NUR 254 Exams 1 - 4 | Galen College | (2026/2027)
Complete Maternal & Pediatric Nursing Bundle
EXAM 1: Foundations of Maternal Nursing & Pregnancy
---
Question 1
A pregnant patient's last normal menstrual period (LNMP) began on May 4th. Using Naegele’s
rule, what is the estimated date of delivery (EDD)?
A) February 1st
B) February 11th
C) January 28th
D) February 18th
**Answer: B** — Naegele’s rule: Subtract 3 months from the first day of the LNMP and add 7
days (and add 1 year if crossing the year boundary). May 4 minus 3 months = February 4.
February 4 plus 7 days = February 11.
---
Question 2
,A nurse is assessing a pregnant patient at 12 weeks gestation. Which of the following is a
presumptive (possible) sign of pregnancy?
A) Chadwick's sign
B) Positive pregnancy test
C) Hegar's sign
D) Breast tenderness and fatigue
**Answer: D** — Presumptive signs are those felt by the patient (amenorrhea, nausea,
fatigue, breast tenderness). Probable signs are those observed by the examiner (Chadwick's
sign, Hegar's sign, positive pregnancy test). Positive signs are absolute proof of pregnancy
(fetal heartbeat on ultrasound, fetal movement).
---
Question 3
A pregnant patient asks the nurse, "When will I start to feel the baby move?" The nurse knows
that quickening (fetal movement) is typically felt by a primigravida at:
A) 12–14 weeks
B) 16–20 weeks
C) 24–26 weeks
D) 28–30 weeks
**Answer: B** — Quickening is typically felt by a primigravida at 16–20 weeks. A multigravida
may feel it earlier, around 14–16 weeks, because they recognize the sensation.
---
Question 4
Which hormone is responsible for maintaining the corpus luteum during early pregnancy and
is the hormone detected in pregnancy tests?
A) Progesterone
,B) Estrogen
C) Human chorionic gonadotropin (hCG)
D) Relaxin
**Answer: C** — hCG is produced by the chorionic villi and maintains the corpus luteum so it
continues to produce progesterone and estrogen until the placenta takes over at around 10–12
weeks.
---
Question 5
A nurse is teaching a pregnant patient about nutritional needs. Which statement by the patient
indicates a need for further teaching?
A) "I need to increase my folic acid intake to prevent neural tube defects."
B) "I should increase my iron intake because my blood volume is expanding."
C) "I need to consume an extra 500 calories a day in my first trimester."
D) "I should avoid raw fish and unpasteurized cheeses."
**Answer: C** — Caloric needs do not increase during the first trimester. The
recommendation is an additional 300 calories per day during the second and third trimesters.
Folic acid, iron, and avoiding raw/unpasteurized foods are correct.
---
Question 6
A patient at 24 weeks gestation has a hemoglobin level of 10.5 g/dL. The nurse recognizes this
as:
A) Iron deficiency anemia requiring immediate blood transfusion
B) Physiologic anemia of pregnancy
C) A normal hemoglobin level for a pregnant woman
, D) Sickle cell crisis
**Answer: B** — Physiologic (dilutional) anemia of pregnancy occurs because plasma
volume expands more rapidly than red blood cell mass (up to 50% vs. 30%). Hemoglobin levels
normally drop to around 10.5–11.0 g/dL in the second trimester.
---
Question 7
A pregnant patient has darkening of the line from the umbilicus to the pubic area. The nurse
documents this as:
A) Striae gravidarum
B) Linea nigra
C) Chloasma
D) Epulis
**Answer: B** — Linea nigra is a dark, vertical line on the abdomen. Striae gravidarum are
stretch marks. Chloasma is the "mask of pregnancy" (darkening of the face). Epulis is a benign
gingival tumor.
