A.
Clavicle fracture due to macrosomia
1. A newborn presents with bright red diaper B. Caput succedaneum due to rapid labor
rash with satellite lesions. Which factor in the C. Subgaleal hemorrhage due to vacuum
maternal history MOST likely contributed to extraction only
this condition? D. Facial nerve injury due to forceps
ANSWER: A
A. Prolonged labor
B. Maternal diabetes 6. During delivery, Nurse Rae observes that
C. Use of forceps during delivery the fetal head molds extensively due to a
D. Maternal vaginal candidiasis tight fit through the maternal pelvis. Which
ANSWER: D maternal factor is MOST likely contributing to
this?
A. Post-term pregnancy
2. Which nursing intervention should be B. Cephalopelvic disproportion
AVOIDED in managing erythema toxicum C. Uterine hypotony
neonatorum? D. Maternal infection
A. Parental reassurance ANSWER: B
B. Routine newborn bathing
C. Application of topical antifungal agents 7. After a difficult delivery, Nurse Rae notes
D. Continued monitoring facial asymmetry in a newborn when crying.
ANSWER: C The mother had a prolonged second stage of
labor. Which birth injury does this scenario
3. A newborn born to a mother with active MOST likely represent?
genital herpes develops vesicular lesions on A. Brachial plexus injury
an erythematous base at 5 days old. What is B. Facial nerve injury
the PRIORITY nursing action? C. Clavicle fracture
A. Apply topical antibiotic cream D. Cephalohematoma
B. Place the infant in contact precautions and ANSWER: B
notify the physician
C. Reassure parents and observe for 8. Nurse Rae is caring for a newborn after
resolution vacuum-assisted delivery. The baby shows
D. Obtain a complete blood count rapidly increasing scalp swelling, pallor,
ANSWER: B tachycardia, and hypotension. What is the
MOST appropriate action?
4. Which organism is MOST likely A. Reassure the parents; this is normal
responsible for Bullous Impetigo? swelling
A. Streptococcus pyogenes B. Monitor for spontaneous resolution
B. Candida albicans C. Notify the physician immediately; suspect
C. Staphylococcus aureus subgaleal hemorrhage
D. Herpes simplex virus D. Apply cold compress and continue routine
ANSWER: C care
ANSWER: C
5. Nurse Rae is preparing to assist a mother
in labor who is 43 weeks’ gestation. Which
potential birth injury should she anticipate as
a higher risk for the newborn?
9. A newborn delivered via vacuum D. ABO incompatibility leading to hemolysis
extraction has scrapes and superficial skin ANSWER: D
loss over the occiput and forehead. Nurse
Mike notes mild bleeding from the lesions. 14. A 28-week preterm infant receiving IV
Which type of birth injury is this? fluids has a blood glucose of 250 mg/dL with
A. Caput succedaneum polyuria and lethargy. Which action is most
B. Abrasions appropriate?
C. Subgaleal hemorrhage A. Increase glucose infusion rate
D. Ecchymoses B. Reduce glucose infusion rate and monitor
ANSWER: B closely
C. Give phototherapy
10. A 3-day-old term infant develops jaundice D. Administer Vit. K
in the skin and sclera. Total bilirubin is 15 ANSWER: B
mg/dL. Which of the following best describes
this type of jaundice? 15. Which of the following is a feature of
A. Pathologic jaundice physiologic jaundice?
B. Hemolytic jaundice A. Jaundice appears within the first 24 hours
C. Physiologic jaundice B. Associated with hemolysis
D. Breastmilk jaundice C. Total bilirubin rises slowly, peaks at 3-5
ANSWER: C days
D. Requires immediate exchange transfusion
11. During Phototherapy, the priority nursing ANSWER: C
care is to
A. Limit feeding 16. The classic site of bleeding in
B. Maintain hydration Hemorrhagic Disease of the Newborn is:
C. Cover the chest A. Umbilical cord stump
D. Apply lotion during skin care B. Gastrointestinal tract
ANSWER: B C. Skin (bruising, petechiae)
D. All of the above
12. A term infant with mild jaundice is ANSWER: D
exclusively breastfed and feeding poorly.
Which intervention helps reduce bilirubin 17. Which measure is most effective in
levels? preventing infection in high-risk newborns in
A. Start formula feeding only the NICU?
B. Increase frequency of breastfeeding A. Prophylactic antibiotic for all high-risk
C. Delay feeding until bilirubin peaks infants
D. Administer phototherapy immediately B. Restrict parents visits indefinitely
without feeding C. Place them in phototherapy
ANSWER: B D. Maintain strict hand hygiene and aseptic
technique
13. A newborn shows jaundice within the first ANSWER: D
12 hours of life. The mother is O-, the baby is
B+. What is the likely pathophysiology?
