الملف الثالث (صحة الأم و الطفل)

‫دورة االعداد الشاملة‬
‫الختبار الهيئة السعودية للتخصصات الصحية(للتمريض)‬

‫‪SNLE‬‬
‫الملف الثالث‬
‫صحة األم و الطفل‬
‫إعداد و تقديم‬
‫أ‪ .‬إسالم الحايك‬ ‫&‬ ‫أ‪ .‬أحمد محمد‬

‫‪@nursesmap‬‬ ‫‪@SNLEeasy‬‬
‫محتويات الملف‬
‫‪A. Maternity & Gynecology‬‬
‫‪B. Neonatal‬‬
‫‪C. Pediatric‬‬
‫الملف الثالث‪ :‬صحة األم و الطفل ( أحمد محمد – إسالم الحايك)‬ ‫‪1‬‬
A. Maternity & Gynecology
388. Beth is 39 weeks pregnant with her third baby. She has been pregnant 3 times. Her first pregnancy
resulted in a baby girl born at 39 weeks gestation. Her second pregnancy resulted in a baby boy born at 38
weeks gestation. What is her GTPAL?
A. G 4 T 3 P 1 A 0 L 3
B. G 3 T 3 P 3 A 3 L 3
C. G3 T 2 P 0 A 0 L 2
D. G 4 T 2 P 0 L 2
389. A 26-year-old female is currently 26 weeks pregnant. She had a miscarriage at 10 weeks gestation five
years ago. She has a three-year-old who was born at 39 weeks. What is her GTPAL?
A. G=3, T=1, P=0, A=1, L=1
B. G=3, T=1, P=1, A=0, L=3
C. G=3, T=2, P=0, A=2, L=2
D. G=2, T=1, P=0, A=1, L=1
390. A 36 years old woman is in her 18 weeks pregnancy came to antenatal clinic and assessed by the nurse.
She has three previous abortion during the first trimesters prior to pregnancy. How the nurse will document
the status of the mother?
A. Parity
B. Nullipara
C. Multipara
D. Primipara
391. During a prenatal visit a patient tells you her last menstrual period was March 14, 2016. Based on the
Naegele's Rule, when is the estimated due date of her baby?
A. January 27, 2017
B. December 21, 2016
C. December 28, 2016
D. January 1, 2016
)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 2

392. The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse
measures the fundal height in centimeters and notes that the fundal height is 30 cm. How should the nurse
interpret this finding?
A. The client is measuring large for gestational age.
B. The client is measuring small for gestational age.
C. The client is measuring normal for gestational age.
D. More evidence is needed to determine size for gestational age
393. A primigravida attend the antenatal clinic for her routine visit the nurse performed an abdominal
palpitation and found the fundus to be midway between the symphysis pubis and the umbilicus what are the
weeks of gestation according to this findings?
A. 8 Weeks
B. 16 weeks
C. 24 weeks
D. 28 weeks
394. Laboring client is in the first stage of labor and has progressed 6 cm in cervical dilation. In which of the
following phases of the first stage does cervical dilation occur most rapidly?
A. Preparatory phase
B. Latent phase
C. Active phase
D. Transition phase
395. During which of the following stages of labor would the nurse assess "crowning"?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
396. For which of the following issues should the nurse observe the movie closely during the 4TH stage of
labor?
A. Uterine irritability
B. Signs of infection
C. Signs of bleeding
D. Unwillingness to breastfeed

397. Nurse is caring for a client in labor. The nurse determines that the client is beginning in the 2nd stage of
labor when which of the following assessments is noted?
A. The client begins to expel clear vaginal fluid
B. The cervix is dilated completely
C. The contractions are regular
D. The membranes have ruptured
398. Which of the following danger signs should be reported promptly during the antepartum period?
A. Constipation
B. Breast tenderness
C. Nasal stuffiness
D. Leaking amniotic fluid
399. A 35-year-old female is in labor. The baby is engaged in the pelvis. As the nurse you know that this means
that the fetal station is approximately?
A. +1
B. 0
C. +2
D. -1
400. During the assessment of a laboring woman, it is noted the fetal station is +2. You interpret this to
mean?*
A. The baby's presenting part is 2 cm above the iliac spine.
B. The baby's presenting part is 2 cm below the iliac spine.
C. The baby's presenting part is 2 cm above the ischial spine.
D. The baby's presenting part is 2 cm below the ischial spine.
401. A postdate pregnant woman is admitted for the induction of labor. Her fetal heart rate and vital signs are
within normal range her intravenous line is maintained and she is to be started on low doses of labor inducing
medication. Which of the following medication the mother is likely to receive intravenously?
A. Oxytocin
B. Carvedilol
C. Cytotec
D. Cytoxan

402. During vaginal examination the nurse palpated the posterior fontanel to be at the right side and lower
quadrant of the maternal pelvis?
A. ROP
B. LOP.
C. ROA
D. LOA
403. During vaginal examination the nurse palpated the posterior fontanel to be at the right side and upper
quadrant of the maternal pelvis?
A. ROP
B. LOP.
C. ROA
D. LOA
404. Which of the following characteristics of contractions would the nurse expect to find in a client
experiencing true labor?
A. Occurring at irregular intervals
B. Gradually increasing intervals
C. Increasing intensity with walking
D. Starting mainly in the abdomen
405. The nurse is teaching 32-week pregnant women how to distinguish between false contractions and true
labor contractions. Which statement about false contraction is accurate?
A. They are regular and increase gradually
B. They are felt in the abdomen
C. They start at the back and radiate to the abdomen
D. They become more intense during walking
406. A client diagnosed with gestational hypertension has just been admitted and is in early active labor.
Which assessment finding should the nurse most likely expect to note?
A. Increased urine output
B. Increased blood pressure
C. Decreased fetal heart rate
D. Decreased brachial reflexes

