The Maternal-Newborn & Pediatric Core Review

Free preview · Original latest version

Sample questions from The Maternal-Newborn & Pediatric Core Review

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

1. 1.A client at 10 weeks' gestation reports nausea that is worse in the morning. Which recommendation is most appropriate?

   • A.Eat a few crackers before getting out of bed.
   • B.Drink a large glass of fluid with each meal.
   • C.Skip breakfast until the nausea resolves.
   • D.Lie flat for 30 minutes after eating.

   Rationale: Eating a small amount of dry food before rising may reduce nausea associated with an empty stomach. Large amounts of fluid with meals can worsen fullness, skipping meals may aggravate nausea, and lying flat after eating can worsen reflux. Small, frequent meals and fluids between meals are common first-line strategies.

2. 2.A pregnant client at 28 weeks' gestation has a blood pressure of 146/92 mm Hg and reports a persistent headache and blurred vision. What is the nurse's priority action?

   • A.Notify the health care provider promptly.
   • B.Recheck the blood pressure at the next prenatal visit.
   • C.Encourage the client to lie supine and rest.
   • D.Teach the client to reduce dietary calcium.

   Rationale: Hypertension with persistent headache and visual changes after 20 weeks raises concern for preeclampsia with severe features and requires prompt evaluation. Waiting until the next visit delays care, and supine positioning can reduce venous return in pregnancy. Calcium should not be restricted; these findings require assessment rather than dietary teaching alone.

3. 3.A client at 30 weeks' gestation reports painless, bright-red vaginal bleeding. Which action should the nurse take first?

   • A.Perform a digital vaginal examination to assess cervical dilation.
   • B.Place the client on an external fetal monitor and notify the provider.
   • C.Encourage ambulation to determine whether bleeding increases.
   • D.Prepare for immediate oxytocin administration.

   Rationale: Painless bright-red bleeding in the third trimester suggests placenta previa; fetal monitoring and prompt provider notification are appropriate. A digital vaginal examination can disrupt the placenta and cause severe hemorrhage, and ambulation is unsafe. Oxytocin is not given without evaluation and an indicated plan for delivery.

4. 4.A pregnant client at 34 weeks' gestation has sudden abdominal pain, a rigid uterus, and dark vaginal bleeding. Which complication is most likely?

   • A.Placenta previa
   • B.Abruptio placentae
   • C.Cervical insufficiency
   • D.Preterm premature rupture of membranes

   Answer and rationale are in the full material.

5. 5.A client at 39 weeks' gestation is group B streptococcus positive and has no penicillin allergy. Which intervention is indicated during labor?

   • A.Administer intravenous penicillin according to protocol.
   • B.Give the newborn oral antibiotics after birth.
   • C.Administer a single dose of intramuscular penicillin at the first prenatal visit.
   • D.Withhold antibiotics unless the newborn develops symptoms.

   Answer and rationale are in the full material.