Group 5 C. Assess the liquid because a 10.

During a postpartum
breast discharge is diagnostic of a assessment, the nurse performs a
mammary infection. Homan’s sign. Which of the
1. The nurse has provided teaching
D. Reassure the mother that this is following actions does the nurse
to a post-op cesarean client who is
normal in the third trimester. perform?
being discharged on Colace
A. Taps the patellae with a reflex
(docusate sodium) 100 mg po tid.
5. Which finding would the nurse hammer.
Which of the following would
view as normal when evaluating the B. Dorsiflexes the feet.
indicate that the teaching was
laboratory reports of a 34-week C. Palpates the calves and ankles.
successful?
gestation client? D. Monitor the color of the
A. The woman swallows the tablets
A. Anemia. extremities.
whole.
B. Thrombocytopenia.
B. The woman takes the pills
C. Polycythemia.
between meals.
D. Hyperbilirubinemia. 11. A mother has just experienced
C. The woman calls the doctor if
quickening. Which of the following
she develops a headache.
6. A third-trimester client is being developmental changes would the
D. The woman does not worry when
seen for routine prenatal care. nurse expect to occur at the same
her urine turns orange.
Which of the following assessments time in the woman’s pregnancy?
will the nurse perform during the A. Fetal heart begins to beat.
2. After analyzing an internal fetal
visit? Select all that apply. B. Lanugo covers the fetal body.
monitor tracing, the nurse concludes
A. Blood glucose. C. Kidneys secrete urine.
that there is moderate short-term
B. Blood pressure. D. Fingernails begin to form.
variability. Which of the following
C. Fetal heart rate.
interpretations should the nurse
D. Urine protein. 12. A woman is carrying dizygotic
make in relation to this finding?
E. Pelvic ultrasound. twins. She asks the nurse about the
A. The fetus is becoming hypoxic.
babies. Which of the following
B. The fetus is becoming alkalotic.
7. Which of the following skin explanations is accurate?
C. The fetus is in the middle of a
changes should the nurse highlight A. During a period of rapid growth,
sleep cycle.
for a pregnant woman’s health care the fertilized egg divided
D. The fetus has a healthy nervous
practitioner? completely.
system.
A. Linea nigra. B. When the woman ovulated, she
B. Melasma. expelled two mature ova.
3. The nurse is assessing an internal
C. Petechiae. C. The babies share one placenta
fetal heart monitor tracing of an
D. Spider nevi. and a common chorion.
unmedicated, full-term gravida who
D. The babies will definitely be the
is in transition. Which of the
8. A client has been transferred to same sex and have the same blood
following heart rate patterns would
the post–anesthesia care unit from a type.
the nurse interpret as normal?
cesarean delivery. The client had
A. Variable baseline of 140 with V-
spinal anesthesia for the surgery. 13. During a vaginal examination,
shaped decelerations to 120
Which of the following the nurse palpates fetal buttocks that
unrelated to contractions.
interventions should the nurse are facing the left posterior and are
B. Variable baseline of 140 with
perform at this time? 1 cm above the ischial spines.
decelerations to 100 that mirror
A. Assess the level of the Which of the following is consistent
each of the contractions.
anesthesia. with this assessment?
C. Flat baseline of 140 with
B. Encourage the client to urinate in A. LOA 1 station.
decelerations to 120 that return to
a bedpan. B. LSP 1 station.
baseline after the end of the
C. Provide the client with the diet of C. LMP 1 station.
contractions.
her choice. D. LSA 1 station.
D. Flat baseline of 140 with no
D. Check the incision for signs of
obvious decelerations or
infection. 14. On examination, it is noted that
accelerations.
a full-term primipara in active labor
9. Below are four important is right occiput anterior (ROA), 7
4. A 37-week gravid client states
landmarks of fetal development. cm dilated, and 3 station. Which of
that she noticed a “white liquid”
Place them in chronological order: the following should the nurse
leaking from her breasts during a
A. Four-chambered heart is formed. report to the physician?
recent shower. Which of the
B. Vernix caseosa is present. A. Descent is progressing well.
following nursing responses is
C. Blastocyst development is B. Fetal head is not yet engaged.
appropriate at this time?
complete. C. Vaginal delivery is imminent.
A. Advise the woman that she may
D. Testes have descended into the D. External rotation is complete.
have a galactocele.
scrotal sac.
B. Encourage the woman to pump
15. A client is in the second stage of
her breasts to stimulate an adequate
labor. She falls asleep immediately
milk supply.
after a contraction. Which of the
following actions should the nurse
perform as a result?
A. Awaken the woman and remind
her to push.
B. Cover the woman’s perineum
with a sheet.
C. Assess the woman’s blood
pressure and pulse.
D. Administer oxygen to the woman
via face mask.
16. A nurse is teaching a class of
pregnant couples the most
therapeutic breathing technique for
the latent phase of labor. Which of
the following techniques did the
nurse teach?
A. Alternately panting and blowing.
B. Rapid, deep breathing.
C. Grunting and pushing with
contractions.
D. Slow chest breathing.
17. Which of the following
exercises should be taught to a
pregnant woman who complains of
backaches?
A. Kegeling.
B. Pelvic tilting.
C. Leg lifting.
D. Crunching.
18. The nurse should explain to a
client who is experiencing
premature contractions in the thirty-
fifth week of gestation with the
cervix dilated 2 cm that coitus:
A. Need not be restricted in
any way
B. Is prohibited, as it may
stimulate labor
C. Should be restricted to the
side-lying position
D. Is permitted as long as
penile penetration is
shallow
19. In the fifth month of pregnancy,
ultrasonography is performed on a
client. The results indicate that the
fetus is small for gestational age and
there is evidence of a low-lying
placenta. The nurse would use this
information in the last trimester of
pregnancy by assessing the client
for signs of possible:
A. Placenta previa
B. Premature labor
C. Abruptio placentae
D. Precipitate delivery
20. The fetus is most likely to be C. Delivery of twins or
structurally damaged by the hydramnios
pregnant woman’s ingestion of D. Uncomplicated
drugs during the: gestational hypertension
A. First trimester
B. Second trimester 26. The nurse evaluates that the
C. Third trimester danger of seizure in a woman with
D. Entire trimester eclampsia ends:
A. After the labor begins
21. A 42-year old client has an B. After delivery occurs
amniocentesis during the sixteenth C. 24 hours postpartum
week of gestation because of D. 48 hours postpartum
concern about Down syndrome.
Examination of the amniotic fluid 27. When taking the health history
will also provide information the nurse recognizes that a client
regarding: would be at risk for pregnancy-
A. Fetal diabetes induced hypertension if it is
B. Fetal lung maturity determined that she:
C. Cardiac anomalies A. Is 31 years old
D. Presence of neural tube B. Is an obese primigravida
defects C. Has had six previous
pregnancies
22. One of the most causes of D. Has been on oral
hypotonic uterine dystocia is: contraceptives within 3
A. Twin gestation months of conception
B. Maternal anemia
C. Pelvic contracture 28. During an emergency delivery ,
D. Pregnancy-induced the nurse notes the baby’s head
hypertension crowning on the perineum. The
nurse priority action is to support
23. A client comes to the clinic for a the head by:
sonography at 36 weeks gestation. A. Applying suprapubic
Before the test begins, the client pressure over it
complains of severe abdominal B. Distributing the fingers
pain. Heavy vaginal bleeding is evenly around it.
noted and the client’s BP drops C. Placing the hand firmly
while her pulse rate increases. The against the perineum
nurse should suspect that the client D. Maintaining firm pressure
has a: against the anterior
A. Hydatidiform mole fontanel
B. Vena caval syndrome
C. Marginal placenta previa 29. When a client is admitted to the
D. Complete abruptio labor suite with a blood pressure of
placentae 130/90 +2 proteinuria, and edema of
the hands and face, the nurse should
24. A client experiences an episode ask the client about the presence of:
of painless vaginal bleeding during A. Constipation, edema,
the last trimester. The nurse realizes visual problems, headache
that this may be caused by: B. Leakage of fluid,
A. Placenta previa bleeding, edema, pain in
B. Abruptio placentae the abdomen
C. Frequent intercourse C. Visual disturbances,
D. Excessive alcohol headaches, constipation,
ingestion bleeding
D. Headache, visual
25. When assessing clients after disturbances, edema, pain
delivery, the nurse should be aware in the abdomen
that postpartal hemorrhage rarely
occurs as complication of: 30. At 38 weeks' gestation a client
A. Retained placenta begins active labor and is placed on
B. Overdistended bladder a fetal monitor. Late decelerations
in the FHR begin to appear when
she is 6 cm dilated, with q 4-minute
contractions lasting 45 seconds.
