1. The nurse is caring for a term infant born via scheduled Cesarean section to a diabetic mother. Right after birth, the infant had continuous severe retractions, nasal flaring, and audible  grunting.  Thirty minutes later the infant displays intermittent retractions, occasional nasal flaring, and grunting on auscultation.  Which intervention will the nurse implement?

Notify the primary care provider

Provide warm oxygen via hood

Request an order for a chest x ray

Document the findings

2. The nurse is caring for a child in the 95^th percentile for weight. What intervention will the nurse include ?

Monitor blood pressure and blood glucose regularly

Encourage parents to make sure the child eats what is on their plate

Encourage parents to substitute fruit juice for carbonated softdrinks

Educate the family about a high protein ketogenic diet

3. The nurse is reading the charts of their assigned mother-baby couplets. Which couplet’s data will prompt the nurse to monitor the infant for the development of jaundice?

Mother’s blood type is O negative and infant’s blood type is A positive

Mother is AB positive.  Cord blood sample for typing was not sent

Mother is O positive.  Infant’s blood type is O negative

Mother’s blood type is B negative. Refused prophylactic Rhogan at 28 weeks.  Baby’s blood type is O negative.

4. The nurse is caring for a 36 weeks pregnant patient diagnosed with preeclampsia. Which assessment findings will the nurse immediately report to the physician?

The patient reports increased thirst but decreased appetite

Serum platelets 265,000 per microliter

Serum AST 113 IU/L

The patient reports occasional tightening of the uterine muscle

5. The nurse is reviewing the social history of 16 year old patient coming to the clinic for a routine wellness exam. Which findings may have a lifelong impact on the patient’s overall health

The patient’s favorite subject is biology

The patient father died six years ago

The patient’s caregivers are their aunt and grandmother

The patient has two younger siblings

The patient has moved six times in the last five years

6. The nurse is interviewing a new patient who suspects she is pregnant. What will the nurse identify as a presumptive sign of pregnancy?

Nausea

Fetal heart tones

Positive pregnancy test

Ballottement

7. The nurse is teaching a group of patients who are newly diagnosed with gestational diabetes. What potential complications should the nurse include in the teaching plan? Select all that apply

Increased risk for birth injuries

Neonatal hypoglycemia

Neonatal hyperbilirubinemia

Delivering a large for gestational age baby (LGA)

Increased risk of developing type 1 diabetes

8. A nurse is reviewing the obstetric chart of a pregnant patient and reads that the patient is a G6, T2, P2, A1, L4. What is the nurse’s interpretation of this patient’s obstetric history? Select all that apply

2 birth at 37-42 weeks gestation

2 deliveries between 12-20 weeks gestation

4 children currently living

2 pregnancies between 20-36 6/7 weeks

1 birth at 20-37 weeks gestation

9. The nurse performs an admission assessment on a term newborn. When the nurse gently strokes the infant’s right cheek, the infant opens their mouth and turns to the right side. What will the nurse document regarding this assessment

Positive rooting reflex

Spontaneous fencing reflex

Possible facial nerve palsy

Partial sucking reflex

10. The nurse is caring for a woman at her 37 week prenatal visit. The patient asks When is my next prenatal visit?  What is the nurse’s response

In four weeks

Return in one week

In two weeks

In three weeks

11. The nurse is caring for a mother infant couplet. Infant was born one hour prior and is bonding with mother.  The mother asks why vitamin K needs to be administered and if it can be given orally.  What is the nurse’s reply?

Vitamin K for newborns has to be given as an infection in the muscle.  Vitamin K is needed for coagulation and your baby will not have enough until bacteria in the gut makes it, which will take a few days.

Vitamin K can also be given intravenously.  Vitamin K is needed for coagulation and your baby will not have enough until bacteria in her gut makes it, which will take several weeks

Oral medications are not safe for infants.  Vitamin K is needed for coagulation and your baby will not have enough until bacteria in the gut makes it, which will take several months.

Vitamin K for newborns is administered as an injection  in the fat tissue.  Vitamin K stimulates the e.coli in the baby’s gut to produce coagulation factors.

12. The nurse is administering vaccinations for a 12 month old child. The child is up to date on prior vaccines, including a third dose of Hepatitis B at 9 months. Which vaccinations  will the nurse prepare for this child?

DTaP

Hepatitis B

Rotavirus

Varicella

13. The nurse is obtaining the first APGAR score on a term infant delivered via caesarian section for fetal distress. The infant has central cyanosis, weak and shallow respiration, grimaces when mouth is suctioned, and minimal resistance to extension. Heart rate is 110 beats per minute.  What score will the nurse document

14. The nurse is caring for a patient diagnosed with placenta previa. The patient tells the nurse that she does not understand why she has this condition.  How will the nurse respond?

Your two prior C-sections increased the risk for developing placenta previa.