407. Which of the following would the nurse identify as a classic sign of PIH (Pregnancy Induced
Hypertension)?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache
408. The nurse has admitted a client diagnosed with gestational hypertension who is in labor. The nurse
monitors the client closely for which complication of gestational hypertension?
A. Seizures
B. Hallucinations
C. Placenta previa
D. Altered respiratory status
409. The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which
assessment finding indicates a worsening of the preeclampsia and the need to notify the health care provider
(HCP)?
A. Urinary output has increased.
B. Dependent edema has resolved.
C. Blood pressure reading is at the prenatal baseline.
D. The client complains of a headache and blurred vision
410. The nurse is performing an assessment on a pregnant client in the last trimester with a diagnosis of
severe preeclampsia. The nurse reviews the assessment findings and determines that which finding is most
closely associated with a complication of this diagnosis?
A. Enlargement of the breasts
B. Complaints of feeling hot when the room is cool
C. Periods of fetal movement followed by quiet periods
D. Evidence of bleeding, such as in the gums, petechiae, and purpura
411. A nurse is assessing a pregnant woman with gestational hypertension. Which of the following would lead
the nurse to suspect that the client has developed severe preeclampsia?
A. Urine protein 300 mg/24 hours
B. Blood pressure 150/96 mm Hg
C. Mild facial edema
D. Hyperreflexia
412. Which of the following would the nurse have readily available for a client who is receiving magnesium
sulfate to treat severe preeclampsia?
A. Calcium gluconate
B. Potassium chloride
C. Ferrous sulfate
D. Calcium carbonate
413. A woman with gestational hypertension experiences a seizure. Which of the following would be the
priority?
A. Fluid replacement
B. Oxygenation
C. Control of hypertension
D. Delivery of the fetus
414. Which of the following assessment is contraindicated while providing intrapartum nursing care for a
patient with HELLP syndrome?
A. Heart sounds
B. Blood studies
C. Leopold's maneuvers
D. Deep tendon reflexes
415. The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational
diabetes mellitus. Which statement made by the client indicates a need for further teaching?
A. “I should stay on the diabetic diet.”
B. “I should perform glucose monitoring at home.”
C. “I should avoid exercise because of the negative effects on insulin production.”
D. “I should be aware of any infections and report signs of infection immediately to my health care provider
(HCP).
416. Which piece of equipment will the nurse routinely use to assess the fetal heart rate of a woman at 16
weeks’ gestation?
A. Fetal heart monitor
B. An adult stethoscope
C. Bell of a stethoscope
D. Ultrasound fetoscope

417. The nurse is performing an assessment on a client who is at 38 weeks’ gestation and notes that the fetal
heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority nursing action?
A. Document the finding.

If fetal bradycardia or tachycardia occurs, change the
B. Check the mother’s heart rate. position of the mother, administer oxygen, and assess
the mother’s vital signs. Notify the health care provider
C. Notify the health care provider (HCP).
(HCP) as soon as possible.
D. Tell the client that the fetal heart rate is normal.
418. The nurse in the labor room is caring for a client in the active stage of the first phase of labor. The nurse
is assessing the fetal patterns and notes a late deceleration on the monitor strip. What is the most
appropriate nursing action?
A. Administer oxygen via face mask.
B. Place the mother in a supine position.
C. Increase the rate of the oxytocin intravenous infusion.
D. Document the findings and continue to monitor the fetal patterns.
419. The nurse is monitoring a client in active labor and notes that the client is having contractions every 3
minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 beats/
minute. Which nursing action is most appropriate?
A. Notify the health care provider (HCP).
B. Continue monitoring the fetal heart rate.
C. Encourage the client to continue pushing with each contraction.
D. Instruct the client’s coach to continue to encourage breathing techniques.
420. The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes
the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most
appropriate?
A. Notify the health care provider of the findings.
B. Reposition the mother and check the monitor for changes in the fetal tracing.
C. Take the mother’s vital signs and tell the mother that bed rest is required to conserve oxygen.
D. Document the findings and tell the mother that the pattern on the monitor indicates fetal well- being.

421. The nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which is noted
on the external monitor tracing during a contraction?
A. Variability
B. Accelerations
C. Early decelerations
D. Variable decelerations
422. The nurse is caring for a client in active labor. Which intervention should the nurse implement to prevent
fetal heart rate decelerations?
A. Discourage the client from walking.
B. Increase the rate of the oxytocin infusion.
C. Monitor the fetal heart rate every 30 minutes.
D. Encourage upright or side-lying maternal positions.
423. The nurse is performing an assessment of a client who is scheduled for a cesarean delivery at 39 weeks of
gestation. Which assessment finding indicates the need to contact the health care provider (HCP)?
A. Hemoglobin of 11 g/dL (110 mmol/L)
B. Fetal heart rate of 180 beats/minute
C. Maternal pulse rate of 85 beats/minute
D. White blood cell count of 12,000 mm3 (12.0 Â 109/L)
424. Which assessment following an amniotomy should be conducted first?
A. Cervical dilation
B. Bladder distention
C. Fetal heart rate pattern
D. Maternal blood pressure
425. Which of the following is described as premature separation of a normally implanted placenta during the
second half of pregnancy. Usually with severe hemorrhage?
A. Placenta Previa
B. Ectopic pregnancy

