FIRST SET OF ANSWER KEY
1. Answer: A. Use rubber nipples with small opening in order
to prevent aspiration – does not belong to the group since it
is advised to use rather soft nipples with large opening.
2. Answer: D. six months to eighteen months old. The
surgical intervention is planned on this stage since it may
require a series of operation for the child to undergo.
3. Answer: C. Airway patency – this is still the most
important nursing care at the moment. While the rest are
also correct, however after the surgical procedure airway
and oxygenation are important aspects for faster healing.
4. Answer: B. An asthma attack can happen when the child
is exposed to certain allergens that would trigger an allergic
reaction to the bronchioles causing constriction of the
bronchial tree. This is either acquired or being hereditary. –
Talking to a mother means giving information according to
the level of their understanding. Informing the mother using
medical terms can generally be misunderstood. As a general
rule, it is always important to gauge the level of
understanding
5. Answer: A. Provide health teaching to the family –
Teaching the family about caring for a child with asthma can
be the least nursing action since there is a higher need for
attention to the child’s respiratory status.
6. Answer: A. Physical abuse – A child victim of physical
abuse can have a huge array of signs and symptoms.
Generally a child has a problem with trusting people that’s
why he or she avoids physical contact.
7. ANSWER B. Blood pumped by the embryo’s heart leaves
the embryo through two umbilical arteries. Once oxygenated,
the blood then is returned by one umbilical vein. Arteries
carry deoxygenated blood and waste products from the
fetus, and veins carry oxygenated blood and provide oxygen
and nutrients to the fetus
8. ANSWER C. Quickening is fetal movement and may
occur as early as the 16th and 18th week of gestation, and
the mother first notices subtle fetal movements that gradually
increase in intensity. Braxton Hicks contractions are
irregular, painless contractions that may occur throughout
the pregnancy. A thinning of the lower uterine segment
occurs about the 6th week of pregnancy and is called
Hegar’s sign.
9. ANSWER D. The pregnant woman should be instructed to
wash the breasts with warm water and keep them dry. The
woman should be instructed to avoid using soap on the
nipples and areola area to prevent the drying of tissues.
Wearing a supportive bra with wide adjustable straps can
decrease breast tenderness. Tight-fitting blouses or dresses
will cause discomfort.
10. ANSWER D. The pregnant woman should be instructed
to wash the breasts with warm water and keep them dry.
The woman should be instructed to avoid using soap on the
nipples and areola area to prevent the drying of tissues.
Wearing a supportive bra with wide adjustable straps can
decrease breast tenderness. Tight-fitting blouses or dresses
will cause discomfort.
11. ANSWER B. Normal heart rate of the newborn is 120 to
160 bpm. The remaining answer choices are normal
assessment findings (uneven head shape is molding).
12. ANSWER B. When administering chemotherapy, the
nurse should observe for an anaphylactic reaction for 20
minutes and stop the medication if one is suspected.
Chemotherapy is associated with both general and specific
adverse effects, therefore close monitoring for them is
important.
13. ANSWER C. If the child is hungry he/she more likely
would finish his meals. Therefore, the mother should be
advised not to give snacks to the child. The child is a “busy
toddler.” He/she will not able to keep still for a long time.
14. ANSWER B. The glycosolated hemoglobin test
measures glucose levels for the previous 3 to 4 months
15. ANSWER D. Mycostatin suspension is given as swab.
Never mix medications with food and formula.
16. ANSWER B. The primary role of the nurse when a
patient has a seizure is to protect the patient from harming
him or herself.
17. ANSWER A. For the child with iron deficiency anemia,
the blood study results most likely would reveal decreased
mean corpuscular volume (MCV) which demonstrates
microcytic anemia, decreased hemoglobin, decreased
hematocrit and elevated total iron binding capacity
18. Answer: C. Calendar Guided Pills – This is an artificial
method of family planning wherein the woman takes pills in a
month with corresponding pill per day in order to stop the
ovulation.
19. Answer: B. itching sensation – This itching sensation
may signal irritation locally or systematically. This needs
more attention by the physician.
20. Answer: C. Low birth weight – Diabetes in pregnancy
can make the child large for gestation age. A macrosomic
baby can result when the diabetes is not controlled.
21. B. The most common denominator is tubal obstruction
and injury. Previous pelvic inflammatory disease, especially
when caused by Chlamydia trachomatis, is a major risk
factor for ectopic pregnancy.
22. C. The first stage in the evaluation of women with a
suspected ectopic pregnancy is to determine if the patient is
pregnant. The human chorionic gonadotropin (β-hCG)
enzyme immunoassay, with a sensitivity of 25 mIU/mL, is an
accurate screening test for ectopic pregnancy and is positive
in virtually all cases of ectopic pregnancy.
23. A. Macrosomia is often associated with diabetes mellitus
in pregnancy, especially in women without vasculopathy.
24. C. On initial testing, almost 85% of high-risk patients
show a reactive NST, and the remaining 15% are
nonreactive. Other factors besides fetal hypoxia, asphyxia,
behavioral states, and gestational age can lead to a
nonreactive NST. They include depressants (narcotics,
phenobarbital), beta-blockers (propranolol), and smoking
(causes decreased NST reactivity). Preterm fetuses are less
likely to have FHR accelerations in association with fetal
movements. Thus, the lower the gestational age, the higher
the percentage of nonreactive NSTs. This concept should be
kept in mind, as fetuses may undergo antepartum
surveillance at < 32 weeks.
25. C. Although allergy to drugs is possible, it usually causes
urticarial or maculopapular eruption. Upper limit of CBD
diameter in an adult is 7 mm, and it is not unusual to find
slightly dilated CBD. Gallbladder hypomotility and
lithogenicity are consequences of pregnancy and do not
need attention unless there is a complication. Elevation of
transaminases is a sensitive early test for ICP. Total bile acid
concentration should be measured to confirm the diagnosis.
26. B. Autoimmune hepatitis, like other chronic liver
diseases, reduces fertility but, after successful treatment,
fertility returns, and these patients can get pregnant. In most
cases, they have to continue low-dose immunosuppressant
medication long term, and the risk of teratogenicity is very
small at these doses. There is an increased risk of
prematurity, stillbirth, preeclampsia, etc. Some patients can
come off all immunosuppressant medication after 18–24
months. All these patients should be managed in close
consultation with a hepatologist.
27. A. The only absolute contraindication for laparoscopy is
shock or hemodynamic instability.
28. B. The interstitial part of the fallopian tube is the proximal
portion that lies within the muscular wall of the uterus.
Interstitial implantation of the blastocyst is the rarest form
(1.9%) of tubal ectopic pregnancy. Abdominal pregnancy
occurs in approximately 1 in 8000 births and represents
1.4% of ectopic pregnancies. Ovarian pregnancy is an
infrequent variant of ectopic pregnancy with an incidence of
0.5–3% of all ectopic pregnancies. Cervical pregnancy,
which results from 147 implantation of the blastocyst within
the cervical canal, is a rare complication of pregnancy. Its
incidence varies from 1 in 2400 to 1 in 50 000 normal
pregnancies.
29. A. Without VZIG, infants of mothers who develop
chickenpox from 5 days before and up to 2 days following
delivery are at high risk of developing disseminated varicella.
This high risk relates to delivery of an infant presumably
before development of maternal antibodies against
chickenpox.
30. C. During labor, up to 50% of growth-restricted fetuses
exhibit abnormal heart rate patterns. Oligohydramnios is a
common finding in growth-restricted fetuses. Incidences of
low Apgar scores and cord blood acidemia increase
significantly in small-for-gestational-age neonates.
31. A. Macrosomia is often associated with diabetes mellitus
in pregnancy, especially in women without vasculopathy
