NUR 254 MidteRM PRactice exaM: MateRNal & PediatRic NURsiNg
galeN college of NURsiNg exaM 2026||||qUestioNs aNd aNsweRs
with RatioNales/gRaded a+/2026 UPdate/100% coRRect
/iNstaNt dowNload
SECTION 1: MATERNAL NURSING – ANTEPARTUM CARE (Questions 1-15)
**Question 1**
A nurse is caring for a client at 10 weeks gestation who reports nausea and vomiting.
Which of the following recommendations should the nurse provide?
A) Eat large, heavy meals three times daily
B) Drink fluids with meals to help digestion
C) Eat dry crackers before getting out of bed in the morning
D) Lie flat immediately after eating
**Answer:** C) Eat dry crackers before getting out of bed in the morning
**Rationale:** Nausea and vomiting (morning sickness) in the first trimester is common
and often exacerbated by an empty stomach and low blood sugar. Eating dry crackers or
toast before getting out of bed helps alleviate symptoms. Small, frequent meals are
recommended (not large meals). Fluids should be taken between meals, not with meals.
Lying flat can worsen reflux .
---
**Question 2**
A nurse is reviewing lab results for a client at 12 weeks gestation. Which finding requires
immediate follow-up?
,A) Hemoglobin 11.2 g/dL
B) White blood cell count 12,000/mm³
C) Rubella titer 1:8 (low)
D) Blood type A positive
**Answer:** C) Rubella titer 1:8 (low)
**Rationale:** A low rubella titer (1:8 or below) indicates the client is not immune to
rubella. Because the rubella vaccine is a live virus vaccine, it cannot be administered
during pregnancy. The client should be advised to avoid exposure to rubella during
pregnancy and receive the vaccine postpartum before discharge .
---
**Question 3**
A nurse is calculating the expected date of delivery (EDD) using Naegele's rule for a
client whose last menstrual period (LMP) began on May 15. What is the EDD?
A) February 8
B) February 22
C) March 8
D) March 22
**Answer:** B) February 22
**Rationale:** Naegele's rule: subtract 3 months from LMP and add 7 days. May 15
minus 3 months = February 15, plus 7 days = February 22.
---
,**Question 4**
A nurse is assessing a client at 24 weeks gestation. Which finding should the nurse
report to the provider?
A) Braxton Hicks contractions
B) 1+ protein in urine
C) Fetal heart rate of 140 beats per minute
D) Fundal height of 24 cm
**Answer:** B) 1+ protein in urine
**Rationale:** Proteinuria during pregnancy may indicate preeclampsia, especially when
accompanied by hypertension. Braxton Hicks contractions (irregular, painless uterine
contractions) are normal in the second trimester. Fetal heart rate of 110-160 bpm is
normal. Fundal height in cm should approximate gestational age (±2 cm) .
---
**Question 5**
A nurse is providing education to a client about physiological changes during pregnancy.
Which of the following is an expected cardiovascular change during pregnancy?
A) Decreased heart rate
B) Decreased blood volume
C) Increased cardiac output
D) Increased peripheral vascular resistance
**Answer:** C) Increased cardiac output
, **Rationale:** Cardiac output increases by 30-50% during pregnancy due to increased
heart rate and stroke volume. Blood volume increases by 40-50%. Heart rate increases
(not decreases) by 10-15 bpm. Peripheral vascular resistance decreases (not increases)
due to vasodilation from progesterone .
---
**Question 6**
A nurse is assessing a client at 36 weeks gestation. Which finding should the nurse
recognize as an expected change of pregnancy?
A) Dyspnea on exertion
B) Pitting edema of the hands and face
C) Decreased respiratory rate
D) Persistent headache unrelieved by acetaminophen
**Answer:** A) Dyspnea on exertion
**Rationale:** As the uterus enlarges, it pushes upward against the diaphragm, causing
shortness of breath on exertion. This is an expected finding in the third trimester. Pitting
edema of hands and face, persistent headache, and visual changes may indicate
preeclampsia and require immediate evaluation .
---
**Question 7**
A nurse is reviewing laboratory results for a client at 8 weeks gestation. Which of the
following is an expected finding?
