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    Exam Review

    1. A nurse is assisting a client who is postpartum with her first breastfeeding experience. When the client asks how much of the nipple she should put into the newborn's mouth, which of the following responses should the nurse make?
      A)"Babies know instinctively how much of the nipple to take into their mouth."
      B)"While your baby is so small she will only be able to take part of the nipple."
      C)"You should place your nipple and as much of the areola as possible into her mouth."
      D)"Try to place the nipple, the areola, and some breast tissue beyond the areola into her mouth."
    2. A newborn, 48 hours old, exposed to opioids in utero, exhibits irritability, a high-pitched cry, frequent yawning, and vomiting after feeds. The nurse implements non-pharmacologic interventions, but symptoms persist. Which next step is most appropriate?
      A)Administer ordered morphine as part of NAS protocol
      B)Increase environmental stimulation to assess consolability
      C)Delay intervention until withdrawal peaks at 72 hours
      D)Continue only non-pharmacologic care for another 24 hours
    3. The nurse is caring for a 4-year-old child who is post tonsillectomy. The nurse includes which of the following assessments with the child's post- operative care and vital signs?
      A)Observe for hyperactivity.
      B)Monitor for frequent swallowing
      C)Obtain child's weight and document body mass index.
      D)Assess bowel sounds
    4. A nurse is teaching a client with polycystic ovary syndrome (PCOS) who desires pregnancy. Which nursing action best supports fertility outcomes according to current evidence?
      A)Initiate estrogen-only hormonal therapy to regulate menses
      B)Encourage use of barrier contraception until regular cycles resume
      C)Emphasize dietary modification, weight reduction, and adherence to metformin therapy
      D)Restrict all physical exercise to preserve ovarian reserve
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    Exam Review

    1. A nurse assesses a 2-day-old infant with suspected FAS. Findings include growth restriction, microcephaly, flat philtrum, and poor suck reflex. Which interpretation is most appropriate?
      A)Findings indicate Down syndrome and warrant genetic counseling
      B)Symptoms will resolve spontaneously without long-term effects
      C)Findings strongly suggest teratogenic alcohol exposure
      D)Findings are consistent with normal newborn transition
    2. A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?
      A)Replacement fluids with electrolytes.
      B)Diluted apple juice
      C)Water
      D)Broth
    3. A nurse is caring for a client who is breastfeeding for the first time and states that her milk does not seem to be enough for her newborn. Which of the following responses from the nurse would be most helpful at this time?
      A)"It is too early to tell if you will be able to make enough milk for your baby."
      B)"Breast milk right after birth has colostrum in it that is full of immunities for your baby."
      C)"Your baby will start gaining weight soon."
      D)"You can choose to feed your newborn infant formula if needed
    4. At 32 weeks, a client reports severe headache and blurred vision. Which nursing action is priority?
      A)Perform a 3-hour oral glucose tolerance test
      B)Assess blood pressure and test urine for protein
      C)Encourage rest and hydration only
      D)Provide reassurance and monitor weekly
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    Exam Review

    1. A 25-year-old mother with opioid use disorder is in recovery with buprenorphine therapy. At her postpartum visit, she expresses fear of relapse due to social stressors and lack of support. Which nursing intervention best promotes long-term health?
      A)Recommend immediate discontinuation of buprenorphine
      B)Encourage her to "try harder to stay abstinent without external support
      C)Focus only on infant milestones during the visit.
      D)Refer her to a peer support group and coordinate follow-up with addiction services
    2. A nurse is assessing the pain of an 8-year-old child using the numerical pain scale. Which of the following questions should the nurse ask the child?
      A)"Touch the face that best describes your pain."
      B)"What changes in your behavior have you noticed since the pain started?"
      C)"Can you tell me the number of your pain between 0 to 10?"
      D)"Can you describe your pain with words such as none, a little, medium, or a lot?"
    3. A nurse is providing community education at a maternal-child health clinic. During the session, a client asks about national priorities for improving pregnancy outcomes in the United States. The nurse explains that the Healthy People 2030 initiative establishes evidence-based objectives to reduce risks and improve health outcomes for mothers and infants. Which of the following goals from Healthy People 2030 should the nurse emphasize as a key maternal-child health priority?
      A)Encourage cesarean births among low-risk clients
      B)Decrease the fetal death rate before 20 weeks gestation
      C)Decrease birth rate
      D)Decrease maternal deaths
    4. A nurse is caring for an infant whose caregiver comforts them as soon as they cry. The nurse should identify that the infant is experiencing which of the following stages of Erikson's theory of psychosocial development?
      A)Identity vs. Role Confusion
      B)Autonomy vs. Shame and Doubt
      C)Integrity vs. Despair
      D)Trust vs. Mistrust
    Page 3 of 13

