Saudi Prometric Nursing Maternal and Child Nursing 2 — Questions and Answers
Question 1: A nurse is teaching a pregnant woman about folic acid supplementation. When should supplementation ideally begin?
- At least 1 month before conception and through the first trimester (Correct answer)
- Only after pregnancy is confirmed
- In the second trimester
- At the beginning of the third trimester
Correct answer: At least 1 month before conception and through the first trimester
Folic acid (400–800 mcg/day) should be started at least 1 month (ideally 3 months) before conception and continued through the first trimester to prevent neural tube defects, which occur during the first weeks of development, often before pregnancy is known.
Question 2: A postpartum patient is assessed 2 hours after delivery. Her fundus is firm but deviated to the right of the midline. What is the most likely cause?
- A full urinary bladder (Correct answer)
- Normal uterine involution
- Retained placental fragments
- Uterine atony
Correct answer: A full urinary bladder
A deviated uterine fundus (typically to the right) is most commonly caused by a full bladder displacing the uterus. The nurse should assist the patient to void. If the fundus is boggy and displaced, atony with bladder distension is the cause.
Question 3: A nurse is assessing a child with suspected intussusception. Which clinical finding is classic for this condition?
- Currant jelly stools (blood and mucus mixed stool) (Correct answer)
- Projectile non-bilious vomiting
- High fever with peritoneal signs
- Watery diarrhea for more than 3 days
Correct answer: Currant jelly stools (blood and mucus mixed stool)
Intussusception (telescoping of bowel) classically presents with colicky abdominal pain, a sausage-shaped abdominal mass, and 'currant jelly' stools — dark red mucus mixed with blood — caused by mucosal ischemia and sloughing.
Question 4: The nurse is preparing to administer a vaccine to a 2-month-old infant. Which vaccine is given at this age?
- DTaP, Hib, PCV13, IPV, and Hepatitis B (Correct answer)
- MMR and Varicella
- Influenza and Hepatitis A
- HPV and Meningococcal
Correct answer: DTaP, Hib, PCV13, IPV, and Hepatitis B
At 2 months, the recommended vaccines include DTaP (diphtheria, tetanus, pertussis), Hib, PCV13 (pneumococcal), IPV (polio), and the second dose of hepatitis B. MMR and Varicella are given at 12–15 months.
Question 5: A nurse is caring for a 32-week premature infant. Which condition is the premature infant most at risk for due to surfactant deficiency?
- Respiratory distress syndrome (RDS) (Correct answer)
- Necrotizing enterocolitis
- Retinopathy of prematurity
- Intraventricular hemorrhage
Correct answer: Respiratory distress syndrome (RDS)
Surfactant deficiency in premature infants causes respiratory distress syndrome (RDS), formerly called hyaline membrane disease. Surfactant reduces alveolar surface tension; its absence leads to alveolar collapse, hypoxemia, and respiratory failure.
Question 6: The nurse is monitoring a woman in active labor and notes the FHR drops to 80 bpm with each contraction and recovers only 60 seconds after contraction ends. This pattern is:
- Late decelerations — indicates uteroplacental insufficiency (Correct answer)
- Early decelerations — head compression
- Variable decelerations — cord compression
- Accelerations — normal reassuring pattern
Correct answer: Late decelerations — indicates uteroplacental insufficiency
Late decelerations begin after the peak of the contraction and recover after it ends. They indicate uteroplacental insufficiency — the placenta cannot provide adequate oxygenation during contractions. This is a non-reassuring pattern requiring immediate intervention.
Saudi Prometric Nursing Maternal and Child Nursing 2
A nurse is teaching a pregnant woman about folic acid supplementation.
When should supplementation ideally begin?