NUR 254 Exams 1-4 Galen College Maternal
Pediatric Nursing Bundle ACTUAL EXAM
2026/2027 | Galen NUR 254 | Verified Q&A |
Pass Guaranteed - A+ Graded
EXAM 1 — Antepartum Nursing
30 Questions | Prenatal Care, Fetal Development, & Complications
Q1: A 28-year-old G1P0 at 10 weeks gestation presents for her first prenatal visit. She reports nausea
and breast tenderness. Which hormone is primarily responsible for maintaining the corpus luteum and
progesterone production during early pregnancy?
A. Estrogen
B. Human chorionic gonadotropin (hCG). [CORRECT]
C. Prolactin
D. Oxytocin
Correct Answer: B
Rationale: hCG is produced by the syncytiotrophoblast after implantation and maintains the corpus
luteum, which continues progesterone production until the placenta takes over at approximately 10–12
weeks. Estrogen supports pregnancy but does not maintain the corpus luteum. Prolactin prepares
breasts for lactation. Oxytocin stimulates uterine contractions during labor. (Wong's Essentials of
Pediatric Nursing, p. 284)
Q2: A pregnant patient at 16 weeks asks the nurse when she should expect to feel fetal movement.
What is the most accurate response?
A. "You should have already felt movement by now."
B. "Most first-time mothers feel movement between 18 and 20 weeks." [CORRECT]
C. "Fetal movement is not felt until 24 weeks."
D. "You will feel movement at 12 weeks."
,Correct Answer: B
Rationale: Quickening (maternal perception of fetal movement) typically occurs between 18–20 weeks
for primigravidas and 16–18 weeks for multigravidas. First-time mothers often mistake early flutters for
gas. Stating movement should already be felt causes unnecessary anxiety, while 12 weeks and 24 weeks
are outside the normal range. (Silvestri, Saunders Comprehensive Review for the NCLEX-RN Examination)
Q3: A 32-year-old G2P1 at 28 weeks gestation has a fundal height measurement of 26 cm. Which action
should the nurse take first?
A. Schedule an immediate ultrasound
B. Recheck the measurement using proper technique and assess fetal position. [CORRECT]
C. Document as normal variation and recheck at next visit
D. Notify the provider of intrauterine growth restriction
Correct Answer: B
Rationale: Fundal height should approximate gestational age in weeks between 20–36 weeks (±2 cm). A
2-cm discrepancy may result from incorrect technique, fetal position (breech), maternal obesity, or
amniotic fluid variation. The nurse must first verify measurement accuracy before escalating to
diagnostic testing. Immediate IUGR diagnosis or dismissal as normal without reassessment are
inappropriate. (AWHONN Guidelines)
Q4: A pregnant patient at 24 weeks has a fasting blood glucose of 142 mg/dL on her 75-g oral glucose
tolerance test. What is the correct interpretation?
A. Normal glucose tolerance
B. Gestational diabetes mellitus. [CORRECT]
C. Type 2 diabetes mellitus
D. Impaired glucose tolerance requiring repeat testing
Correct Answer: B
Rationale: A fasting glucose ≥92 mg/dL on the 75-g OGTT meets diagnostic criteria for gestational
diabetes mellitus (GDM) per the IADPSG/ADA criteria. Normal fasting is <92 mg/dL. Type 2 diabetes
would require testing outside pregnancy or more severe values. No repeat testing is needed once GDM
criteria are met. (ACOG Practice Bulletin No. 190)
Q5: A 19-year-old G1P0 at 32 weeks presents with blood pressure 158/96 mmHg, proteinuria 2+ on
dipstick, and severe headache. Which finding indicates progression to severe preeclampsia?
