A.

B.
A.
B.
A.
B.
C.
D.

A.
B.
C.
D.

A.
B.

A.
B.
C.
D.

A.
B.
C.
D.

A.
B.
C.
D.

PART 1
1. Accompanied by her husband, a patient seeks admission to the labor and delivery area. The
client states that she is in labor, and says she attended the hospital clinic for prenatal care.
Which question should the nurse ask her first?
a. Do you have any chronic illness?
b. Do you have any allergies?
c. What is your expected due date?
d. Who will be with you during labor?
2. A patient is in the second stage of labor. During this stage, how frequently should the nurse in
charge assess her uterine contractions?
Every 5 minutes
C.
Every 30 minutes
Every 15 minutes
D.
Every 60 minutes
E. 3. A patient is in last trimester of pregnancy. Nurse Jane should instruct her to notify her
primary health care provider immediately if she notices:
Blurred vision
C.
Increased vaginal mucus
Hemorrhoids
D.
Shortness of breath on exertion
E. 4. The nurse in charge is reviewing a patients prenatal history. Which finding indicates a
genetic risk factor?
The patient is 25 years old
The patient has a child with cystic fibrosis
The patient was exposed to rubella at 36 weeks gestation
The patient has a history of preterm labor at 32 weeks gestation
F. 5. A adult female patient is using the rhythm (calendar-basal body temperature) method
of family planning. In this method, the unsafe period for sexual intercourse is indicated
by;
Return preovulatory basal body temperature
Basal body temperature increase of 0.1 degrees to 0.2 degrees on the 2nd or 3rd day of
cycle
3 full days of elevated basal body temperature and clear, thin cervical mucus
Breast tenderness and mittelschmerz
G. 6. During a nonstress test (NST), the electronic tracing displays a relatively flat line for
fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the
strip, the nurse in charge should instruct the client to push the control button at which
time?
At the beginning of each fetal
C.
After every three fetal movements
movement
D.
At the end of fetal movement
At the beginning of each contraction
E. 7. When evaluating a clients knowledge of symptoms to report during her pregnancy,
which statement would indicate to the nurse in charge that the client understands the
information given to her?
Ill report increased frequency of urination.
If I have blurred or double vision, I should call the clinic immediately.
If I feel tired after resting, I should report it immediately.
Nausea should be reported immediately.
F. 8. When assessing a client during her first prenatal visit, the nurse discovers that the
client had a reduction mammoplasty. The mother indicates she wants to breast-feed.
What information should the nurse give to this mother regarding breast-feeding
success?
Its contraindicated for you to breast-feed following this type of surgery.
I support your commitment; however, you may have to supplement each feeding with
formula.
You should check with your surgeon to determine whether breast-feeding would be
possible.
You should be able to breast-feed without difficulty.
G. 9. Following a precipitous delivery, examination of the clients vagina reveals a fourthdegree laceration. Which of the following would be contraindicated when caring for this
client?
Applying cold to limit edema during the first 12 to 24 hours
Instructing the client to use two or more peripads to cushion the area
Instructing the client on the use of sitz baths if ordered
Instructing the client about the importance of perineal (Kegel) exercises

A.
B.

A.
B.
C.
A.
B.

H. 10. A client makes a routine visit to the prenatal clinic. Although shes 14 weeks
pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr.
Diaz diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse
expects ultrasonography to reveal:
an empty gestational sac.
C.
a severely malformed fetus.
grapelike clusters.
D.
an extrauterine pregnancy.
E. 11. After completing a second vaginal examination of a client in labor, the nurse-midwife
determines that the fetus is in the right occiput anterior position and at 1 station. Based
on these findings, the nurse-midwife knows that the fetal presenting part is:
1 cm below the ischial spines.
D.
in no relationship to the ischial
directly in line with the ischial spines.
spines.
1 cm above the ischial spines.
E. 12. Which of the following would be inappropriate to assess in a mother whos breastfeeding?
The attachment of the baby to the
C.
Audible swallowing.
breast.
D.
The babys lips smacking
The mothers comfort level with
positioning the baby.

