Nurse Julia is documenting the obstetrical history of a client who is 39 weeks pregnant.
The client
reports having had a son born at 38 weeks of gestation, a daughter born at 30 weeks of gestation, and
a miscarriage at approximately 8 weeks of pregnancy.
1. How should Nurse Julia record this obstetrical history?
1/1
A. G4 T1 P1 A1 L2
B. G3 T1 P1 A0 L2
C. G3 T2 P0 A0 L2
D. G2 T2 P0 A0 L2
2. While doing rounds, Nurse Julia notes positive ballottement in the client's prenatal record. This finding
suggests which of the following?
0/1
A. Passive movement of the unengaged fetus.
B. Palpable contractions on the abdomen.
C. Fetal kicking felt by the client.
D. Enlargement and softening of the uterus.
3. During a pelvic examination, the Nurse Julia observes a purple-blue coloration of the cervix. How
should she record this finding?
1/1
A. Chadwick's sign.
B. Braxton-Hicks sign.
C. Goodle's sign
D. McDonald's sign
4. A pregnant client asks the nurse at the clinic when she might start feeling fetal movements. Nurse Julia
informs the multiparous mother that she is likely to notice these movements between which of the
following weeks of gestation?
0/1
A. 10 to 12 weeks.
B. 16 and 18 weeks.
C. 18 to 20 weeks.
D. 8 and 10 weeks.
5. Which of the following options reflects the typical amount of weight gained during pregnancy?
0/1
A. 25 to 40 lbs.
B. 24 to 30 Ibs.
C. 12 to 22 lbs.
D. 15 to 25 lbs.
Situation
2 of 5 points
Mr. Mandy Ramirez and his wife, Mrs. Inieto, have just welcomed a healthy 7-pound baby boy named
Vlake. The newborn's adjustment to life outside the womb is a critical and sensitive phase. Nurse
Harrah has been designated to care for their baby and must be adept at providing care during this
period.
6. As the newborn begins to breathe after birth, certain chemical changes occur that stimulate his
respiration, which include:
1/1
A. Respiratory acidosis.
B. Metabolic alkalosis.
C. Decreasing PCO2.
D. Increasing PO2
7. To prevent hypothermia, Nurse Harrah is aware that a common cause of convective heat loss in the
Neonatal Unit is _____.
0/1
A. Cool air-condition.
B. Cool incubator walks.
C. Low room humidity.
D. Cool weighing scale.
8. Following birth, the newborn’s circulation shifts from fetal to neonatal patterns. Nurse Harrah
recognizes that the rise in the infant's PO2 leads to the closure of a shunt, specifically:
0/1
A. Ductus Arteriosus.
B. Foramen Ovale.
C. Ductus Venosus.
D. Ventricular Septum
9. An hour later, after the newborn was held by Mrs. Inieto, Nurse Harrah evaluates the neonate and
records the following observations: axillary temperature of 95.8°F, apical pulse of 110 beats per minute,
and respirations of 64 breaths per minute. Which nursing diagnosis should be prioritized at this time?
0/1
A. Risk for altered body temperature related to heat loss.
B. Altered parenting related to the addition of a new family member.
C. Risk for fluid volume deficit related to insensible fluid loss.
D. Risk for infection related to transition to the extrauterine environment.
10. If the baby boy starts gagging and his skin turns a dusky color, what is the first action Nurse Harrah
should take?
1/1
A. Calm the neonate.
B. Notify the physician.
C. Provide oxygen using a face mask.
D. Aspirate the nose and the mouth with a bulb syringe.
Situation
2 of 5 points
Mrs. Michaela Miranda, 24 years old and expecting her first baby, is seeking help at the maternity
clinic as her family is not around. Nurse Jocelyn is assisting her. Mrs. Michaela inquires with Nurse
Jocelyn about signs of pregnancy.
11. Mrs. Miranda inquires with Nurse Jocelyn about whether she is pregnant. Nurse Jocelyn explains that
a definitive sign of pregnancy is when:
0/1
A. The fetal movement is felt by the examiner.
B. The fetal movement is felt by the mother.
C. There is enlargement of the uterus.
D. Pregnancy test is positive (+)
12. In line with Reva Rubin's Theory, what occurrence in the second trimester will support Mrs. Miranda
in embracing her pregnancy?
0/1
A. Quickening
B. Lightening
C. Ballottement
D. Pseudocyesis
13. Dr. Riego has ordered an ultrasound for Mrs. Miranda. As Nurse Jocelyn prepares the client, who is in
her fourth month of pregnancy, for the abdominal ultrasound, she should advise her to _________.
