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    Exam Review

    1. As the nurse cares for four postpartum patients, which patient is at highest risk for hemorrhage?
      A)A primiparous patient who delivered a 7pound 10 ounce baby 24 hours ago.
      B)A multiparous patient who delivered a 9 pound baby 4 hours ago.
      C)A primiparous patient who delivered a late preterm baby 24 hours ago.
      D)A multiparous patient who delivered a 7 pound baby 6 hours ago.
    2. A nurse is preparing to perform a physical assessment on a 20-month-old toddler who is initially uncooperative and anxious. Which approach should the nurse prioritize to facilitate an effective and less distressing assessment?
      A)Perform all intrusive procedures first to get them over with quickly, minimizing total assessment time.
      B)Remove all clothing at once to speed up the process and avoid repeated exposure that may upset the toddler.
      C)Allow the toddler to sit in the parent's lap and examine the least invasive areas first, offering simple choices and praise to encourage cooperation.
      D)Start the examination with the toddler on the exam table immediately to establish control over the assessment environment.
    3. A newborn is being assessed for risk of hyperbilirubinemia. The infant has both caput succedaneum and a cephalohematoma. The nurse understands that phototherapy is more likely to be required in which condition, and why?
      A)Caput succedaneum can lead to severe bruising and therefore often requires phototherapy.
      B)Neither condition increases bilirubin levels so phototherapy is not needed for either.
      C)Phototherapy is more likely needed with caput succedaneum because it increases blood cell breakdown under the scalp.
      D)Cephalohematoma increases the risk of hyperbilirubinemia due to the breakdown of trapped red blood cells, which may require phototherapy.
    4. The patient has an order for a single dose of ceftriaxone 400 mg IM. The final concentration is 500 mg/1.2 ml. How many milliliters will you administer? (Round to the nearest hundredth.)
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    Exam Review

    1. A nurse is teaching a prenatal patient about pregnancy hormones, Which hormone is primarily responsible for maintaining the uterine lining and preventing contractions during pregnancy?
      A)Estrogen
      B)Progesterone
      C)Human Chorionic Gonadotropin (hCG)
      D)Relaxin
    2. Surgical closure of the ductus arteriosus would result in which of the following?
      A)Prevent the return of oxygenated blood to the lungs
      B)Decrease the edema in the legs and feet
      C)Stop the loss of unoxygenated blood to the systemic circulation
      D)Increase the oxygenation of blood
    3. A 4-year-old child is admitted with a persistent fever for 6 days. The nurse notes bilateral conjunctival injection without exudate, red cracked lips, a "strawberry" tongue, swollen and erythematous hands and feet, and a polymorphous rash on the trunk. Which condition should the nurse suspect?
      A)Scarlet fever
      B)Kawasaki disease
      C)Rheumatic fever
      D)Measles
    4. Which is a common clinical manifestation of Hodgkin disease?
      A)Painful, enlarged lymph nodes
      B)Enlarged, firm, nontender lymph nodes
      C)Petechiae
      D)Bone and joint pain
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    Exam Review

    1. A 4-year-old child with short bowel syndrome is admitted for nutritional management. The nurse notes the child has poor weight gain, frequent loose stools. and signs of iron deficiency anemia. Considering the child's condition, which nursing intervention should be prioritized to address the nutritional deficits?
      A)Limit fluid intake to reduce bowel movements and prevent dehydration.
      B)Withhold iron supplementation until full bowel recovery is confirmed to prevent irritation.
      C)Administer partially hydrolyzed, high-calorie enteral formulas to improve nutrient absorption.
      D)Encourage a high-fiber diet to promote bowel regularity and reduce diarrhea.
    2. Latex allergy is suspected in a child with spina bifida. What intervention should be included in the child's plan of care?
      A)Teaching the family about long-term management of asthma
      B)Avoiding using any latex product
      C)Administering medication for long-term desensitization
      D)Using only nonallergenic latex products
    3. A nurse is providing discharge teaching to the parents of a child who has a new diagnosis of diabetes mellitus. Which statement made by the parents indicates an understanding of the teaching?
      A)"Sweating can occur with hyperglycemia."
      B)"My son might have nausea and vomiting with hypoglycemia."
      C)"My son might complain of feeling shaky when he has a low blood glucose level."
      D)The onset of low blood glucose usually occurs slowly."
    4. A 9-month-old infant is inconsolable and repeatedly tugs at the right ear. The infant also cries when lying down. What is the nurse's best action to determine the source of pain?
      A)Gently assess the ear and check for redness, swelling, or drainage
      B)Administer pain medication without further assessment
      C)Assume the pain is generalized to the entire head
      D)Ask the infant to point to where it hurts
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    Exam Review