C. Incompetent cervix
D. Abruptio placentae
426. The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the
maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse
expect to note if this condition is present?
A. Soft abdomen
B. Uterine tenderness
C. Absence of abdominal pain
D. Painless, bright red vaginal bleeding
427. An ultrasound is performed on a client at term gestation who is experiencing moderate vaginal bleeding.
The results of the ultrasound indicate that abruptio placentae is present. On the basis of these findings, the
nurse should prepare the client for which anticipated prescription?
A. Delivery of the fetus
B. Strict monitoring of intake and output
C. Complete bed rest for the remainder of the pregnancy
D. The need for weekly monitoring of coagulation studies until the time of delivery
428. Which of the following classifications of placenta previa is applicable when the placental edge is 5 cm
away from the internal cervical OS?
A. Total
B. Partial
C. Marginal
D. Complete
429. The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is
experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the health
care provider’s prescriptions and should question which prescription?
A. Prepare the client for an ultrasound.
B. Obtain equipment for a manual pelvic examination.
C. Prepare to draw a hemoglobin and hematocrit blood sample.
D. Obtain equipment for external electronic fetal heart rate monitoring

430. The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following
a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for
which risk associated with placenta previa?
A. Infection
B. Hemorrhage
C. Chronic hypertension
D. Disseminated intravascular coagulation
431. A nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of
ectopic pregnancy. The nurse develops a plan of care for the client and determines that which of the following
nursing actions is the priority?
A. Monitoring daily weight
B. Assessing for edema
C. Monitoring the apical pulse
D. Monitoring the temperature
432. Which of the following best describes preterm labor?
A. Labor that begins after 20 weeks gestation and before 37 weeks gestation
B. Labor that begins after 15 weeks gestation and before 37 weeks gestation
C. Labor that begins after 24 weeks gestation and before 28 weeks gestation
D. Labor that begins after 28 weeks gestation and before 40 weeks gestation
433. The nurse is performing an assessment on a client who has just been told that a pregnancy test is
positive. Which assessment finding indicates that the client is at risk for preterm labor?
A. The client is a 35-year-old primigravida.
B. The client has a history of cardiac disease.
C. The client’s hemoglobin level is 13.5 g/dL (135 mmol/L).
D. The client is a 20-year-old primigravida of average weight and height.

[
434. Which of the following factors is the underlying cause of dystocia?
A. Nutritional
B. Mechanical
C. Environmental
D. Medical

435. The nurse has created a plan of care for a client experiencing dystocia and includes several nursing
actions in the plan of care. What is the priority nursing action?
A. Providing comfort measures
B. Monitoring the fetal heart rate
C. Changing the client’s position frequently
D. Keeping the significant other informed of the progress of the labor
436. The nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. The nurse
notes the presence of the umbilical cord protruding from the vagina. What is the first nursing action with this
finding?
A. Gently push the cord into the vagina.
B. Place the client in Trendelenburg position.
C. Find the closest telephone and page the health care provider stat.
D. Call the delivery room to notify the staff that the client will be transported immediately.
437. The nurse is caring for four 1-day postpartum clients. Which client assessment requires the need for
follow-up?
A. The client with mild after pains
B. The client with a pulse rate of 60 beats/minute
C. The client with colostrum discharge from both breasts
D. The client with lochia that is red and has a foul-smelling odor
438. A postpartum nurse caring for a client who delivered vaginally 2 hours ago palpates the fundus and notes
the character of the lochia. Which characteristic of the lochia should indicate to the nurse that the client’s
recovery is normal?
A. Pink-colored lochia
B. White-colored lochia
C. Serosanguineous lochia
D. Dark red-colored lochia

439. The nurse is assessing a client in the fourth stage of labor and notes that the fundus is firm, but that
bleeding is excessive. Which should be the initial nursing action?
A. Record the findings.
B. Massage the fundus.
C. Notify the health care provider (HCP).
D. Place the client in Trendelenburg’s position.
440. On assessment of a postpartum client, the nurse notes that the uterus feels soft and boggy. The nurse
should take which initial action?
A. Document the findings.
B. Elevate the client’s legs.
C. Massage the fundus until it is firm.
D. Push on the uterus to assist in expressing clots.
441. The midwife was assessing a 36-year-old gravis 4 para 2mother. The patient was in labor for 10 hour and
had extraction. Two saturated pads were fully soaked with blood with hours been admitted in the postnatal
ward. Which of the following is the appropriate nursing diagnosis?
A. Anxiety related to blood loss
B. Fatigue related to lack of oral intake
C. Activity intolerance due to discomfort