1/1
A. Drink at least 3 to 4 glasses of water before the procedure and not to void until the procedure is done.
B. Observe NPO from midnight to avoid vomiting.
C. Do perineal flushing properly before the procedure.
D. Void immediately before the procedure for better visualization.
14. Nurse Jocelyn is getting Mrs. Miranda ready for Leopold's Maneuver. The proper position for this
procedure is:
1/1
A. Supine with knees flexed.
B. Supine.
C. Left lateral.
D. Knee chest.
15. Nurse Jocelyn is preparing to listen to the fetal heart tones. Abdominal palpation reveals a hard,
rounded mass just above the symphysis pubis, small, irregular shapes on the right side of the abdomen,
and a firm mass on the left side. Based on these findings, the optimal location to auscultate the fetal
heart tone is the:
0/1
A. Left upper quadrant.
B. Right lower quadrant.
C. Right upper quadrant.
D. Left lower quadrant.
Situation
3 of 5 points
Maloi is now 7 years old and attending school. His parents provide him with love and support.
16. Based on developmental theory of Freud, Maloi is now in his.
1/1
A. Latent phase.
B. Anal phase
C. Phallic phase.
D. Oral phase.
17. Maloi shows no apparent developmental progress. This stage is referred to as:
1/1
A. Age of Suppression.
B. Age of Oppression.
C. Age of Aggression.
D. Age of Assimilation.
18. Nurse Bossing suggests the type of play that is most appropriate for Maloi at his school is:
0/1
A. Competitive play.
B. Parallel Play.
C. Cooperative play.
D. Solitary play.
19. Nurse Bossing should inspect the development of his teeth which include the following EXCEPT_
1/1
A. Bicuspid.
B. Lateral Incisor.
C. Central Incisor.
D. First Molar.
20. Nurse Bossing must also safeguard school-age children, such as Maloi, from fractures. What is the
most likely type of fracture that Maloi might experience due to his porous bones?
0/1
A. Green stick fracture.
B. Comminuted fracture.
C. Impacted fracture.
D. Longitudinal fracture.
Situation
4 of 5 points
Mrs. Lizette, under the care of Nurse Gisella, returns for her 7th-month prenatal checkup. Her physical
exam results are normal, and she has gained 12 pounds in the last 2 months.
21. How does Nurse Gisella interpret the success of the nutritional guidance?
1/1
A. She needs further instruction and reinforcement.
B. She is compliant with her diet as previously taught.
C. She needs to increase her caloric intake.
D. She needs to be placed on a restrictive diet immediately.
22. Mrs. Lizette inquired, "What is the safe amount of alcohol to consume during pregnancy?" Which of
the following would be the most appropriate response from the Nurse Gisella?
1/1
A. No alcohol
B. Up to 3 oz daily
C. Social drinking only
D. Up to 0.5 oz daily
23. Mrs. Lizette mentioned that she is experiencing frequent urination. In her role as a health educator,
Nurse Gisella should first respond by:
0/1
A. Ask if Mrs. Red feels a burning sensation on urination.
B. Instruct Mrs. Red to increase her fluid intake to replace losses.
C. Explain the reason for frequency of voiding
D. Reassure Mrs. Red that frequent urination is normal in pregnancy.
24. During a health education session with all the first-time pregnant women, including Mrs. Lizette, the
nurse highlighted various conditions harmful to their unborn babies. Nurse Gisella knows that the
condition identified as a known teratogen is:
1/1
A. German measles
B. Scarlet fever.
C. Coronary Heart Disease
D. Pneumonia.
25. Nurse Gisella discovered that for pregnant women to adhere to health education guidelines, the
most crucial action she needs to take is to:
1/1
A. Establish a therapeutic relationship with them
B. Provide privacy.
C. Use open-ended questions.
D. Omit highly personal questions.
Situation
3 of 5 points
Mr. Rozen and Mrs. Trisha have two adolescent children, Alysa, who is 13 years old, and Carl, who is 16
years old. They frequently visit the Pediatric clinic, whether they are ill or in good health. Nurse Karen
is responsible for their care.
26. Both Carl and Alysa shared their fears with Nurse Karen. Based on her knowledge of adolescent
concerns, the fear that is least likely to have been mentioned by Carl and Alysa is:_
0/1
A. Hospitalization.
B. Acne.
C. Obesity.
D. Death.
27. Mrs. Trisha voiced her concerns to Nurse Karen about Carl indifference. The nurse's best response
would be to explain that, at this age, Carl regards her peers as the most important people.
