Saudi Prometric Nursing Maternal and Child Nursing 4 — Questions and Answers
Question 1: A patient at 34 weeks gestation is diagnosed with placenta previa. Which clinical presentation is classic?
- Painless bright red vaginal bleeding (Correct answer)
- Severe abdominal pain with a rigid boardlike uterus
- Dark red vaginal bleeding with contractions
- Decreased fetal movement with no bleeding
Correct answer: Painless bright red vaginal bleeding
Placenta previa presents with painless, bright red vaginal bleeding (often sudden) due to the placenta covering the cervical os. Placental abruption, in contrast, presents with painful dark red bleeding and a rigid uterus.
Question 2: The nurse is caring for a newborn with jaundice receiving phototherapy. Which action is most important?
- Cover the eyes with phototherapy shields and monitor hydration (Correct answer)
- Apply sunscreen to exposed skin
- Dress the baby in light clothing
- Keep the baby clothed to prevent heat loss
Correct answer: Cover the eyes with phototherapy shields and monitor hydration
During phototherapy, the newborn's eyes must be protected with opaque shields to prevent retinal damage from the light. The baby should be maximally exposed (except for genitals) to maximize light absorption. Hydration is important as phototherapy can cause increased insensible fluid loss.
Question 3: A nurse is teaching a mother about sudden infant death syndrome (SIDS) prevention. Which sleeping position is recommended?
- Supine (on the back) (Correct answer)
- Prone (on the stomach)
- Side-lying with a rolled towel
- In a slightly elevated position in a car seat
Correct answer: Supine (on the back)
The 'Back to Sleep' campaign (now 'Safe to Sleep') has dramatically reduced SIDS rates. Infants should always be placed supine (on their back) on a firm, flat surface without loose bedding, pillows, or soft toys.
Question 4: During a contraction stress test (CST), the nurse notes consistent late decelerations. How should this result be interpreted?
- Positive (abnormal) — suggests uteroplacental insufficiency (Correct answer)
- Negative (normal) — no decelerations observed
- Equivocal — further testing needed
- Reactive — reassuring fetal status
Correct answer: Positive (abnormal) — suggests uteroplacental insufficiency
A positive CST means late decelerations occur with at least 50% of contractions and is interpreted as abnormal, suggesting uteroplacental insufficiency. A negative (normal) CST shows no late decelerations, indicating adequate placental reserve.
Question 5: A child with nephrotic syndrome develops sudden severe abdominal pain and fever. The nurse should suspect:
- Spontaneous bacterial peritonitis (Correct answer)
- Testicular torsion
- Acute appendicitis
- Inguinal hernia
Correct answer: Spontaneous bacterial peritonitis
Children with nephrotic syndrome are immunocompromised due to urinary loss of immunoglobulins, making them highly susceptible to infections. Spontaneous bacterial peritonitis (SBP), often due to pneumococcus, is a serious complication presenting with sudden abdominal pain, fever, and tenderness.
Question 6: A postpartum patient's lochia changes from rubra to serosa. On what day postpartum does this transition typically begin?
- Day 3–4 (Correct answer)
- Day 1–2
- Day 10–14
- Day 6–8
Correct answer: Day 3–4
Lochia rubra (red) lasts for the first 1–3 days, lochia serosa (pink-brown, watery) begins around day 3–4 and lasts through day 10, followed by lochia alba (white/yellow) until day 21–28 or longer. Deviation from this timeline may indicate infection or hemorrhage.
Saudi Prometric Nursing Maternal and Child Nursing 4
A patient at 34 weeks gestation is diagnosed with placenta previa.
Which clinical presentation is classic?