NUR 254 MEGA Exam Bundle 2026/2027 |
Exams 1–4, Midterm & Final Maternal and
Pediatric Nursing | Galen College of Nursing
Verified Q&A PDF
• This is a comprehensive NUR 254 Maternal and Pediatric Nursing exam bundle
covering Exams 1–4, Midterm, and Final — use it by practicing questions under
timed conditions, then reviewing EXPERT RATIONALE to reinforce clinical
reasoning.
• Features 200 verified Q&A items with highlighted correct answers and detailed
EXPERT RATIONALE to help you master both maternal and pediatric concepts for
Galen College of Nursing assessments.
QUESTION 1
A nurse is caring for a client who is 38 weeks pregnant and reports decreased
fetal movement. Which action should the nurse take first?
A. Notify the physician immediately
B. Prepare for an emergency cesarean section
C. Administer oxygen via face mask
D. Perform a nonstress test (NST)
E. Instruct the client to drink cold water and lie on her left side
Correct Answer: D. Perform a nonstress test (NST)
EXPERT RATIONALE: The NST is the first-line assessment for evaluating fetal well-
being when decreased fetal movement is reported. It monitors fetal heart rate in
response to movement. Notifying the physician comes after initial assessment data is
gathered.
QUESTION 2
A primigravida at 10 weeks gestation asks the nurse about the purpose of
alpha-fetoprotein (AFP) screening. What is the best response?
,A. It detects chromosomal abnormalities like Down syndrome with 100% accuracy
B. It determines the sex of the baby
C. It measures placental function and fetal oxygenation
D. It screens for neural tube defects and certain chromosomal abnormalities
E. It identifies gestational diabetes early in pregnancy
Correct Answer: D. It screens for neural tube defects and certain
chromosomal abnormalities
EXPERT RATIONALE: AFP is a protein produced by the fetus. Abnormal levels in
maternal blood can indicate neural tube defects (elevated AFP) or chromosomal issues
such as trisomy 21 (low AFP). It is a screening, not diagnostic, tool.
QUESTION 3
A nurse is teaching a pregnant client about warning signs to report
immediately. Which statement by the client indicates a need for further
teaching?
A. "I should call if I notice sudden swelling in my face and hands."
B. "I will report any vaginal bleeding right away."
C. "Severe headaches that don't go away need to be reported."
D. "Mild backache is a danger sign I should report immediately."
E. "Blurred vision should be reported to my provider."
Correct Answer: D. "Mild backache is a danger sign I should report
immediately."
EXPERT RATIONALE: Mild backache is a common discomfort of pregnancy and is not
a danger sign. True warning signs include severe headache, sudden edema, visual
disturbances, vaginal bleeding, and decreased fetal movement.
,QUESTION 4
A nurse is assessing a newborn immediately after delivery. Which finding
requires immediate intervention?
A. Acrocyanosis of the hands and feet
B. Heart rate of 110 beats per minute
C. Vernix caseosa covering the body
D. Central cyanosis of the lips and trunk
E. Irregular respiratory rate of 40–60 breaths per minute
Correct Answer: D. Central cyanosis of the lips and trunk
EXPERT RATIONALE: Central cyanosis indicates inadequate oxygenation and
requires immediate intervention. Acrocyanosis (peripheral) is normal in the first hours.
Heart rate of 110 and respiratory rate of 40–60 are within normal newborn ranges.
QUESTION 5
A client at 32 weeks gestation is diagnosed with placenta previa. Which
assessment finding is most consistent with this diagnosis?
A. Severe abdominal pain with board-like rigidity
B. Painful uterine contractions with bloody show
C. Painless, bright red vaginal bleeding
D. Sudden onset of sharp epigastric pain
E. Fetal bradycardia with late decelerations
Correct Answer: C. Painless, bright red vaginal bleeding
EXPERT RATIONALE: Placenta previa is characterized by painless, bright red vaginal
bleeding because the placenta covers the cervical os. Painful bleeding with a rigid
abdomen suggests abruptio placentae.
, QUESTION 6
A nurse is caring for a client with severe preeclampsia receiving magnesium
sulfate. Which finding should the nurse report immediately?
A. Urine output of 35 mL/hr
B. Respiratory rate of 14 breaths per minute
C. Absent deep tendon reflexes
D. Mild headache rated 3/10
E. Blood pressure of 150/95 mmHg
Correct Answer: C. Absent deep tendon reflexes
EXPERT RATIONALE: Absent deep tendon reflexes (DTRs) are an early sign of
magnesium toxicity. Normal or hyperactive DTRs are expected in preeclampsia. Loss of
DTRs precedes respiratory depression and cardiac arrest from magnesium overdose.
QUESTION 7
Which instruction is most important for the nurse to give a client who is 20
weeks pregnant regarding fetal kick counts?
A. Count kicks only in the morning when the fetus is most active
B. Report if you feel more than 10 kicks in 2 hours
C. Contact your provider if fewer than 10 movements are felt in 2 hours
D. Kick counts are only necessary after 36 weeks gestation
E. Fetal movement should always be felt every 30 minutes
Correct Answer: C. Contact your provider if fewer than 10 movements are
felt in 2 hours
EXPERT RATIONALE: The Cardiff Count-to-Ten method recommends that the mother
count until she feels 10 movements. Fewer than 10 movements in 2 hours warrants
further evaluation of fetal well-being.