32. E. Active sleep is characterized by frequent gross body
movements, rapid eye movements, breathing, normal FHR
variability, and accelerations. The near-term fetus spends its
time mainly in either a quiet or an active sleep state.
33. A. With a face presentation, the head is completely
extended. With a vertex presentation, the head is completely
or partially flexed. With a brow (forehead) presentation, the
head would be partially extended.
34. D. The zygote is the single cell that reproduces itself
after conception. The chromosome is the material that
makes up the cell and is gained from each parent. Blastocyst
and trophoblast are later terms for the embryo after zygote.
35. B. The ischial spines are located in the mid-pelvic region
and could be narrowed due to the previous pelvic injury. The
symphysis pubis, sacral promontory, and pubic arch are not
part of the mid-pelvis.
36. A. The greenish tint is due to the presence of meconium.
Lanugo is the soft, downy hair on the shoulders and back of
the fetus. Hydramnios represents excessive amniotic fluid.
Vernix is the white, cheesy substance covering the fetus.
37. D. Prepared childbirth was the direct result of the 1950’s
challenging of the routine use of analgesic and anesthetics
during childbirth. The LDRP was a much later concept and
was not a direct result of the challenging of routine use of
analgesics and anesthetics during childbirth. Roles for nurse
midwives and clinical nurse specialists did not develop from
this challenge.
38. A. Cramping and vaginal bleeding coupled with cervical
dilation signifies that termination of the pregnancy is
inevitable and cannot be prevented. Thus, the nurse would
document an imminent abortion. In a threatened abortion,
cramping and vaginal bleeding are present, but there is no
cervical dilation. The symptoms may subside or progress to
abortion. In a complete abortion all the products of
conception are expelled. A missed abortion is early fetal
intrauterine death without expulsion of the products of
conception.
39. C. For the client with an ectopic pregnancy, lower
abdominal pain, usually unilateral, is the primary symptom.
Thus, pain is the priority. Although the potential for infection
is always present, the risk is low in ectopic pregnancy
because pathogenic microorganisms have not been
introduced from external sources. The client may have a
limited knowledge of the pathology and treatment of the
condition and will most likely experience grieving, but this is
not the priority at this time.
40. C. Feeding more frequently, about every 2 hours, will
decrease the infant’s frantic, vigorous sucking from hunger
and will decrease breast engorgement, soften the breast,
and promote ease of correct latching-on for feeding.
Narcotics administered prior to breast feeding are passed
through the breast milk to the infant, causing excessive
sleepiness. Nipple soreness is not severe enough to warrant
narcotic analgesia. All postpartum clients, especially
lactating mothers, should wear a supportive brassiere with
wide cotton straps. This does not, however, prevent or
reduce nipple soreness. Soaps are drying to the skin of the
nipples and should not be used on the breasts of lactating
mothers. Dry nipple skin predisposes to cracks and fissures,
which can become sore and painful.
41. Answer: C. A recent episode of pharyngitis
A recent episode of pharyngitis is the most important factor
in establishing the diagnosis of rheumatic fever. Although the
child may have a history of fever or vomiting or lack interest
in food, these findings are not specific to rheumatic fever.
42. Answer: C. Critically ill and under age 3
In an emergency, intraosseous drug administration is
typically used when a child is critically ill and under age 3.
43. Answer: D. Behavioral patterns are passed from one
generation to the next
A family’s behavioral patterns and values are passed from
one generation to the next.
44. Answer: A. Notify the doctor
Because the anterior fontanel normally closes between ages
12 and 18 months, the nurse should notify the doctor
promptly of this finding. An open fontanel does not indicate
abuse and is not associated with Tay-Sachs disease.
45. Answer: B. Profuse diarrhea
Ulcerative colitis causes profuse diarrhea, intense abdominal
cramps, anal fissures, and abdominal distensions are more
common in Crohn’s disease.
46. Answer: D. Vastus lateralis
The recommended injection site for an infant is the vastus
lateralis or rectus femoris muscles.
47. Answer: C. Total protein
A negative nitrogen balance may result from inadequate
protein intake and is best detected by measuring the total
protein level.
48. Answer: B. Establishing an identity
According to Erikson, the primary psychosocial task during
adolescence is to establish a personal identity confusion.
The adolescent attempts to establish a group identity by
seeking acceptance and approval from peers and strives to
attain a personal identity by becoming more independent
from the family.
49. Answer: B. Preschool age
Preschool-age children are most likely to view illness as a
punishment for misdeeds. Option A: Separation anxiety,
although seen in all age group, is most common in older
infants.
50. Answer: C. “What did your child eat for breakfast?”
The nurse should obtain objective information about the
child’s nutritional intake, such as by asking about what the
child ate for a specific meal. The other options ask for
subjective replies that would be open to interpretation.
51. Answer: A. Heart rate, respiratory rate, and blood
pressure
The most important data to obtain on a child’s arrival in the
emergency department are vital sign measurements. The
nurse should gather the other data later.
52. Answer: D. The child returns to a level of behavior that
increases the sense of security.
The stress of starting nursery school may trigger a return to
a level of successful behavior from earlier stages of
development.
53. Answer: D. “How are you doing in school?”
A child’s poor progress in school may indicate a visual
disturbance. The other options are more appropriate
questions to ask when assessing vision in a geriatric patient.
54. Answer: C. Rice cereal
Rice cereal is the first solid food an infant should receive
because it is easy to digest and is associated with few
allergies. Next, the infant can receive pureed fruits, such as
bananas, applesauce, and pears, followed by pureed
vegetables, egg yolks, cheese, yogurt, and finally, meat.
55. Answer: C. Atropine sulfate
Succinylcholine is an ultra-short-acting depolarizing agent
used for rapid-sequence intubation. Bradycardia can occur,
especially in children. Atropine is the drug of choice in
treating succinylcholine-induced bradycardia.
56. Answer: A. Bryant’s traction
Bryant’s traction is used to treat femoral fractures of
congenital hip dislocation in children under age 2 who weigh
less than 30 lb (13.6 kg).
57. Answer: D. Providing age-appropriate reading materials
Because adolescents absorb less information through
reading, providing age-appropriate reading materials is the
least effective way to teach parenting skills to an adolescent.
58. Answer: D. Renal anomalies
Normally the top of the ear aligns with an imaginary line
drawn across the inner and outer canthus of the eye. Ears
set below this line are associated with renal anomalies or
mental retardation.
59. Answer: A. Ride a tricycle
At age 3, gross motor development and refinement in eye-
hand coordination enable a child to ride a tricycle.
60. Answer: A. Eustachian tubes
In a child, Eustachian tubes are short and lie in a horizontal
plane, promoting entry of nasopharyngeal secretions into the
tubes and thus setting the stage for otitis media.
61. Answer: A. Increased urine output
Increased urine output, a sign of improving kidney function,
typically is the first sign that a child with acute post
streptococcal glomerulonephritis (APSGN) is improving.
62. Answer: C. To decrease proteinuria
The primary purpose of administering corticosteroids to a
child with nephritic syndrome is to decrease proteinuria.
63. Answer: A. A sunken fontanel
In an infant, signs of fluid volume deficit (dehydration)
include sunken fontanels, increased pulse rate, and
decreased blood pressure. They occur when the body can
no longer maintain sufficient intravascular fluid volume.
When this happens, the kidneys conserve water to minimize
fluid loss, which results in concentrated urine with a high
specific gravity.
64. Answer: C. By shaking it so that all the drug particles are