E.

A.
B.
A.
B.
C.
D.
A.
B.
C.
D.

A.
B.
A.
B.

A.
B.
C.
D.
A.
B.

A.
B.

F. 13. During a prenatal visit at 4 months gestation, a pregnant client asks whether tests
can be done to identify fetal abnormalities. Between 18 and 40 weeks gestation, which
procedure is used to detect fetal anomalies?
Amniocentesis.
C.
Fetoscopy.
Chorionic villi sampling.
D.
Ultrasound
E. 14. A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate
the health of her fetus. Her BPP score is 8. What does this score indicate?
The fetus should be delivered within 24 hours.
The client should repeat the test in 24 hours.
The fetus isnt in distress at this time.
The client should repeat the test in 1 week.
F. 15. A client whos 36 weeks pregnant comes to the clinic for a prenatal checkup. To
assess the clients preparation for parenting, the nurse might ask which question?
Are you planning to have epidural anesthesia?
Have you begun prenatal classes?
What changes have you made at home to get ready for the baby?
Can you tell me about the meals you typically eat each day?
G. 16. A client whos admitted to labor and delivery has the following assessment findings:
gravida 2 para 1, estimated 40 weeks gestation, contractions 2 minutes apart, lasting 45
seconds, vertex +4 station. Which of the following would be the priority at this time?
Placing the client in bed to begin
C.
Checking for ruptured membranes.
fetal monitoring.
D.
Providing comfort measures.
Preparing for immediate delivery.
E. 17. Nurse Roy is caring for a client in labor. The external fetal monitor shows a pattern of
variable decelerations in fetal heart rate. What should the nurse do first?
Change the clients position.
C.
Check for placenta previa.
Prepare for emergency cesarean
D.
Administer oxygen.
section.
E. 18. The nurse in charge is caring for a postpartum client who had a vaginal delivery with
a midline episiotomy. Which nursing diagnosis takes priority for this client?
Risk for deficient fluid volume related to hemorrhage
Risk for infection related to the type of delivery
Pain related to the type of incision
Urinary retention related to periurethral edema
F. 19. Which change would the nurse identify as a progressive physiological change in
postpartum period?
Lactation
C.
Uterine involution
Lochia
D.
Diuresis
E. 20. A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of
vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most
likely causing the clients complaint of vaginal bleeding?
Placenta previa
C.
Ectopic pregnancy
Abruptio placentae
D.
Spontaneous abortion