,A. Blood pressure 140/90 mmHg
B. Proteinuria 1+
C. Thrombocytopenia (platelets 85,000/µL). [CORRECT]
D. Mild ankle edema
Correct Answer: C
Rationale: Severe preeclampsia is diagnosed by any of the following: systolic BP ≥160 or diastolic ≥110
on two occasions, thrombocytopenia (<100,000/µL), impaired liver function, renal insufficiency (Cr >1.1
mg/dL), pulmonary edema, or new-onset cerebral/visual symptoms. Thrombocytopenia is a severe
feature. Mild BP elevation, 1+ proteinuria, and ankle edema are nonspecific or mild features. (ACOG
Task Force on Hypertension in Pregnancy)
Q6: A patient at 8 weeks gestation reports she has been taking isotretinoin for acne. What is the nurse's
priority action?
A. Reassure the patient that topical retinoids are safe
B. Instruct her to stop isotretinoin immediately and notify the provider due to teratogenicity. [CORRECT]
C. Document the medication and continue prenatal care
D. Schedule genetic counseling for next trimester
Correct Answer: B
Rationale: Isotretinoin is a known teratogen causing severe craniofacial, cardiac, and CNS
malformations. It is absolutely contraindicated in pregnancy. The nurse must instruct immediate
discontinuation and urgent provider notification for risk assessment and counseling. Reassurance is
dangerous, and delayed action increases teratogenic exposure. (Briggs, Drugs in Pregnancy and
Lactation)
Q7: A pregnant patient at 18 weeks asks about safe exercise during pregnancy. Which activity should the
nurse advise her to avoid?
A. Swimming
B. Walking
C. Hot yoga or sauna use. [CORRECT]
D. Prenatal yoga in a climate-controlled room
Correct Answer: C
Rationale: Hot yoga and sauna use should be avoided during pregnancy because hyperthermia in the
first trimester increases neural tube defect risk, and in later pregnancy, excessive heat exposure can
cause dehydration, hypotension, and reduced uterine blood flow. Swimming, walking, and climate-
controlled prenatal yoga are safe, low-impact exercises that support cardiovascular health and reduce
pregnancy discomfort. (ACOG Committee Opinion No. 804)
, Q8: A G3P2 at 34 weeks presents with painless bright red vaginal bleeding. She denies contractions and
reports fetal movement. Vital signs are stable. Which diagnosis is most likely?
A. Placental abruption
B. Placenta previa. [CORRECT]
C. Preterm labor
D. Cervical laceration
Correct Answer: B
Rationale: Painless, bright red bleeding in the third trimester is the classic presentation of placenta
previa (placenta covering or adjacent to the internal cervical os). Placental abruption typically presents
with painful bleeding and uterine tenderness. Preterm labor involves regular contractions. Cervical
laceration is unrelated to pregnancy and would not cause third-trimester bleeding. Digital vaginal exam
is contraindicated until previa is ruled out by ultrasound. (AWHONN, High-Risk & Critical Care Obstetrics)
Q9: A patient at 12 weeks gestation has a rubella titer of <8 IU/mL (nonimmune). What is the
appropriate nursing action?
A. Administer rubella vaccine immediately
B. Counsel about avoiding exposure and vaccinate postpartum. [CORRECT]
C. Reassure the patient that rubella is no longer a concern
D. Order repeat titers in the third trimester
Correct Answer: B
Rationale: Live attenuated vaccines including MMR are contraindicated during pregnancy due to
theoretical teratogenic risk. Nonimmune pregnant patients must be counseled to avoid exposure to
rubella, and vaccination should be administered immediately postpartum before discharge. Immediate
vaccination during pregnancy is contraindicated, and rubella remains a significant teratogen causing
congenital rubella syndrome. (CDC Guidelines for Vaccinating Pregnant Women)
Q10: A 35-year-old G2P1 at 20 weeks asks about prenatal screening for chromosomal abnormalities.
Which test is most appropriate at this gestational age?