Late decelerations may signify:
A. Imminent vaginal delivery
B. Uteroplacental
insufficiency
C. A pattern of
nonprogressive labor
D. A reassuring response to
contractions
31. Following delivery of the
placenta in a client who has six
living children, an infusion of
lactated Ringer's with 10 units of
Pitocin is ordered. The nurse
understands that this is indicated for
this client because:
A. Multigravidas are at
increased risk for uterine
atony
B. Retained placental
fragments must be
expelled
C. This was an extramural
delivery
D. She had a precipitate
delivery
32. A pregnant client with diabetes
is referred to the clinic nutritionist
for nutritional assessment and
counseling. The dietary program
worked out for this client would be:
A. A diet high in protein of
good biologic value and
decreased calories
B. A balanced diet to meet
increased dietary needs
with insulin adjusted as
necessary
C. Adequate balance of
carbohydrate and fat to
meet energy demands and
prevent ketosis
D. A low-carbohydrate, low-
calorie diet to stay within
her present insulin
coverage and avoid
hyperglycemia
33. The nurse notifies the physician
that a client has been admitted in
her thirty-sixth week of pregnancy.
The client is bleeding, has severe
abdominal pain, a hard fundus, and
is demonstrating signs of shock. In
addition to notifying the physi- cian,
the nurse also prepares for:
A. A high forceps delivery
B. The insertion of a fetal
monitor
C. An immediate cesarean
delivery
D. The administration of
oxytocin (Pitocin)
34. In the immediate postpartum
period, the most critical assessment
of a client with pregnancy-induced
hypertension would be:
A. Obtaining the client's
vital signs
B. Observing for signs of
hemorrhage
C. Evaluating the client's
emotional status
D. Monitoring for
hypovolemic shock
resulting from fluid shifts
35. The uterus has already risen out
of the pelvis and is experiencing
farther into the abdominal area at
about the
A. a. 8th week of pregnancy
B. b. 10th week of pregnancy
C. c. 12th week of pregnancy
D. d. 18th week of pregnancy
36. Nurse Geli explains to the client
who is 33 weeks pregnant and is
experiencing vaginal bleeding that
coitus:
A. a. Need to be modified in
any way by either partner
B. b. It is permitted if penile
penetration is not deep.
C. c. Should be restricted
because it may stimulate
uterine activity.
D. d. Is safe as long as she is
in a side-lying position.
37. Mrs. Precilla Abuel, a 32-year-
old mulripara is admitted to labor
and delivery. Her last 3 pregnancies
were in short stage one of labor. The
nurses decide to observe her closely.
The physician determines that Mrs.
Abuel’s cervix is dilated to 6 cm.
Mrs. Abuel states that she is
extremely uncomfortable. To lessen
Mrs. Abuel’s discomfort, the nurse
can advise her to:
A. a. lie face down
B. b. not drink fluids
C. c. practice holding breaths
between contractions
D. d. assume Sim’s position
38. A pregnant client is diagnosed
with gestational diabetes at 29
weeks’ gestation during a prenatal
visit. The nurse provides
information by teaching the client
about this condition. Which
information would the nurse most
likely provide to this client about
managing this condition?
A. a. The client should test
urine ketones each time
she uses the bathroom
B. b. The client should avoid
exercising more than
twice a week to reduce
stress on the body
C. c. The client should check
blood glucose regularly to
keep fasting levels less
than 90 mg/dL
D. d. The client should meet
with a pharmacist for
insulin dosing and take
her oral insulin according
to her glucose results
39. After reviewing an 11-week
pregnant client’s history, a nurse
knows that which of the following
puts the client at risk for gestational
hypertension?
A. Age greater than 40
B. Current blood pressure of
142/90
C. She is underweight
D. This is her third
pregnancy
40. The nurse is working with a
client who requires hemodialysis
and has become pregnant. The client
asks the nurse, “Will I be able to
continue with dialysis even though I
am pregnant?” Which response
from the nurse is accurate?
A. "You should be able to
have peritoneal dialysis
but not hemodialysis"
B. "Most women terminate
their pregnancies if they
need hemodialysis"
C. "You will not be able to
continue with
hemodialysis while you
are pregnant; it is too
dangerous"
 D. "Some women can have
hemodialysis while
pregnant, but it will be a
high-risk pregnancy"
41. A nurse is educating a client
with Type 1 Diabetes about how to
know if she can have a healthy
pregnancy. Which statement
indicates the client understood the
teaching?
a. “As long as I take my oral
antidiabetic medications as
scheduled”
b. “If I find I don’t have to take as
much insulin.”
c. “If I find I’m taking a lot of
insulin”
d. “I need my hemoglobin A1C to
be less than 6”
42. A pregnant client asks the nurse
if it’s okay to have the occasional
glass of red wine. What is the most
appropriate response by the nurse?
a. “There is no known safe amount
to recommend in pregnancy”
b. “As long as it is a wine you are
safe to drink a glass a day”
c. “Drinking one glass once a week
with meals is safe”
d. “One glass is ok as long as you
are in the second or third trimester”
43. A nurse is educating a client
who has very high blood pressure
during pregnancy. Which statement
by the client indicates the most
understanding regarding gestational
hypertension?
a. “My baby will have high blood
pressure when she is born”
b. “My baby may be too small when
she is born”
c. “My baby can grow very large
because of this”
d. “My blood pressure should be
better immediately after having the
baby”
44. The nurse is caring for a
primigravida at about 2 months and
1 week gestation. After explaining
self-care measures for common
discomforts of pregnancy, the nurse
determines that the client
understands the instructions when
she says:
a. “Nausea and vomiting can be
decreased if I eat a few crackers
before arising”
b. “If I start to leak colostrum, I
should cleanse my nipples with soap
and water”
c. “If I have a vaginal discharge, I
should wear nylon underwear”
d. “Leg cramps can be alleviated if I
put an ice pack on the area”
45. Normal lochial findings in the
first 24 hours post-delivery include:
a. Bright red blood
b. Large clots or tissue fragments
c. A foul odor
d. The complete absence of lochia
46. Because cervical effacement and
dilation are not progressing in a
patient in labor, Dr. Smith orders
I.V. administration of oxytocin
(Pitocin). Why must the nurse
monitor the patient’s fluid intake
and output closely during oxytocin
administration?
a. Oxytocin causes water
intoxication
b. Oxytocin causes excessive thirst
c. Oxytocin is toxic to the kidneys
d. Oxytocin has a diuretic effect
47. The nurse is developing a
teaching plan for a patient who is 8
weeks pregnant. The nurse should
tell the patient that she can expect to
feel the fetus move at which time?
a. Between 10 and 12 weeks’
gestation
b. Between 16 and 20 weeks’
gestation
c. Between 21 and 23 weeks’
gestation
d. Between 24 and 26 weeks’
gestation
48. A primigravida patient is
admitted to the labor delivery area.
Assessment reveals that she is in
early part of the first stage of labor.
Her pain is likely to be most
intense:
a. Around the pelvic girdle
b. Around the pelvic girdle and in
the upper arms
c. Around the pelvic girdle and at
the perineum
d. At the perineum
49. A nurse is counseling a pregnant
client who has been diagnosed with
an incompetent cervix. Which of the
following statements by the nurse
would be included as part of
teaching?
a. Call the doctor's office if you
experience skin changes on your
face or abdomen
b. You should not lift anything over
15 pounds
c. Try to drink less fluids and
instead eat more foods with protein
d. You will need to abstain from
sexual intercourse until the provider
gives permission
50. A nurse is caring for a client
who is 15-weeks pregnant. The
ultrasound shows a shortening of
her cervix on ultrasound. Which of
the following diagnoses would the
nurse anticipate?
a. Incompetent cervix
b. A threatened miscarriage
c. Normal finding in pregnancy
d. Inevitable miscarriage
51. A nurse is evaluating a group of
pregnant clients with cervical
shortening on ultrasound. Which of
the following clients is likely to
receive a cervical cerclage?
a. A 22-week pregnant client with a
history of multiple preterm losses
b. A 28-week pregnant client who is
having mild irregular contractions
c. A 32-week pregnant client with
ruptured membranes
d. A 29-week pregnant client with a
thinning cervix that is 3 cm dilated
52.. When assessing a child’s
cultural background, the nurse in
charge should keep in mind that:
A. Cultural background usually has
little bearing on a family’s health
practices
B. Physical characteristics mark the
child as part of a particular culture
C. Heritage dictates a group’s
shared values
D. Behavioral patterns are passed
from one generation to the next
53. A child with a poor nutritional
status and weight loss is at risk for a
negative nitrogen balance. To help
diagnose this problem, the nurse in
charge anticipates that the doctor
will order which laboratory test?