1/1
A. Girlfriend.
B. Mother.
C. Father.
D. Teacher.
28. One day, Mr. Rozen reported that Alysa made an unprovoked gesture towards a school staff member.
Nurse Karen explains that this behavior is most likely indicative of Alysa being: _
0/1
A. Testing boundaries.
B. Showing signs of immaturity.
C. Manipulating others.
D. Threatening others.
29. Alysa has been reported to spend her time daydreaming in her room, causing concern for her
parents. The least helpful response from Nurse Karen would be:
1/1
A. Do not worry. This is a normal behavior at this stage of development.
B. Would you feel comfortable in discussing your observation?
C. She may have some problems in school. Has she ever related to you about it?
D. Was there any stressful event in your home lately?
30. Which of the following is least likely to be characteristic of Carl during puberty?
1/1
A. Enlargement of the prostate.
B. Nocturnal emission.
C. Enlargement of the testes.
D. Change in voice quality.
Situation
4 of 5 points
Mrs. Pokwang, 28 years old and married for 4 years, delayed pregnancy to focus on her career as a
lawyer. She consulted an obstetrician due to vaginal spotting and to explore options for conception.
After undergoing various diagnostic tests, she was diagnosed with endometriosis.
31. Which statement BEST describes endometriosis?
1/1
A. It is caused by growth of endometrial tissues outside the uterus.
B. It Is a major cause of primary dysmenorrhea.
C. It is an infection of the endometrium.
D. It is caused by abnormal proliferation of the endometrial lining.
32. The nurse conducts an assessment on Mrs. Pokwang. Which findings would suggest the presence of
endometriosis? Select all that apply.
1. Spotting after intercourse
2. Menorrhagia
3. Persistent dysmenorrhea
4. Mass felt on palpation.
5. Dyspareunia
6. Yellow purulent discharge
1/1
A. 2, 3 and 4
B. 3, 4 and 5
C. 1, 2 and 3
D. 4, 5 and 6
33. The physician prescribes Danazol (Danocrine) for Mrs. Pokwang. The nurse should inform her that
while on this medication, she will likely experience all of the following symptoms EXCEPT?
0/1
A. Diminished menstrual flow.
B. Cessation of her menses.
C. Anovulation.
D. Weight gain and edema.
34. Endometriosis interferes with fertility because.
1/1
A. Of tubal blockage of endometrial tissues.
B. The ovaries stop producing adequate estrogen.
C. The uterine cervix becomes inflamed and swollen.
D. Of pressure on the pituitary that leads to decreased FHS levels.
35. Mrs. Pokwang is scheduled for laparoscopy. What is the correct instruction the nurse should
provide?
1/1
A. Do not drink carbonated beverages 48 hours after the procedure.
B. The dressing can be removed the next day and the incision must be exposed to air.
C. The dye which will be used will color your urine blue for the first few voiding’s.
D. Notify the physician if you feel pain on your shoulders.
Situation
2 of 5 points
Nurse Yana's obstetrical history reveals that Michelle, who is 21 and currently pregnant, experienced
her first pregnancy at age 19, which ended in a 21-week stillbirth. Her subsequent pregnancy
successfully delivered healthy identical twins.
36. Which of the following statements accurately reflects Michelle's obstetrical history?
0/1
A. Michelle is G4P3.
B. Since there has been a twin, Michelle is G5 P4.
C. Since there was an abortion, Michelle is G3P3.
D. Michelle is G3P2.
37. Michelle is currently in the second stage of labor, with her cervix dilated to 8 cm. Nurse Yana places
her in the lithotomy position. One of the potential risks of this position that Nurse Yana should monitor
for in Michelle is:
1/1
A. Supine hypotension.
B. Supine hypertension.
C. Supine tachypnea.
D. Supine hyperventilation
38. If Michelle experiences a prolonged second stage of labor and remains in the lithotomy position for
an extended period, Nurse Yana should take various safety measures, EXCEPT:
0/1
A. Put 2 pillows under her head.
B. Wrap legs with elastic bandages.
C. Place a small pad under her sacral area.
D. Put a rolled towel under the Michelle's right hip.
39. Nurse Yana recognizes that Michelle requires additional support and encouragement during the peak
and most painful phase of uterine contractions, known as the: _•
1/1
A. Acme.
B. Decrescendo.
C. Increment.
D. Decrement.
40. Before performing the initial vaginal examination, commonly known as an internal examination, what
should Nurse Yana check first?