dispersed uniformly
The nurse should shake a suspension before administration
to dispersed drug particles uniformly.
65. Answer: A. 20 ml/kg
Fluid volume replacement must be calculated to the child’s
weight to avoid over-hydration. Initial fluid bolus is
administered at 20 ml/kg, followed by another 20 ml/kg bolus
if there is no improvement in fluid status.
66. Answer: B. Mildly retarded but educable
According to the American Association on Mental Deficiency,
a person with an intelligence quotient (IQ) between 50 and
70 is classified as mildly mentally retarded but educable.
67. Answer: C. “Do you like yourself physically?”
Role and relationship patterns focus on body image and the
patient’s relationship with others, which commonly
interrelated with food intake.
68. Answer: B. At I week to 1 year of age, peaking at 2 to 4
months
SIDS can occur any time between 1 week and 1 year of age.
The incidence peaks at 2 to 4 months of age.
69. Answer: D. A preoccupation with death
An adolescent who demonstrates a preoccupation with
death (such as by talking about death frequently) should be
considered at high risk for suicide.
70. Answer: D. An abdominal mass
The most common sign of Wilms’ tumor is a painless,
palpable abdominal mass, sometimes accompanied by an
increase in abdominal girth.
71. Answer: B. Observing the child for 10 minutes to note for
signs of anaphylaxis
When administering chemotherapy, the nurse should
observe for an anaphylactic reaction for 20 minutes and stop
the medication if one is suspected. Chemotherapy is
associated with both general and specific adverse effects,
therefore close monitoring for them is important.
72. Answer: D. From least to most intrusive
When examining a toddler or any small child, the best way to
perform the exam is from least to most intrusive.
73. Answer: C. Group A β-hemolytic streptococcus
Rheumatic fever results from a delayed reaction to
inadequately treated group A β-hemolytic streptococcal
infection.
74. Answer: A. Polycythemia
The child with congenital heart disease develops
polycythemia resulting from an inadequate mechanism to
compensate for decreased oxygen saturation
75. Answer: D. Swab Mycostatin on the affected areas
Mycostatin suspension is given as swab. Never mix
medications with food and formula.
76. Option B: When using a warming device the neonate’s
temperature should be continuously monitored for undesired
elevations. Option A: The use of heat lamps is not safe as
there is no way to regulate their temperature. Option C:
Warming medications and fluids is not indicated. Option D:
While touching with cold hands can startle the infant it does
not pose a safety risk.
77. Option B: Peripheral neuropathy can lead to lack of
sensation in the lower extremities. Clients do not feel
pressure and/or pain and are at high risk for skin impairment.
78. Option D: Nursing care for a child having a seizure
includes maintaining airway patency, ensuring safety,
administering medications, and providing emotional support.
Options A and C: Since the seizure has already started,
nothing should be forced into the child’s mouth and they
should not be moved. Of the choices given, first priority
would be for safety.
79. Option D: Any activity that involves straining should be
avoided in clients with glaucoma. Such activities would
increase intraocular pressure.
80. Option D: An adverse reaction of a fever should be
reported immediately. Other reactions that should be
reported include crying for > 3 hours, seizure activity, and
tender, swollen, reddened areas.
81. Answer: C. The father may resent the infant’s demands
on the mother’s body
With breastfeeding, the father’s body is not capable of
providing the milk for the newborn, which may interfere with
feeding the newborn, providing fewer chances for bonding,
or he may be jealous of the infant’s demands on his wife’s
time and body.
82. Answer: A. The test was performed less than 10 days
after an abortion
A false-positive reaction can occur if the pregnancy test is
performed less than 10 days after an abortion.
83. Answer: D. 20 weeks gestation
The FHR can be auscultated with a fetoscope at about 20
week’s gestation. FHR usually is auscultated at the midline
suprapubic region with Doppler ultrasound transducer at 10
to 12 week’s gestation. FHR, cannot be heard any earlier
than 10 weeks’ gestation.
84. Answer: C. April 12
The FHR can be auscultated with a fetoscope at about 20
week’s gestation. FHR usually is auscultated at the midline
suprapubic region with Doppler ultrasound transducer at 10
to 12 week’s gestation. FHR, cannot be heard any earlier
than 10 weeks’ gestation.
85. Answer: A. Uterus in the pelvis
When the LMP is unknown, the gestational age of the fetus
is estimated by uterine size or position (fundal height). The
presence of the uterus in the pelvis indicates less than 12
weeks’ gestation. At approximately 12 to 14 weeks, the
fundus is out of the pelvis above the symphysis pubis. The
fundus is at the level of the umbilicus at approximately 20
weeks’ gestation and reaches the xiphoid at term or 40
weeks.
86. Answer: D. Leaking amniotic fluid
Danger signs that require prompt reporting leaking of
amniotic fluid, vaginal bleeding, blurred vision, rapid weight
gain, and elevated blood pressure.
87. Answer: B. Rubella titer less than 1:8
A rubella titer should be 1:8 or greater. Thurs, a finding of a
titer less than 1:8 is significant, indicating that the client may
not possess immunity to rubella.
88. Answer: D. Increasing intensity with walking
With true labor, contractions increase in intensity with
walking. In addition, true labor contractions occur at regular
intervals, usually starting in the back and sweeping around
to the abdomen. The interval of true labor contractions
gradually shortens.
89. Answer: B. Second stage
Crowing, which occurs when the newborn’s head or
presenting part appears at the vaginal opening, occurs
during the second stage of labor.
90. Answer: C. They rapidly transfer across the placenta,
and lack of an antagonist make them generally inappropriate
during labor.
Barbiturates are rapidly transferred across the placental
barrier, and lack of an antagonist makes them generally
inappropriate during active labor.
91. Answer: D. Promote parent-newborn interaction.
During the third stage of labor, which begins with the delivery
of the newborn, the nurse would promote parent-newborn
interaction by placing the newborn on the mother’s abdomen
and encouraging the parents to touch the newborn.
92. Answer: A. Placing the newborn under a radiant warmer.
The newborn’s ability to regulate body temperature is poor.
Therefore, placing the newborn under a radiant warmer aids
in maintaining his or her body temperature.
93. Answer: D. External rotation
Immediately before expulsion or birth of the rest of the body,
the cardinal movement of external rotation occurs.
94. Answer: B. Foramen ovale
The foramen ovale is an opening between the right and left
auricles (atria) that should close shortly after birth so the
newborn will not have a murmur or mixed blood traveling
through the vascular system.
95. Answer: B. Uric acid crystals
Uric acid crystals in the urine may produce the reddish “brick
dust” stain on the diaper.
96. Answer: B. 100 beats per minute
The normal heart rate for a newborn that is sleeping is
approximately 100 beats per minute. If the newborn was
awake, the normal heart rate would range from 120 to 160
beats per minute.
97. Answer: C. The anterior is large in size when compared
to the posterior fontanel.
The anterior fontanel is larger in size than the posterior
fontanel. Additionally, the anterior fontanel, which is diamond
shaped, closes at 18 months, whereas the posterior
fontanel, which is triangular shaped, closes at 8 to 12
weeks. Neither fontanel should appear bulging, which may
indicate increased intracranial pressure, or sunken, which
may indicate dehydration.
98. Answer: B. Blink, cough, sneeze, gag
Blink, cough, sneeze, swallowing and gag reflexes are all
present at birth and remain unchanged through adulthood.
Reflexes such as rooting and stepping subside within the
first year.
99. Answer: A. The newborn’s toes will hyperextend and fan
apart from dorsiflexion of the big toe when one side of foot is
stroked upward from the ball of the heel and across the ball
of the foot.
With the Babinski reflex, the newborn’s toes hyperextend
and fan apart from dorsiflexion of the big toe when one side
of the foot is stroked upward from the heel and across the