You are 16 years old.  Being young increases your odds of developing this condition.

You were underweight when you become pregnant, which increases your risk

You used marijuana in early pregnancy which could have  caused this condition.

15. The nurse is admitting a newborn who was delivered at home to a mother with no prenatal care. The mother does not remember the date of her last menstrual period. What physical characteristic will the nurse assess to obtain the best indicator of the newborn’s maturity

The soles of the feet have creases over the entire surface

Amount of hear on the head

The infant’s weight

Head circumference measurement

16. During a second trimester prenatal visit, the patient states “I feel some contractions occasionally but they don’t hurt. Is this okay”  What is the nurse’s response

Yes, these are Braxton Hicks contractions.

No, go to the hospital immediately, labor is starting

No, these contractions are related to over hydration

Yes, these contractions will start dilating your cervix

17. The nurse is caring for a patient diagnosed with severe preeclampsia at 30 weeks gestation. Prior to administering the prescribed betamethasone, what will the nurse explain to the patient?

Betamethasone will facilitate your baby’s lungs maturity

Betamethasone will prevent your baby from being born with premature kidneys

Betamethasone will facilitate the maturity of  your baby’s liver to prevent jaundice.

Betamethasone will prevent your baby from a cardiac deformity.

18. The nurse is evaluating an infant’s percentage weight loss on the fourth day of life. The infant was 3,500 grams at birth and now weighs 3,130 grams.  Which intervention will the nurse implement?

Notify the infant’s primary care provider

Assess if the mother’s breasts are producing milk

Document findings and continue routine care

Reassure parents that this amount of weight loss is expected

19.  The nurse is providing anticipatory guidance to the parents of a typically developing child nearing their 4^th birthday. Which new skills will the nurse teach the parents to expect from the child within the next few months? Select all that apply.

Draws circles and squares

May learn to skate or swim

Asks many questions

Says name and address

Dress and undress without assistance

20. A nurse at a childcare facility is assessing children for developmental delays. Which child will the nurse refer for evaluation?

A two-year old who has gained 3 pounds in the past year.

A two-year old who is unable to copy circles

An 18 month old toddler who does not walk

A three year old child who communicates in short sentences

21. The nurse is anticipating the delivery of an infant who is estimated to be 43 weeks gestation. Which possible complication will the nurse plan to monitor for in this infant?

Polycythemia

Hyperglycemia

Inability to handle stimulus

Uncoordinated suck and swallow

22. The nurse is assessing a newborn following vertex delivery. Which finding is considered a normal deviation?

Caput succedaneum

Hydrocephalus

Subdural hematoma

Cephalhematoma

23. The nurse is educating a patient at 8 weeks gestation. The nurse evaluates that teaching was effective when the patient makes which statement?

My nausea should resolve by the time I reach 20 weeks

It is recommended that most of my protein come from eating swordfish

I should eat an extra 300 calories a day until the end of my pregnancy.

I will need to do prenatal visits every month when I get to my 30^th week of pregnancy

24  The nurse is taking the history of a patient who is 9 weeks pregnant during the first prenatal appointment.  The patient reports that her primary health care told her that she might have “prediabetes.”  What will the nurse tell the patient

The patient must fast tonight and return in the morning for a one-hour glucose screen.

The primary care provider will recommend that you eliminate sugar from your diet.

The three hour glucose tolerance test will be performed today

The primary care provider will discuss screening for diabetes today.

25, The clinic nurse is interviewing a primigravida who is estimated to be 8 weeks gestation by dates. The patient complains of severe nausea throughout the day.  What will the nurse recommend to this patient? Select all that apply

Brush teeth immediately after eating

Eat dry crackers/toast in bed before rising

Eat small meals frequently during the day

Avoid eating greasy food

Drink fluids with meals

26, The nurse receives an order for intravenous magnesium sulfate, a loading dose of 4 grams over 15 minutes. The bag pictured is available.  What is the rate (ml/hr) for the loading dose? Enter numbers only (no units)

27 A nurse is educating a group of parents about car seat safety. What information will the nurse include? Select all that apply

Car seat use is based on child’s height and weight

Use of a forward facing car seat until age 6

Place the child in a rear facing car seat for as long as possible

Most child outgrow a booster seat by 10 – 12 years old

Children under 13 should ride in the backseat

28 The nurse receives a phone call from a patient who is 32 weeks pregnant. The patient reports having a face that looked “puffy” that morning and that her wedding ring is no longer fitting. What is the nurse’s intervention?