0/1
A. Abdominal palpation for fetal lie and position.
B. Blood pressure for hypo/hypertension.
C. Heart rate of Michelle for chest compressions.
D. Abdominal palpation for signs of fetal distress.
Situation
4 of 5 points
Trixie delivered a 3,203.5 g (7 lb, 1 oz) baby boy via cesarean section 20 minutes ago. She had reached
39 weeks of a healthy pregnancy. She and her husband, Limuel, are now prepared to hold their
newborn son.
41. When the couple touches the newborn's shoulders and finds the skin warm, the nurse explains that
the newborn's best form of insulation is:_.
1/1
A. Brown fat.
B. Glucose.
C. Glycogen.
D. Lanugo.
42. To help keep the baby warm, the nurse advises Trixie to keep a blanket wrapped around him. The
nurse explains that thermoregulation can be challenging for newborns because: _________.
1/1
A. The thin layer subcutaneous fat provides poor insulation.
B. The flexed position of the newborn encourages heat loss.
C. The liver Isn't fully developed.
D. The production of glucose is inadequate.
43. In addition to ensuring the airway remains open, the nurse's top priority while the neonate is in the
nursery is to: _________.
1/1
A. Maintain a neutral thermal environment.
B. Prevent infection.
C. Initiate the first feeding.
D. Facilitate parent-neonate interaction.
44. Which of the following would the nurse recognize as a key goal of newborn care during the initial
postpartum period?
1/1
A. To identify actual or potential problems requiring immediate or emergency attention.
B. To facilitate development of a close parent-newborn relationship.
C. To assist parents in developing healthy attitudes about children’s practices.
D. To provide the parents of the newborn with information about well-baby programs.
45. Which of the following nursing diagnoses would be the top priority for a newborn delivered via
cesarean section?
0/1
A. Impaired gas exchange.
B. RISK of infection.
C. Ineffective thermoregulation.
D. Altered nutrition- less than body requirements.
Situation
4 of 5 points
Nurse Makidato works in the Pediatric ward, where she cares for many toddlers and preschoolers with
non-communicable diseases. She focuses on effectively communicating each child's needs for
diagnosis, treatment, and care.
46. A 2-year-old client named Glenn was admitted for bronchiolitis, with his mother and older sister
taking turns caring for him. When Nurse Makidato offers medication, Glenn shakes his head, covers his
mouth, and says, "I do not like it." How should Nurse Makidato address Glenn's refusal?
0/1
A. Limit questions and offer options.
B. Do a nonverbal approach by distracting him with some food.
C. Tell him that you will be angry if he will not drink his drug.
D. Ask the child if he wants it to be mixed with milk.
47. Pre-schoolers Aaron and Silver are having a fight over a toy provided by the ward. How will Nurse
Makidato respond to the situation
1/1
A. She asks: "Tell me what happened".
B. She demands: "Explain to me why you did this?"
C. She threatens the two saying:"You are both in a lot of trouble."
D. She asks: "How many fights have you two had today?"
48. Four-year-old Mhaecy, who is able to walk, is crying and tugging at his hospital gown while holding a
teddy bear. How should Nurse Makidato respond to Mhaecy's behavior?
1/1
A. "I Know you feel scared. This must be your special teddy bear."
B. "If you will not stop crying I will put your teddy bear in the trash bin.'
C. "Please stop crying nobody will hurt you."
D. "Hello, I am Nurse. Rizza, let us go to the play room."
49. When Nurse Makidato brings a dinner tray, Mhaecy says, "I am too sick to feed myself." How should
Nurse Makidato respond?
1/1
A. "Wait for few minutes and I will be back to help you."
B. "Try to eat as much as you can."
C. "You can eat later when you feel better."
D. "You are a big boy now and you are able to feed yourself."
50. A mother voices her concern to the nurse about Mhaecy spending a lot of time playing with
imaginary friends. How should Nurse Makidato respond?
1/1
A. "Imaginary playmates are his way to release his tension and anxiety.
B. "You have a reason to be concern as this is not a typical behavior.
C. "I suggest psychological counseling."
D. "That is the effect of absentee parent.
Situation
3 of 3 points
Nurse Austria is conducting a cephalocaudal assessment on a 6-month-old infant during a routine well-
child visit. As part of the assessment, Nurse Austria focuses on evaluating the infant’s head and its
development.
