NUR 254 MATERNAL & PEDIATRIC
NURSING Actual Exam 2026/2027
Complete Questions and Answers | 100%
Verified Detailed Rationales - Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Exam 1: Maternal Health: Antepartum and Intrapartum | Q1 – Q12
Section 2 | Exam 2: Postpartum and Newborn Care | Q13 – Q25
Section 3 | Exam 3: Pediatric Growth, Development, and Common Illnesses | Q26 – Q37
Section 4 | Exam 4: Pediatric Complex Conditions and Family-Centered Care | Q38 –
Q50
══════════════════════════════════════
SECTION 1: EXAM 1 — MATERNAL HEALTH: ANTEPARTUM AND INTRAPARTUM Q1 –
Q12
══════════════════════════════════════
Question 1 of 50
A 28-year-old primigravida at her first prenatal visit at 10 weeks gestation tells the nurse
she has been taking a prenatal vitamin but also continues her daily multivitamin with
5,000 IU of vitamin A. The nurse's priority teaching should focus on:
A. Encouraging the continuation of both vitamins to ensure adequate micronutrient
intake
B. Advising the client to stop the additional multivitamin due to teratogenic risk of
excessive vitamin A ✓ CORRECT
C. Recommending she switch to a children's multivitamin with lower doses
D. Suggesting she take the multivitamin every other day to reduce total intake
,Correct Answer: B
Rationale: Excessive vitamin A (retinol) intake exceeding 10,000 IU daily during
pregnancy is associated with teratogenic effects including craniofacial abnormalities
and central nervous system defects; prenatal vitamins already contain adequate vitamin
A, making additional supplementation unnecessary and potentially harmful. Option A is
dangerous because it fails to recognize the cumulative toxicity risk and could lead to
birth defects. The nurse should review all supplements and medications at the first
prenatal visit, emphasizing that more is not always better during pregnancy.
Question 2 of 50
A 32-year-old client at 28 weeks gestation presents to the obstetric clinic with a blood
pressure of 152/96 mmHg, 2+ proteinuria on dipstick, and reports of headache and
visual disturbances for the past 24 hours. The nurse recognizes these findings as most
consistent with:
A. Gestational hypertension, which resolves spontaneously after delivery without further
complications
B. Severe preeclampsia, requiring immediate assessment and possible delivery
planning ✓ CORRECT
C. Chronic hypertension with superimposed preeclampsia, which requires only blood
pressure monitoring
D. Mild preeclampsia, which can be managed with home blood pressure checks and
weekly visits
Correct Answer: B
Rationale: Severe preeclampsia is diagnosed when a client with new-onset hypertension
and proteinuria develops symptoms including headache, visual disturbances, or right
upper quadrant pain, indicating end-organ involvement and requiring immediate
intervention to prevent eclampsia. Option D is tempting because the blood pressure
elevation seems moderate, but the presence of neurological symptoms (headache,
visual changes) automatically classifies this as severe regardless of the exact pressure
,reading. The nurse should prepare for magnesium sulfate administration, seizure
precautions, and potential emergent delivery depending on gestational age and fetal
status.
Question 3 of 50
A nurse is caring for a client in active labor at 6 cm dilation. The fetal heart rate baseline
is 140 bpm with moderate variability and occasional early decelerations that return to
baseline within 30 seconds of each contraction. The nurse's most appropriate action is:
A. Reposition the client to her left side and apply oxygen at 10 L/min via face mask
B. Notify the provider immediately and prepare for an emergent cesarean delivery
C. Continue routine monitoring, as early decelerations are a normal response to head
compression ✓ CORRECT
D. Insert an intrauterine pressure catheter to assess for tachysystole
Correct Answer: C
Rationale: Early decelerations are benign, uniform decelerations that mirror the
contraction pattern and are caused by fetal head compression; they are reassuring and
require no intervention beyond continued monitoring. Option A is appropriate for late
decelerations or fetal bradycardia, not early decelerations, and unnecessary
interventions can disrupt the labor process. The nurse must distinguish between early,
variable, and late decelerations to provide appropriate care and avoid unnecessary
escalation that could lead to iatrogenic complications.