ball of the foot.
100. Answer: B. Severe nausea and vomiting leading to the
electrolyte, metabolic, and nutritional imbalances in the
absence of other medical problems.
The description of hyperemesis gravidarum includes severe
nausea and vomiting, leading to the electrolyte, metabolic,
and nutritional imbalances in the absence of other medical
problems.
 SECOND SET OF ANSWER KEY
101.ANSWER : A, C, D
RATIONALE : Crawling infants may explore their
environments through taste and touch. They tend to put
everything in their mouths. Therefore, the nurse should
advise the parents to always keep a watch on their child and
never leave their child unattended. Children at 9 months of
age will begin to be able to pull themselves up to standing
positions, potentially giving them access to cabinets,
drawers, and containers that they were unable to access
before. Therefore, the parents need to thoroughly childproof
the home. The parents should be warned about providing
small, colorful toys or leaving small objects on the floor
because the child will be attracted to such objects and may
attempt to swallow them, which may result in choking. The
child is 8 months old. By this age, solid foods are permitted.
The child should be allowed to play and crawl on the floor,
as this is helpful for the development of the child's gross
motor skills.
102.ANSWER : A, B, C, D
RATIONALE: Pediatric social illness is a new morbidity in
children. It refers to "the behavior, social, and educational
problems that the children face". Poor socioeconomic status
is a social problem. Animal cruelty is a behavioral problem.
Problem within the family is a social problem Failure at
school is an educational problem, and behavior with other
children is also a behavioral problem. Any of these could
cause pediatric social illness. Going to school does not
cause social illness. It helps the child to gain knowledge,
learn moral values, and to lead a successful life.
103. ANSWER: C
RATIONALE: According to National Quality Forum, the
nurse has to measure the patient-centered outcome. The
nurse has to assess the patients in the intensive care unit
(ICU) regularly to identify the urinary tract infections
associated with the urinary catheter. Signs and symptoms of
a urinary tract infection are fever, burning urination, and
yellow urine. The urinalysis is done to confirm the presence
of urinary tract infection (UTI). Urinary catheterization has no
direct association with changes in arterial or venous oxygen
saturation, respiratory, or cardiac complication.
104.ANSWER: A,B,C,D
RATIONALE: Atraumatic care refers to the provision of the
therapeutic interventions that would minimize or eliminate a
patient's physical and psychologic distress. Atraumatic care
includes interventions to reduce physical distress such as
pain control measures. Interventions such as allowing the
child privacy, respecting cultural differences, and fostering
the parent-child relationship are examples of interventions
those are helpful in minimizing psychologic distress in the
child. Preventive measures such as vaccination for
preventing tetanus are not an intervention included in a
traumatic care.
105.ANSWER: C,D,E
RATIONALE: Breast milk contains enzymes that are helpful
in the digestion of milk and improve the bioavailability of all
nutrients in the milk. Immunoglobulins in milk give immunity
against infections and allergies. Hence, breastfeeding can
decrease infant mortality and morbidity. Breast milk is rich in
micronutrients. Breast milk has immunologic properties, so it
can be given to the infants with fever.
106.ANSWER: D,C,A,E,B
RATIONALE: The five-step nursing process model is
assessment, diagnosis, planning, implementation, and
evaluation. The first step is assessment in which the nurse
collects, and analyzes subjective and objective data of the
patient. This step is very crucial in determining the Client
Needs. The second step is the formulation of the nursing
diagnosis. In this phase, the nurse interprets and makes
decisions about the acquired data. The third step is planning
wherein the nurse develops a care plan and establishes the
desired outcomes in the patient. This care plan also includes
the interventions that would help the patient to achieve the
desired outcomes. The fourth step is implementation in
which the interventions that have been listed in the care plan
are carried out in a systematic manner. Evaluation is the last
step of nursing process which establishes the efficacy of the
interventions provided to the patient.
107. ANSWER: B, C, E
RATIONALE: A child's home environment with limited
access to safe outdoor play areas and abundant access to
television and video games is a major contributing factor for
childhood obesity. Childhood obesity increases the risk for
hypertension, diabetes, and hypercholesterolemia, among
other conditions. Tooth decay is associated with poor dental
care, not lack of exercise contributing to childhood obesity.
Growth delays are associated with malnutrition, not lack of
exercise contributing to childhood obesity.
108.ANSWER: A,B,C,D
RATIONALE: The nurse should inform the parents that
culture has some influence on children's eating habits, and
the child is likely to follow it. Cholesterol is required for the
synthesis of neurons in the child's brain and should be
included in the diet. During adolescence, children tend to
make food choices for sociability and the first 3 years of life
are crucial in establishing eating habits of children.
Cholesterol is present only in animal products such as meat,
milk, and eggs but not present in plant products.
109.ANSWER: D
RATIONALE: Prevention is the current focus of health care,
one in which nursing plays a major role. Traditionally,
treating disease or disability is the role of the physician.
National health care planning is not a major trend.
Accountability to professional codes is an established
responsibility, not a trend.
110.ANSWER: A
RATIONALE: Birth weight of less than 2,500 grams or 5.5
pounds in considered low birth weight (LBW). LBW is
associated with higher neonatal mortality rate in the United
States when compared with other countries. The lower the
birth weight, the higher the mortality rate. Birth weight of the
neonates born to uncontrolled diabetic mother can be high.
The mortality rate of neonates born with a birth weight of
more than 3.5 g is lower than that of neonates born with
LBW. Febrile convulsions seldom cause death in neonates.
111.ANSWER:C
RATIONALE: Impaired bowel motility caused by surgical
anesthesia, pain medication, and immobility (C) is the priority
nursing diagnosis and addresses the potential problem of a
paralytic ileus. (A and B) are both caused by impaired bowel
motility. (D) is not as important as impaired motility
112.ANSWER:C
RATIONALE: Erythromycin ointment is instilled into the
lower conjunctiva of each eye within 2 hours after birth to
prevent ophthalmia neonatorum, an infection caused by
gonorrhea (C), and inclusion conjunctivitis, an infection
caused by Chlamydia. The infant may be exposed to these
bacteria when passing through the birth canal. Ophthalmic
ointment is not effective against (A, B, or D).
113.ANSWER:C
RATIONALE: The infant is becoming frustrated and so is the
mother; both need a time out. The mother should be
encouraged to comfort the infant and to relax herself (C).
After such a time out, breastfeeding is often more
successful. (A and D) would cause nipple confusion. (B)
would only cause the infant to be more resistant, resulting in
the mother and infant to become more frustrated.
114.ANSWER:A
RATIONALE: Ovulation occurs 14 days before the first day
of the menstrual period (A). Although ovulation can occur in
the middle of the cycle or 2 weeks after menstruation, this is
only true for a woman who has a perfect 28-day cycle. For
many women, the length of the menstrual cycle varies. (B, C,
and D) are incorrect.
115.ANSWER:C
RATIONALE: Tingling fingers and dizziness are signs of
hyperventilation (blowing off too much carbon dioxide).
Hyperventilation is treated by retaining carbon dioxide. This
can be facilitated by breathing into a paper bag or cupped
hands (C). (A) is inappropriate because the carbon dioxide
level is low, not the oxygen level. (B and D) are not specific
for this situation.
116. ANSWER:D
RATIONALE: Learning is facilitated by an interested pupil.
The couple is most interested in childbirth toward the end of
the pregnancy, when they are beginning to anticipate the