Instruct the patient to start monitoring her weight daily

Ask the patient to lie down on her side and count fetal kicks for one hour

Tell the patient that she needs to be evaluated by the health care provider

Assess the patient’s sodium intake the prior day

29 The nurse is obtaining a urine pregnancy test. Which marker is measured in this test?

Follicle stimulating hormone

Human chorionic gonadotropin

Progesterone

Oxytocin

30 The nurse is caring for a patient diagnosed with placental abruption. Which of the following assessment findings should the nurse report to the attending physician. Select all that apply

Blood in the urine

Decreased fibrinogen

Oozing from injection sites

Platelets 190,000 per microliter

Prolonged clotting times

31  The nurse is administering a 20 ml/kg fluid bolus of 09. NS  to a child weighing 40 lbs over 30 minutes. What rate in ml/hr will the nurse set on the IV pump? Round to the nearest whole number .  Only enter a number ; no unitss

32 The clinic nurse is screening a group of patients during their first prenatal visit. The nurse identifies which patient as being the most at risk for developing gestational diabetes mellitus?

23 year old with a BMI of 22

36 year old with a BMI of 29.5

37 year old with a BMI of 17.5

29 year old with a history of eating disorders

33  The nurse is caring for a pregnant woman who is 32 weeks gestation diagnosed with severe preeclampsia.  The patient is receiving intravenous magnesium sulfate.  What will the nurse include in the hourly focused assessment?  Select all that apply

Eliciting deep tendon reflexes

Intake and output

Obtaining a full set of vital signs

Consistency of bowel movements

Evaluating fetal heart rate patterns

34  The nurse is caring for a patient who suspects she is pregnant and is waiting to be examined.  Which assessment finding will the nurse note as a probable indicator of pregnancy?

Amenorrhea

Positive pregnancy test

Fetal movement felt by the practitioners

Brest enlargement

35. The nurse prepares a plan of care for the baby depicted in the image above. Which intervention s would the nurse plan to implement?

Monitor infant serum bilirubin

Remove the baby from the light if the baby cries

Reposition the baby at least every two hours

Monitor baby’s temperature

Monitor the intake and output

36  A nurse is caring for a patient diagnosed with a severe preeclampsia and receiving an intravenous infusion of magnesium sulfate.  What findings will the nurse immediately report to the health care provider?  Select all that apply?

Blood glucose level of 122 mg/dL

Respirations of 12/min

Serum magnesium level of 9.5 mg/dL

Urinary output of 70 ml/hr

Absent deep tendon reflexes

37. The nurse is teaching the parent of a 4 month old child about the introduction of new foods. What information will the nurse include in the teaching?

Introduction of new foods should be spaced out by 3 – 5 days

Egg and peanut should be avoided in the first year

Food allergy testing is very accurate and should be done by 6 months

Cow’s milk should be introduced at 6 months

38  The nurse is preparing to administer acetaminophen to a child weighing 15 lbs.  The acetaminophen dose ordered is 15mg/kg/dose.  Acetaminophen is available in liquid forms 160 mg/5ml.  How much acetaminophen will the nurse administer in ml?  Round your answer to the nearest tenth.  Enter a number only.  Do not add units.

39  A nurse assesses a 2 ½ year old child in an outpatient office.  The mother states “I’m concerned because my child is only talking in two or three word sentences.  What is the nurse’s response?

Most children speaks in 3-4 word sentences by the time they are about 36 months old

We will be concerned if your child isn’t speaking 5-20 words by 30 months

Your child should be using complex sentences by this time

Developmental abilities are mostly genetic, so this is concerning if you were an early talker

40  The nurse is caring for a patient in her first trimester with a Body Mass Index (BMI) of 31.  What will the nurse teach is the recommended amount of weight gain during pregnancy

15 to 25 pounds

11 to 20 pounds

25 to 35 pounds

28 to 40 pounds

41. The school nurse is teaching parents bout cyberbullying. What information will the nurse include in the teaching?

Cyberbullying often lasts longer than bullying in person

Up to 75% adolescents have reported being cyberbullied

Participation in sports will decrease the risk of being cyberbullied

Cyberbullying is not as big a risk, since there is rarely a threat of physical violence

42. The nurse is preparing to discharge a mother-baby couplet home 36 hours after an uncomplicated vaginal delivery. Which of these actions must be done before the couplet leaves the hospital?  Select all that apply?

Hearing screening on the baby was completed and results were shared with parents

Test for genetic and inborn metabolic errors (PKU) completed

An appropriate infant car seat is in place for the ride home

Infant has a baseline serum CBC (complete blood count) during hospitalization

Parents have demonstrated how to properly obtain a rectal temperature in their infant

43. The nurse is reviewing a patient’s prenatal record. Which information will alert the nurse to a high risk for a placental abruption?

A previous delivery at 32 weeks gestation

Admits to substance abuse.

Body mass index is 19

History of severe vomiting in the first trimester

44. The nurse is providing anticipatory guidance to the parent of a 6 month old infant. Which new developmental milestone will the nurse teach the parent to expect by 8 months of age.

Walking

Sitting unsupported

Using fingers to eat

Batting at objects

45 A nurse is counseling parents on safe firearm storage. The nurse identifies the need for further teaching when the parent states which response?