Question 4 of 50
A 24-year-old client at 34 weeks gestation is diagnosed with placenta previa after an
episode of painless bright red vaginal bleeding. The nurse prepares the client for
management that will include:
A. Immediate vaginal delivery to prevent ongoing hemorrhage
, B. Expectant management with bed rest, pelvic rest, and close monitoring if bleeding is
minimal and fetal status is reassuring ✓ CORRECT
C. Amniocentesis to assess fetal lung maturity followed by induction of labor
D. Routine vaginal examinations every 4 hours to assess cervical change
Correct Answer: B
Rationale: Placenta previa with minimal bleeding and stable maternal-fetal status is
managed expectantly to prolong gestation and improve fetal maturity; bed rest and
pelvic rest (no intercourse, no tampons, no vaginal exams) reduce bleeding risk. Option
A is contraindicated because vaginal delivery with placenta previa causes catastrophic
hemorrhage as the placenta tears away from the cervix during dilation. The nurse
should ensure no vaginal examinations are performed, monitor for recurrent bleeding,
and prepare for emergent cesarean delivery if bleeding becomes heavy or fetal
compromise occurs.
Question 5 of 50
A nurse is assessing a client at 38 weeks gestation who reports decreased fetal
movement over the past 24 hours. The nurse applies the external fetal monitor and
notes a nonreactive nonstress test with no accelerations in 40 minutes. The next step in
management should be:
A. Reassure the client that decreased movement is normal at term and send her home
B. Perform a biophysical profile or contraction stress test to further assess fetal
well-being ✓ CORRECT
C. Schedule a routine follow-up appointment in one week for repeat nonstress testing
D. Administer terbutaline to stimulate fetal movement and improve reactivity
Correct Answer: B
Rationale: A nonreactive nonstress test requires further evaluation with a biophysical
profile or contraction stress test to determine if fetal hypoxia is present, as decreased
movement combined with nonreactivity may indicate fetal compromise requiring
delivery. Option A is dangerous because decreased fetal movement at term is never
NURSING Actual Exam 2026/2027
Complete Questions and Answers | 100%
Verified Detailed Rationales - Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Exam 1: Maternal Health: Antepartum and Intrapartum | Q1 – Q12
Section 2 | Exam 2: Postpartum and Newborn Care | Q13 – Q25
Section 3 | Exam 3: Pediatric Growth, Development, and Common Illnesses | Q26 – Q37
Section 4 | Exam 4: Pediatric Complex Conditions and Family-Centered Care | Q38 –
Q50
══════════════════════════════════════
SECTION 1: EXAM 1 — MATERNAL HEALTH: ANTEPARTUM AND INTRAPARTUM Q1 –
Q12
══════════════════════════════════════
Question 1 of 50
A 28-year-old primigravida at her first prenatal visit at 10 weeks gestation tells the nurse
she has been taking a prenatal vitamin but also continues her daily multivitamin with
5,000 IU of vitamin A. The nurse's priority teaching should focus on:
A. Encouraging the continuation of both vitamins to ensure adequate micronutrient
intake
B. Advising the client to stop the additional multivitamin due to teratogenic risk of
excessive vitamin A ✓ CORRECT
C. Recommending she switch to a children's multivitamin with lower doses
D. Suggesting she take the multivitamin every other day to reduce total intake
,Correct Answer: B
Rationale: Excessive vitamin A (retinol) intake exceeding 10,000 IU daily during
pregnancy is associated with teratogenic effects including craniofacial abnormalities
and central nervous system defects; prenatal vitamins already contain adequate vitamin
A, making additional supplementation unnecessary and potentially harmful. Option A is
dangerous because it fails to recognize the cumulative toxicity risk and could lead to
birth defects. The nurse should review all supplements and medications at the first
prenatal visit, emphasizing that more is not always better during pregnancy.