A. Total iron-binding capacity
B. Hemoglobin
C. Total protein
D. Serum transferrin causes of death in infants. At what
age is the diagnosis of SIDS most
54. A female child, age 2, is brought likely?
to the emergency department after
ingesting an unknown number of A. At 1 to 2 years of age
aspirin tablets about 30 minutes
earlier. On entering the examination B. At I week to 1 year of age,
room, the child is crying and peaking at 2 to 4 months
clinging to the mother. Which data
should the nurse obtain first? C. At 6 months to 1 year of age,
A. Heart rate, respiratory rate, and peaking at 10 months
blood pressure
D. At 6 to 8 weeks of age
B. Recent exposure to
communicable diseases 59. Which of the following would
be inappropriate when
C. Number of immunizations administering chemotherapy to a
received child?
A. Monitoring the child for both
D. Height and weight general and specific adverse effects
55. To decrease the likelihood of B. Observing the child for 10
bradyarrhythmias in children during minutes to note for signs of
endotracheal intubation, anaphylaxis
succinylcholine (Anectine) is used
with which of the following agents? C. Administering medication
A. epinephrine (Adrenalin) through a free-flowing intravenous
line
B. isoproterenol (Isuprel)
D. Assessing for signs of infusion
C. atropine sulfate (Atropine) infiltration and irritation
D. Lidocaine hydrochloride 60. Which of the following is most
(Xylocaine) likely associated with a
cerebrovascular accident (CVA)
56. Dr. Jones prescribes resulting from congenital heart
corticosteroids for a child with disease?
nephritic syndrome. What is the A. Polycythemia
primary purpose of administering
corticosteroids to this child? B. Cardiomyopathy
A. To increase blood pressure C. Endocarditis
D. Low blood pressure
B. To reduce inflammation
61. Clay is an 8-year-old boy
C. To decrease proteinuria diagnosed with heart failure. Which
of the following shows that he is
D. To prevent infection strictly following the directed
therapeutic regimen?
57. What should be the initial bolus
of crystalloid fluid replacement for
A. Daily use of an antibiotic
a pediatric patient in shock? B. Pulse rate less than 50
A. 20 ml/kg beats/minute
B. 10 ml/kg C. Normal weight for age
C. 30 ml/kg D. Elevation in red blood cell
(RBC) count
D. 15 ml/kg
62. Bryce is a child diagnosed with
58. Sudden infant death syndrome coarctation of aorta. While
(SIDS) is one of the most common assessing him, Nurse Zach would
expect to find which of the B. A sibling of Baby Angie who C. Feeling guilty about
following? died of SIDS surviving the event
A. Squatting posture D. Development of above-
C. Baby Gabriel with prenatal drug average intelligence
B. Absent or diminished femoral exposure
pulses
D. Baby Gabby who sleeps on his 71. Anorexia nervosa is most
C. Severe cyanosis at birth back commonly diagnosed in which age
group?
D. Cyanotic ("tet") episodes 67. Archie who weighs 44 lb has
been given an order for amoxicillin
A. Early childhood (ages 5-
63. Appropriate intervention is vital 500 mg b.i.d. The drug text notes
8)
for many children with heart disease that the daily dose of amoxicillin is
in order to go on to live active, full 50 mg/kg/day in two divided doses. B. Puberty or adolescence
lives. Which of the following What dose in milligrams is safest (ages 13-20)
outlines an effective nursing for this child? C. Late adulthood (ages
intervention to decrease cardiac A. 1000 mg 65+)
demands and minimize cardiac
workload? D. Infancy (ages 0-2)
B. 750 mg
A. Feeding the infant over long
periods C. 500 mg 72. What is the virus that causes
B. Allowing the infant to have her warts?
way to avoid conflict D. 250 mg
A. Influenza virus
C. Scheduling care to provide for 68. Immunization of children with
uninterrupted rest periods Haemophilus influenzae type B B. Papillomavirus
(Hib) vaccine decreases the C. Rhinovirus
D. Developing and implementing a incidence of which of the following
conditions? D. Herpesvirus
consistent care plan
A. Bronchiolitis
64. The procedure that has to be 73. Besides limiting food intake,
performed in order to shift the high B. Laryngotracheobronchitis
(LTB) which other behaviors are listed as
pressure from the right ventricle to ways children with eating disorders
the left ventricle in Transposition of C. Epiglottitis might control their weight?
the Great Arteries (TGA) is: D. Pneumonia
A. Rashkind Procedure
A. Skipping baths and
69. What is a characteristic showering less frequently
B. Rastelli Procedure symptom of Oppositional Defiant
Disorder (ODD) in children? B. Excessive exercise and
C. Pulmonary Artery Banding purging behaviors
C. Wearing loose-fitting
D. Jatene Procedure A. Difficulty making friends
clothing
B. Above average
65. Veronica’s parents were told D. Spending more time
intelligence
that their daughter needs ribavirin socializing
C. Frequent temper
(Virazole). This drug is used to treat
outbursts directed at
which of the following? 74. What is a potential medical
authority figures
A. Cystic fibrosis consequence of eating disorders
mentioned?
B. Otitis media D. Preference for solitary activities
A. Increased risk of cavities
C. Respiratory syncytial virus 70. Which of the following is NOT
(RSV) B. Delayed psychosexual
a symptom of Post-traumatic Stress
development
Disorder (PTSD) in children?
D. Bronchitis C. Development of psychic
abilities
66. Which of the following infants A. Recurring nightmares
is least probable to develop sudden about the traumatic event D. Improved athletic
infant death syndrome (SIDS)? performance
B. Intense anxiety when
A. Baby Angela who was reminded of the event
premature
75. What are the primary physical
injuries associated with shaken baby
syndrome (SBS)?
A. Broken bones
B. Whiplash injury to the
neck
C. Internal organ damage
D. Skin abrasions
76. Which of the following is NOT
a characteristic of ritual abuse?
A. It is motivated by
religious or spiritual
beliefs.
B. It involves physical or
sexual abuse.
C. It is typically a one-time
event.
D. It may involve multiple
perpetrators and victims.
77. A diving reflex that can help
very young children survive in cold
water. What triggers this reflex?
A. Holding their breath for a long
time
B. Shivering to generate heat
C. Submerging their face first in
cold water (below 70°F)
D. Wearing a life jacket
78. How do parents typically react
to a SIDS death
A. They become angry and blame
medical professionals.
B. They readily accept death and
move on quickly.
C. They may use both past and
present tense when discussing the
child.
D. They often experience symptoms
of physical illness due to grief.
79. It is mentions that prolonged
apnea is a possible factor in SIDS.
What does "apnea" refer to in this
context?
A. Shallow breathing
B. Difficulty swallowing
C. Complete cessation of breathing
for a short period
D. Rapid and labored breathing
80. How often should diapers be
changed to promote good diaper-
area hygiene?
A. Every hour
B. Every 2-4 hours
C. Only when the diaper is visibly
soiled
D. Whenever the baby wakes up
81. When using baby powder on an
infant, what is the recommend to
avoid?
A. Using a scented powder
B. Applying the powder directly to
the baby's skin
C. Leaving the powder container
within the baby's reach
D. All of the above
82. What is a common location for
miliaria (prickly heat rash) to appear
first on an infant?
A. Arms and legs
B. Face and cheeks
C. Neck
D. Diaper area
83. What is the name of the tooth
decay problem caused by putting an
infant to sleep with a bottle
containing sugary liquids, according
to the passage?