“I will keep my firearms and ammunition locked in  separate locations.”

“I will keep my firearm and ammunition hidden in my closet.”

I will store my firearm at the gun range.”

I will unload my firearm before placing it in the lock box.”

46  The nurse is caring for a woman diagnosed with unruptured ectopic pregnancy.  The woman is to be managed medically with a single dose IM injection of Methotrexate.  Before administering methotrexate, the nurse must assess for which contraindication.

Hypertension

Diabetes

Acid Reflux

Peptic ulcer

47.  The nurse is supervising a medical assistant preparing to give vaccinations to a 4 year old child. The medical assistant has laid out a 22 gauge needle for each vaccine.  Which vaccinations would the nurse clarify with the medical assistant due to a potential error

MMR

IPV

Seasonal influenza

DTaP

48. The nurse is counseling a patient who is 24 weeks pregnant and has a history of chronic hypertension.  The patient asks.  “How will they know if I develop pre-eclampsia?” What will the nurse reply?

“Your liv enzymes will start to drop”

“Your urine will be positive for protein.”

“It is very unlikely that you will develop pre-eclampsia.”

“Your serum platelets will start to increase.”

49. The nurse in the delivery room is performing an initial assessment on a newborn infant. When examining the umbilical cord, the nurse should expect to observe which finding?

Two arteries

One artery

Two veins

One artery and one vein.

50. The nurse is assessing a primigravida patient in her second trimester who reports constipation after starting iron supplements. What possible complication will the nurse assess for in this patient?

Heartburn

Physiologic anemia

Hemorrhoids

Excessive salivation.

51. The nurse admits a patient at 10 weeks gestation with cramping, bleeding, and passing of tissue. Ultrasound reveals an empty uterine cavity and a closed cervix. Cramping has ceased and bleeding is scant.  What will the nurse instruct the patient to do  upon discharge.

Read information on D & C (dilation & curettage

Avoid another pregnancy for a year

Refrain from sexual intercourse for 8 weeks

Seek emotional support as needed

52.The clinic nurse is interviewing a new patient who suspects she is pregnant.  The patient reports her last menstrual period was from July 7 until July 11, 2022.  What will the nurse record as an estimate date of delivery (EDD)?

April 10^th 2023

April 14^th 2023

May 14^th 2023

June 10^th 2023

53.  The nurse and student are caring for an adolescent who states that he is gay but his parents to do not know. The nurse will need to correct  the student nurse I they make which statement?

“Concealing your identity can be harmful to you but we also understand that you might be afraid of how your family will react.”

We can help connect you with a support group for LGTBQ adolescents.”

“We will need to discuss what you told us with your parents.”

Using proper protection is important because rates of sexually transmitted infections are higher in gay males.” 

54. The nurse has just received a shift report on our pregnant patients. Which of the patients should the nurse assess first?

G5 P2202, 32 weeks, with a history of anemia

G2 P0101, 39 weeks, gestational hypertension, blood pressure 137/88

G2 P1001, 39 week with 0 blood group and Rh-negative

G1 P0000 32 weeks, placental abruption, fetal heart 125 bpm

55. The pregnant patient states “my partner is also experiencing signs and symptoms of pregnancy how can this be? The nurse explains to the patient that these symptoms can be defined as which term?

Turners syndrome

Couvade syndrome

Willi syndrome

Klinefelter syndrome

56.  The clinic nurse is preparing a teaching plan for a group of primigravidas at their first prenatal class.  What will the nurse include in the teaching plan?
Have at least 4 servings of tuna every week

Avoid sexual activity for two months

Take a daily laxative when constipated

Call the provider if you see vaginal bleeding.

57.  The mother of a day-old infant asks the nurse. “what is this red mark on my baby’s head? What will the nurse reply?

“That appears to be a mark left by the vacuum they used during delivery”

“That mark is the result of bleeding in the periostium, known as acrocyanosis on the head.”

“This mark is what doctors refer to as “caput succedaneum’ and it goes away in about 24 hour

“This mark is known as a stork bite.  It is the result of superficial scalp swelling.”

58. What is the most appropriate nursing intervention for a newborn who is jittery and has a high pitched cry/or weak cry?

Monitor blood pressure

Obtain urine sample

Obtain serum glucose

Feed the infant

59. The nurse is assessing a four year old child. Which approach to assessment is developmentally appropriate for the nurse to include?

Ask the child if they want their parent to leave during the examination

Draw lab work before performing physical assessment

Explain what the stethoscope is used for

Have the parent hold the child firmly on their lap

60.  The nurse assesses a woman who reports intimate partner violence. The nurse identifies the patient being at higher risk for which outcome?  Select all that apply

Sexually transmitted infections

Adequate nutrition

Delusions

Uterine Rupture

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