A. First-trimester combined screening (nuchal translucency + PAPP-A + hCG)
B. Cell-free DNA testing
C. Quad screen (AFP, hCG, estriol, inhibin A). [CORRECT]
D. Amniocentesis without screening
Pediatric Nursing Bundle ACTUAL EXAM
2026/2027 | Galen NUR 254 | Verified Q&A |
Pass Guaranteed - A+ Graded
EXAM 1 — Antepartum Nursing
30 Questions | Prenatal Care, Fetal Development, & Complications
Q1: A 28-year-old G1P0 at 10 weeks gestation presents for her first prenatal visit. She reports nausea
and breast tenderness. Which hormone is primarily responsible for maintaining the corpus luteum and
progesterone production during early pregnancy?
A. Estrogen
B. Human chorionic gonadotropin (hCG). [CORRECT]
C. Prolactin
D. Oxytocin
Correct Answer: B
Rationale: hCG is produced by the syncytiotrophoblast after implantation and maintains the corpus
luteum, which continues progesterone production until the placenta takes over at approximately 10–12
weeks. Estrogen supports pregnancy but does not maintain the corpus luteum. Prolactin prepares
breasts for lactation. Oxytocin stimulates uterine contractions during labor. (Wong's Essentials of
Pediatric Nursing, p. 284)
Q2: A pregnant patient at 16 weeks asks the nurse when she should expect to feel fetal movement.
What is the most accurate response?
A. "You should have already felt movement by now."
B. "Most first-time mothers feel movement between 18 and 20 weeks." [CORRECT]
C. "Fetal movement is not felt until 24 weeks."
D. "You will feel movement at 12 weeks."
,Correct Answer: B
Rationale: Quickening (maternal perception of fetal movement) typically occurs between 18–20 weeks
for primigravidas and 16–18 weeks for multigravidas. First-time mothers often mistake early flutters for
gas. Stating movement should already be felt causes unnecessary anxiety, while 12 weeks and 24 weeks
are outside the normal range. (Silvestri, Saunders Comprehensive Review for the NCLEX-RN Examination)
Q3: A 32-year-old G2P1 at 28 weeks gestation has a fundal height measurement of 26 cm. Which action
should the nurse take first?
A. Schedule an immediate ultrasound
B. Recheck the measurement using proper technique and assess fetal position. [CORRECT]
C. Document as normal variation and recheck at next visit
D. Notify the provider of intrauterine growth restriction
Correct Answer: B
Rationale: Fundal height should approximate gestational age in weeks between 20–36 weeks (±2 cm). A
2-cm discrepancy may result from incorrect technique, fetal position (breech), maternal obesity, or
amniotic fluid variation. The nurse must first verify measurement accuracy before escalating to
diagnostic testing. Immediate IUGR diagnosis or dismissal as normal without reassessment are
inappropriate. (AWHONN Guidelines)
Q4: A pregnant patient at 24 weeks has a fasting blood glucose of 142 mg/dL on her 75-g oral glucose
tolerance test. What is the correct interpretation?
A. Normal glucose tolerance
B. Gestational diabetes mellitus. [CORRECT]
C. Type 2 diabetes mellitus
D. Impaired glucose tolerance requiring repeat testing
Correct Answer: B
Rationale: A fasting glucose ≥92 mg/dL on the 75-g OGTT meets diagnostic criteria for gestational
diabetes mellitus (GDM) per the IADPSG/ADA criteria. Normal fasting is <92 mg/dL. Type 2 diabetes
would require testing outside pregnancy or more severe values. No repeat testing is needed once GDM
criteria are met. (ACOG Practice Bulletin No. 190)
Q5: A 19-year-old G1P0 at 32 weeks presents with blood pressure 158/96 mmHg, proteinuria 2+ on
dipstick, and severe headache. Which finding indicates progression to severe preeclampsia?