D. Fluid volume deficit due to uterine atony
442. A pregnant woman visits the Outpatient clinic complaining of excessive vaginal secretion. Which of the
following is the appropriate nursing assessment?
A. Fetal heart rate
B. Fundal height
C. Signs of infection
D. Fetal presentations and position
443. A pregnant mother at early pregnancy was admitted in Emergency Room with leakage of amniotic fluid,
vaginal bleeding and lower abdominal cramping pain. What is the possible diagnosis should the nurse
suspected?
A. Missed
B. Inevitable
C. Incomplete
D. Threatened
444. A 28-year-old primigravida who is pregnant at 16 weeks of attended at the emergency department
because of dark brown discharge. investigation showed a decline in pregnancy test for which of the following
is the most likely type of the spontaneous abortion?
A. Missed
B. Threatened
C. Incomplete
D. Inevitable
445. A woman in labor is progressing well. She has been diagnosed with a large fibroid in the fundus. What
should the nurse observe her for after delivery?
A. Thrombophlebitis
B. Postpartum depression
C. Postpartum hemorrhage
D. Loss of bladder tone during puerperium
446. nurse is instructing a female client how to do breast self-exam. Which of the followings is the best time
to perform this exam?
A. After ovulation
B. After the period
C. Two weeks after period
D. Three days before period
447. Which test should be performed to screen for cervical neoplasia during antenatal assessment?
A. Papanicolaou (PAP)
B. Vaginal rectal culture
C. Rapid plasma regain test (PPR)
D. Venereal disease research laboratory test (VDRL)
448. women should get their (pap smear test) every:
A. 6 month
B. 1year
C. 3years
d- 5 years

449. the antenatal clinic, a 9-month pregnant woman notifies the nurse that e is concerned that she gained
15Kg during this pregnancy and she is and needs to start a diet program. which of the following is the best
nursing response?
A. This weight gain is normal during pregnancy
B. You can reduce the carbohydrates in your diet
C. Wait till you have the baby and start a diet program
D. This weight is lower than you should gain during pregnancy
450. multiparous patient on day 1 postpartum is asking the nurse to send her baby to the nursery so she can
sleep. What is the most likely phase of psychological adaptation?
A. Taking-go
B. Letting-go
C. Taking-in
D. Letting-in
451. postpartum psychological phases sequences is?
A. Taking in, taking hold, letting hold
B. Taking in, taking hold, letting go
C. Taking hold, taking in, letting hold
D. Letting go, taking hold, taking in

B. Neonatal
452. The nurse assisted with the birth of a newborn. Which nursing action is most effective in preventing heat
loss by evaporation?
A. Warming the crib pad

B. Closing the doors to the room
C. Drying the infant with a warm blanket
D. Turning on the overhead radiant warmer
453. The mother of a newborn calls the clinic and reports that when cleaning the umbilical cord, she noticed
that the cord was moist, and that discharge was present. What is the most appropriate nursing instruction for
this mother?
A. Bring the infant to the clinic.

B. This is a normal occurrence, and no further action is needed.
C. Increase the number of times that the cord is cleaned per day.
D. Monitor the cord for another 24 to 48 hours and call the clinic if the discharge continues.
454. The nurse in a neonatal intensive care unit (NICU) receives a telephone call to prepare for the admission
of a 43-week gestation newborn with Apgar scores of 1 and 4. In planning for admission of this newborn,
what is the nurse’s highest priority?
A. Turn on the apnea and cardiorespiratory monitors.

B. Connect the resuscitation bag to the oxygen outlet.
C. Set up the intravenous line with 5% dextrose in water.
D. Set the radiant warmer control temperature at 36.5 °C (97.6 °F).
455. The nurse is assessing a newborn after circumcision and notes that the circumcised area is red with a
small amount of bloody drainage. Which nursing action is most appropriate?
A. Apply gentle pressure.

B. Reinforce the dressing.
C. Document the findings.
D. Contact the health care provider (HCP).

456. The postpartum nurse is providing instructions to the mother of a newborn with hyperbilirubinemia who
is being breast-fed. The nurse should provide which instruction to the mother?
A. Feed the newborn less frequently.

B. Continue to breast-feed every 2 to 4 hours.
C. Switch to bottle-feeding the infant for 2 weeks.
D. Stop breast-feeding and switch to bottle-feeding Permanently.
457. The nurse administers erythromycin ointment (0.5%) to the eyes of a newborn and the mother asks the
nurse why this is performed. Which explanation is best for the nurse to provide about neonatal eye
prophylaxis?
A. Protects the newborn’s eyes from possible infections acquired while hospitalized.
B. Prevents cataracts in the newborn born to a woman who is susceptible to rubella.
C. Minimizes the spread of microorganisms to the newborn from invasive procedures during labor.
D. Prevents an infection called ophthalmia neonatorum from occurring after birth in a newborn born to a
woman with an untreated gonococcal infection.
458. The nurse creates a plan of care for a woman with human immunodeficiency virus (HIV) infection and her
newborn. The nurse should include which intervention in the plan of care?
A. Monitoring the newborn’s vital signs routinely

B. Maintaining standard precautions at all times while caring for the newborn
C. Initiating referral to evaluate for blindness, deafness, learning problems, or behavioral problems.
D. Instructing the breast-feeding mother regarding the treatment of the nipples with nystatin ointment
459. The nurse is planning care for a newborn of a mother with diabetes mellitus. What is the priority nursing
consideration for this newborn?
A. Developmental delays because of excessive size

B. Maintaining safety because of low blood glucose levels
C. Choking because of impaired suck and swallow reflexes
D. Elevated body temperature because of excess fat and glycogen

460. The nurse prepares to administer a phytonadione (vitamin K) injection to a newborn, and the mother
asks the nurse why her infant needs the injection. What best response should the nurse provide?
A. “Your newborn needs the medicine to develop immunity.”

B. “The medicine will protect your newborn from being jaundiced.”
C. “Newborns have sterile bowels, and the medicine promotes the growth of bacteria in the bowel.”
D. “Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding.”
461. The nurse asks a nursing student to describe the procedure for administering erythromycin ointment to
the eyes of a newborn. Which student statement indicates that further teaching is needed about
administration of the eye medication?
A. “I will flush the eyes after instilling the ointment.”