A.
B.
C.
D.
A.
B.
A.
B.

A.
B.

A.
B.
C.
D.
A.
B.
C.
D.
A.
B.

A.
B.
E.

A.
B.
A.
B.

A.
B.

E. 21. A client with type 1 diabetes mellitus whos a multigravida visits the clinic at 27 weeks
gestation. The nurse should instruct the client that for most pregnant women with type 1
diabetes mellitus:
Weekly fetal movement counts are made by the mother.
Contraction stress testing is performed weekly.
Induction of labor is begun at 34 weeks gestation.
Nonstress testing is performed weekly until 32 weeks gestation
F. 22. When administering magnesium sulfate to a client with preeclampsia, the nurse
understands that this drug is given to:
Prevent seizures
C.
Slow the process of labor
Reduce blood pressure
D.
Increase dieresis
E. 23. Whats the approximate time that the blastocyst spends traveling to the uterus for
implantation?
2 days
C.
10 days
7 days
D.
14 weeks
E. 24. After teaching a pregnant woman who is in labor about the purpose of the
episiotomy, which of the following purposes stated by the client would indicate to the
nurse that the teaching was effective?
Shortens the second stage of labor
C.
Prevents perineal edema
Enlarges the pelvic inlet
D.
Ensures quick placenta delivery
E. 25. A primigravida client at about 35 weeks gestation in active labor has had no prenatal
care and admits to cocaine use during the pregnancy. Which of the following persons
must the nurse notify?
Nursing unit manager so appropriate agencies can be notified
Head of the hospitals security department
Chaplain in case the fetus dies in utero
Physician who will attend the delivery of the infant
F. 26. When preparing a teaching plan for a client who is to receive a rubella vaccine
during the postpartum period, the nurse in charge should include which of the following?
The vaccine prevents a future fetus from developing congenital anomalies
Pregnancy should be avoided for 3 months after the immunization
The client should avoid contact with children diagnosed with rubella
The injection will provide immunity against the 7-day measles.
G. 27. A client with eclampsia begins to experience a seizure. Which of the following would
the nurse in charge do first?
Pad the side rails
C.
Insert a padded tongue blade into
Place a pillow under the left buttock
the mouth
D.
Maintain a patent airway
E. 28. While caring for a multigravida client in early labor in a birthing center, which of the
following foods would be best if the client requests a snack?
Yogurt
C.
Vegetable soup
Cereal with milk
D.
Peanut butter cookies
F. 29. The multigravida mother with a history of rapid labor who us in active labor calls out
to the nurse, The baby is coming! which of the following would be the nurses first
action?
Inspect the perineum
C.
Auscultate the fetal heart rate
Time the contractions
D.
Contact the birth attendant
E. 30. While assessing a primipara during the immediate postpartum period, the nurse in
charge plans to use both hands to assess the clients fundus to:
Prevent uterine inversion
C.
Hasten the puerperium period
Promote uterine involution
D.
Determine the size of the fundus
E.
F. Part 2
G. 1. A postpartum patient was in labor for 30 hours and had ruptured membranes for 24
hours. For which of the following would the nurse be alert?
Endometritis
C.
Salpingitis
Endometriosis
D.
Pelvic thrombophlebitis
E. 2. A client at 36 weeks gestation is schedule for a routine ultrasound prior to an
amniocentesis. After teaching the client about the purpose for the ultrasound, which of
the following client statements would indicate to the nurse in charge that the client needs
further instruction?

A.
B.
C.
D.
F.
A.
B.
E.
A.
B.
C.
D.
F.

A.
B.
E.
A.
B.
C.
D.
F.

A.
B.
E.
A.
B.
E.
A.
B.
C.
D.
F.
A.
B.
E.
A.
B.
E.
A.
B.
C.
D.

The ultrasound will help to locate the placenta

The ultrasound identifies blood flow through the umbilical cord
The test will determine where to insert the needle
The ultrasound locates a pool of amniotic fluid
3. While the postpartum client is receiving herapin for thrombophlebitis, which of the
following drugs would the nurse Mica expect to administer if the client develops
complications related to heparin therapy?
Calcium gluconate
C.
Methylegonovine (Methergine)
Protamine sulfate
D.
Nitrofurantoin (macrodantin)
4. When caring for a 3-day-old neonate who is receiving phototherapy to treat jaundice,
the nurse in charge would expect to do which of the following?
Turn the neonate every 6 hours
Encourage the mother to discontinue breast-feeding
Notify the physician if the skin becomes bronze in color
Check the vital signs every 2 to 4 hours
5. A primigravida in active labor is about 9 days post-term. The client desires a bilateral
pudendal block anesthesia before delivery. After the nurse explains this type of
anesthesia to the client, which of the following locations identified by the client as the
area of relief would indicate to the nurse that the teaching was effective?
Back
C.
Fundus
Abdomen
D.
Perineum
6. 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:
Nausea and vomiting can be decreased if I eat a few crackers before arising
If I start to leak colostrum, I should cleanse my nipples with soap and water
If I have a vaginal discharge, I should wear nylon underwear
Leg cramps can be alleviated if I put an ice pack on the area
7. Thirty hours after delivery, the nurse in charge plans discharge teaching for the client
about infant care. By this time, the nurse expects that the phase of postpartal
psychological adaptation that the client would be in would be termed which of the
following?
Taking in
C.
Taking hold
Letting go
D.
Resolution
8. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis,
the nurse tells the client that the usual treatment for partial placenta previa is which of
the following?
Activity limited to bed rest
C.
Immediate cesarean delivery
Platelet infusion
D.
Labor induction with oxytocin
9. Nurse Julia plans to instruct the postpartum client about methods to prevent breast
engorgement. Which of the following measures would the nurse include in the teaching
plan?
Feeding the neonate a maximum of 5 minutes per side on the first day
Wearing a supportive brassiere with nipple shields
Breast-feeding the neonate at frequent intervals
Decreasing fluid intake for the first 24 to 48 hours
10. When the nurse on duty accidentally bumps the bassinet, the neonate throws out its
arms, hands opened, and begins to cry. The nurse interprets this reaction as indicative of
which of the following reflexes?
Startle reflex
C.
Grasping reflex
Babinski reflex
D.
Tonic neck reflex
11. A primigravida client at 25 weeks gestation visits the clinic and tells the nurse that
her lower back aches when she arrives home from work. The nurse should suggest that
the client perform:
Tailor sitting
C.
Shoulder circling
Leg lifting
D.
Squatting exercises
12. Which of the following would the nurse in charge do first after observing a 2-cm circle
of bright red bleeding on the diaper of a neonate who just had a circumcision?
Notify the neonates pediatrician immediately
Check the diaper and circumcision again in 30 minutes
Secure the diaper tightly to apply pressure on the site
Apply gently pressure to the site with a sterile gauze pad