onset of labor and the birth of their child. (D) is closest to the
time when parents would be ready for such classes. (A, B,
and C) are not the best times during a pregnancy for the
couple to attend childbirth education classes. At these times
they will have other teaching needs. Early pregnancy
classes often include topics such as nutrition, physiologic
changes, coping with normal discomforts of pregnancy, fetal
development, maternal and fetal risk factors, and evolving
roles of the mother and her significant others.
117. ANSWER:D
RATIONALE: This infant is demonstrating signs of
hypoglycemia, possibly secondary to a low body
temperature. The nurse should first determine the serum
glucose level (D). (A) is an intervention for a lethargic infant.
(B) should be done based on the temperature, but first the
glucose level should be obtained. (C) helps raise the blood
sugar, but first the nurse should determine the glucose level.
118.ANSWER:A
RATIONALE: Continuous breastfeeding on a 3- to 4-hour
schedule during the day will cause a release of prolactin,
which will suppress ovulation and menses, but is not
completely effective as a birth control method (A). (B) is
incorrect because alcohol can immediately enter the breast
milk. Nicotine is transferred to the infant in breast milk (C).
Taking a warm shower will stimulate the production of milk,
which will be more painful after breastfeedings (D).
119.ANSWER: C
RATIONALE: Checking the blood pressure for an elevation
(C) is the best instruction to give at this time. A blood
pressure exceeding 140/90 mm Hg is indicative of
preeclampsia. Epigastric pain can be a sign of an impending
seizure (eclampsia), a life-threatening complication of
gestational hypertension. Additional data are needed to
confirm an emergency situation as described in (A). (B and
D) ignore the threat to client safety posed by a significant
increase in blood pressure.
120.ANSWER: D
RATIONALE: The health care provider should be notified (D)
when a client practices pica (craving for and consumption of
nonfood substances). The practice of pica may displace
more nutritious foods from the diet, and the client should be
evaluated for anemia. (A) is overreacting and may be
perceived as punishment by the patient. (B) allows the
dietary department to customize the client's tray but fails to
address physiologic problems associated with not
consuming nutritious foods in pregnancy. (C) is judgmental
and blocks further communication.
121. ANSWER:D
RATIONALE:Permitting the child to handle the equipment
and see the dial move allows him to play out the experience
ahead of time. The parent's presence will be helpful, but it
will not alleviate fear of the unknown. The child will not be
able to understand the relationship between blood pressure
and feeling better. Additionally, there is no evidence that this
procedure will help him get well more quickly. Explaining
how blood flows through the arm is too complex for this age
group.
122. ANSWER:A
RATIONALEThe nurse should administer dantrolene sodium
intravenously as the patient is showing signs of malignant
hyperthermia (MH). Symptoms of MH include hypercarbia,
elevated temperature, tachycardia, tachypnea, acidosis,
muscle rigidity, and rhabdomyolysis. The nurse uses ice
packs on the groin, axillae, and neck as MH is usually
accompanied by hyperthermia. A family or previous history
of sudden high fever associated with a surgical procedure
and myotonia increase the risk for MH. But the patient will
not be assessed for it now as MH has already set in. Use of
inhaled anesthetics increase the risk of MH; therefore, they
should not be administered as the patient is exhibiting
symptoms of MH.
123.ANSWER:B
RATIONALE:Infants and young children are unable to retain
the solution after it is administered, so the buttocks must be
held together for a short time to retain the fluid. A careful
explanation may help ease any concerns or fears the child
may have about the procedure. The enema is administered
and expelled while the child is lying with the buttocks over
the bedpan and with the head and back supported by
pillows. An enema is an intrusive procedure.
124.ANSWER:A
RATIONALE:The safest sleeping position to prevent SIDS is
wholly supine. No pillows should be placed in a young
infant's crib while the infant is sleeping. Lying prone or lying
on the side can raise the risk of sudden infant death
syndrome as the infant's nose may get covered by the bed.
Putting the child on a chair may be unsafe as the child may
fall off of the chair.
125.ANSWER:D
RATIONALE:Health promotion provides opportunities to
reduce differences in current health status among members
of different groups and provides a better chance to achieve
the fullest health potential. The patient and family is the unit
of care for the health care provider. Discharge planning
begins when the patient is admitted. The focus of pediatric
health care is trending away from acute hospital settings.
126. ANSWER:C
RATIONALE:Identifying characteristics derived from patient
assessment is the third part of the nursing diagnosis , the
signs and symptoms. Projected changes in health status are
the outcomes or goals that are established. An individual's
response to health pattern deficits is the definition of the
problem statement, the first component of the nursing
diagnosis. The factors that cause the problem or influence its
development is the definition of etiology, the second
component of the nursing diagnosis.
127.ANSWER:A, B, C, E
RATIONALE:Giving toys, clothes, food, and other items to
the patient; working overtime to take care of a particular
patient; calling the hospital or patient's home frequently to
inquire about the patient's health; and meeting the patient or
family outside of the hospital indicate that the nurse is
overinvolved with the child and the family. Thus, such
actions should be avoided to develop a good nurse-patient
relationship. Asking if the mother is involved in the child's
care indicates that the nurse is concerned about the patient
and the family. It indicates a therapeutic relationship
between the nurse and the child and family.
128.ANSWER:C
RATIONALE:The nurse is not supposed to develop personal
relationships with the children and families during the care
and after the discharge. Therefore, the nurse has to
courteously reject such invitations that may lead to
personnel relationships. Even if the nurse is busy, the nurse
should not accept invitations for lunch, dinners, or other
parties, or ask the families to invite other medical staff. This
shows unprofessional behavior.
129.ANSWER:A,B,C,D
RAIONALE:The responses of the nurse to health and illness
have to be followed in an order. The nurse has to identify
specific questions to collect appropriate information and
develop a care plan to implement. Identification of specific
questions to be asked to the patient would help to formulate
a clear and precise assessment plan. Collection of
subjective and objective information of the patient would be
helpful in determining the needs of the patient. Developing a
care plan of the patient would help in establish the desired
outcomes and the interventions required to achieve those
outcomes. Finally, the nurse should evaluate the
effectiveness of the intervention to determine if the care plan
designed for the patient was successful.
Test-Taking Tip: In this Question Type, you are asked to
prioritize (put in order) the options presented. For example,
you might be asked the steps of performing a nursing action
or skill such as those involved in medication administration.
Which actions of the
130.ANSWER:A, D, E
RATIONALE:One important goal of atraumatic care is to
reduce psychological distress of patients and their families. It
is important that the nurse patiently listens to the parents'
concerns and provides emotional support. Preventing and
minimizing bodily pain is another important aspect of
atraumatic care. Therefore, the nurse should give
appropriate pain medications to the child. Another goal of
atraumatic care is to keep the parents informed about the
child's disease, treatments given, and the disease
progression. Thus, the nurse should explain the treatments
given to the parents. Spending off-duty time with the patient
indicates that the nurse is overinvolved with the patient.
Allowing a parent to stay with the child at all times is not part
of atraumatic care.
131.ANSWER:D
RATIONALE:The GRADE criteria are used for grading the
evidence of research by nurses. According to this, if