A. Rampant caries
B. Baby bottle tooth decay
C. Early childhood caries
D. Enamel erosion
84. What is a potential sign of
hidden abdominal bleeding after
trauma?
A. Fever
B. Increased appetite
C. Hypotension (low blood
pressure)
D. Diarrhea
85. What describes two terms
related to drowning incidents. What
is the difference between
"drowning" and "near drowning"?
A. Drowning refers to saltwater
submersion, near drowning refers to
freshwater submersion.
B. Drowning is always fatal, near
drowning refers to survival after
submersion with medical
intervention.
C. Drowning is caused by
hyperventilation, near drowning is
caused by lack of oxygen.
D. Drowning is more common in
summer, near drowning is more
common in winter.
86.) During pregnancy, which
physiological change is expected in
the cardiovascular system?
A) Decreased cardiac output
B) Decreased blood volume
C) Increased heart rate
D) Decreased blood pressure
87.) What is a common skin change
that occurs during pregnancy?
A) Decreased pigmentation
B) Increased oil production
C) Formation of stretch marks
(striae gravidarum)
D) Reduced perspiration
88.) What is a common
hematological change in pregnancy?
A) Decreased white blood cell count
B) Decreased platelet count
C) Increased risk of anemia
D) Increased blood viscosity
89.) Which breast change is
expected during pregnancy?
A) Decreased breast size
B) Reduced nipple sensitivity
C) Darkening of the areolas
D) Decreased blood flow to the
breasts
90.) Which sleep-related change
may occur during pregnancy?
A) Increased deep sleep (slow-wave
sleep)
B) Decreased total sleep duration
C) Reduced incidence of sleep
disturbances
D) Increased sleep efficiency
91.) Which endocrine change occurs
during pregnancy?
A) Decreased insulin sensitivity
B) Decreased thyroid hormone
production
C) Increased cortisol secretion
D) Increased prolactin levels
92.) In a lecture on sexual
functioning, the nurse plans to
include the fact that ovulation
occurs when the:
A. Oxytocin is too high.
B. Blood level of LH is too high.
C. Progesterone level is high.
D. Endometrial wall is sloughed off.
93.) The main function
progesterone is the:
A. Development of the female
reproductive system.
B. Stimulation of the follicles for
ovulation to occur.
C. Preparation of the uterus to
receive a fertilized egg.
D. Establishment of secondary male
sex characteristics.
94.) After the first four months of
pregnancy, the chief source of
estrogen and progesterone is the:
A. Placenta
B. Adrenal cortex
C. Corpus luteum
D. Anterior hypophysis
95.) Which of the following terms
applies to the tiny, blanched,
slightly raised end arterioles found
on the face, neck, arms, and chest
during pregnancy?
A. Epulis
B. Linea nigra
C. Striae gravidarum
D. Telangiectasias
96.) Which of the following answers
best describes the stage of
pregnancy in which maternal and
fetal blood are exchanged?
A. Conception
B. 9 weeks’ gestation, when the
fetal heart is well developed.
of
C. 32-34 weeks gestation
D. Maternal and fetal blood are
never exchanged.
97.) A client states that she had a
spontaneous abortion 12 months
ago. The client asks if her hormones
may have contributed to the loss of
the pregnancy. The nurse’s response
is based upon her knowledge of
which of the following facts?
A. Implantation occurs when
progesterone levels are low.
B. hCG reaches a maximum level at
4 weeks gestation.
C. Progesterone decreases the
contractility of the uterus.
D. Progesterone is only produced by
the corpus luteum during
pregnancy.
98.) After being rehydrated in the
emergency department, a 24-year-
old primipara in her 18th week of
pregnancy is at home and is to rest
at home for the next two days and
take in small but frequent fluids and
food as possible. Discharge teaching
at the hospital by the nurse has been
effective if the patient makes which
statement?
A. “I’m going to eat five to six
small servings per day, which
contain such foods and fluids as tea,
crackers, or a few bites of baked
chicken.”
B. “A strip of bacon and a fried egg
will taste good as long as I eat them
slowly.”
C. “As long as I eat small amounts
and allow enough time for
digestion, I can eat almost anything,
like barbequed chicken or
spaghetti.”
D. “I’m going to stay only on clear
fluids for the next 24 hours and then
add dairy products like eggs and
milk.”
99.) A pregnant patient has a
systolic blood pressure that exceeds
160 mm Hg. Which action should
the nurse take for this patient?
A. Administer magnesium sulfate
intravenously.
B. Obtain a prescription for
antihypertensive medications.
C. Restrict intravenous and oral
fluids to 125 mL/hr.
D. Monitor fetal heart rate (FHR) B. Forceps delivery
and uterine contractions (UCs).
C. Schultz delivery
100.) A nurse is conducting a
prenatal class on the female
D. Weak bearing down efforts
reproductive system. When a client
in the class asks why the fertilized
ovum stays in the Fallopian tube for 103. The parents of a 9-month old
3 days, the nurse responds that the bring the infant to the clinic for a
reason for this is that it: regular check up. The infant has
received no immunizations. Which
vaccine order would the nurse
A. Promotes the fertilized ovum’s
question?
chances of survival.
A. Diphtheria, tetanus, and
B. Promotes the fertilized ovum’s
acellular pertussis
exposure to estrogen &
(DTaP).
progesterone.
B. Haemophilus influenzae
type B (Hib).
C. Promotes the fertilized ovum’s
C. Measles, mumps, and
normal implantation in the top
portion of the uterus. rubella (MMR).
D. Hepatitis B (Hep B).
D. Promotes the fertilized ovum’s
exposure to LH and FSH. 104. To assess the development of
a 1-month-old, the nurse asks the
101.) A nurse is monitoring a client parent if the infant is able to:
in active labor and notes that the
client is having contractions every 3 A. Smile and laugh out loud
minutes that last 45 seconds. The
B. Roll from the back to side.
nurse notes that the fetal heart rate
between contractions is 100 BPM. C. Hold a rattle briefly.
Which of the following nursing D. Hepatitis B (Hep B)
actions is most appropriate?
105. The nurse should refer the
A. Encourage the client’s coach to parents of an 8-month old child to a
continue to encourage breathing health care provider if the child is
exercises. unable to:
B. Encourage the client to continue A. stand momentarily
pushing with each contraction. without holding onto
furniture.
C. Continue monitoring the fetal B. stand alone well for long
heart rate. periods of time.
C. stoop to recover an object.
D. Notify the physician or nurse- D. sit without support for
midwife. long periods of time.
102.)A nurse in a labor room is 106. Which infant most needs a
assisting with the vaginal delivery developmental referral for a gross
of a newborn infant. The nurse motor delay?
would monitor the client closely for
the risk of uterine rupture if which
of the following occurred? A. The 2-month-old who
does not roll over
A. Hypotonic contractions
 B. The 4-month-old who
does sit without support
C. The 6-month-old who
does not creep
D. The 9-month-old who
does not stand holding on.
107. Which intervention should the
nurse employ to reduce trauma
caused by vaccine administration to
an infant ?
A. Use a 5/8inch (1.6cm)
needle
B. simultaneously administer
vaccines at separate sites
C. aspirate to verify needle
placement
D. breast-feed right before
administering the vaccines
108. A 2-year-old child brought to
the clinic by her parents is
uncooperative when the nurse tries
to look in her ears. Which of the
following should nurse try first?
A. ask another nurse to assist
B. allow a parent to assist
C. wait until the child calms
down
D. restrain the child’s arm
109. The mother asks the nurse for
advice about discipline for her 18-
month-old. Which of the following
should nurse suggest that the mother
use?
A. structured
interactions
B. spanking
C. reasoning
D. time-out
110. To encourage autonomy in a 4-
year old, the nurse should instruct
the mother to:
A. Discourage the child’s
choice of clothing.
B. button the child’s coat and
blouse.
C. praise the child’s attempts
to dress herself.
D. tell the child when the
combination of clothes is
not appropriate.
111. when assessing the pain in a
toddler, which of the following
method should be the most
appropriate?
A. ask the child about the
pain
B. observe the child for
restlessness
C. use a numeric pain scale
D. assess for changes in vital
signs
112. The nurse is teaching the
parents of an 8-month-old about
what the child should eat. The nurse
should include which of the follow
points in the teaching plan?