    1. A nurse is caring for a pediatric patient in skeletal traction for a femur fracture. Which nursing action is the highest priority to prevent complications associated with skeletal traction?
      A)Ensure the weights hang freely and do not touch the floor to maintain proper traction force.
      B)Remove the traction weights every 6 hours to prevent skin breakdown,
      C)Limit monitoring of pin sites to once every 24 hours to reduce patient discomfort.
      D)Place the rope knot in contact with the pulley to stabilize the traction system.
    2. A nurse is caring for a 4-year-old child who underwent surgery. The child is unable to verbalize pain reliably. Which pain assessment tool is most appropriate?
      A)Visual Analog Scale
      B)FLACC scale
      C)Faces Pain Scale
      D)Numeric Rating Scale
    3. A 4-year-old child is admitted for dehydration and requires peripheral IV insertion for fluid replacement. The child is crying, clinging to the parent, and repeatedly saying, "I don't want a shot." The parent appears anxious and asks if there is any way to make the procedure less traumatic. Indicate whether each intervention Supports or Does Not Support atraumatic care.
      Support Atraumatic CareDoes NOT support Atraumatic Care
      Providing choices when possible✓
      Threatening loss of privileges✓
      Using a calm, reassuring tone✓
      Asking the parent to leave✓
    4. The nurse is caring for a patient who gave birth to an infant with a congenital heart anomaly. The patient asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate?
      A)"it depends on what caused the defect."
      B)"They usually occur in the first 2 weeks of development."
      C)"We don't really know when such defects occur."
      D)"They occur between the third and eighth weeks of development."
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    Exam Review

    1. A nurse in a prenatal clinic is reviewing the record of a patient at 28 weeks gestation. The woman's history reveals one pregnancy terminated by elective abortion at 12 weeks; the birth of twins at 34 weeks and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes her present situation?
      A)4-0-1-2-2
      B)4-2-0-2-2
      C)20-02-2
      D)30-2-0-2
    2. Which immunization should be considered carefully before being given to a child receiving chemotherapy for cancer?
      A)Diphtheria, pertussis, tetanus (DPT)
      B)Measles, rubella, mumps
      C)Tetanus vaccine
      D)Inactivated poliovirus vaccine
    3. Which of the following is the first physical sign of puberty in most females?
      A)The development of pubic hair
      B)Breast development
      C)The onset of menstruation
      D)The growth spurt
    4. A 5-year-old child is recovering after undergoing surgery for a brain tumor. The nurse is reviewing the child's postoperative care plan. The child is alert, but the nurse notices that the child is vomiting and complaining of a headache. The nurse's priority action should be:
      A)Encourage the child to drink fluids to stay hydrated
      B)Position the child in a flat supine position to prevent increased intracranial pressure (ICP)
      C)Administer an antiemetic to control vomiting
      D)Assess the child's neurological status and check for signs of increased intracranial pressure
    Page 5 of 25

    Exam Review

    1. A parent asks why their 12-month-old can pull to stand but cannot walk alone. Which explanation reflects the sequential trend in development?
      A)All children develop skills randomly
      B)Walking should have occurred first: the child is delayed
      C)Development occurs only in spurts and cannot be predicted
      D)Development follows a predictable order: standing precedes independent walking
    2. Tanner Stages can be used to help determine an adolescent's stage of puberty. You have a 13-year-old female patient. What information does the nurse need to collect in order to use this scale for puberty determination? (Select All that Apply.)(SATA)
      A)Breast development
      B)Pubic hair growth
      C)BMI
      D)Hip girth
      E)Age of menarche
    3. A patient who is pregnant asks the nurse for her due date. The patient's last menstrual period began on January 10th. What is the patient's due date based on Naegele's rule?
    4. A 30-year-old Rh-negative pregnant woman is at 17 weeks gestation and has an Rh-positive partner. She has had no prior sensitization. She asks the nurse when she will receive Rho(D) immune globulin. Which of the following is the best response?
      A)"Rho(D) immune globulin is only given after delivery, so you don't need it now."
      B)"You will receive Rho(D) immune globulin monthly during pregnancy and then after 72 hours after delivery"
      C)"You will receive Rho(D) immune globulin at 28 weeks of pregnancy and again within 72 hours after delivery if your baby is Rh-positive to prevent your immune system from becoming sensitized."
      D)"You only need Rho(D) Immune globulin after your second pregnancy"
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