B. “I will clean the newborn’s eyes before instilling ointment.”
C. “I need to administer the eye ointment within 1 hour after delivery.”
D. “I will instill the eye ointment into each of the newborn’s conjunctival sacs.”
462. The nurse is preparing to administer exogenous surfactant to a premature infant who has respiratory
distress syndrome. The nurse prepares to administer the medication by which route?
A. Intradermal
B. Intratracheal
C. Subcutaneous
D. Intramuscular
463. After the nurse assessed a newborn, she reported that the baby has syndactyly the student nurse asks
the nurse in charge what is the syndactyly? Which of the following is the best nursing response
A. Fistula.
B. Abnormal big head
C. Extra finger or toes
D. Finger or toes wholly or partly united
464. A newborn is diagnosed with Ventricular Septal Defect (VSD) Which of the following information should
the nurse give to the newborn's mother?
A. Cyanosis will occur most of the time during sleeping.

B. Breast feeding is not recommended for your child.
C. The defect might close spontaneously after 6 months.
D. Blood pressure is different on the child's arm and leg.

465. Which of the following vaccines should be given to 9 months old?
A. Hepatitis
B. Varicella & Measles
C. Oral Polio and Bacillus-Calmette-Guerin
D. Measles and Meningococcal Conjugate Quadrivalent (MCV4)
466. A woman delivered her baby boy 3 hours ago with caput succedaneum. Which of the following does the
nurse expects to find when she examines the newborn baby caput?
A. Soft, fluctuant mass filled with fluid.

B. Bilateral mass on both biparietal boons
C. A mass with clear edges that end at the suture lines.
D. A hard mass that is filled with blood.
467. A newborn born by elective caesarian section under general anesthesia 28 weeks of pregnancy. His
weight is 850 gm, and he is in (20) th percentile in intrauterine growth chart. He is admitted to Neonatal
Intensive Care Unit. Which of the following is the classification of this newborn according to gestational age
and birth weight using intrauterine growth chart?
A. He is appropriate for gestational age.

B. He is extremely low birth weight.
C. He is small for gestational age.
D. He is very low birth weight.
468. A baby born at 38 weeks of gestation with birth weight 1800 gram. Which of the following is the
classification of this infant?
A. Low birth weight

B. Very low birth weight
C. Appropriate for gestational age
D. Small for gestational age

469. Immediately following the birth of a full-term newborn, which of the following is the priority nursing
diagnosis for this newborn?
A. Ineffective airway clearance related to nasal & oral secretions.

B. Ineffective thermoregulation related to environmental factors.
C. Risk for imbalance fluid volume related to weak sucking reflex.
D. Risk for injury related to immature defense mechanisms.
470. A full term newborn is admitted to NICU with a diagnosis of meningocele. Which of the following
admission assessments is needed?
A. Specific gravity of urine

B. Head circumference
C. Weight and length
D. Palpation of the abdomen
471. A 30 week gestational preterm admitted to NICU 2hours ago the neonate starts to have grunting, nasal
flaring which of the following the nurse recognize regarding signs and symptoms?
A. Neonate has respiratory distress syndrome (RDS)

B. It is normally in the first 24 hours of birth.
C. This is not significant unless becomes cyanosis.
D. Neonate has hypoglycemia.
472. Which of organism can cause neonate to develop septicemia including respiratory distress apnea and
hypotension within 12 hours of birth
A. Escherichia coli
B. Cytomegalovirus
C. varicella zoster virus
D. Group B streptococcus
473. While a nurse was assessing an infant born 11 hours ago caesarean section, she auscultated moist lung
sounds. Which of the following is the most likely interpretation?
A. Abnormal finding
B. Normal finding
C. Pneumothorax
D. Surfactant aspiration

474. Newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained
sebaceous secretions. When charting this observation, the nurse identifies it as:
A. Milia
B. Lanugo
C. Whiteheads
D. Mongolian spots
475. A 25 years old primipara is admitted for labor. The infant is delivered by forceps because of breech
presentation and full body assessment shows large blue macular marking over left buttocks which of the
following the most likely cause?
A. Ecchymosis
B. Nervus flames
C. Telangiectasia nevi
D. Mongolian spots
476. A nurse was observing the stool color for a newborn on the first day after delivery. What is the expected
color of stool for this newborn?
A. Brown
B. Light green
C. Light brown
D. Brownish green
477. A neonatal is admitted to the NICU with a meningomyelocele. HR130, RR 28, TEM 36.7 which of the
following actions the nurse should perform to prevent infection of the meningomyelocele sac?
A. Wash the sac with betadine every shift.

B. Expose the defect to the room air.
C. Apply antibiotic cream every 24 hours.
D. Cover the sac with moist sterile saline dressing.