A. items from all food
groups should be
introduced to the infant by
the time the child is 10
months old.
B. solid foods should not be
introduced until the infant
is 10 months old.
C. Iron deficiency rarely
develops before 12
months of age, so iron
fortified cereals should
not be introduced until the
infant is 12 months old.
D. the infants diet can be
changed from formula to
whole milk when the
infant is 12 months old.
113. The parents of a preschooler
ask the nurse how to handle their
child's temper tantrums. Which of
the following should the nurse
include in the teaching plan? Select
all that apply.
A. Putting the child in “time-
out.”
B. Telling the child to go to
his bedroom.
C. Ignoring the child.
D. Putting the child to bed.
E. Spanking the child.
F. Trying to reason with the
child.
114. After teaching a group of
parents of preschoolers attending a
well-child clinic about oral hygiene
and tooth brushing, the nurse
determines that the teaching has
been successful when the parents
state that children can begin to
brush their teeth without help at
which of the following ages?
A. 3 years.
B. 5 years.
C. 7 years.
D. 9 years.
115. After having a blood sample
drawn, a 5-year-old child insists that
the site be covered with a bandage.
When the parent tries to remove the
bandage before leaving the office,
the child screams that all the blood
will come out. The nurse
encourages the parent to leave the
bandage in place and tells the parent
that the child:
A. Fears another procedure.
B. Does not understand body
integrity.
C. Is expressing pain.
D. Is attempting to regain
control.
116. The family of a 5-year-old,
only child has just moved to a rural
setting. At the well-child visit, the
father expresses concern that his
child seems prone to minor
accidents such as skinning his
elbow and knees or falling off his
scooter. The nurse tells the father:
A. “Only children use
accidents as a way to seek
parental attention.”
B. “Children who live in the
suburbs typically have
more accidents.”
 C. “Children frequently
have more accidents when
families experience
change.”
D. “We see a relationship
between accidents and
parental education.”
117. When developing the teaching
plan about illness for the mother of
a preschooler, which of the
following should the nurse include
about how a preschooler perceives
illness?
A. A necessary part of life.
B. A test of self-worth.
C. A punishment for
wrongdoing.
D. The will of God.
118. When planning a 15-month-old
toddler's daily diet with the parents,
which of the following amounts of
milk should the nurse include?
A. ½ to 1 cup (125 to 250
mL).
B. 2 to 3 cups (500 to 750
mL).
C. 3 to 4 cups (750 to 1,000
mL).
D. 4 to 5 cups (1,000 to
1,250 mL).
119. When observing the parent
instilling prescribed ear drops
prescribed twice a day for a toddler,
the nurse decides that the teaching
about positioning of the pinna for
instillation of the drops is effective
when the parent pulls the toddler's
pinna in which of the following
directions?
A. Up and forward.
B. Up and backward.
C. Down and forward.
D. Down and backward.
120, In a lecture on sexual
functioning, the nurse plans to
include the fact that ovulation
occurs when the:
b. G5 T2 P2 A1 L4
a. Oxytocin is too high. c. G5 T2 P1 A1 L4
b. Blood level of LH is too d. G4 T3 P1 A1 L4
high.
c. Progesterone level is high. 126, An expected cardiopulmonary
d. Endometrial wall is adaptation experienced by most
sloughed off. pregnant women is:
a. Tachycardia
121, The chief function of b. Dyspnea at rest
progesterone is the: c. Progression of dependent
a. Development of the edema
female reproductive d. Shortness of breath on
system. exertion
b. Stimulation of the
follicles for ovulation to 127, Nutritional planning for a
occur. newly pregnant woman of average
c. Preparation of the uterus height and weighing 145 pounds
to receive a fertilized egg. should include:
d. D. Establishment of a. A decrease of 200 calories
secondary male sex a day.
characteristics. b. An increase of 300
calories a day.
122, The developing cells are called c. An increase of 500
a fetus from the: calories a day.
a. Time the fetal heart is d. A maintenance of her
heart present caloric intake per
b. Eighth week to the time of day.
birth.
c. Implantation of the
fertilized ovum. 128, When involved in prenatal
d. End of the send week to teaching, the nurse should advise
the onset of labor. the clients that an increase in
vaginal secretions during pregnancy
123, After the first four months of is called leukorrhea and is caused by
pregnancy, the chief source of increased:
estrogen and progesterone is the: a. Metabolic rates.
a. Placenta b. Production of estrogen.
b. Adrenal cortex c. Functioning of the
c. Corpus luteum Bartholin glands.
d. Anterior hypophysis d. Supply of sodium chloride
to the cells of the vagina.
124, The nurse recognizes that an
expected change in the hematologic 129, The nurse teaches a pregnant
system that occurs during the 2nd woman to avoid lying on her back.
trimester of pregnancy is: The nurse has based this statement
a. A decrease in WBC’s on the knowledge that the supine
b. Increase in hematocrit. position can:
c. An increase in blood a. Unduly prolonged labor.
volume. b. Cause decreased placental
d. A decrease in perfusion.
sedimentation rate. c. Lead to transient episodes
of hypotension.
125, A pregnant client is making her d. Interfere with free
first antepartum visit. She has a 2- movement of the coccyx
year-old son born at 40 weeks, a 5-
year-old daughter born at 38 weeks, 130, Which of the following
and 7-year-old twin daughters born symptoms occurs with a
at 35 weeks. She had a spontaneous hydatidiform mole?
abortion 3 years ago at 10 weeks. a. Heavy, bright red
Using the GTPAL format, the nurse bleeding every 21 days.
should identify that the client is: b. Fetal cardiac motion after
a. G4 T3 P2 A1 L4 6 weeks gestation.
 c. Benign tumors found in
the smooth muscle of the
uterus.
d. “Snowstorm” pattern on
ultrasound with no fetus
or gestational sac.
131, Which of the following terms
applies to the tiny, blanched,
slightly raised end arterioles found
on the face, neck, arms, and chest
during pregnancy?
a. Epulis
b. Linea nigra
c. C. Striae gravidarum
d. Telangiectasias
132, A nurse is assessing a newborn
infant following circumcision and
notes that the circumcised area is
red with a small amount of bloody
drainage. Which of the following
nursing actions would be most
appropriate?
a. Document the findings
b. Contact the physician
c. Circle the amount of
bloody drainage on the
dressing and reassess in
30 minutes
d. Reinforce the dressing
133, A nurse is planning a home
visit program to a new mother who
is 2 weeks postpartum and
breastfeeding, the nurse includes in
her health teaching about the
resumption of fertility,
contraception and sexual activity.
Which of the following statement
indicates that the mother has
understood the teaching?
a. “Because breastfeeding
speeds the healing process
after birth, I can have sex
right away and not worry
about infection”
b. “Because I am
breastfeeding and my
hormones are decreased, I
may need to use a vaginal
lubricant when I have
sex”
c. “After birth, you have to
have a period before you
can get pregnant again’
d. “Breastfeeding protects
me from pregnancy
because it keeps my
hormones down, so I
don’t need any
contraception until I stop
breastfeeding”
134, The client visits the clinic for
prenatal check-up. While waiting
for the physician, the nurse decided
to conduct health teaching to the
client. The nurse informed the client
that primigravida mother should go
to the hospital when which patter is
evident?
a. Contractions are 2-3
minutes apart, lasting 90
seconds, and membranes
have ruptured
b. Contractions are 5-10
minutes apart, lasting 30
seconds, and are felt as
strong menstrual cramps
c. Contractions are 3-5
minutes apart,
accompanied by rectal
pressure and bloody show
d. Contractions are 5
minutes apart, lasting 60
seconds, and increasing in
intensity
135, The community nurse is
conducting a health teaching in the
group of married women. When
teaching a woman about fertility
awareness, the nurse should
emphasize that the basal body
temperature:
a. Should be recorded each
morning before any
activity
b. Is the average temperature
taken each morning
c. Can be done with a
mercury thermometer but
not a digital one
d. Has a lower degree of
accuracy in predicting
ovulation than the cervical
mucus test
136, An 8-month-old infant is
admitted to the hospital due to
diarrhea. The nurse caring for the
client tells the mother to stay beside
the infant while making assessment.