Exams 1–4, Midterm & Final Maternal and
Pediatric Nursing | Galen College of Nursing
Verified Q&A PDF
• This is a comprehensive NUR 254 Maternal and Pediatric Nursing exam bundle
covering Exams 1–4, Midterm, and Final — use it by practicing questions under
timed conditions, then reviewing EXPERT RATIONALE to reinforce clinical
reasoning.
• Features 200 verified Q&A items with highlighted correct answers and detailed
EXPERT RATIONALE to help you master both maternal and pediatric concepts for
Galen College of Nursing assessments.
QUESTION 1
A nurse is caring for a client who is 38 weeks pregnant and reports decreased
fetal movement. Which action should the nurse take first?
A. Notify the physician immediately
B. Prepare for an emergency cesarean section
C. Administer oxygen via face mask
D. Perform a nonstress test (NST)
E. Instruct the client to drink cold water and lie on her left side
Correct Answer: D. Perform a nonstress test (NST)
EXPERT RATIONALE: The NST is the first-line assessment for evaluating fetal well-
being when decreased fetal movement is reported. It monitors fetal heart rate in
response to movement. Notifying the physician comes after initial assessment data is
gathered.
QUESTION 2
A primigravida at 10 weeks gestation asks the nurse about the purpose of
alpha-fetoprotein (AFP) screening. What is the best response?
,A. It detects chromosomal abnormalities like Down syndrome with 100% accuracy
B. It determines the sex of the baby
C. It measures placental function and fetal oxygenation
D. It screens for neural tube defects and certain chromosomal abnormalities
E. It identifies gestational diabetes early in pregnancy
Correct Answer: D. It screens for neural tube defects and certain
chromosomal abnormalities
EXPERT RATIONALE: AFP is a protein produced by the fetus. Abnormal levels in
maternal blood can indicate neural tube defects (elevated AFP) or chromosomal issues
such as trisomy 21 (low AFP). It is a screening, not diagnostic, tool.
QUESTION 3
A nurse is teaching a pregnant client about warning signs to report
immediately. Which statement by the client indicates a need for further
teaching?
A. "I should call if I notice sudden swelling in my face and hands."
B. "I will report any vaginal bleeding right away."
C. "Severe headaches that don't go away need to be reported."
D. "Mild backache is a danger sign I should report immediately."
E. "Blurred vision should be reported to my provider."
Correct Answer: D. "Mild backache is a danger sign I should report
immediately."
EXPERT RATIONALE: Mild backache is a common discomfort of pregnancy and is not
a danger sign. True warning signs include severe headache, sudden edema, visual
disturbances, vaginal bleeding, and decreased fetal movement.
,QUESTION 4
A nurse is assessing a newborn immediately after delivery. Which finding
requires immediate intervention?
A. Acrocyanosis of the hands and feet
B. Heart rate of 110 beats per minute
C. Vernix caseosa covering the body
D. Central cyanosis of the lips and trunk
E. Irregular respiratory rate of 40–60 breaths per minute
Correct Answer: D. Central cyanosis of the lips and trunk
EXPERT RATIONALE: Central cyanosis indicates inadequate oxygenation and
requires immediate intervention. Acrocyanosis (peripheral) is normal in the first hours.
Heart rate of 110 and respiratory rate of 40–60 are within normal newborn ranges.
QUESTION 5
A client at 32 weeks gestation is diagnosed with placenta previa. Which
assessment finding is most consistent with this diagnosis?
A. Severe abdominal pain with board-like rigidity
B. Painful uterine contractions with bloody show
C. Painless, bright red vaginal bleeding
D. Sudden onset of sharp epigastric pain
E. Fetal bradycardia with late decelerations
Correct Answer: C. Painless, bright red vaginal bleeding
EXPERT RATIONALE: Placenta previa is characterized by painless, bright red vaginal
bleeding because the placenta covers the cervical os. Painful bleeding with a rigid
abdomen suggests abruptio placentae.
, QUESTION 6
A nurse is caring for a client with severe preeclampsia receiving magnesium
sulfate. Which finding should the nurse report immediately?
A. Urine output of 35 mL/hr
B. Respiratory rate of 14 breaths per minute
C. Absent deep tendon reflexes
D. Mild headache rated 3/10
E. Blood pressure of 150/95 mmHg
Correct Answer: C. Absent deep tendon reflexes
EXPERT RATIONALE: Absent deep tendon reflexes (DTRs) are an early sign of
magnesium toxicity. Normal or hyperactive DTRs are expected in preeclampsia. Loss of
DTRs precedes respiratory depression and cardiac arrest from magnesium overdose.
QUESTION 7
Which instruction is most important for the nurse to give a client who is 20
weeks pregnant regarding fetal kick counts?
A. Count kicks only in the morning when the fetus is most active
B. Report if you feel more than 10 kicks in 2 hours
C. Contact your provider if fewer than 10 movements are felt in 2 hours
D. Kick counts are only necessary after 36 weeks gestation
E. Fetal movement should always be felt every 30 minutes
Correct Answer: C. Contact your provider if fewer than 10 movements are
felt in 2 hours
EXPERT RATIONALE: The Cardiff Count-to-Ten method recommends that the mother
count until she feels 10 movements. Fewer than 10 movements in 2 hours warrants
further evaluation of fetal well-being.