A.
B.

A.
B.
C.
D.

A.
B.
C.
D.

A.
B.
A.
B.
C.
D.

A.
B.
A.
B.

A.
B.
A.
B.
C.
D.
A.
B.
A.
B.
C.
D.

F. 13. Which of the following would the nurse Sandra most likely expect to find when
assessing a pregnant client with abruption placenta?
Excessive vaginal bleeding
C.
Titanic uterine contractions
Rigid, boardlike abdomen
D.
Premature rupture of membranes
E. 14. While the client is in active labor with twins and the cervix is 5 cm dilates, the nurse
observes contractions occurring at a rate of every 7 to 8 minutes in a 30-minute period.
Which of the following would be the nurses most appropriate action?
Note the fetal heart rate patterns
Notify the physician immediately
Administer oxygen at 6 liters by mask
Have the client pant-blow during the contractions
F. 15. A client tells the nurse, I think my baby likes to hear me talk to him. When
discussing neonates and stimulation with sound, which of the following would the nurse
include as a means to elicit the best response?
High-pitched speech with tonal variations
Low-pitched speech with a sameness of tone
Cooing sounds rather than words
Repeated stimulation with loud sounds
G. 16. A 31-year-old multipara is admitted to the birthing room after initial examination
reveals her cervix to be at 8 cm, completely effaced (100 %), and at 0 station. What
phase of labor is she in?
Active phase
C.
Expulsive phase
Latent phase
D.
Transitional phase
E. 17. A pregnant patient asks the nurse Kate if she can take castor oil for her constipation.
How should the nurse respond?
Yes, it produces no adverse effect.
No, it can initiate premature uterine contractions.
No, it can promote sodium retention.
No, it can lead to increased absorption of fat-soluble vitamins.
F. 18. A patient in her 14th week of pregnancy has presented with abdominal cramping and
vaginal bleeding for the past 8 hours. She has passed several cloth. What is the primary
nursing diagnosis for this patient?
Knowledge deficit
C.
Anticipatory grieving
Fluid volume deficit
D.
Pain
E. 19. Immediately after a delivery, the nurse-midwife assesses the neonates head for
signs of molding. Which factors determine the type of molding?
Fetal body flexion or extension
C.
Maternal and paternal ethnic
Maternal age, body frame, and
backgrounds
weight
D.
Maternal parity and gravidity
E. 20. For a patient in active labor, the nurse-midwife plans to use an internal electronic
fetal monitoring (EFM) device. What must occur before the internal EFM can be applied?
The membranes must rupture
C.
The cervix must be dilated fully
The fetus must be at 0 station
D.
The patient must receive anesthesia
E. 21. 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:
Around the pelvic girdle
Around the pelvic girdle and in the upper arms
Around the pelvic girdle and at the perineum
At the perineum
F. 22. A female adult patient is taking a progestin-only oral contraceptive, or minipill.
Progestin use may increase the patients risk for:
Endometriosis
C.
Premenstrual syndrome
Female hypogonadism
D.
Tubal or ectopic pregnancy
E. 23. A patient with pregnancy-induced hypertension probably exhibits which of the
following symptoms?
Proteinuria, headaches, vaginal bleeding
Headaches, double vision, vaginal bleeding
Proteinuria, headaches, double vision
Proteinuria, double vision, uterine contractions
F. 24. 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
patients fluid intake and output closely during oxytocin administration?