Which of the following
developmental milestones the infant
has reached?
a. Has a three-word
vocabulary
b. Interacts with other
infants
c. Stands alone
d. Recognizes but is fearful
of strangers
137.All postpartum patients are at
risk for uterine hemorrhage.What
assessment data should the nurse
first collect when appraising B.C.’s
risk for hemorrhage?
a. Ask her to describe her
perennial care.
b. Assess the skin
integrity of her
abdomen.
c. Assess her oxygen
saturation level.
d. Assess her uterus for
height and tone.
138.Supposed Angela has a retained
placental fragment that is causing
extensive postpartum bleeding.
Which test prescribed by her
primary care provider would best
reveal a retained fragment is
present?
a. Placental and cord
blood estrogen.
b. Progesterone.
c. Pelvic ultrasound.
d. Oxytocin.
139. Aurora develops
endometritis.When planning nursing
care, which activity would be best
to advise for Aurora?
a. Walking around her room
listening to music.
b. Lying supine with a cold cloth on
her forehead.
c. Reading while resting in a slight
Trendelenburg position.
d. Alternating between prone and
supine positions.
140.Anna has a risk for deep vein
thrombosis duriYou.ng postpartum
period.What would be the best
suggestion the nurse could make to
help prevent this?
a. Rest in bed as much as possible
for the first several days.
b. Assume a knee-chest position for
15 minutes every day.
c. Increase fluid intake to reduce
blood viscosity.
d. Ambulate early and consistently
to improve circulation.
141.The nurse is making an effort to
address Andrea’s psychological
health in addition to her physiologic
well-being. Which of Andreas'
statements would be most
suggestive of possible postpartum
psychosis?
a. ‘’I wish my baby had longer
hair.’’
b. ‘’I have felt exhausted ever since
birth.’’
c. ‘’I am happy not to have any
children.’’
d.‘’Breastfeeding is way harder than
I thought.’’
142. A 24-year-old woman, who is
30 weeks’ pregnant, presents with
malaise, tiredness, and mild nausea.
Her physical examination is
unremarkable. On laboratory tests,
her hemoglobin (Hb) is 11g/dL,
white blood cell (WBC)
11000mm3, count Plt 110000mm3,
total bilirubin (TBR) 1.8mg/dL,
aspartate aminotransferase (AST)
152IU/L, alanine aminotranferase
(ALT) 155IU/L, alkaline
phosphatase (ALP) 230IU/L,
gamma-glutamyl transferase (GGT)
70IU/L. Ultrasound (US) of the
abdomen shows a gravid uterus,
distended gallbladder but no stones.
The following would be the most
appropriate workup:
a. Some elevation of liver enzymes
is expected with pregnancy. She
should be observed with repeat liver
function tests in 2–3 weeks
b. The clinical and laboratory
picture is consistent with HELLP
syndrome, and she should be
managed conservatively
c. Distended gallbladder and
abnormal liver tests including TBR
and ALP indicate cholecystitis, and
a surgical consultation should be
sought
d. Check hepatitis A, B, and C
serology. If negative, look for other
causes of acute hepatitis
143. 2 A 32-year-old woman is 34
weeks’ pregnant with her second
pregnancy. She presents with
preeclampsia with hypertension
(HTN), proteinuria, and edema,
which is treated with
antihypertensives. Two weeks later
she returns with increasing nausea,
malaise, and epigastric pain.
Physical examination reveals
peripheral edema, blood pressure
(BP) of 140/90, palmer erythema,
mild icterus, spider angioma on the
trunk, uterus consistent with
gestation, but otherwise normal
abdominal examination. Initial
laboratory data show Hb 8.5, WBC
12000, Plt 90000, TBR 4.2, direct
bilirubin (BR) 1.2mg/dL, AST 450,
ALT 300, ALP 200, GGT 130. The
appropriate next step would be:
a. Admit the patient to hospital,
observe closely, and consider
delivery at 36–37 weeks’ gestation
b. Check hepatitis serology (A, B,
C, Herpes simplex) and ask her to
return in 1 week. If any of these
tests are positive, treat accordingly.
If negative, investigate further
c. Liver biopsy to establish a quick
diagnosis and then treat
accordinglyabdomen showing fatty
liver and areas of liver infarction
d. Immediate admission and
delivery
144. A Caucasian woman who is 33
weeks’ pregnant presents with
epigastric pain, nausea, vomiting,
and malaise of 2 weeks’ duration,
which has got worse. Two days ago,
she also noticed dark urine. On
examination, her BP is 150/95,
temperature 99.2°F, pulse 90 beats
per minute (b.p.m.). She has mild
icterus. Abdominal examination
reveals a gravid uterus and liver
edge palpable 2 cm below the costal
margin. Admission laboratory
results show Hb 11, WBC 14500,
Plt 110000, TBR 3.2, AST 150,
ALT 175, ALP 300, GGT 230,
international normalized ratio (INR)
1.5. She is admitted and tests are
sent for hepatitis serology (A, B, C),
antinuclear antibody (ANA),
antimitochondrial antibody (AMA),
and alpha 1-antitrypsin. Two days
later, she is more somnolent. Her
liver enzymes have remained
unchanged. Her INR has increased
to 2.8. US of liver is normal. The
best course of action would be:
a. Correct INR with vitamin K and
monitor on the wards
b. Send blood cultures, hepatitis E
and Herpes simplex serology, and
serum ceruloplasmin levels to cover
all conditions that can cause acute
hepatitis
c. Give fresh frozen plasma (FFP)
to correct INR. Then consider liver
biopsy to establish diagnosis. Wait 3
weeks until she is at 36 weeks’
gestation and then deliver
d. Transfer to intensive care unit
(ICU), observe closely and, if INR
increases further and somnolence
worsens, proceed with immediate
delivery
145. The following is diagnostic of
acute fatty liver of pregnancy
(AFLP):
a. US showing fatty change in the
liver in a patient in the third
trimester with abnormal liver blood
tests
b. MRI of abdomen showing fatty
liver and areas of liver infarction
c. Liver biopsy showing large
globules of fat in hepatocytes, with
lymphocytic infiltration in the
centrilobular region
d. Liver biopsy showing
hepatocytes with microvesicular fat
and minimal inflammatory cell
infiltration
146. Suicide is the leading cause of
maternal (antenatal and postpartum)
mortality.
a. True
b. False.
147. The recommended dose of
folate for women taking
anticonvulsant mood stabilizers
(valproic acid and carbamazepine)
is 4 mg per day.
a. True
b. False
148. Women with bipolar disorder
(manic depressive disorder) have a
40% chance of postpartum
psychosis, mania, or depression if
they do not take their mood
stabilizers after delivery.
a. True
b. False
149. 5 The first-line agent for use
in bipolar disorder in pregnancy is:
a. Valproic acid (Depakote)
b. Carbamazepine (Tegretol)
c. Lithium (Lithobid)
d. Lamotrigine (Lamictal)
150.Which antidepressants are
recommended for use in pregnancy
(based upon prospective exposure
data)?
1. Sertraline (Zoloft), fluoxetine
(Prozac) and citalopram (Celexa)
2. Monoamine oxidase inhibitors
(Nardil)
.3 Nortriptyline (Pamelor) and
desipramine (Norpramine)
151. Escitalopram (Lexapro)
a. If 1, 2, and 3 are correct
b. If 1 and 3 are correct
c. If 2 and 4 are correct
d. If only 4 is correct
e. If all are correct
152.Guidelines for administering
antidepressants in pregnancy
include:
1. Beginning at a lower dose for
women with high anxiety
2. Using the same medication
during pregnancy and lactation
3. Ruling out previous manic
episodes before the initiation of an
antidepressant
4. The addition of a second
antidepressant if the first one is not
effective
a. If 1, 2, and 3 are correct
b. If 1 and 3 are correct
c. If 2 and 4 are correct
d. If only 4 is correct
e. If all are correct
153. A woman with a previous
incidence of prolonged pregnancy is
less likely to experience another
prolonged pregnancy
a. True
b. False
154. The Foley Family is caring for
their youngest child, Justin, who is
suffering from tetralogy of Fallot.
Which of the following are defects
associated with this congenital heart
condition?
