Saudi Prometric Nursing Maternal and Child Health 2 — Questions and Answers
Question 1: What is the primary nursing intervention for a neonate with jaundice?
- Restrict feeding
- Ensure adequate hydration, frequent feeding, monitor bilirubin levels, and prepare for phototherapy if levels are elevated (Correct answer)
- Keep the baby in a dark room
- Administer antibiotics
Correct answer: Ensure adequate hydration, frequent feeding, monitor bilirubin levels, and prepare for phototherapy if levels are elevated
Neonatal jaundice management: frequent feeding (promotes bilirubin excretion through stool), adequate hydration, monitor serum bilirubin levels, phototherapy (blue light breaks down bilirubin) if levels exceed threshold, protect eyes during phototherapy, and assess skin/sclera color.
Question 2: What is preeclampsia and what are its key nursing assessments?
- A type of anemia
- A pregnancy complication with hypertension and proteinuria, requiring monitoring of BP, urine protein, reflexes, and fetal status (Correct answer)
- Normal weight gain in pregnancy
- A vitamin deficiency
Correct answer: A pregnancy complication with hypertension and proteinuria, requiring monitoring of BP, urine protein, reflexes, and fetal status
Preeclampsia presents after 20 weeks with BP ≥140/90 and proteinuria. Nursing assessments: frequent BP monitoring, urine protein (dipstick/24-hour), deep tendon reflexes (hyperreflexia = worsening), daily weights, fetal monitoring, and watching for progression to eclampsia (seizures).
Question 3: What are the developmental milestones a nurse should assess in a 6-month-old infant?
- Walking independently
- Sitting with support, reaching and grasping objects, babbling, responding to name, and rolling over (Correct answer)
- Speaking in sentences
- Running and jumping
Correct answer: Sitting with support, reaching and grasping objects, babbling, responding to name, and rolling over
At 6 months, infants should: sit with support (may sit briefly alone), reach and grasp objects (transferring hand to hand), babble consonant sounds ('ba-ba'), recognize familiar faces, respond to name, roll both ways, and show interest in solid foods.
Question 4: What is the nursing management for a child with dehydration from gastroenteritis?
- Restrict all fluids
- Assess dehydration severity, initiate oral rehydration therapy (ORT) for mild-moderate cases, IV fluids for severe dehydration, and monitor I&O (Correct answer)
- Only give plain water
- Administer antibiotics immediately
Correct answer: Assess dehydration severity, initiate oral rehydration therapy (ORT) for mild-moderate cases, IV fluids for severe dehydration, and monitor I&O
Dehydration management: assess severity (mild/moderate/severe using clinical signs), ORT with electrolyte solutions for mild-moderate cases, IV fluid resuscitation for severe dehydration, monitor strict I&O, daily weights, assess skin turgor, mucous membranes, and fontanelle (infants).
Question 5: What is the nurse's role in supporting breastfeeding in Saudi hospitals?
- Discourage breastfeeding if the mother has difficulty
- Educate on positioning and latch, support early initiation within 1 hour of birth, encourage rooming-in, and follow Baby-Friendly Hospital Initiative guidelines (Correct answer)
- Recommend formula for all newborns
- Breastfeeding support is not a nursing responsibility
Correct answer: Educate on positioning and latch, support early initiation within 1 hour of birth, encourage rooming-in, and follow Baby-Friendly Hospital Initiative guidelines
Saudi hospitals follow WHO/UNICEF Baby-Friendly Hospital Initiative: initiate breastfeeding within 1 hour of birth, teach proper positioning and latch, encourage 24-hour rooming-in, feed on demand, avoid supplemental bottles, and provide ongoing lactation support and education.
Question 6: What are the signs of respiratory distress in a newborn?
- Normal breathing rate
- Nasal flaring, grunting, intercostal retractions, tachypnea (>60/min), and cyanosis (Correct answer)
- Only crying loudly
- Sleeping peacefully
Correct answer: Nasal flaring, grunting, intercostal retractions, tachypnea (>60/min), and cyanosis
Neonatal respiratory distress signs: nasal flaring (widening nostrils with breathing), expiratory grunting, intercostal/subcostal/sternal retractions, tachypnea (>60 breaths/min), central cyanosis, and poor feeding. These require immediate medical intervention and possible NICU admission.
Saudi Prometric Nursing Maternal and Child Health 2
What is the primary nursing intervention for a neonate with jaundice?