evidence is found to be unusually strong from unbiased
observational studies, it should be graded as moderate. Low
grade is given to the evidence with at least one critical
outcome from the observation studies. High grade is given to
the studies with exceptionally strong evidence from unbiased
observational studies and very low grade is given to studies
with at least one critical outcome from very indirect evidence.
132.ANSWR:B
RATIONALE:Lower income families may need resources
and information about how to obtain assistance in getting
expensive foods such as meats to get enough protein intake.
During adolescence, parental influence diminishes and the
adolescent makes food choices related to peer acceptability
and sociability. Occasionally these choices are detrimental to
adolescents with chronic illnesses, such as diabetes,
obesity, chronic lung disease, hypertension, cardiovascular
risk factors, and renal disease. Families that struggle with
lower incomes, homelessness, and migrant status generally
lack the resources to provide their children with adequate
food intake; nutritious foods, such as fresh fruits and
vegetables; and appropriate protein intake. The result is
nutritional deficiencies with subsequent growth and
developmental delays, depression, and behavior problems.
Behavior problems can indeed be related to nutritional
deficiencies.
133.ANSWER:A
RATIONALE:One of the major disadvantages of long-term
ventilator care is ventilator-associated pneumonia. The
nurse has to assess the patient for ventilator-associated
pneumonia or for the early detection of respiratory
complications due to ventilators. Lung cancer is not
associated with ventilator support. Cystic fibrosis is due to
defect in chromosome number 7. Pulmonary edema is not
the main concern associated with ventilators in the ICU.
134. ANSWER:D
RATIONALE:Unintentional injuries and accidents are the
leading cause of death in children ages 5 to 9 because this
age group have the ability to run and climb and may
experience falls, burns, and collisions. Therefore, the nurse
should focus mainly on reducing the risk of accidents.
Suicide is not a significant cause of mortality in children
under the age of 10. Being overweight is a significant
problem in childhood, but not the leading cause of deaths in
the 5-9 age group. Heart diseases are the most significant
causes of mortality in children ages 1-4 years and 15-19
years.
135.ANSWER:A, C, E
RATIONALE:The nurse should understand that the child is
taking to illicit drugs. Preventive measures to reduce the
youth's illicit drug use include encouraging participation in
organized sports, scouts, and other church activities. The
children and parents should be educated on the ill effects of
drugs. Sports are not contraindicated and first aid is not a
preventive measure.
136. ANSWER:A
RATIONALE:The safest sleeping position to prevent SIDS is
wholly supine. No pillows should be placed in a young
infant's crib while the infant is sleeping. Lying prone or lying
on the side can raise the risk of sudden infant death
syndrome as the infant's nose may get covered by the bed.
Putting the child on a chair may be unsafe as the child may
fall off of the chair.
137..ANSWER:B
RATIONALE:Although it is best to provide high-quality,
nutritious foods, the child may desire foods and liquids that
contain mostly empty or non-nutritional calories. Some well-
tolerated foods include gelatin, diluted clear soups,
carbonated drinks, flavored ice pops, dry toast, and
crackers. Even though these substances are not nutritious,
they can provide necessary fluid and calories. The nurse
should not force the child to eat. Forcing a child to eat meets
with rebellion and reinforces the behavior as a control
mechanism. Calling the child's parents may make the child
more irritated. The dietician is referred to before meal
planning, and is consulted only if the child refuses to have
any hospital food.
138.ANSWER:A
RATIONALE:Contrary to popular belief, neither the rise in
temperature nor its response to antipyretics indicates the
severity or etiology of the infection. This casts doubt on the
value of using fever as a diagnostic or prognostic indicator.
Chills are common as the body tries to conserve heat and
raise the central temperature to a new set point. Antipyretics
bring down the temperature but they do not treat the
condition. Fever has physiologic benefits, including
increased white blood cell activity, interferon production and
effectiveness, and antibody production and enhancement of
some antibiotic effects.
139.ANSWER:A, B, D, E
RATIONALE:Assent of the patient should include four key
teachings. The nurse should help the patient achieve a
developmentally appropriate awareness of the nature of their
condition. The nurse should tell the patient what can be
expected. The nurse should also make a clinical assessment
of the patient's understanding, and solicit an expression of
the patient's willingness to accept the proposed procedure.
Such measures help reduce anxiety in the patient and are
important for their assent. Information about the legal
procedures of obtaining consent is not related to the surgical
procedure and will not be as helpful in reducing anxiety.
140.ANSWER:A
RATIONALE:The temperature is usually retaken 30 minutes
after the antipyretic is given to assess its effect but should
not be measured repeatedly. Another dose is not
administered before 4 hours but no more than 5 times in 24
hours. The child's weight is taken if fluid imbalance is
suspected. Aspirin toxicity can cause hyperthermia and is
only assessed for if such toxicity is suspected.
141. A) Health promotion
Health promotion means educating clients to be aware of
good health through teaching and role modeling. Health
maintenance means intervening to maintain health when risk
of illness is present. Health restoration is promptly
diagnosing and treating illness using interventions that will
return clients to wellness most rapidly. Health rehabilitation
means preventing further complications from an illness, or
bringing an ill client back to an optimal state of wellness or
helping a client to accept inevitable death.
142. A) Healthy, well-functioning families provide members
of all ages with fulfilling, supporting relationships.
The family is the basic unit of society. In order for this to
work well, members of the family must work together.
Families make a central contribution to enhance the quality
of our society. Families must consider how their actions will
impact others, and one member cannot fulfill all roles within
the family.
143. A) Fertility rate
The term fertility rate, the number of pregnancies per 1,000
women of childbearing age, reflects what proportion of
women who could have babies are having them. The birth
rate is the number of births per 1,000 population.
144. B)"The nurse should screen for these problems at every
client encounter." Both child and
intimate partner abuse is increasing in incidence. Families
are more mobile than previously. Screening for child or
intimate partner abuse should be included in all family
contacts. Nurses must be aware of the legal responsibilities
for reporting abuse.
145. C) People have taken less responsibility for their own
health. Due to the
influence of managed care, the focus on prevention, better
education, and technological advances, people have taken
increased responsibility for their own health. Parents now
want information about their child's illness, they want to
participate in making decisions about treatment, and they
want to accompany their children to all health care
situations.
146. B) Withhold the vaccines
The client would frequently be considered
emancipated and therefore legally able to make legal
decisions regarding the health care of the infant. The nurse
should withhold the vaccines but inquire to the reason for no
vaccination.
147. A) Puerperium
A postpartum period begins immediately after the birth of a
child as the mother's body, including hormone levels and
uterus size, returns to a non-pregnant state. The terms
puerperium or puerperal period, or immediate postpartum
period are commonly used to refer to the first six weeks
following childbirth.
148. A) Someone who has never delivered
149. B) Sperm motility
Although all of the factors listed are important, sperm motility
is the most significant criterion when assessing male
infertility.
150. D) Self-esteem disturbance related to infertility.
Based on the partner’s statement, the couple is verbalizing