A. Aorta exits from the right
ventricle, pulmonary artery exits
from the left ventricle, and two
noncommunicating circulations
B. Ventricular septal defect,
overriding aorta, pulmonic stenosis
(PS), and right ventricular
hypertrophy
C. Coarctation of aorta, aortic valve
stenosis, mitral valve stenosis, and
patent ductus arteriosus
D. Tricuspid valve atresia, atrial
septal defect, ventricular septal
defect, and hypoplastic right
ventricle
155. Which of the following
instructions would Nurse Courtney
include in a teaching plan that
focuses on initial prevention for
Sheri who is diagnosed with
rheumatic fever?
A. Treating streptococcal throat
infections with an antibiotic
B. Giving penicillin to patients with
rheumatic fever
C. Using corticosteroid to reduce
inflammation
D. Providing an antibiotic before
dental work
156. Mr. and Mrs. Baker’s only
daughter is diagnosed with heart
failure. Which of the following
interventions would be appropriate
to promote optimal nutrition for the
infant?
A. Replacing regular nipples with
easy-to-suck ones
B. Allowing the infant to feed for at
least 1 hour
C. Providing large feedings evenly
spaced every 4 hours
D. Offering formula that is high in
sodium and calories
157. Which of these statements
regarding the conduction system of
the heart is NOT correct? Select all
that apply.
A. The sinoatrial (SA) node of the
heart acts as the pacemaker.
B. The SA node is located on the
upper wall of the left atrium.
C. The AV node conducts action
potentials rapidly through it.
D. Action potentials are carried
slowly through the atrioventricular
bundle.
158. The ductus arteriosus is
another fetal structure that is
important in the intrauterine life. It
functions to:
A. Shunts the combined cardiac
output from the pulmonary artery to
the aorta going to the lungs
B. Shunts the combined cardiac
output from the pulmonary artery to
the systemic circulation
C. Shunts the combined cardiac
output from the aorta to the
pulmonary artery and later to the
pulmonary veins
D. Shunts the combined cardiac
output from the aorta to the
pulmonary artery to the right
ventricle
159. Beta-adrenergic agonists such
as albuterol are given to Reggie, a
child with asthma. Such drugs are
administered primarily to do which
of the following?
A. Dilate the bronchioles
B. Reduce secondary infections
C. Decrease postnasal drip
D. Reduce airway inflammation
160. Fred is a 12-year-old boy
diagnosed with pneumococcal
pneumonia. Which of the following
would Nurse Nica expect to assess?
A. Mild cough
B. Slight fever
C. Chest pain
D. Bulging fontanel
161. The Andrews family has been
taking good care of their youngest,
Archie, who was diagnosed with
asthma. Which of the following
statements indicate a need for
further home care teaching?
A. "He should increase his fluid
intake regularly to thin secretions."
B. "We'll make sure that he avoids
exercise to prevent attacks."
C. "He is to use his bronchodilator
inhaler before the steroid inhaler."
D. "We need to identify what
things trigger his attacks."
162.Which of the following
respiratory conditions is always
considered a medical emergency?
A. Asthma
B. Cystic fibrosis (CF)
C. Epiglottitis
D. Laryngotracheobronchitis (LTB)
163. Nurse Veronica is teaching a
group of parents about otitis media.
When discussing why children are
predisposed to this disorder, the
nurse should mention the
significance of which anatomical
feature?
A. Nasopharynx
B. Eustachian tubes
C. External ear canal
D. Tympanic membrane
164. Veronica is a 14-year-old girl
who wears a brace for structural
scoliosis; which of the following
statements indicate effective use of
the brace?
A. "I sure am glad that I only have
to wear this awful thing at night."
B. "I'm really glad that I can take
this thing off whenever I get tired."
C. "I wonder if I can take the brace
off when I go to the homecoming
dance."
D. "I'll look forward to taking this
thing off to take my bath every
day."
165. Nurse Cheryl is assessing Fred,
a 14-year-old boy who had
scoliosis; besides checking
neurologic status directly after
Harrington rod instrumentation and
spinal fusion, she should be
regarded with which of the
following factors?
A. Comfort level
B. Dietary tolerance
C. Physical therapy needs
D. Understanding of the procedure
166. Nurse Kevin is assessing a
newborn for developmental
dysplasia of the hip (DDH); he
would expect to assess which of the
following?
A. Characteristic limp
B. Ortolani's sign
C. Symmetrical gluteal folds
D. Trendelenburg's signs
167. ncomplete development of
teeth, bones, and ligaments is the
result of:
A. Congenital hip dysplasia
B. Duchenne's muscular dystrophy
C. Osteogenesis imperfecta
D. Osteomyelitis
168. Neurovascular assessment for a
fracture patient includes: Select all
that apply.
A. Prosthesis
B. Polyps
C. Pain
D. Pallor
E. Pulselessness
F. Paresthesia
G. Paralysis
H. Poikilothermia
169 Which of the following is
TRUE about sickle cell disease
(SCD)? Select all that apply.
A. Sickle cell anemia (SCD) is an
inherited disorder of the hemoglobin
in blood.
B. Sickle cell anemia requires the
inheritance of two sickle cell genes.
C. Sickle cell trait, which is the
inheritance of one sickle gene,
almost never causes problems.
D. Virtually all of the major
symptoms of sickle cell anemia are
the direct result of the abnormally-
shaped sickled red blood cells
obstructing the flow of blood.
E. The contemporary treatment of
sickle cell anemia is focused
primarily toward managing the
individual features of the illness as
they occur.
170. Mr. and Mrs. Smith’s child has
hemophilia; which of the following
actions would you instruct them to
avoid?
A. Immobilizing the joint
B. Lowering the injured area
C. Applying cold to the area
D. Applying pressure
171. A nurse is educating a parent
regarding the immunizations that a
child is to receive during the first
year of life. Which of the following
immunizations did the nurse
discuss?
A. Measles
B. Mumps
C. Rubella
D. Polio
172. A nurse is educating a parent
regarding the psychosocial stage of
development of the infancy period.
Which of the following information
did the nurse include in the
discussion?
A. Infants should have their
needs met in a timely
fashion.
B. Mothers should let their
babies cry themselves to
sleep each night.
C. Infants should be scolded
for bad behavior
whenever they break
objects.
D. Mothers should sneak out
of the room when they
must leave their babies.
173. The mother of a 2-month-old
who is being seen in the
pediatrician’s office states, “I am
really worried because my child’s
head is not shaped right.” The nurse
should ask a question to obtain
which of the following information?
A. "Is the child yet able to roll over
by himself?"
B. "Do the parents put the child on
his stomach during supervised
play?"
C. "Is the child turning his head to
follow an object?"
D. "Do the parents elicit a smile
from the child when they speak to
him?"
174. A mother visits her child’s
primary health-care provider for the
child’s 12-month visit. The child
weighed 2,800 grams at birth.
Which of the following weights is
most consistent with the expected
weight for this child?
A. 7,500 grams
B. 8,000 grams
C. 8,500 grams
D. 9,000 grams
175. The nurse assesses a 2-month-
old girl. The baby weighed 3,400
grams at birth, 3,800 grams at 1
month, and 4,000 grams at 2 months
of age. The nurse plots the
information on the scale below.
Which of the following conclusions
and actions would be appropriate
for the nurse to make?
A. Conclusion: the child’s
growth is normal. Action
—no change: the baby is
growing appropriately,
therefore no feeding
changes are needed.
B. Conclusion: the child’s
growth is excessive.
Action—change: the baby
is overweight, and the
information should be
reported.
C. Conclusion: the child’s
growth is inconsistent.
Action—no change: the
baby’s weight was larger
than normal at birth, but
the current weight is
appropriate.
D. Conclusion: the child’s
growth is below expected.
Action—change: the
baby’s weight is markedly
lower than normal, and
the information should be
reported.
176. A 6-month-old child received
the following play things as a gift
from a relative. The nurse should
advise the parents that which of the
items is potentially dangerous for
the child to play with?
A. Stuffed animal
B. Balloon
C. Toy cell phone
D. Shape sorter
177. A mother of an 8-month-old
boy states that the family is
vacationing in a beach house for the
next 2 weeks. Which of the
following information should the
nurse educate the mother about in
relation to sun exposure? Select all
that apply.
A. Reapply sun lotions to all
exposed skin every 4 to 6
hours.
B. Use sun lotions that
protect against both UVA
and UVB rays.
C. Have the baby wear child-
sized sunglasses whenever
he is in the sun.