A) Decreased hematocrit
B) Increased platelet count
galeN college of NURsiNg exaM 2026||||qUestioNs aNd aNsweRs
with RatioNales/gRaded a+/2026 UPdate/100% coRRect
/iNstaNt dowNload
SECTION 1: MATERNAL NURSING – ANTEPARTUM CARE (Questions 1-15)
**Question 1**
A nurse is caring for a client at 10 weeks gestation who reports nausea and vomiting.
Which of the following recommendations should the nurse provide?
A) Eat large, heavy meals three times daily
B) Drink fluids with meals to help digestion
C) Eat dry crackers before getting out of bed in the morning
D) Lie flat immediately after eating
**Answer:** C) Eat dry crackers before getting out of bed in the morning
**Rationale:** Nausea and vomiting (morning sickness) in the first trimester is common
and often exacerbated by an empty stomach and low blood sugar. Eating dry crackers or
toast before getting out of bed helps alleviate symptoms. Small, frequent meals are
recommended (not large meals). Fluids should be taken between meals, not with meals.
Lying flat can worsen reflux .
---
**Question 2**
A nurse is reviewing lab results for a client at 12 weeks gestation. Which finding requires
immediate follow-up?
,A) Hemoglobin 11.2 g/dL
B) White blood cell count 12,000/mm³
C) Rubella titer 1:8 (low)
D) Blood type A positive
**Answer:** C) Rubella titer 1:8 (low)
**Rationale:** A low rubella titer (1:8 or below) indicates the client is not immune to
rubella. Because the rubella vaccine is a live virus vaccine, it cannot be administered
during pregnancy. The client should be advised to avoid exposure to rubella during
pregnancy and receive the vaccine postpartum before discharge .
---
**Question 3**
A nurse is calculating the expected date of delivery (EDD) using Naegele's rule for a
client whose last menstrual period (LMP) began on May 15. What is the EDD?
A) February 8
B) February 22
C) March 8
D) March 22
**Answer:** B) February 22
**Rationale:** Naegele's rule: subtract 3 months from LMP and add 7 days. May 15
minus 3 months = February 15, plus 7 days = February 22.
---
,**Question 4**
A nurse is assessing a client at 24 weeks gestation. Which finding should the nurse
report to the provider?
A) Braxton Hicks contractions
B) 1+ protein in urine
C) Fetal heart rate of 140 beats per minute
D) Fundal height of 24 cm
**Answer:** B) 1+ protein in urine
**Rationale:** Proteinuria during pregnancy may indicate preeclampsia, especially when
accompanied by hypertension. Braxton Hicks contractions (irregular, painless uterine
contractions) are normal in the second trimester. Fetal heart rate of 110-160 bpm is
normal. Fundal height in cm should approximate gestational age (±2 cm) .
---
**Question 5**
A nurse is providing education to a client about physiological changes during pregnancy.
Which of the following is an expected cardiovascular change during pregnancy?
A) Decreased heart rate
B) Decreased blood volume
C) Increased cardiac output
D) Increased peripheral vascular resistance
**Answer:** C) Increased cardiac output
, **Rationale:** Cardiac output increases by 30-50% during pregnancy due to increased
heart rate and stroke volume. Blood volume increases by 40-50%. Heart rate increases
(not decreases) by 10-15 bpm. Peripheral vascular resistance decreases (not increases)
due to vasodilation from progesterone .
---
**Question 6**
A nurse is assessing a client at 36 weeks gestation. Which finding should the nurse
recognize as an expected change of pregnancy?
A) Dyspnea on exertion
B) Pitting edema of the hands and face
C) Decreased respiratory rate
D) Persistent headache unrelieved by acetaminophen
**Answer:** A) Dyspnea on exertion
**Rationale:** As the uterus enlarges, it pushes upward against the diaphragm, causing
shortness of breath on exertion. This is an expected finding in the third trimester. Pitting
edema of hands and face, persistent headache, and visual changes may indicate
preeclampsia and require immediate evaluation .
---
**Question 7**
A nurse is reviewing laboratory results for a client at 8 weeks gestation. Which of the
following is an expected finding?
A) Decreased hematocrit
B) Increased platelet count