A. Vit. K Deficiency
B. Hyperglycemia
C. Pathologic jaundice
18. A 3-hour old newborn shows jitteriness 22. Differentiate between Central Apnea and
and poor feeding. Blood glucose level is 35 Obstructive Apnea.
mg/dL. The infant is large for gestational age. A. Central apnea: airway blocked;
Which factor most likely contributed to Obstructive apnea: no respiratory effort
hypoglycemia? B. Central apnea: no respiratory effort;
A. Maternal gestational diabetes causing Obstructive apnea: airway blocked but effort
fetal hyperinsulinemia present
B. Delayed cord clamping C. Both types involve airway obstruction only
C. Vit. K Deficiency D. Both types involve lack of respiratory
D. Exclusive breastfeeding effort only
ANSWER: A ANSWER: B
19. Define Small for Gestational Age (SGA) 23. Which nursing interventions help
and identify one physical characteristic maintain thermal neutrality in preterm infants?
commonly seen in these infants. A. Incubator use and warm humidified
A. Infant with birth weight above the 90th oxygen
percentile; ruddy skin B. Frequent bathing and exposure to cool air
B. Infant with birth weight below the 10th C. Skin uncovered to promote air circulation
percentile; wasted appearance D. Cold IV fluids to reduce fever
C. Infant born after 42 weeks; parchment-like ANSWER: A
skin
D. Infant born before 37 weeks; lanugo 24. Why are post-term infants more prone to
present meconium aspiration?
ANSWER: B A. They have excessive glycogen stores
B. Placental insufficiency causes fetal
20. What is the primary cause of distress and meconium passage
hypoglycemia in SGA infants? C. They have immature lungs lacking
A. Increased insulin production surfactant
B. Decreased glycogen stores D. They are smaller in size
C. Excessive feeding ANSWER: B
D. Polycythemia
ANSWER: B 25. A preterm infant shows expiratory
grunting and intercostal retractions. What
21. Why are infants with SGA at risk for immediate nursing interventions should you
polycythemia? prioritize?
A. Excess maternal glucose crosses the A. Place infant in prone position and feed
placenta immediately
B. Anoxia stimulates red blood cell B. Provide oxygen support and monitor
production saturation
C. Poor glycogen storage C. Delay interventions until physician arrives
D. Premature surfactant deficiency D. Administer antibiotics immediately
ANSWER: B ANSWER: B
26. During delivery, thick meconium is noted. 29. The nurse notices a newborn’s small
Infant is not crying. What steps should be frame and the faint sound of a murmur during
taken? his routine examination. Following an
A. Stimulate infant vigorously before echocardiogram, the diagnosis is confirmed:
suctioning the baby has a moderate-sized ventricular
B. Visualize vocal cords and suction via ET septal defect (VSD). Which blood flow
tube before stimulation patterns may arise because of a ventricular
C. Perform routine bulb suction only septal defect?
D. Delay suction until infant cries A. Mixed blood flow
ANSWER: B B. Decrease pulmonary blood flow
C. Increased pulmonary blood flow
27. A preterm infant with respiratory distress D. Obstructive blood flow to pulmonary artery
syndrome is receiving oxygen therapy. The ANSWER: C
nurse notes oxygen saturation at 98% with
FiO₂ set at 60%. What is the most 30. What is the cardiac output of a
appropriate nursing action? preschooler if her stroke volume is 80 ml and
A. Continue current oxygen therapy since a heart rate of 50 beats per minute?
saturation is within normal range A. 1 L/min
B. Reduce FiO₂ gradually while closely B. 2 L/min
monitoring oxygen saturation C. 4 L/min
C. Immediately discontinue oxygen therapy D. 6 L/min
to avoid oxygen toxicity ANSWER: C.
D. Increase FiO₂ further to ensure saturation
remains stable 31. What is the MOST common reason that
ANSWER: B the nurse could provide to a young girl in
vaso-occlusive sickle cell crisis regarding the
28. Which of the following cardiovascular need and reason for the infusion of large
defects causes blood flow to be obstructed? volumes of fluid?
A. Aortic stenosis A. Provide the iron to replace depleted stores.
B. Atrial septal defect B. Increase her energy so she will not be as
C. Patent ductus arteriosus tired.
D. Transposition of the great arteries C. Infuse nutrients that will help to fight the
ANSWER: A infection in her body.
D. Help her blood flow better to reduce
blockages that cause pain.
ANSWER: D
32. Nurse Liza, a pediatric nurse, is taking 36. Which of the following statements
care of a 7-year-old child diagnosed with ACCURATELY describes thalassemia?
Rheumatic fever. She knows that the A. It is caused by a deficiency in vitamin D.
following is nursing intervention for B. It primarily affects the liver and kidneys.
Rheumatic Fever, EXCEPT for: C. It is typically treated with antibiotics.
A. Encourage patients to jog and exercise D. It is characterized by abnormal
daily. hemoglobin production.
B. Use pain rating scale and medicate ANSWER: D
appropriately.