[Link] anterior fontanelle is characterized as:
1/1
A. 3-4 cm antero-posterior diameter and 2-3 cm transverse diameter and diamond shape
B. 2-3 cm antero-posterior diameter act. 3-4 cm: transverse diameter and: diamond shape:
C. 2-3 cm in both antero-posterior and transverse diameter and diamond shape
D. none of the above
52. Nurse Austria is developing a care plan for a newborn with fetal alcohol syndrome. What priority
interventions should be included in the plan?
1/1
A. Allow the newborn infant to establish own sleep-rest pattern.
B. Maintain the newborn infant in a brightly lighted area of the nursery.
C. Encourage frequent handling of the newborn infant by staff and' parents.
D. Monitor the newborn Infant's response to feedings and weight gain pattern.
53. Nurse Austria is caring for an infant diagnosed with hydrocephalus. A key preoperative nursing
intervention is to:
1/1
A. Test the urine for protein.
B. Reposition the infant frequently.
C. Provide a stimulating environment.
D. Obtain blood pressures every 30 minutes
Situation
2 of 4 points
Nurse Matic is conducting a routine assessment of different children confined at the pediatric clinic. As
part of the assessment, Nurse Matic focuses on evaluating patient’s sensory development, including
his hearing, vision, and touch responses.
54. Nurse Matic is observing a 2-year-old child and suspects the child might have strabismus. What signs
should the nurse look for to indicate this condition?
1/1
A. The child has difficulty hearing.
B. The child consistently tilts the head to see.
C. The child consistently turns the head to see.
D. The child does not respond when spoken to.
55. Baby Moco was born with Down syndrome. During a physical assessment, the nurse should pay close
attention to the infant's:
0/1
A. Heart sounds
B. Lung expansion
C. Gluteal fold
D. Normal reflexes
56. Nurse Matic is caring for a newborn with tracheoesophageal fistula. What should be the priority
nursing diagnosis?
1/1
A. Risk for dehydration
B. Ineffective airway clearance
C. Altered nutrition
D. Risk for Injury
57. Nurse Matic is caring for a child who has just returned from surgery after a tonsillectomy and
adenoidectomy. What is the appropriate action for the nurse to take?
0/1
A. Offer Ice cream every 2 hours
B. Place the child in a supine position
C. Allow the child' to drink through a straw
D. Observe swallowing patterns
Situation
1 of 5 points
A pregnant client named Mrs. Zarinna has been diagnosed with Deep Vein Thrombosis (DVT) and has
been admitted for potential treatment. This is Nurse Pantig's first experience managing such a case,
and she feels that it will contribute to her professional growth.
58. Nurse Pantig recalls that as part of the inflammation process and edema, the client's skin will be
stretched making it shiny and white known as "milk leg" and this is medically termed as_.
0/1
A. Phlegmasia Alba Dolens.
B. Hyperfibrinogenemia.
C. Homan's Sign.
D. Leg Cramps.
59. Mrs. Zarinna is undergoing treatment for deep venous thrombophlebitis. Nurse Pantig knows that
the effectiveness of the treatment will be monitored by regularly checking the client for:
0/1
A. Hematuria, ecchymosis, and epistaxis.
B. Dysuria, ecchymosis, and vertigo.
C. Epistaxis, hematuria, and dysuria.
D. Hematuria, ecchymosis, and vertigo.
60. Mrs. Zarinna is receiving intravenous heparin therapy. What medication should Nurse Pantig have on
hand in case of a heparin overdose?
1/1
A. Protamine.
B. Amicar
C. Imferon.
D. Diltiazem.
61. Mrs. Zarinna is currently receiving heparin therapy for deep vein thrombosis. Nurse Pantig needs to
closely monitor which of the following laboratory values?
0/1
A. Activated PTT.
B. Platelet count.
C. Bleeding time.
D. Clotting.
62. Nurse Pantig is instructed by the physician to inform Client Zarinna about precautions related to
heparin therapy. What over-the-counter medication should Zarinna be advised to avoid?
0/1
A. Salicylates.
B. Cough medicines with guaifenesin.
C. Histamine blockers.
D. Laxatives containing magnesium salts.
Situation
4 of 5 points
In the May 2014 AIDS Registry, the total number of reported cases reached 18,836, with 495 cases
reported just in May. Approximately 14% of these cases are from Region IVA, which ranks second after
NCR, which has 43%. Nurse Orozco, working in a resettlement community in Cavite, recommended
that the health team implement health education activities, a suggestion that was approved by the
team.
63. Health education is a technique used in both health promotion and disease prevention. Which of the
following statements is NOT correct?
0/1
A. Health education is most needed and most important in tertiary level disease prevention because
people living with HIV will be able to identify measures to prevent opportunistic infections and cancers.