A.
B.
C.
D.
G.
A.
B.
E.
A.
B.
E.
A.
B.
E.
A.
B.
C.
D.
F.
A.
B.
C.
D.
G.
A.
B.
E.
F.
A.
B.
C.
D.
G.
A.
B.

A.
B.
A.
B.
A.
B.
C.
D.
A.
B.
C.
D.

Oxytoxin causes water intoxication

Oxytocin causes excessive thirst
Oxytoxin is toxic to the kidneys
Oxytoxin has a diuretic effect
25. Five hours after birth, a neonate is transferred to the nursery, where the nurse
intervenes to prevent hypothermia. What is a common source of radiant heat loss?
Low room humidity
C.
Cools incubator walls
Cold weight scale
D.
Cool room temperature
26. After administering bethanechol to a patient with urine retention, the nurse in charge
monitors the patient for adverse effects. Which is most likely to occur?
Decreased peristalsis
C.
Dry mucous membranes
Increase heart rate
D.
Nausea and Vomiting
27. The nurse in charge is caring for a patient who is in the first stage of labor. What is
the shortest but most difficult part of this stage?
Active phase
C.
Latent phase
Complete phase
D.
Transitional phase
28. After 3 days of breast-feeding, a postpartal patient reports nipple soreness. To
relieve her discomfort, the nurse should suggest that she:
Apply warm compresses to her nipples just before feedings
Lubricate her nipples with expressed milk before feeding
Dry her nipples with a soft towel after feedings
Apply soap directly to her nipples, and then rinse
29. 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?
Between 10 and 12 weeks gestation
Between 16 and 20 weeks gestation
Between 21 and 23 weeks gestation
Between 24 and 26 weeks gestation
30. Normal lochial findings in the first 24 hours post-delivery include:
Bright red blood
C.
A foul odor
Large clots or tissue fragments
D.
The complete absence of lochia
PART III
1. Which of the following would be inappropriate when administering chemotherapy to a
child?
Monitoring the child for both general and specific adverse effects
Observing the child for 10 minutes to note for signs of anaphylaxis
Administering medication through a free-flowing intravenous line
Assessing for signs of infusion infiltration and irritation
2. Which of the following is the best method for performing a physical examination on a
toddler
From head to toe
C.
From abdomen to toes, the to head
Distally to proximally
D.
From least to most intrusive

E.
F. 3. Which of the following organisms is responsible for the development of rheumatic
fever?
Streptococcal pneumonia
C.
Group A -hemolytic streptococcus
Haemophilus influenza
D.
Staphylococcus aureus
E. 4. Which of the following is most likely associated with a cerebrovascular accident (CVA)
resulting from congenital heart disease?
Polycythemia
C.
Endocarditis
Cardiomyopathy
D.
Low blood pressure
E. 5. How does the nurse appropriately administer mycostatin suspension in an infant?
Have the infant drink water, and then administer mycostatin in a syringe
Place mycostatin on the nipple of the feeding bottle and have the infant suck it
Mix mycostatin with formula
Swab mycostatin on the affected areas
F. 6. A mother tells the nurse that she is very worried because her 2-year old child does not
finish his meals. What should the nurse advise the mother?
make the child seat with the family in the dining room until he finishes his meal
provide quiet environment for the child before meals
do not give snacks to the child before meals
put the child on a chair and feed him