    Exam Review

    1. A 32-year-old pregnant client at 30 weeks' gestation presents to the clinic with severe headache, blurred vision, blood pressure of 170/112, and a platelet count of 85,000. Fetal monitoring shows variable decelerations. The provider prescribes several interventions. Which action should the nurse implement first?
      A)Administer IV labetalol for blood pressure control
      B)Prepare the client for cesarean delivery
      C)Initiate magnesium sulfate infusion for seizure prophylaxis
      D)Place the client on bed rest in a side-lying position
    2. A client with large uterine fibroids reports heavy menstrual bleeding and dizziness. Which assessment finding is most urgent for the nurse to evaluate?
      A)Serum thyroid-stimulating hormone (TSH)
      B)Blood pressure and orthostatic vital signs
      C)Pap smear cytology report
      D)Hemoglobin and hematocrit
    3. A nurse is preparing to administer 0.9% sodium chloride (NSS) 3000 mL IV to infuse over 24 hr. The drop factor on the manual IV tubing is 10 gtt/mL. The nurse should deliver how many gtt/min to provide the fluid required? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
    4. A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?
      A)"I should expect him to have an increased appetite."
      B)"He is such a picky eater, but I am not worried that he refuses milk, meats and fruits since he loves bread."
      C)"I make sure the finger foods I provide him have good nutrition value."
      D)"His average daily intake of milk should be about one cup."
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    Exam Review

    1. A mother on stable methadone maintenance therapy delivers a full-term infant. She asks about breastfeeding, but her partner expresses concern about "methadone poisoning the baby." Which nursing response demonstrates best practice?
      A)"Your baby will need NICU care regardless of your feeding choice."
      B)"Methadone passes in small amounts but can actually reduce NAS severity."
      C)"You should not breastfeed while on methadone."
      D)"Formula is safer because no substances pass to the baby."
    2. A newborn with opioid exposure is evaluated using the Eat, Sleep, Console (ESC) model. The infant is able to breastfeed, sleeps for 90 minutes, and can be consoled in 8 minutes with skin-to-skin contact. Which conclusion is correct?
      A)ESC criteria met, continue non-pharmacologic care
      B)Infant requires immediate pharmacologic therapy
      C)Symptoms indicate severe NAS requiring NICU admission
      D)Parent-infant interaction should be limited to avoid overstimulation
    3. A 32-year-old at 34 weeks presents to the ED with severe abdominal pain, tense abdomen, and vaginal bleeding after cocaine use. FHR shows late decelerations and minimal variability. What is the nurse's immediate priority?
      A)Prepare the client for emergency delivery
      B)Insert a Foley catheter for output monitoring
      C)Provide relaxation techniques and emotional support
      D)Administer IV magnesium sulfate for fetal neuroprotection
    4. A nurse is caring for an adolescent client who reports they are beginning to rebel against their caregivers and spend more time with their friends. The nurse should identify that the client is experiencing which of the following stages of Erikson's theory of psychosocial development?
      A)Trust vs. Mistrust
      B)Autonomy vs. Shame and Doubt
      C)Identity vs. Role Confusion
      D)Integrity vs. Despair
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    Exam Review

    1. A nurse shows an understanding of cultural competence if she does which of the following?
      A)The nurse checks a client's chart for any notes on culture.
      B)The nurse tells a client about the nurse's own cultural background.
      C)The nurse observes a client's actions and reports they do not see any cultural practices.
      D)The nurse asks a client if they have any cultural beliefs the nurse needs to be aware of.
    2. A 22-year-old primigravida with type 1 diabetes presents at 12 weeks for her prenatal visit. She asks what she can do to lower her risk of preeclampsia. Which teaching should the nurse provide?
      A)Increase salt intake after 20 weeks of pregnancy
      B)Start folic acid supplementation in the third trimester
      C)Begin low-dose aspirin daily before 16 weeks of gestation
      D)Avoid all physical activity throughout pregnancy
    3. A nurse is preparing to administer fluconazole 400 mg by IV. Available is fluconazole 400 mg in 0.9% sodium chloride (NaCl) 200 mL to infuse over 2 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)
    4. A nurse is assessing the psychosocial development of a toddler. The nurse should recognize that this stage is characterized by which of the following?
      A)Erikson's stage of initiative versus guilt
      B)Imaginary playmates
      C)Demonstrations of sexual curiosity
      D)Negative behaviors characterized by the need for autonomy
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