,A. Blood pressure 140/90 mmHg
B. Proteinuria 1+
C. Thrombocytopenia (platelets 85,000/µL). [CORRECT]
D. Mild ankle edema
Correct Answer: C
Rationale: Severe preeclampsia is diagnosed by any of the following: systolic BP ≥160 or diastolic ≥110
on two occasions, thrombocytopenia (<100,000/µL), impaired liver function, renal insufficiency (Cr >1.1
mg/dL), pulmonary edema, or new-onset cerebral/visual symptoms. Thrombocytopenia is a severe
feature. Mild BP elevation, 1+ proteinuria, and ankle edema are nonspecific or mild features. (ACOG
Task Force on Hypertension in Pregnancy)
Q6: A patient at 8 weeks gestation reports she has been taking isotretinoin for acne. What is the nurse's
priority action?
A. Reassure the patient that topical retinoids are safe
B. Instruct her to stop isotretinoin immediately and notify the provider due to teratogenicity. [CORRECT]
C. Document the medication and continue prenatal care
D. Schedule genetic counseling for next trimester
Correct Answer: B
Rationale: Isotretinoin is a known teratogen causing severe craniofacial, cardiac, and CNS
malformations. It is absolutely contraindicated in pregnancy. The nurse must instruct immediate
discontinuation and urgent provider notification for risk assessment and counseling. Reassurance is
dangerous, and delayed action increases teratogenic exposure. (Briggs, Drugs in Pregnancy and
Lactation)
Q7: A pregnant patient at 18 weeks asks about safe exercise during pregnancy. Which activity should the
nurse advise her to avoid?
A. Swimming
B. Walking
C. Hot yoga or sauna use. [CORRECT]
D. Prenatal yoga in a climate-controlled room
Correct Answer: C
Rationale: Hot yoga and sauna use should be avoided during pregnancy because hyperthermia in the
first trimester increases neural tube defect risk, and in later pregnancy, excessive heat exposure can
cause dehydration, hypotension, and reduced uterine blood flow. Swimming, walking, and climate-
controlled prenatal yoga are safe, low-impact exercises that support cardiovascular health and reduce
pregnancy discomfort. (ACOG Committee Opinion No. 804)
, Q8: A G3P2 at 34 weeks presents with painless bright red vaginal bleeding. She denies contractions and
reports fetal movement. Vital signs are stable. Which diagnosis is most likely?
A. Placental abruption
B. Placenta previa. [CORRECT]
C. Preterm labor
D. Cervical laceration
Correct Answer: B
Rationale: Painless, bright red bleeding in the third trimester is the classic presentation of placenta
previa (placenta covering or adjacent to the internal cervical os). Placental abruption typically presents
with painful bleeding and uterine tenderness. Preterm labor involves regular contractions. Cervical
laceration is unrelated to pregnancy and would not cause third-trimester bleeding. Digital vaginal exam
is contraindicated until previa is ruled out by ultrasound. (AWHONN, High-Risk & Critical Care Obstetrics)
Q9: A patient at 12 weeks gestation has a rubella titer of <8 IU/mL (nonimmune). What is the
appropriate nursing action?
A. Administer rubella vaccine immediately
B. Counsel about avoiding exposure and vaccinate postpartum. [CORRECT]
C. Reassure the patient that rubella is no longer a concern
D. Order repeat titers in the third trimester
Correct Answer: B
Rationale: Live attenuated vaccines including MMR are contraindicated during pregnancy due to
theoretical teratogenic risk. Nonimmune pregnant patients must be counseled to avoid exposure to
rubella, and vaccination should be administered immediately postpartum before discharge. Immediate
vaccination during pregnancy is contraindicated, and rubella remains a significant teratogen causing
congenital rubella syndrome. (CDC Guidelines for Vaccinating Pregnant Women)
Q10: A 35-year-old G2P1 at 20 weeks asks about prenatal screening for chromosomal abnormalities.
Which test is most appropriate at this gestational age?
A. First-trimester combined screening (nuchal translucency + PAPP-A + hCG)
B. Cell-free DNA testing
C. Quad screen (AFP, hCG, estriol, inhibin A). [CORRECT]
D. Amniocentesis without screening