A.
B.
C.
D.
A.
B.
C.
D.
A.
B.
A.
B.
C.
D.
A.
B.
C.
D.

A.
B.
A.
B.
C.
D.

A.
B.
A.
B.
C.
D.
A.
B.
A.
B.
C.

G. 7. The nurse is assessing a newborn who had undergone vaginal delivery. Which of the
following findings is least likely to be observed in a normal newborn?
uneven head shape
respirations are irregular, abdominal, 30-60 bpm
(+) moro reflex
heart rate is 80 bpm
H. 8. Which of the following situations increase risk of lead poisoning in children?
playing in the park with heavy traffic and with many vehicles passing by
playing sand in the park
playing plastic balls with other children
playing with stuffed toys at home
I. 9. An inborn error of metabolism that causes premature destruction of RBC?
G6PD
C.
Phenylketonuria
Hemocystinuria
D.
Celiac Disease
E. 10. Which of the following blood study results would the nurse expect as most likely
when caring for the child with iron deficiency anemia?
Increased hemoglobin
Normal hematocrit
Decreased mean corpuscular volume (MCV)
Normal total iron-binding capacity (TIBC)
F. 11. The nurse answers a call bell and finds a frightened mother whose child, the patient,
is having a seizure. Which of these actions should the nurse take?
The nurse should insert a padded tongue blade in the patients mouth to prevent the
child from swallowing or choking on his tongue.
The nurse should help the mother restrain the child to prevent him from injuring himself.
The nurse should call the operator to page for seizure assistance.
The nurse should clear the area and position the client safely.
G. 12. At the community center, the nurse leads an adolescent health information group,
which often expands into other areas of discussion. She knows that these youths are
trying to find out who they are, and discussion often focuses on which directions they
want to take in school and life, as well as peer relationships. According to Erikson, this
stage is known as:
identity vs. role confusion.
C.
career experimentation.
adolescent rebellion.
D.
relationship testing
E. 13. The nurse is assessing a 9-month-old boy for a well-baby check up. Which of the
following observations would be of most concern?
The baby cannot say mama when he wants his mother.
The mother has not given him finger foods.
The child does not sit unsupported.
The baby cries whenever the mother goes out.
F. 14. Cheska, the mother of an 11-month-old girl, KC, is in the clinic for her daughters
immunizations. She expresses concern to the nurse that Shannon cannot yet walk. The
nurse correctly replies that, according to the Denver Developmental Screen, the median
age for walking is:
12 months.
C.
10 months.
15 months.
D.
14 months.
E. 15. Sally Kent., age 13, has had a lumbar puncture to examine the CSF to determine if
bacterial infection exists. The best position to keep her in after the procedure is:
prone for two hours to prevent aspiration, should she vomit.
semi-fowlers so she can watch TV for five hours and be entertained.
supine for several hours, to prevent headache.
on her right sides to encourage return of CSF
F. 16. Bucks traction with a 10 lb. weight is securing a patients leg while she is waiting for
surgery to repair a hip fracture. It is important to check circulation- sensation-movement:
every shift.
C.
every 4 hours.
every day.
D.
every 15 minutes.
E. 17. Carol Smith is using bronchodilators for asthma. The side effects of these drugs that
you need to monitor this patient for include:
tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and
seizures.
tachycardia, headache, dyspnea, temp . 101 F, and wheezing.
blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria.