478. 24 weeks of gestation neonate is admitted to the Neonatal Intensive Unit immediately after delivery
with respiratory distress syndrome.
heart rate 140 /min
respiratory rate 77 /min
Temperature 36.5
Which of the following methods of feeding is recommended with this premature?
A. Enteral feeding of breast milk

B. Enteral feeding of premature formula
C. Oral breast feeding
D. Oral premature formula
479. A nurse is caring for a newborn in Well Born Nursery. She wraps the baby with a blanket and ensures the
nursey temperature is suitable for the babies. What type of heat loss is the nurse preventing?
A. Radiation
B. Conduction
C. Convention
D. Evaporation
480. A term baby boy has been diagnosed with Down syndrome. Physical examination revealed flattened
nose, low set ears, upward slanting eyes, single palmer crease. Which of the following is the most common
congenital anomaly associated with this disease?
A. Developmental dysplasia of hip (DDH)

B. Congenital heart disease
C. Hypospadias
D. Pyloric stenosis
481. If full term infant weighs 3 kg at birth, approximately how should the infant weigh at 12 months old?
A. 7 kg
B. 9 kg
C. 11kg
D. 13kg

482. A nurse is performing physical examination on the newborn. She notes that the baby has
cephalohematoma this baby is risk to develop which of the following?
A. Sudden death
B. Pathological jaundice
C. Infected umbilical cord
D. Increased intracranial pressure.
483. A 4-day old baby diagnosed with physiological jaundice. His father is distressed and wants to know why
he has this condition. What is the most prominent cause of physiological jaundice?
A. Immature hepatic function

B. Decrease milk intake.
C. Rh incompatibility
D. Red blood cell enzyme defects
484. A newborn with hyperbilirubinemia started phototherapy. What will be the nurse's instruction regarding
feeding?
A. Feed glucose drinks

B. Breastfeed every two hours.
C. Bottle feed till the bilirubin level is reduced.
D. Breastfeed alternatively with bottle feeds.
485. A baby born at 35-week was admitted in neonatal intensive unit 27hours ago, physical examination
revealed yellow discoloration sclera and mucus membrane. The result of bilirubin level every 170mmol. The
infant was diagnosed with neonatal jaundice physician order to start single phototherapy. Which of the
following should the nurse consider as a priority during phototherapy of this newborn?
A. Ensure proper fitting of eye covering (patches)

B. Monitor bilirubin levels every 48 hours.
C. Feed the infant formula every 4 to 5 hours.
D. Avoid removing the infant from phototherapy.
486. When performing a new-born assessment, the nurse should measure the vital signs in the following
sequence:
A. Pulse, respirations, temperature

B. Temperature, pulse, respirations
C. Respirations, temperature, pulse
D. Respirations, pulse, temperature

487. A maternity nurse is performing a newborn assessment thirty minutes after delivery of a baby who did
not receive any prenatal care and has an unknown gestational age. The skin is extensively leathery, cracked,
and dry and there is an absence of lanugo and vernix. How many weeks of gestation’ is this neonate?
A. <30
B. 30-35
C. 36-40
D. >40
488. Client who is breastfeeding her newborn requests assistance from the lactation nurse. Which reflex does
the nurse explain in order to assist with latching on?
A. Extrusion reflex
B. Rooting reflex
C. Swallowing reflex
D. Tonic neck reflex
489. A mother asked the nurse that while she was changing the diaper for her female newborn, she noticed a
brick red stain on it. What is the best response from the nurse?
A. It is a sign of low iron excretion.

B. It is expected in female newborn.
C. It is due to medication given to the mother.
D. It is due to medication given to the newborn.
490. On the second day of hospitalization for ventriculoperitoneal shunt revision, a child with spina bifida
developed hives, itching and wheezing. The nurse should determine if the patient has been exposed to:
A. Peanuts
B. Strawberries
C. Eggs
D. Latex
491. A mother brought her 6-month-old healthy infant to the well-baby clinic. Which immunization should the
nurse anticipate administering as per World Health Organization's recommendation?
A. Varicella (Chicken pox)

B. Rotavirus and hepatitis
C. Measles, Mumps, Rubella
D. Diphtheria, Tetanus, and pertussis

492. In determining the one-minute APGAR score of a male infant the nurse assesses a heart rate of 120 beats
per minute and respiratory rate of 44 per minute. He has flaccid muscle tone with slight flexion and resistance
to straightening. He has a loud cry with color is acrocyanotic. What is the APGAR score for the infant.
A. 7
B. 8
C. 9
D. 10
493. The nurse is aware that the age at which the anterior fontanelle closes is........ months
A. 20 to 24
B. 16 to 18
C. 6 to 10
D. 10 to 12

C. Pediatric
494. A nurse is assisting a new mother as she is breastfeeding her infant. The infant has been diagnosed with
tetralogy of Fallot. During feeding, the infant becomes cyanotic and is having difficulty breathing. What
should be the nurse's first action?
A. Administer morphine to the infant
B. Administer oxygen via mask
C. Assess infant's vital signs and pulse oximetry
D. Place the infant in the knee-chest position
495. The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data
would the nurse expect to obtain when asking the parent about the child’s symptoms?
A. Watery diarrhea
B. Projectile vomiting
C. Increased urine output
D. Vomiting large amounts of bile
496. A 7-week-old infant boy is admitted with projectile vomiting decreased urine output, decreased bowel
movements and weight loss. He has poor turgor and appears hungry. The nurse observes left-to right
peristaltic waves after he vomits. The nurse would expect to find which of the following during the physical
assessment?
A. Hepato-splenomegaly
B. A palpable pyloric mass
C. Lymphadenopathy
D. Bulging fontanelle
497. Child came to ER with projectile vomiting and dehydration. The child diagnosed with pyloric stenosis.
What should the nurse expect developing for?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis

