Saudi Prometric Nursing Maternal and Child Health 4 — Questions and Answers
Question 1: A child with nephrotic syndrome will most likely exhibit which classic finding?
- Hematuria and hypertension
- Generalized edema and massive proteinuria (Correct answer)
- Oliguria and elevated BUN
- Fever and flank pain
Correct answer: Generalized edema and massive proteinuria
Nephrotic syndrome is characterized by the tetrad of massive proteinuria, hypoalbuminemia, generalized edema (anasarca), and hyperlipidemia.
Question 2: A nurse is caring for a woman in active labor whose fetal monitor shows late decelerations. The priority intervention is to:
- Increase IV oxytocin infusion rate
- Place the mother in left lateral position and give oxygen (Correct answer)
- Prepare for immediate cesarean section
- Perform an amniotomy
Correct answer: Place the mother in left lateral position and give oxygen
Late decelerations indicate uteroplacental insufficiency; repositioning to left lateral reduces aorto-caval compression and supplemental oxygen improves fetal oxygenation.
Question 3: At what age should a healthy infant be able to sit independently without support?
- 4 months
- 6 months (Correct answer)
- 9 months
- 12 months
Correct answer: 6 months
Most infants achieve independent sitting without support at approximately 6 months of age as a gross motor milestone.
Question 4: Which lab value is most indicative of HELLP syndrome in a pregnant woman?
- Elevated serum creatinine
- Thrombocytopenia and elevated liver enzymes (Correct answer)
- Decreased hemoglobin with normal platelets
- Proteinuria greater than 5 g/24 hours
Correct answer: Thrombocytopenia and elevated liver enzymes
HELLP syndrome is defined by Hemolysis, Elevated Liver enzymes, and Low Platelets — thrombocytopenia and elevated AST/ALT are diagnostic hallmarks.
Question 5: A nurse is teaching parents about fever management in a 2-year-old. Which statement by a parent indicates a need for further teaching?
- 'I will give paracetamol for fever above 38.5°C.'
- 'I will use lukewarm sponging to help bring down the fever.'
- 'I will give aspirin to reduce the fever quickly.' (Correct answer)
- 'I will increase fluids and monitor for signs of dehydration.'
Correct answer: 'I will give aspirin to reduce the fever quickly.'
Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but life-threatening condition affecting the liver and brain.
Question 6: The Naegele's rule is used in obstetrics to calculate:
- Estimated blood loss during delivery
- Expected date of delivery (EDD) (Correct answer)
- Fetal weight at term
- Gestational age from fundal height
Correct answer: Expected date of delivery (EDD)
Naegele's rule calculates the estimated date of delivery: add 7 days and subtract 3 months (or add 9 months) to the first day of the last menstrual period.
Question 7: A child presents with a sandpaper-like rash, strawberry tongue, and sore throat. The most likely causative organism is:
- Staphylococcus aureus
- Group A beta-hemolytic Streptococcus (Correct answer)
- Neisseria meningitidis
- Haemophilus influenzae
Correct answer: Group A beta-hemolytic Streptococcus
Scarlet fever is caused by Group A beta-hemolytic Streptococcus (Streptococcus pyogenes), which produces erythrogenic toxins causing the characteristic rash and strawberry tongue.
Saudi Prometric Nursing Maternal and Child Health 4
A child with nephrotic syndrome will most likely exhibit which classic finding?