D. Avoid exposing the child
to the sun between the
hours of 12 and 2 p.m.
E. Dress the child in
lightweight clothing that
covers the majority of his
skin
178. The mother of an 11-month-old
states, “My child has 8 teeth. I brush
them every morning with bubble
gum-flavored toothpaste. My child
loves it.” Which of the following
responses by the nurse is
appropriate?
A. “That is great. Even
though they are baby
teeth, it is very important
to brush them with
toothpaste.”
B. “I am so glad to hear that
your child loves
toothpaste. So many
babies get cavities
because they refuse to use
toothpaste.”
C. “I am very happy to know
that you are cleaning your
baby’s teeth, but I am
 afraid that the bubble gum
flavor will spoil him.”
D. “It is wonderful that you
are brushing your child’s
teeth, but it is
recommended for you not
to use toothpaste.
179. A mother questions the nurse
regarding car seat safety for her
infant. Which of the following
information should the nurse
include in the discussion?
A. Place the infant car seat
rear facing in the back
seat of the car.
B. Move the car seat to the
forward-facing position
when the child reaches 1
year of age.
C. Keep the child in a bucket
seat until the child is at
least 12 months of age.
D. Tighten the straps of the
seat so that only an adult
fist fits under the straps.
180. A 4-year-old child, who is
hospitalized with pneumonia, tells
the nurse, “I got sick because I was
bad. I yelled at my little sister
yesterday.” The nurse determines
that which of the following is an
accurate explanation for the child’s
comment? The child is:
A. Trying to get sympathy
from the nurse.
B. Exhibiting an example of
magical thinking.
C. Making up stories to
entertain the nurse.
D. Expressing remorse for
having yelled at her sister.
181. The nurse is giving a 5-year-
old child a vaccine injection. The
child cries loudly during the
procedure. Which of the following
interventions would be appropriate
for the nurse to perform after the
injection?
A. Advise the child that big
children are quiet during
injections.
B. Explain to the child why
vaccinations are
administered.
C. Inform the child that the
vaccine was ordered by
the primary health-care
provider.
D. Comfort the child and
give the child a sticker as
a present
182. A mother tells the nurse that it
is difficult to get her 4-year-old
child to bed at night. Which of the
following should the nurse suggest
that the mother do?
A. Give the child a small
present if he goes to bed
when he is asked to.
B. Play a running game with
the child right before
bedtime.
C. Develop a bedtime routine
that is followed every
night.
D. Let the child stay up late
on weekends if he goes to
bed on time on
weeknights.
183. A parent asks the nurse the
following question: “My son plays
with his penis all the time. What
should I do?” Which of the
following responses is appropriate
for the nurse to give the parent?
“Advise your child that:
A. he should touch his penis
only when he is
urinating.”
B. the behavior is
appropriate when he is
alone in a private place.”
C. only boys who are old
enough to have sex should
touch their penises.”
D. bad men may try to hurt
him if they see him
playing with his penis.”
184. A nurse is interviewing a group
of 4th grade children. It would be
appropriate for the nurse to
diagnose the child who made which
of the following statements as “Risk
for Altered Coping related to poor
psychosocial development”?
A. “My teacher put the
picture I drew up on the
board.”
B. “I made a goal during our
soccer game yesterday.”
C. “I strike out every time I
bat when we play soft ball
in gym class.”
D. “My teacher let me read
out loud last week and
again this week.”
185. A child’s 3rd grade teacher
informs the parents, “Your child’s
handwriting is quite poor. It is
important that your child practice
skills that might improve the
handwriting.” Which of the
following activities could the
parents encourage the child to
perform? Select all that apply.
A. Throw a ball back and
forth
B. Begin to play a musical
instrument
C. Build a model of a
favorite structure
D. Learn a new and popular
dance
E. Draw or paint a colorful
picture
186. The nurse working in a local
school district is developing the
curriculum for a new sex education
program for the 2nd grade students.
Which of the following content
would be appropriate to include in
the class?
A. External genitalia of
males and females
B. List of names of the
registered sex offenders
living in the school
district
C. Difference between
heterosexual contact and
homosexual contact
D. Etiology of human
immunodeficiency virus
187. A student informs the school
nurse that she is planning to get a
tattoo. Which of the following
information should the nurse teach
the student about tattoos?
A. Tattoos are easily
removed with lasers and
bleach.
 B. The student should
request that only blue and
red dye be used.
C. Infections are rare
because tattoo needles and
inks are kept hot.
D. Skin lesions may develop
where tattoos are placed
188.A child with a poor nutritional
status and weight loss is at risk for a
negative nitrogen balance. To help
diagnose this problem, the nurse in
charge anticipates that the doctor
will order which laboratory test?
A. Total iron-binding
capacity
B. Hemoglobin
C. Total protein
D. Serum transferrin
189. A female child, age 2, is
brought to the emergency
department after ingesting an
unknown number of aspirin tablets
about 30 minutes earlier. On
entering the examination room, the
child is crying and clinging to the
mother. Which data should the
nurse obtain first?
A. Heart rate, respiratory
rate, and blood pressure
B. Recent exposure to
communicable diseases
C. Number of
immunizations received
D. Height and weight
190. To decrease the likelihood of
bradyarrhythmias in children during
endotracheal intubation,
succinylcholine (Anectine) is used
with which of the following agents?
A. epinephrine (Adrenalin)
B. isoproterenol (Isuprel)
C. atropine sulfate (Atropine)
D. Lidocaine hydrochloride
(Xylocaine)
191. Dr. Jones prescribes
corticosteroids for a child with
nephritic syndrome. What is the
primary purpose of administering
corticosteroids to this child?
A. To increase blood pressure
B. To reduce inflammation
C. To decrease proteinuria
D. To prevent infection
192. What should be the initial
bolus of crystalloid fluid
replacement for a pediatric patient
in shock?
A. 20 ml/kg
B. 10 ml/kg
C. 30 ml/kg
D. 15 ml/kg
193. Sudden infant death syndrome
(SIDS) is one of the most common
causes of death in infants. At what
age is the diagnosis of SIDS most
likely?
A. At 1 to 2 years of age
B. At I week to 1 year of age,
peaking at 2 to 4 months
C. At 6 months to 1 year of
age, peaking at 10 months
D. At 6 to 8 weeks of age
194. Which of the following would
be inappropriate when
administering chemotherapy to a
child?
A. Monitoring the child for
both general and specific
adverse effects
B. Observing the child for 10
minutes to note for signs
of anaphylaxis
C. Administering medication
through a free-flowing
intravenous line
D. Assessing for signs of
infusion infiltration and
irritation
195. Which of the
following is most likely
associated with a
cerebrovascular accident
(CVA) resulting from
congenital heart disease?
A. Polycythemia
B. Cardiomyopathy
C. Endocarditis
D. Low blood pressure
196. Clay is an 8-year-old
boy diagnosed with heart
failure. Which of the
following shows that he is
strictly following the
directed therapeutic
regimen?
A. Daily use of an antibiotic
B. Pulse rate less than 50
beats/minute
C. Normal weight for age
D. Elevation in red blood cell
(RBC) count
197. Bryce is a child
diagnosed with
coarctation of aorta.
While assessing him,
Nurse Zach would expect
to find which of the
following?
A. Squatting posture
B. Absent or diminished
femoral pulses
C. Severe cyanosis at birth
D. Cyanotic ("tet") episodes
198. Appropriate
intervention is vital for
many children with heart
disease in order to go on
to live active, full lives.
Which of the following
outlines an effective
nursing intervention to
decrease cardiac demands
 and minimize cardiac
workload?

A. Feeding the infant over

long periods
B. Allowing the infant to have
her way to avoid conflict
C. Scheduling care to provide
for uninterrupted rest
periods
D. Developing and
implementing a consistent
care plan

199. Veronica’s parents

were told that their
daughter needs ribavirin
(Virazole). This drug is
used to treat which of the
following?

A. Cystic fibrosis
B. Otitis media
C. Respiratory syncytial virus
(RSV)
D. Bronchitis

200. Which of the

following infants is least
probable to develop
sudden infant death
syndrome (SIDS)?

A. Baby Angela who was

premature
B. A sibling of Baby Angie
who died of SIDS
C. Baby Gabriel with prenatal
drug exposure
D. Baby Gabby who sleeps on
his back