Question 2 of 50
A 32-year-old client at 28 weeks gestation presents to the obstetric clinic with a blood
pressure of 152/96 mmHg, 2+ proteinuria on dipstick, and reports of headache and
visual disturbances for the past 24 hours. The nurse recognizes these findings as most
consistent with:
A. Gestational hypertension, which resolves spontaneously after delivery without further
complications
B. Severe preeclampsia, requiring immediate assessment and possible delivery
planning ✓ CORRECT
C. Chronic hypertension with superimposed preeclampsia, which requires only blood
pressure monitoring
D. Mild preeclampsia, which can be managed with home blood pressure checks and
weekly visits
Correct Answer: B
Rationale: Severe preeclampsia is diagnosed when a client with new-onset hypertension
and proteinuria develops symptoms including headache, visual disturbances, or right
upper quadrant pain, indicating end-organ involvement and requiring immediate
intervention to prevent eclampsia. Option D is tempting because the blood pressure
elevation seems moderate, but the presence of neurological symptoms (headache,
visual changes) automatically classifies this as severe regardless of the exact pressure
,reading. The nurse should prepare for magnesium sulfate administration, seizure
precautions, and potential emergent delivery depending on gestational age and fetal
status.
Question 3 of 50
A nurse is caring for a client in active labor at 6 cm dilation. The fetal heart rate baseline
is 140 bpm with moderate variability and occasional early decelerations that return to
baseline within 30 seconds of each contraction. The nurse's most appropriate action is:
A. Reposition the client to her left side and apply oxygen at 10 L/min via face mask
B. Notify the provider immediately and prepare for an emergent cesarean delivery
C. Continue routine monitoring, as early decelerations are a normal response to head
compression ✓ CORRECT
D. Insert an intrauterine pressure catheter to assess for tachysystole
Correct Answer: C
Rationale: Early decelerations are benign, uniform decelerations that mirror the
contraction pattern and are caused by fetal head compression; they are reassuring and
require no intervention beyond continued monitoring. Option A is appropriate for late
decelerations or fetal bradycardia, not early decelerations, and unnecessary
interventions can disrupt the labor process. The nurse must distinguish between early,
variable, and late decelerations to provide appropriate care and avoid unnecessary
escalation that could lead to iatrogenic complications.
Question 4 of 50
A 24-year-old client at 34 weeks gestation is diagnosed with placenta previa after an
episode of painless bright red vaginal bleeding. The nurse prepares the client for
management that will include:
A. Immediate vaginal delivery to prevent ongoing hemorrhage
, B. Expectant management with bed rest, pelvic rest, and close monitoring if bleeding is
minimal and fetal status is reassuring ✓ CORRECT
C. Amniocentesis to assess fetal lung maturity followed by induction of labor
D. Routine vaginal examinations every 4 hours to assess cervical change
Correct Answer: B
Rationale: Placenta previa with minimal bleeding and stable maternal-fetal status is
managed expectantly to prolong gestation and improve fetal maturity; bed rest and
pelvic rest (no intercourse, no tampons, no vaginal exams) reduce bleeding risk. Option
A is contraindicated because vaginal delivery with placenta previa causes catastrophic
hemorrhage as the placenta tears away from the cervix during dilation. The nurse
should ensure no vaginal examinations are performed, monitor for recurrent bleeding,
and prepare for emergent cesarean delivery if bleeding becomes heavy or fetal
compromise occurs.
Question 5 of 50
A nurse is assessing a client at 38 weeks gestation who reports decreased fetal
movement over the past 24 hours. The nurse applies the external fetal monitor and
notes a nonreactive nonstress test with no accelerations in 40 minutes. The next step in
management should be:
A. Reassure the client that decreased movement is normal at term and send her home
B. Perform a biophysical profile or contraction stress test to further assess fetal
well-being ✓ CORRECT
C. Schedule a routine follow-up appointment in one week for repeat nonstress testing
D. Administer terbutaline to stimulate fetal movement and improve reactivity
Correct Answer: B
Rationale: A nonreactive nonstress test requires further evaluation with a biophysical
profile or contraction stress test to determine if fetal hypoxia is present, as decreased
movement combined with nonreactivity may indicate fetal compromise requiring
delivery. Option A is dangerous because decreased fetal movement at term is never
