INTRODUCTION: - / Actual Exam Questions and Correct Detailed An...

NUR 254 Exam 3 | Galen College of Nursing | / Actual Exam Questions and Correct Detailed Answers​ Comprehensive Exam Review – Maternal, Pediatrics, and Advanced Nursing Concepts

INTRODUCTION:​

This document provides the latest updated NUR 254 Exam 3 review material for Galen College of Nursing, covering actual exam-style questions with 100% correct answers and detailed rationales. Designed to reinforce nursing knowledge, enhance test preparation, and ensure mastery of maternal and pediatric concepts.

Exam Coverage:

Maternal Health Nursing​ • Advanced antepartum, intrapartum, and postpartum care​ • Management of high-risk pregnancy conditions​ • Complex labor and delivery interventions​ • Postpartum complications and advanced patient education Pediatric Nursing​ • Advanced growth and development principles​ • Pediatric medication safety and complex calculations​ • Management of acute and chronic pediatric conditions​ • Family-centered care and advanced patient education Advanced Nursing Concepts​ • Prioritization and delegation in maternal and pediatric settings​ • Interprofessional collaboration and communication​ • Critical thinking and clinical judgment in complex scenarios

Answer Format:​

Every question is paired with the correct answer in bold green and supported by a detailed explanation that emphasizes nursing judgment, reasoning, and application to real-world practice.

Maternal Health Nursing Questions 1 / 3

• A nurse is caring for a client at 37 weeks gestation with suspected

placental abruption. What is the priority nursing action?​

a) Encourage ambulation to promote labor​

b) Monitor fetal heart rate and prepare for emergency delivery​

c) Administer tocolytics to stop contractions​

d) Document findings as normal​

b) Monitor fetal heart rate and prepare for emergency delivery​

Rationale: Placental abruption is a medical emergency requiring immediate fetal monitoring and preparation for delivery due to risks of fetal hypoxia, per ACOG and NUR 254 guidelines.​

Concept: High-risk pregnancy​

Clinical Reasoning: Abruption can cause fetal distress; continuous monitoring and rapid intervention are critical.​

Example: Observing variable decelerations and notifying the provider.​

Test-Taking Tip: Prioritize fetal safety in obstetric emergencies.

• A postpartum client on day 3 reports a fever of 100.8°F and foul-smelling

lochia. What should the nurse suspect?​

a) Normal postpartum recovery​

b) Endometritis​

c) Mastitis​

d) Urinary tract infection​

b) Endometritis​

Rationale: Fever and foul-smelling lochia suggest endometritis, a postpartum uterine infection, per ACOG and NUR 254 guidelines.​

Concept: Postpartum complications​

Clinical Reasoning: Assess for uterine tenderness and notify the provider for antibiotic therapy.​

Example: Administering IV antibiotics for confirmed endometritis.​

Test-Taking Tip: Link specific symptoms to postpartum infections. 3. A client in labor at 40 weeks gestation has a prolonged second stage.What is the nurse’s priority intervention?​

a) Administer oxytocin immediately​

b) Assess maternal and fetal status​

c) Encourage immediate pushing​

d) Prepare for vaginal delivery​

b) Assess maternal and fetal status​

Rationale: A prolonged second stage requires assessment of maternal exhaustion and fetal heart rate to guide interventions, per ACOG and NUR 254 guidelines.​

Concept: Intrapartum care​

Clinical Reasoning: Assessment identifies causes like malposition or fetal distress.​

Example: Checking for non-reassuring fetal heart rate patterns.​

Test-Taking Tip: Always assess before intervening in labor complications. 4. A client with gestational hypertension is at risk for which complication during labor?​ 2 / 3

a) Hypoglycemia​

b) Seizures​

c) Hyperbilirubinemia​

d) Respiratory distress​b) Seizures​

Rationale: Gestational hypertension can progress to preeclampsia, increasing seizure risk (eclampsia), per ACOG and NUR 254 guidelines.​

Concept: High-risk pregnancy​

Clinical Reasoning: Monitor for symptoms like headache or visual changes and administer magnesium sulfate as needed.​

Example: Preparing seizure precautions for a preeclamptic client.​

Test-Taking Tip: Link maternal conditions to specific complications.

• A nurse is teaching a postpartum client about contraception options.

Which method is safe for immediate postpartum use?​

a) Combined oral contraceptives​

b) Progestin-only pills​

c) Diaphragm​

d) Transdermal patch​

b) Progestin-only pills​

Rationale: Progestin-only pills are safe for breastfeeding mothers and immediate postpartum use, per ACOG and NUR 254 guidelines. Combined contraceptives increase thromboembolism risk.​

Concept: Patient education​

Clinical Reasoning: Consider breastfeeding and postpartum risks when selecting contraception.​

Example: Educating on progestin-only pill dosing schedules.​

Test-Taking Tip: Prioritize safety for postpartum contraception.

• A client at 34 weeks gestation presents with preterm premature rupture

of membranes (PPROM). What is a priority nursing action?​

a) Administer oxytocin to induce labor​

b) Monitor for signs of infection​

c) Encourage ambulation​

d) Discharge the client with follow-up​

b) Monitor for signs of infection​

Rationale: PPROM increases infection risk (chorioamnionitis); monitoring for fever and uterine tenderness is critical, per ACOG and NUR 254 guidelines.​

Concept: High-risk pregnancy​

Clinical Reasoning: Early infection detection prevents maternal and fetal complications.​

Example: Assessing maternal temperature every 4 hours.​

Test-Taking Tip: Focus on infection prevention in PPROM. 7. A nurse is caring for a client post-cesarean section. What finding indicates a potential wound infection?​

a) Mild serosanguinous drainage​

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