---
Question 8
The nurse is assessing fetal heart rate (FHR) using a Doppler. At 10 weeks gestation, the
expected FHR is:
A) 80–100 bpm
B) 110–160 bpm
C) 160–180 bpm
D) 120–140 bpm
Complete Maternal & Pediatric Nursing Bundle
EXAM 1: Foundations of Maternal Nursing & Pregnancy
---
Question 1
A pregnant patient's last normal menstrual period (LNMP) began on May 4th. Using Naegele’s
rule, what is the estimated date of delivery (EDD)?
A) February 1st
B) February 11th
C) January 28th
D) February 18th
**Answer: B** — Naegele’s rule: Subtract 3 months from the first day of the LNMP and add 7
days (and add 1 year if crossing the year boundary). May 4 minus 3 months = February 4.
February 4 plus 7 days = February 11.
---
Question 2
,A nurse is assessing a pregnant patient at 12 weeks gestation. Which of the following is a
presumptive (possible) sign of pregnancy?
A) Chadwick's sign
B) Positive pregnancy test
C) Hegar's sign
D) Breast tenderness and fatigue
**Answer: D** — Presumptive signs are those felt by the patient (amenorrhea, nausea,
fatigue, breast tenderness). Probable signs are those observed by the examiner (Chadwick's
sign, Hegar's sign, positive pregnancy test). Positive signs are absolute proof of pregnancy
(fetal heartbeat on ultrasound, fetal movement).
---
Question 3
A pregnant patient asks the nurse, "When will I start to feel the baby move?" The nurse knows
that quickening (fetal movement) is typically felt by a primigravida at:
A) 12–14 weeks
B) 16–20 weeks
C) 24–26 weeks
D) 28–30 weeks
**Answer: B** — Quickening is typically felt by a primigravida at 16–20 weeks. A multigravida
may feel it earlier, around 14–16 weeks, because they recognize the sensation.
---
Question 4
Which hormone is responsible for maintaining the corpus luteum during early pregnancy and
is the hormone detected in pregnancy tests?
A) Progesterone
,B) Estrogen
C) Human chorionic gonadotropin (hCG)
D) Relaxin
**Answer: C** — hCG is produced by the chorionic villi and maintains the corpus luteum so it
continues to produce progesterone and estrogen until the placenta takes over at around 10–12
weeks.
---
Question 5
A nurse is teaching a pregnant patient about nutritional needs. Which statement by the patient
indicates a need for further teaching?
A) "I need to increase my folic acid intake to prevent neural tube defects."
B) "I should increase my iron intake because my blood volume is expanding."
C) "I need to consume an extra 500 calories a day in my first trimester."
D) "I should avoid raw fish and unpasteurized cheeses."
**Answer: C** — Caloric needs do not increase during the first trimester. The
recommendation is an additional 300 calories per day during the second and third trimesters.
Folic acid, iron, and avoiding raw/unpasteurized foods are correct.
---
Question 6
A patient at 24 weeks gestation has a hemoglobin level of 10.5 g/dL. The nurse recognizes this
as:
A) Iron deficiency anemia requiring immediate blood transfusion
B) Physiologic anemia of pregnancy
C) A normal hemoglobin level for a pregnant woman
, D) Sickle cell crisis
**Answer: B** — Physiologic (dilutional) anemia of pregnancy occurs because plasma
volume expands more rapidly than red blood cell mass (up to 50% vs. 30%). Hemoglobin levels
normally drop to around 10.5–11.0 g/dL in the second trimester.
---
Question 7
A pregnant patient has darkening of the line from the umbilicus to the pubic area. The nurse
documents this as:
A) Striae gravidarum
B) Linea nigra
C) Chloasma
D) Epulis
**Answer: B** — Linea nigra is a dark, vertical line on the abdomen. Striae gravidarum are
stretch marks. Chloasma is the "mask of pregnancy" (darkening of the face). Epulis is a benign
gingival tumor.
---
Question 8
The nurse is assessing fetal heart rate (FHR) using a Doppler. At 10 weeks gestation, the
expected FHR is:
A) 80–100 bpm
B) 110–160 bpm
C) 160–180 bpm
D) 120–140 bpm