B. Health education in primary level disease prevention enables people to appreciate their health and
control their environment thus preventing them from taking risky behavior and/or exposing themselves
to risk situations.
C. Health education in secondary prevention enables people to identify the rationale for screening
methods and cooperate in the procedures especially that anti-HIV antibody testing is voluntary.
D. Sex education to high school students Is an example of health education in health promotion that can
be utilized to promote sexual and reproductive health.
64. Initially, Nurse Orozco assessed common beliefs about HIV/AIDS. Which of the following beliefs is
accurate??
1/1
A. A couple who are both HIV positives still needs to use condoms when they have sex with each other.
B. One can get HIV infection in using public toilets.
C. A person must not even kiss HIV-infected individual as the virus may evolve and may be transmitted in
saliva.
D. The Incidence of HIV infection Is decreasing world-wide so there is no reason to worry.
65. The primary mode of transmission is through male-to-male sexual contact (accounting for 85% of
cases in May 2014). To implement effective preventive measures, Nurse Orozco needs to identify the
most common transmission methods. What is the most practical method to prevent HIV infection among
men who have sex with men?
1/1
A. Correct, consistent and continuous condom use.
B. Abstinence from sex.
C. Discourage men to have sex with other men as 29% of cumulative cases are bisexuals who may also
transmit the disease to their female partners.
D. Massive indoctrination of children against homosexuality and bisexuality.
66. Nurse Orozco informed the group about the World Health Organization's stance on breastfeeding
infants of mothers with HIV. She stated:
1/1
A. Continue breastfeeding as the advantages outweighs the risk of being infected.
B. Never breast feed for it can be transferred to the baby.
C. Mixed feeding can be used.
D. No feeding for the baby should be done.
67. There are 63 cases of mother-child HIV infection in the cumulative totals. 25-30 only of HIV+ mothers
cross-infect their children. The probability of cross infection (rather to child) is decreased if mother
takes_.
1/1
A. Anti-retroviral the earliest possible time.
B. Antibiotic ASAP.
C. Practice monogamous relationship.
D. Oral contraceptives.
Situation
2 of 7 points
Nurse Al Caguioa is overseeing a patient in active labor. He’s closely monitoring the fetal heart rate
and contractions, providing emotional support, and ensuring that the labor progress is on track. He’s
also preparing for possible interventions if complications arise, such as abnormal fetal heart tones or
prolonged labor.
68. Which of the following nursing interventions would Nurse Caguioa perform during the third stage of
labor?
0/1
A. Obtain a urine specimen and other laboratory tests.
B. Assess uterine contractions every 30 minutes.
C. Coach for effective client pushing
D. Promote parent-newborn interaction
69. Which of the following actions by Nurse Al Caguioa shows an understanding of the newborn's ability
to regulate body temperature?
0/1
A. Placing the newborn under a radiant warmer
B. Suctioning with a bulb syringe
C. Obtaining an Apgar score
D. Inspecting the newborn's umbilical cord
70. Just prior to the expulsion of the fetus, which of the cardinal movements should occur according to
Nurse Caguioa’s knowledge of the birthing process?
0/1
A. Descent
B. External rotation
C. Flexion
D. Extension
71. Fetal heart rate (FHR) variability is not affected by:
0/1
A. Maternal sleep
B. The second stage of labor
C. Fetal sleep
D. Maternal drug use
72. Which assessment finding is not a contraindication for using a tocolytic agent to manage preterm
labor?
1/1
A. Active vaginal bleeding
B. Fetal distress
C. Cervical dilation of 2 to 3 cm
D. Cervical dilation of 4 to 5 cm
73. What labor position should Nurse Caguioa recommend for a cardiac patient who is having problems
due to increased preload?
0/1
A. Left lateral.
B. Prone
C. High semi-fowler's
D. Lithotomy
74. Nurse Caguioa administers prophylactic antibiotics to cardiac patients during labor and after delivery
primarily to prevent:
1/1
A. Mitral valves prolapse.
B. Subacute bacterial endocarditis
C. Pulmonary edema
D. Lower urinary; tract infections
Situation
4 of 5 points
Mr. and Mrs. Yulo are delighted to care for their only child, Carlos, who is now 6 months old. To ensure
he receives proper care, they regularly take him to a pediatric clinic where Nurse Chloe is in charge.