feelings of inadequacy and negative feelings about
themselves and their capabilities. Thus, the nursing
diagnosis of self-esteem disturbance is most appropriate.
151. B) Frequency
Pressure and irritation of the bladder by the growing uterus
during the first trimester is responsible for causing urinary
frequency.
152. C) Decreased gastric acidity
During the second trimester, the reduction in gastric acidity
in conjunction with pressure from the growing uterus and
smooth muscle relaxation, can cause heartburn and
flatulence.
153. D) Cheeks, forehead, and nose
Chloasma also called the mask of pregnancy, is an irregular
hyperpigmented area found on the face. It is not seen on the
breasts, areola, nipples, chest, neck, arms, legs, abdomen,
or thighs.
154. C) Relaxation of the pelvic joints
During pregnancy, hormonal changes cause relaxation of
the pelvic joints, resulting in the typical “waddling” gait.
155. C) 24 to 30 lb
The average amount of weight gained during pregnancy is
24 to 30 lb. This weight gain consists of the following: fetus –
7.5 lb; placenta and membrane – 1.5 lb; amniotic fluid – 2 lb;
uterus – 2.5 lb; breasts – 3 lb; and increased blood volume –
2 to 4 lb; extravascular fluid and fat – 4 to 9 lb.
156. C) Pressure on blood vessels from the enlarging uterus
The pressure of the growing uterus on blood vessels results
in an increased risk for venous stasis in the lower
extremities. Subsequently, edema and varicose vein
formation may occur.
157. C) Probable signs
Cervical softening (Goodell sign) and uterine soufflé are two
probable signs of pregnancy. Probable signs are objective
findings that strongly suggest pregnancy. Other probable
signs include Hegar sign, which is softening of the lower
uterine segment; Piskacek sign, which is an enlargement
and softening of the uterus; serum laboratory tests; changes
in skin pigmentation; and ultrasonic evidence of a gestational
sac.
158. B) Nausea and vomiting
Presumptive signs of pregnancy are subjective signs. Of the
signs listed, only nausea and vomiting are presumptive
signs.
159. D) Ambivalence, fear, fantasies
During the first trimester, common emotional reactions
include ambivalence, fear, fantasies, or anxiety.
160. B) First trimester
First-trimester classes commonly focus on such issues as
early physiologic changes, fetal development, sexuality
during pregnancy, and nutrition. Some early classes may
include pregnant couples.
161. Option A: Normal hemoglobin for males is 13.0 – 18
g/100 ml. Normal hematocrit for males is 42 – 52%. These
values are below normal and indicate mild anemia. The first
thing the nurse should do is ask the client if he’s noticed any
bleeding or change in stools that could indicate bleeding
from the GI tract.
162. Option B: This response encourages the client to get in
touch with their feelings and utilize problem-solving steps to
reduce guilt feelings.
163. Option C: To an adolescent, body image is very
important. The nurse must acknowledge this before
assessment and teaching.
164. The addition of new foods to the infant’s diet may be a
cause of diaper dermatitis.
165. The isolation may occur gradually resulting in a loss of
all meaningful social contacts. Isolation can be self-imposed
or can occur as a result of the inability to express feelings. At
this stage of development, it is important to achieve a sense
of identity and peer acceptance
166. In Erikson’s theory of development, toddlers struggle to
assert independence. They often use the word “no” even
when they mean yes. This stage is called autonomy versus
shame and doubt.
167. 2 gm=2000 mgm 2000 mgm/500 cc = 4 mgm/x cc
2000x = 2000 x= 2000/2000 = 1 cc of IV solution/minute CC
x 60 microdrops = 60 microdrops/minute
168. The use of oral contraceptives in a pregnant woman
who smokes increases her risk of cardiovascular problems,
such as thromboembolic disorders.
169. C: A.L.S. is a chronic progressive disease that involves
degeneration of the anterior horn of the spinal cord as well
as the corticospinal tracts. When the intercostal muscles and
diaphragm become involved, the respirations become
shallow and coughing is ineffective.
170. Option A: Stimulation of the breast during nursing
releases oxytocin, which contracts the uterus. This
contraction is especially important following hemorrhage.
171. Option A: Nausea, metallic taste, and fine hand tremors
are common side effects that usually subside within days.
172. Option C: Mobility reduces the risk of deep vein
thrombosis in the post-surgical client and the adult at risk.
173. Option A: Even if mild hypospadias is suspected,
circumcision is not done in order to save the foreskin for
surgical repair, if needed.
174. Option A: While parents should report any of the
observations, they need to call the healthcare provider
immediately if the level of alertness changes. This indicates
anoxia, which may lead to death. The structural defects
associated with Tetralogy of Fallot include pulmonic
stenosis, ventricular septal defect, right ventricular
hypertrophy and overriding of the aorta. Surgery is often
delayed or may be performed in stages.
175. Option A: Although growth rates vary, infants normally
double their birth weight by 6 months.
176. Option C: The bed should remain flat for at least the
first 24 hours to prevent injury. Logrolling is the best way to
turn for the client while on bed rest.
177. Option A: In an expanded family, it is important for
parents to reassure older children that they are loved and as
important as the newborn.
178. Option A: Polycythemia occurs as a physiological
reaction to chronic hypoxemia which commonly occurs in
clients with Tetralogy of Fallot. Polycythemia and the
resultant increased viscosity of the blood increase the risk of
thromboembolic events. Cerebrovascular accidents may
occur. Signs and symptoms include sudden paralysis,
altered speech, extreme irritability or fatigue, and seizures.
179. Option A: This refers to involuntary muscles spasm of
the eye.
180. Option B: An occupational therapist can assist a client
to improve the fine motor skills needed to prepare an insulin
injection.
181. K: Supine Hypotensive Syndrome
- Pregnant woman may experience nausea, hypotension,
and dizziness if she is in a supine position and the weight of
the uterus, infant, placenta, and amniotic fluid compress the
inferior vena cava, reducing return of blood to the heart and
cardiac output.
182. L: Pseudoanemia
- Apparent anemia that occurs during pregnancy due to rapid
expansion of blood volume; false anemia; lowered
hematocrit (between 33-46%) as a result of the increase in
plasma during pregnancy.
183. M: Chloasma
- It is also called as the “mask of pregnancy”. Changes are
often more obvious in women with darker hair and skin and
may be worsened by sun exposure; generally disappears or
fades significantly soon after pregnancy.
184. N: Linea Negra
- This line is noted in some women during the later months
of their pregnancy; caused by increase in estrogen,
progesterone, and a-melanocyte stimulating hormone levels.
185. O: McDonald’s Sign
- Fundal height, or McDonald's rule, is a measure of the size
of the uterus used to assess fetal growth and development
during pregnancy. It is measured from the top of the
mother's uterus to the top of the mother's pubic symphysis;
when the uterine body and cervix can easily be flexed
against one another.
186. P: Hegar’s Sign
- Classified as a probable sign of pregnancy, may be present
during the 2nd and 3rd months of pregnancy and is palpated
during bimanual examination.
187. Q: Amenorrhea
- It can be a sign of pregnancy. Women who have missed at
least three menstrual periods in a row have amenorrhea.
Other causes of Amenorrhea include problems with the
reproductive organs or with the glands that help regulate
hormone levels.
188. R: Braxton Hicks
- Contractions can begin as early as the second trimester.
However, they are most commonly experienced in the third
trimester. When this happens, the muscles of the uterus
tighten for approximately 30-60 seconds, and sometimes as
long as 2 minutes.
189. S: Ballottement
198. H: Nagele’s Rule
- The rule estimates the expected date of delivery (EDD) by
adding one year, subtracting three months and adding seven
days to the first day of a woman’s last menstrual period
(LMP)
199. I: Ptyalism
- Ptyalism most likely to occur in pregnant women who is
suffering from extreme nausea and morning sickness. The
exact cause of ptyalism during pregnancy remains uncertain,
but changing hormones probably play a role.