D.
A.
B.
A.
B.
C.
D.

A.
B.

A.
B.
A.
B.
A.
B.
C.
D.
A.
B.
C.
A.
B.
A.
B.

A.
B.
A.
B.
A.
B.
A.
B.

restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness.
F. 18. The adolescent patient has symptoms of meningitis: nuchal rigidity, fever, vomiting,
and lethargy. The nurse knows to prepare for the following test:
blood culture.
C.
CAT scan.
throat and ear culture.
D.
lumbar puncture.
E. 19. The nurse is drawing blood from the diabetic patient for a glycosolated hemoglobin
test. She explains to the woman that the test is used to determine:
the highest glucose level in the past week.
her insulin level.
glucose levels over the past several months.
her usual fasting glucose level.
F. 20. The twelve-year-old boy has fractured his arm because of a fall from his bike. After
the injury has been casted, the nurse knows it is most important to perform all of the
following assessments on the area distal to the injury except:
capillary refill.
C.
finger movement
radial and ulnar pulse.
D.
skin integrity
E.
F. PART 4
G. 1. Andrea with suspected rheumatic fever is admitted to the pediatric unit. When
obtaining the childs history, the nurse considers which information to be most important?
A fever that started 3 days ago
C.
A recent episode of pharyngitis
Lack of interest in food
D.
Vomiting for 2 days
E. 2. Nurse Liza is administering a medication via the intraosseous route to a child.
Intraosseous drug administration is typically used when a child is:
Under age 3
C.
Critically ill and under age 3
Over age 3
D.
Critically ill and over age 3
E. 3. When assessing a childs cultural background, the nurse in charge should keep in
mind that:
Cultural background usually has little bearing on a familys health practices
Physical characteristics mark the child as part of a particular culture
Heritage dictates a groups shared values
Behavioral patterns are passed from one generation to the next
F. 4. While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel
is open. The nurse should:
Notify the doctor
D.
Ask about a family history of TayLook for other signs of abuse
Sachs disease
Recognize this as a normal finding
E. 5. The nurse is aware that the most common assessment finding in a child with
ulcerative colitis is:
Intense abdominal cramps
C.
Anal fissures
Profuse diarrhea
D.
Abdominal distention
E. 6. When administering an I.M. injection to an infant, the nurse in charge should use
which site?
Deltoid
C.
Ventrogluteal
Dorsogluteal
D.
Vastus lateralis
E. 7. 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?
Total iron-binding capacity
C.
Total protein
Hemoglobin
D.
Serum transferring
E. 8. When developing a plan of care for a male adolescent, the nurse considers the childs
psychosocial needs. During adolescence, psychosocial development focuses on:
Becoming industrious
C.
Achieving intimacy
Establishing an identity
D.
Developing initiative
E. 9. When developing a plan care for a hospitalized child, nurse Mica knows that children
in which age group are most likely to view illness as a punishment for misdeeds?
Infancy
C.
School age
Preschool age
D.
Adolescence
E. 10. Nurse Taylor suspects that a child, age 4, is being neglected physically. To best
assess the childs nutritional status, the nurse should ask the parents which question?
Has your child always been so thin?
Is your child a picky eater?

C.
D.

A.
B.
C.
D.

A.
B.
C.
D.
A.
B.
C.
D.
A.
B.
A.
B.

A.
B.
A.
B.
C.
D.
A.
B.
A.
B.

A.
B.

A.
B.

What did your child eat for breakfast?