75. Nurse Chloe noticed Carlos toys and advised the couple that the most important feature to look for
in toys for Carlo is that they are:
1/1
A. Washable.
B. Small.
C. Brightly- colored.
D. With breakable parts
76. After weighing Carlos, Nurse Chloe is asked by the couple if his weight is normal. The nurse
appropriately responds that it is normal and that Carlos is growing as expected because his current
weight, compared to his birth weight has:
1/1
A. Doubled.
B. Tripled
C. Quadrupled.
D. Decreased.
77. Mrs. Yulo inquired whether Carlos still needs immunizations despite receiving antibodies through her
breastmilk. Nurse Chloe should respond based on her understanding that breastfeeding:
1/1
A. Can only provide Ryan antibodies that Mrs. Reyes herself has so Ryan still needs to be immunized.
B. Provides the best milk for infants.
C. Provides all the protection needed by Ryan such that there is no need for immunization.
D. Provides active immunity against all childhood diseases.
78. Which of the following behaviors should Nurse Chloe anticipate observing in Carlos?
0/1
A. Fear of strangers.
B. Uses the word "ma."
C. Refined thumb-to-finger coordination.
D. Stands with support.
79. To enhance Carlos's sensory experiences and provide early cognitive stimulation, which stage of
Piaget's theory does this align with?
1/1
A. Sensorimotor.
B. Concrete operations stage.
C. Preoperational stage.
D. Formal operations stage.
Situation
3 of 6 points
Mrs. Yeji, gravida 2 para 1001, arrives in the labor and delivery area reporting that her amniotic
membranes have ruptured. She is experiencing contractions every 3 minutes, each lasting 50 to 60
seconds. The fetus is positioned in the left occiput anterior position.
80. Nurse Ryujin’s initial step should be to:
1/1
A. Check the FHR
B. Call the physician.
C. Check the vaginal discharge with nitrazine paper
D. Admit Mrs. Yeji to the labor and delivery area
81. When Mrs. Yeji describes the amniotic fluid as "brown-tinged," Nurse Ryujin knows that this suggest:
1/1
A. The fetus is not experiencing any undue distress.
B. At some point, the fetus experienced oxygen deprivation
C. Fetal stressed and should be delivered immediately.
D. The fetus is not experiencing any undue distress.
82. Nurse Ryujin sets up an IV line and connects Mrs. Yeji to an electronic fetal monitor. The monitor strip
reveals that the fetal heart rate (FHR) decelerates approximately 30 seconds after the start of each
contraction and returns to baseline once the contraction ends. This type of deceleration is caused by:
0/1
A. Fetal head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Cardiac anomalies
83. For this type of deceleration, the Nurse Ryujin’s initial action should be to:
0/1
A. Increase the IV flow rate
B. Call the physician
C. Position the patient on her left side
D. Continue monitoring the FHR
84. After six hours of labor, Mrs. Yeji’s contractions are occurring every 2 minutes and lasting 80 seconds.
She appears diaphoretic, restless, and irritable, and is moaning about being unable to endure the pain.
Based on these observations, which stage or phase of labor is she likely in?
1/1
A. Latent phase
B. Third stage.
C. Second stage
D. Transitional stage
85. What factor would be most useful in determining the adequacy of Mrs. Yeji's placental perfusion?
0/1
A. The curation and intensity of her contractions
B. Her ability to cope with the discomfort af labor
C. The duration of the rest phases between contractions
D. The effectiveness of her breathing techniques during a contraction
Situation
5 of 10 points
Nurses play a crucial role in managing various diseases in children by providing specialized care,
monitoring progress, and offering emotional support, all of which are essential for improving health
outcomes and ensuring the well-being of young patients.
86. Nurse Veloso is caring for a 14-year-old boy with severe Hemophilia A who was admitted after a
basketball fall, what should the nurse understand about the behavior and care needs of adolescents with
hemophilia?
0/1
A. Must have structured activities
B. Often take part in active sports
C. Explain limitations to peer groups
D. Avoid risks after bleeding episodes
87. Nurse Roman is the postpartum nurse and is providing guidance to a client with a newborn who has
hyperbilirubinemia and is being breastfed. What appropriate instructions should the nurse give to the
client?
1/1
A. Feed the newborn Infant less frequently.
B. Continue to breast-feed every 2 to 4 hours.
C. Switch to bottle-feeding the baby for 2 weeks.
D. Stop the breast-feedings and switch to bottle-feeding permanently.
88. A 4-year-old child with leukemia is admitted to the hospital for chemotherapy and is anxious about
being hospitalized. What nursing intervention would be most effective in easing the child's fears?
