Maternal-Newborn & Pediatric Questons

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Sample questions from Maternal-Newborn & Pediatric Questons

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At a routine prenatal visit, a client at 20 weeks' gestation asks how the nurse will assess whether the fetus is growing as expected. Which measurement is most appropriate?

   • A.Measure the distance from the xiphoid process to the symphysis pubis.
   • B.Estimate fetal weight by palpating the fetal head through the abdomen.
   • C.Measure fundal height from the symphysis pubis to the top of the uterine fundus.
   • D.Measure abdominal circumference at the level of the umbilicus.

   Rationale: From about 20 to 36 weeks, fundal height in centimeters generally approximates gestational age in weeks, with a small expected variation. Abdominal circumference and the xiphoid-to-symphysis distance are not standard measures of fetal growth. Leopold maneuvers help identify fetal lie and presentation but do not provide a reliable fetal-weight estimate.

2. 2.A client who is 9 weeks pregnant reports taking a daily vitamin but is unsure whether it contains enough folic acid. Which daily amount should the nurse recommend for routine prevention of neural tube defects?

   • A.10,000 mcg
   • B.40 mcg
   • C.4,000 mcg
   • D.400 mcg

   Rationale: For most people who could become pregnant, the recommended amount is 400 mcg of folic acid daily, beginning before conception and continuing in early pregnancy. Forty mcg is too little for routine prevention. Higher doses, such as 4,000 mcg, are reserved for specific high-risk situations under clinician guidance, and 10,000 mcg is not a routine recommendation.

3. 3.A client at 28 weeks' gestation says, "I feel dizzy and nauseated when I lie flat on my back." Which actions should the nurse recommend? Select all that apply.

   • A.Place a pillow or wedge under one hip to tilt the uterus off the vena cava.
   • B.Notify the maternity care provider if the symptoms persist despite repositioning.
   • C.Remain supine and elevate the legs until the symptoms pass.
   • D.Turn onto the left side when symptoms occur.
   • E.Change positions slowly when moving from lying to sitting or standing.

   Rationale: Left lateral positioning or a hip tilt reduces uterine pressure on the vena cava and can relieve supine hypotensive symptoms. Changing positions slowly can reduce associated dizziness, and persistent symptoms warrant further assessment. Remaining flat on the back can worsen vena cava compression rather than treat it.

4. 4.The provider schedules a routine gestational diabetes screening for a client at 26 weeks' gestation. Which test should the nurse expect to be performed first for a client at average risk?

   • A.A fasting 100-g oral glucose tolerance test with measurements over 3 hours.
   • B.A 50-g oral glucose challenge followed by a 1-hour plasma glucose measurement.
   • C.A hemoglobin A1c test as the sole screening test at this gestational age.
   • D.A random urine glucose test after the client's next meal.

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which findings require prompt follow-up for possible preeclampsia with severe features? Select all that apply.

   • A.Blood pressure of 164/110 mm Hg at 1015.
   • B.Urine protein-to-creatinine ratio of 0.42.
   • C.New persistent right upper-quadrant pain reported at 1015.
   • D.Platelet count of 92,000/mm3.
   • E.Fetal heart rate of 140/min at 1015.

   Answer and rationale are in the full material.