks contractions are irregular and stop with rest or hydration. [CORRECT]
C. Braxton Hicks contractions cause cervical dilation and effacement.
D. Braxton Hicks contractions become progressively more painful and frequent.
Correct Answer: B
Rationale: Braxton Hicks contractions are often described as "practice" contractions that
are irregular, infrequent, and typically resolve with comfort measures like rest or
hydration, unlike true labor which is regular and progressive.
Q13: A nurse is collecting data on a client with a history of heroin use who is pregnant.
The client states she has stopped using. For which complication is this client at highest
risk immediately after birth?
A. Postpartum hemorrhage
B. Neonatal abstinence syndrome (NAS) [CORRECT]
C. Hyperbilirubinemia
D. Postpartum depression