498. A 6-year-old child was admitted to pediatric medical ward with acute glomerulonephritis. Which of the
following is an indication of acute glomerulonephritis?
A. Pain in urination
B. Frequent urination
C. Difficulty in urination
D. Pharyngitis 15 days ago
499. Nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's
record and expects to note which sign of this disorder documented.
A. watery diarrhea
B. rib bone-like stools
C. profuse projectile vomiting
D. Red jelly stool
500. 25 year old male is admitted in sickle cell crisis. which of the following intervention would be of highest
priority for this client.
A. Tacking hourly blood pressure with mechanical cuff
B. Hydration and pain management
C. Position in high fowlers with knee raised
D. None of above
501. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which
result will most likely be abnormal in this child?
A. Platelet count
B. Hematocrit level
C. Hemoglobin level
D. Partial thromboplastin time
502. The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia.
Which sport activity should the nurse suggest for this child?
A. Soccer
B. Basketball
C. Swimming
D. Field hockey

503. The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of
a liquid oral iron supplement. Which instruction should the nurse tell the parents?
A. Administer the iron at mealtimes.
B. Administer the iron through a straw.
C. Mix the iron with cereal to administer.
D. Add the iron to formula for easy administration
504. 8-year-old child was admitted to the pediatric ward diagnosed with B-thalassemia. The nurse is planning
to give health education to the mother. Which of the following educational needs is recommended for the
mother?
A. compliance to hydroxyurea
B. compliance to hemosiderosis
C. compliance to desferal
D. compliance to Iron supplement
505. The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related
to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further
instruction?
A. Stress
B. Trauma
C. Infection
D. Fluid overload
506. The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The
nurse notes that the platelet count is 19,500 mm3. On the basis of this laboratory result, which intervention
should the nurse include in the plan of care?
A. Initiate bleeding precautions.
B. Monitor closely for signs of infection.
C. Monitor the temperature every 4 hours.
D. Initiate protective isolation precautions.

507. The nurse is monitoring a 3-year-old child for signs and symptoms of increased intracranial pressure (ICP)
after a craniotomy. The nurse plans to monitor for which early sign or symptom of increased ICP?
A. Vomiting
B. Bulging anterior fontanel
C. Increasing head circumference
D. Complaints of a frontal headache
508. An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for
treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?
A. Sweating and tremors
B. Hunger and hypertension
C. Cold, clammy skin and irritability
D. Fruity breath odor and decreasing level of consciousness
509. A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test
indicates a serum phenylalanine level of 1 mg/dL. The nurse reviews this result and makes which
interpretation?
A. It is positive.
B. It is negative.
C. It is inconclusive.
D. It requires rescreening at age 6 weeks.
510. A child has fluid volume deficit. The nurse performs an assessment and determines that the child is
improving and the deficit is resolving if which finding is noted?
A. The child has no tears.
B. Urine specific gravity is 1.035.
C. Capillary refill is less than 2 seconds.
D. Urine output is less than 1 mL/kg/hour.

511. An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The
nurse should place the infant in which best position at this time?
A. Prone position
B. On the stomach
C. Left lateral position
D. Right lateral position
512. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with
tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition
documented in the record?
A. Incessant crying
B. Coughing at nighttime
C. Choking, with feedings
D. Severe projectile vomiting
513. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors
the infant, knowing that which is a clinical manifestation associated with this disorder?
A. Bile-stained fecal emesis
B. The passage of currant jelly–like stools
C. Failure to pass meconium stool in the first 24 hours after birth
D. Sausage-shaped mass palpated in the upper right abdominal quadrant
514. After a tonsillectomy, the nurse reviews the healthcare provider’s (HCP’s) postoperative prescriptions.
Which prescription should the nurse question?
A. Monitor for bleeding.
B. Suction every 2 hours.
C. Give no milk or milk products.
D. Give clear, cool liquids when awake and alert.

515. The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which
finding indicates the child is bleeding?
A. Frequent swallowing
B. A decreased pulse rate
C. Complaints of discomfort
D. An elevation in blood pressure
516. The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus.
Which observation made by the nurse indicates the presence of this condition?
A. The child has difficulty hearing.
B. The child consistently tilts the head to see.
C. The child does not respond when spoken to.
D. The child consistently turns the head to hear.
517. A10-year-old child with asthma is treated for acute exacerbation in the emergency department. The
nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the
condition?
A. Warm, dry skin
B. Decreased wheezing
C. Pulse rate of 90 beats/minute
D. Respirations of 18 breaths/minute
518. Anew parent expresses concern to the nurse regarding sudden infant death syndrome (SIDS). She asks
the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place
the infant?
A. Side or prone
B. Back or prone
C. Stomach with the face turned
D. Back rather than on the stomach

519. The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate
an area of induration measuring 10 mm. The nurse should interpret these results as which finding?
A. Positive
B. Negative
C. Inconclusive
D. Definitive and requiring a repeat test
520. A 10-year-old child admitted to the pediatric ward with rheumatic fever. Which assessment data should
the nurse consider when obtain child’s history to be most significant?
A. Family history of congenital heart disease
B. Recent episode of streptococcal tonsillitis
C. Lack of interest in certain types of food
D. Projectile vomiting and diarrhea for 2 days
521. The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever,
knowing that which laboratory study would assist in confirming the diagnosis?
A. Immunoglobulin
B. Red blood cell count
C. White blood cell count
D. Anti–streptolysin O titer
522. On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to
note which clinical manifestation of the acute stage of the disease?
A. Cracked lips
B. Normal appearance
C. Conjunctival hyperemia
D. Desquamation of the skin