- An obsolete method of diagnosing pregnancy: with the tip
of the forefinger in the vagina, a sharp tap is made against
the lower segment of the uterus; the fetus, if present, is
tossed upward and (if the finger is retained in place) will be
felt to strike against the wall of the uterus as it falls back.
190. T: Antepartum
200. J: hCG – Human Chorionic Gonadotropin Hormone
- This is the key hormone of pregnancy because it produces
placental blastocyst cells and placenta, stimulates
progesterone and estrogen production by the corpus luteum
to promote survival and growth and maintain early
pregnancy.

- This is the longest period of pregnancy before childbirth.

Antepartum refers to the mother.

191. A: Intrapartum

- The Intrapartum period is the labor and delivery of the

pregnant woman. Intrapartum can refer to both the woman
and the fetus.

192. B: Postpartum

- In postpartum period, which begins immediately after

delivery, your body will heal from childbirth, rebuilt its
strength and begin to regain its pre-pregnancy shape.

193. C: Nullipara

- Woman who has not given birth to a viable child.

194. D: Gravida

- Comes from the Latin word gravidus. It is used to describe

a woman who is pregnant and is also a medical term for the
total number of confirmed pregnancies a woman has had,
regardless of the outcome of the pregnancy.

195. E: Para

- It refers to the total number of pregnancies that a woman

has a carried past 20 weeks of pregnancy. This number
includes both live births and pregnancy losses after 20
weeks, such as still births.

196. F: Primipara

- Referring to a woman who has given birth once, where the

fetus reaches viability ranges from region to region, often
falling between 20 – 24 weeks. Primiparity is the condition of
having given birth once. A woman who has given birth once
is primiparous , and is referred to as primipara.

197. G: Primigravida

- Defined as a woman who gets pregnant for the first time, is

in a high-risk group. Comprehensive antenatal care should
be provided in this group of patients to have better maternal
and foetal outcome.