C. Handle painful joints. 37. A 2-year-old toddler is brought to the
D. Encourage intake of nutritious foods and pediatric clinic. During the physical
fluids. examination, the nurse notes that the child’s
ANSWER: A legs appear bowed and the bones feel soft
upon palpation. The parent mentions the
33. What criteria are typically indicative of a child has had minimal sunlight exposure and
positive diagnosis of rheumatic fever? no vitamin supplementation. The nurse
SELECT ALL THAT APPLY. suspects the child is experiencing which
A. Positive GABHS throat culture condition?
B. Elevated ASO titer A. Osteogenesis Imperfecta
C. Increased WBC B. Vitamin D-Deficiency Rickets
D. 2 major criteria and 1 minor criteria C. Developmental Dysplasia of the Hip (DDH)
E. 1 major criteria and 2 minor criteria D. Scoliosis
ANSWER: A,B,D ANSWER: B
34. Nurse Liza is teaching a mother of a 38. Nurse Baby-Em is reviewing the
toddler with Kawasaki disease. Which of the pharmacokinetics of vitamins. The student
following statements by the mother correctly identifies that which group of
ACCURATELY describes Kawasaki disease? vitamins is primarily stored in the liver and
A. It is caused by a bacterial infection. adipose tissues, requiring careful monitoring
B. It commonly presents with a characteristic for toxicity?
rash. A. Vitamin B1, B6, B12, and C
C. It typically resolves spontaneously without B. Vitamins K, A, E, and D
treatment. C. Vitamins C, E, and Beta-carotene
D. It primarily affects adults rather than D. Folate, Pantothenic Acid, and Biotin
children. ANSWER: B
ANSWER: B
39. A child is admitted to the pediatric unit
35. A newborn experiences prolonged with a protruding abdomen and thinning hair.
bleeding after his administration of Hepatitis The parents report that while the child
B vaccine and Vitamin K. Also, the baby has receives an adequate supply of calories for
multiple bruises without petechiae. These energy, their diet is almost entirely lacking in
assessment findings suggest which condition? protein. The nurse recognizes this specific
A. Hemophilia form of malnutrition as:
B. Leukemia A. Marasmus
C. Sickle cell anemia B. Failure to Thrive (FTT)
D. Thalassemia C. Kwashiorkor
D. Scurvy 46. Nurse Rae is teaching parents of a
ANSWER: C newborn with NAS (Neonatal Abstinence
Syndrome). Which instruction BEST applies
40. Nurse Jovence is assessing a newborn evidence-based care?
and notes an abnormal skull shape. A. Continue rooming-in, gentle handling, and
Diagnostic imaging reveals premature fusion feeding on demand to reduce withdrawal
of the skull sutures. The healthcare provider symptoms
explains to the parents that surgical B. Keep the infant in isolation to prevent
intervention will likely be required. The nurse infection
documents this condition as: C. Avoid breastfeeding at all costs
A. Positional Plagiocephaly D. Use high-stimulation activities to tire the
B. True Plagiocephaly infant
C. Pressure Plagiocephaly Answer: A
D. Hydrocephalus
ANSWER: B 47. A preterm infant at 30 weeks gestation
suddenly develops apnea, pallor, and
41. Nurse Lennie is attending a community decreased activity. The nurse suspects
health seminar regarding infant mortality. A intraventricular hemorrhage (IVH). Which
case is discussed involving the sudden death additional clinical sign would most strongly
of an infant under 1 year of age that support this diagnosis?
remained unexplained even after a thorough A. Bulging anterior fontanel
clinical history review, death scene B. Strong suck reflex
examination, and post-mortem examination. C. Pink, warm skin
This clinical scenario describes: D. Regular respiratory pattern
A. Apparent Life-Threatening Event Answer: A
B. Sudden Infant Death Syndrome (SIDS)
C. Accidental Suffocation 48. A preterm newborn suddenly develops
D. Colic apnea, hypotonia, pallor, and a bulging
ANSWER: B anterior fontanel. Which action should the
nurse take first?
[Link] Zarrah Dirty is reviewing the A. Administer prescribed anticonvulsants
laboratory results for a preschool-aged child B. Measure head circumference and report
who was diagnosed with Lead poisoning. findings
The report indicates a blood lead level (BLL) C. Place the newborn in Trendelenburg
of 48 mcg/dL. Which medical intervention is position
the priority threshold for this patient? D. Begin oral feeding to prevent
A. Dietary counseling to increase iron intake hypoglycemia
B. Repeating the lab test in 6 months Answer: B
C. Chelation Therapy
D. Referral to a developmental specialist
Answer: C
49. An infant of a diabetic mother (IDM) is
considered high risk primarily because the
complications experienced by the newborn
are influenced by which of the following
factors?
A. The mother’s age and number of previous
pregnancies
B. The infant’s gestational age and mode of
delivery
C. The type of diabetes the mother has and
how well it is controlled during pregnancy
D. The presence of insulin deficiencies
detected at birth
Answer: C
50. Nurse Dee Ghong is assessing a
newborn delivered via vacuum extraction.
Which finding is the most concerning
indicator of a potential intracranial
neurologic injury related to the delivery
method?
A. The infant crying during a diaper change
B. A soft, flat anterior fontanelle
C. Localized swelling that crosses the suture
lines of the skull
D. A bulging or tense anterior fontanelle
while the infant is quiet
Answer: D