523. The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving
diuretic therapy. The nurse should use which most appropriate method to assess the urine output?
A. Weighing the diapers
B. Inserting a urinary catheter
C. Comparing intake with output
D. Measuring the amount of water added to formula
524. The clinic nurse reviews the record of a child just seen by a health care provider and diagnosed with
suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation
specifically found in this disorder?
A. Pallor
B. Hyperactivity
C. Exercise intolerance
D. Gastrointestinal disturbances
525. A health care provider has prescribed oxygen as needed for an infant with heart failure. In which
situation should the nurse administer the oxygen to the infant?
A. During sleep
B. When changing the infant’s diapers
C. When the mother is holding the infant
D. When drawing blood for electrolyte level testing
526. The nurse performing an admission assessment on a 2-year-old child who has been diagnosed with
nephrotic syndrome notes that which most common characteristic is associated with this syndrome?
A. Hypertension
B. Generalized edema
C. Increased urinary output
D. Frank, bright red blood in the urine

527. The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be
receiving peritoneal dialysis treatment. The nurse should plan to implement which measure?
A. Restrict fluids as prescribed.
B. Care for the arteriovenous fistula.
C. Encourage foods high in potassium.
D. Administer analgesics as prescribed
528. The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which
statement by the parents indicates their understanding of the plan?
A. “Caution should be used when straddling the infant on a hip.”
B. “Vital signs should be taken daily to check for bladder infection.”
C. “Catheterization will be necessary when the infant does not void.”
D. “Circumcision has been delayed to save tissue for surgical repair.”
529. The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for
surgical repair. When analyzing the results of the urinalysis, which should the nurse most likely expect to
note?
A. Hematuria
B. Proteinuria
C. Bacteriuria
D. Glucosuria
530. The nurse notes documentation that a child is exhibiting an inability to extend the leg when the thigh is
flexed anteriorly at the hip. Which condition does the nurse suspect?
A. Meningitis
B. Spinal cord injury
C. Intracranial bleeding
D. Decreased cerebral blood flow

531. A mother arrives at the emergency department with her 5-year-old child and states that the child fell off
a bunk bed. A head injury is suspected. The nurse checks the child’s airway status and assesses the child for
early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP?
A. Nausea
B. Irritability
C. Headache
D. Bradycardia
532. The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse
reviews the health care provider’s (HCP’s) prescriptions and should contact the HCP to question which
prescription?
A. Obtain daily weight.
B. Provide clear liquid intake.
C. Nasotracheal suction as needed.
D. Maintain a patent intravenous line
533. The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse
identifies seizure precautions and documents that which item(s) need to be placed at the child’s bedside?
A. Emergency cart
b. Tracheotomy set
C. Padded tongue blade
D. Suctioning equipment and oxygen
534. A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal
fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that
which results would verify the diagnosis?
A. Clear CSF, decreased pressure, and elevated protein level
B. Clear CSF, elevated protein, and decreased glucose levels
C. Cloudy CSF, elevated protein, and decreased glucose levels
D. Cloudy CSF, decreased protein, and decreased glucose levels

الملف الثالث (صحة الأم و الطفل)

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الملف الثالث (صحة الأم و الطفل)

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‫دورة االعداد الشاملة‬

‫الختبار الهيئة السعودية للتخصصات الصحية(للتمريض)‬

‫أ‪ .‬إسالم الحايك‬ ‫&‬ ‫أ‪ .‬أحمد محمد‬

A. G=3, T=1, P=0, A=1, L=1

B. G=3, T=1, P=1, A=0, L=3

C. G=3, T=2, P=0, A=2, L=2

D. G=2, T=1, P=0, A=1, L=1

A. January 27, 2017

B. December 21, 2016

C. December 28, 2016

)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 2

A. The client is measuring large for gestational age.

B. The client is measuring small for gestational age.

C. The client is measuring normal for gestational age.

D. More evidence is needed to determine size for gestational age

)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 3

A. The client begins to expel clear vaginal fluid

B. The cervix is dilated completely

C. The contractions are regular

D. The membranes have ruptured

D. Leaking amniotic fluid

A. The baby's presenting part is 2 cm above the iliac spine.

B. The baby's presenting part is 2 cm below the iliac spine.

C. The baby's presenting part is 2 cm above the ischial spine.

D. The baby's presenting part is 2 cm below the ischial spine.

)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 4

A. Occurring at irregular intervals

B. Gradually increasing intervals

C. Increasing intensity with walking

D. Starting mainly in the abdomen

A. They are regular and increase gradually

B. They are felt in the abdomen

C. They start at the back and radiate to the abdomen

D. They become more intense during walking

A. Increased urine output

B. Increased blood pressure

C. Decreased fetal heart rate

D. Decreased brachial reflexes

)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 5

A. Edema of the feet and ankles

B. Edema of the hands and face

C. Weight gain of 1 lb/week

D. Early morning headache

D. Altered respiratory status

A. Urinary output has increased.

B. Dependent edema has resolved.

C. Blood pressure reading is at the prenatal baseline.

D. The client complains of a headache and blurred vision

A. Enlargement of the breasts

B. Complaints of feeling hot when the room is cool

C. Periods of fetal movement followed by quiet periods

D. Evidence of bleeding, such as in the gums, petechiae, and purpura

A. Urine protein 300 mg/24 hours

B. Blood pressure 150/96 mm Hg

C. Mild facial edema

D. Delivery of the fetus

D. Deep tendon reflexes

A. “I should stay on the diabetic diet.”

B. “I should perform glucose monitoring at home.”

C. “I should avoid exercise because of the negative effects on insulin production.”

A. Fetal heart monitor

)‫ صحة األم و الطفل ( أحمد محمد – إسالم الحايك‬:‫الملف الثالث‬ 7

A. Document the finding.

A. Administer oxygen via face mask.