0/1
A. Encourage the child's parents to stay with the child.
B. Encourage play with other children of the same age.
C. Advise the family to visit only during the scheduled visiting hours.
D. Provide a private room, allowing the child to bring the favorite toys from home.
89. A 6-year-old child with leukemia is in the hospital receiving combination chemotherapy and has
neutropenia, leading to the initiation of protective isolation procedures. When the child's grandmother
visits and brings a fresh bouquet of flowers from her garden, asking the nurse for a vase, how should
Nurse Dexter respond to her?
1/1
A. "I have a vase in the utility room, and I will get it for you."
B. "I will get the vase and wash it well before you put the flowers in it."
C. "The flowers from your garden are beautiful but should not be placed in the child's room at this time."
D. "When you bring the flowers into the room, place them on the bedside stand as far away from the
child as possible."
90. A child with leukemia is experiencing nausea, Nurse Silver suspects is related to the chemotherapy
regimen. To address concerns about the child's nutritional status during this episode of nausea, what
would be the most appropriate intervention for the nurse to offer?
0/1
A. Cool and clear
B. Low- protein foods
C. Low-calorie foods
D. The child’s favorite foods
91. A 4-year-old girl is having a flare-up of eczema. What nursing diagnosis would be most suitable for
her care?
1/1
A. Risk for infection related to viral lesions.
B. Risk for infection related to scratching of pruritic lesions.
C. Imbalanced nutrition less than body requirements related to throat edema and mouth ulcers.
D. Disturbed body Image related to the presence of thick white crusty plaques over the elbows and
knees.
92. Nurse Colleen, a school nurse, has provided an instructional session about impetigo to parents of the
children attending the school. Which statement, if made by a parent, indicates a need for further
instructions?
0/1
A. “It is extremely contagious.”
B. "It is most common in humid weather."
C. "Lesions most often are located on the arms and chest.”
D. "It might show up in an broken skin Such as an insect bite.”
93. Nurse Lizette, a clinic nurse, is educating the mother of a child with sickle cell anemia about the
factors that can trigger sickling crisis. If the mother identifies one of the following factors, it suggests that
additional instructions are needed.
0/1
A. Stress
B. Trauma
C. Infection
D. Fluid overload
94. A 10-year-old child with hemophilia A has slipped on the ice and injured his knee. Nurse Sarmiento
should prepare to administer an:
1/1
A. Infection of factor X
B. Intravenous infusion of factor VIlI
C. Intravenous infusion of cryoprecipitate
D. Intravenous infusion of desmopressin (DDAVP)
95. A nurse is giving home care instructions to the mother of a 10-year-old child with hemophilia. Which
activities should the nurse recommend that the child can safely participate in with peers?
1/1
A. Soccer
B. Swimming
C. Basketball
D. Field hockey
Situation
3 of 5 points
Nurses play a vital role in managing complications during labor and delivery by monitoring maternal
and fetal health, quickly identifying and addressing issues, and providing support and interventions to
ensure the safety and well-being of both the mother and the baby.
96. While flying to Kuala Lumpur, Malaysia, Nurse Alice Guo is delivering emergency care to a pregnant
client with a prolapsed cord. The mother, feeling anxious and scared, asks the nurse, "Why are so many
people here? Is my baby going to be okay?" What is the most likely issue the client is experiencing at this
moment?
1/1
A. Fear
B. Powerlessness
C. Ineffective coping
D. Disturbed sensory perception
97. Nurse Inosuke is caring for a client receiving ritodrine therapy to stop premature labor. What
condition would suggest an adverse reaction to the ritodrine treatment?
1/1
A. Hypoglycemia
B. Bradycardia
C. Crackles
D. Hyperkalemia
98. Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage. Before giving
the medication, Nurse Licup should contact the healthcare provider if the client’s medical history
includes which of the following conditions?
0/1
A. Hypotension
B. DM
C. Hypothyroidism
D. Peripheral Vascular Disease
99. Nurse Porlante conducts a vaginal assessment on a laboring pregnant client and observes that the
umbilical cord is protruding from the vagina. The nurse should immediately:
0/1
A. Places a gloved hand into the vagina and holds the presenting part off of the umbilical cord.
B. Transports the client to the delivery room
C. Gently pushes the cord into the vagina
D. Position head higher than the hips.
100. A pregnant woman at 14 weeks gestation contacts the obstetrician's office to report clear, odorless
vaginal discharge. Nurse Ejay should advise the client to:
1/1
A. wear a peri-pad to absorb the liquid, which is normal
B. douche with water to see if that improves the drainage
C. do nothing, as vaginal discharge in pregnancy is normal
D. report to the physician's office. immediately for assessment