Do you think your child eats enough?
F. 11. 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?
Heart rate, respiratory rate, and blood pressure
Recent exposure to communicable diseases
Number of immunizations received
Height and weight
G. 12. A mother asks the nurse how to handle her 5-year-old child, who recently started
wetting the pants after being completely toilet trained. The child just started attending
nursery school 2 days a week. Which principle should guide the nurses response?
The child forgets previously learned skills
The child experiences growth while regressing, regrouping, and then progressing
The parents may refer less mature behaviors
The child returns to a level of behavior that increases the sense of security.
H. 13. A female child, age 6, is brought to the health clinic for a routine checkup. To assess
the childs vision, the nurse should ask:
Do you have any problems seeing different colors?
Do you have trouble seeing at night?
Do you have problems with glare?
How are you doing in school?
I. 14. During a well-baby visit, Jenny asks the nurse when she should start giving her
infant solid foods. The nurse should instruct her to introduce which solid food first?
Applesauce
C.
Rice cereal
Egg whites
D.
Yogurt
E. 15. To decrease the likelihood of bradyarrhythmias in children during endotracheal
intubation, succinylcholine (Anectine) is used with which of the following agents?
Epinephrine (Adrenalin)
C.
Atropine sulfate
Isoproterenol (Isuprel)
D.
Lidocaine hydrochloride (Xylocaine)
E. 16. A 1 year and 2-month-old child weighing 26 lb (11.8 kg) is admitted for traction to
treat congenital hip dislocation. When preparing the patients room, the nurse anticipates
using which traction system?
Bryants traction
C.
Overhead suspension traction
Bucks extension traction
D.
90-90 traction
E. 17. Mandy, age 12, is 7 months pregnant. When teaching parenting skills to an
adolescent, the nurse knows that which teaching strategy is least effective?
Providing a one-on-one demonstration and requesting a return demonstration, using a
live infant model
Initiating a teenage parent support group with first and second-time mothers
Using audiovisual aids that show discussions of feelings and skills
Providing age-appropriate reading materials
F. 18. When performing a physical examination on an infant, the nurse in charge notes
abnormally low-set ears. This findings is associated with:
Otogenous tetanus
C.
Congenital heart defects
Tracheoesophageal fistula
D.
Renal anomalies
E. 19. Nurse Raven should expect a 3-year-old child to be able to perform which action?
Ride a tricycle
C.
Roller-skates
Tie the shoelaces
D.
Jump rope
E. 20. Nurse Betina 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?
Eustachian tubes
C.
Tympanic membrane
Nasopharynx
D.
External ear canal
E. 21. The nurse is evaluating a female child with acute poststreptoccocal
glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of
improvement?
Increased urine output
C.
Increased energy level
Increased appetite
D.
Decreased diarrhea
E. 22. Dr. Smith prescribes corticosteroids for a child with nephritic syndrome. What is the
primary purpose of administering corticosteroids to this child?

A.
B.

A.
B.
A.
B.
C.
D.
A.
B.

To increase blood pressure

C.
To decrease proteinuria
To reduce inflammation
D.
To prevent infection
E. 23. Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea
that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous
membranes and lethargy. What other findings suggests a fluid volume deficit?
A sunken fontanel
C.
Increased blood pressure
Decreased pulse rate
D.
Low urine specific gravity
E. 24. How should the nurse May prepare a suspension before administration?
By diluting it with normal saline solution
By diluting it with 5% dextrose solution
By shaking it so that all the drug particles are dispersed uniformly
By crushing remaining particles with a mortar and pestle
F. 25. What should be the initial bolus of crystalloid fluid replacement for a pediatric patient
in shock?
20 ml/kg
C.
30 ml/kg
10 ml/kg
D.
15 ml/kg

A.
B.
C.
D.

A.
B.
C.
D.
A.
B.
C.
D.
A.
B.
C.
D.
A.
B.
C.
D.

E. 26. Becky, age 5, with intelligence quotient of 65 is admitted to the hospital for
evaluation. When planning care, the nurse should keep in mind that this child is:
Within the lower range of normal intelligence
Mildly retarded but educable
Moderately retarded but trainable
Completely dependent on others for care
F. 27. Maureen, age 12, is brought to the clinic for evaluation for a suspected eating
disorder. To best assess the effects of role and relationship patterns on the childs
nutritional intake, the nurse should ask:
What activities do you engage in during the day?
Do you have any allergies to foods?
Do you like yourself physically?
What kinds of food do you like to eat?
G. 28. 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?
At 1 to 2 years of age
At I week to 1 year of age, peaking at 2 to 4 months
At 6 months to 1 year of age, peaking at 10 months
At 6 to 8 weeks of age
H. 29. When evaluating a severely depressed adolescent, the nurse knows that one
indicator of a high risk for suicide is:
Depression
Excessive sleepiness
A history of cocaine use
A preoccupation with death
I. 30. A child is diagnosed with Wilms tumor. During assessment, the nurse in charge
expects to detect:
Gross hematuria
Dysuria
Nausea and vomiting
An abdominal mass
J.
K.