Saudi Prometric Nursing Maternal and Child Health 5 — Questions and Answers
Question 1: Which position is recommended for a woman experiencing shoulder dystocia during delivery?
- Trendelenburg position
- McRoberts maneuver (hyperflexion of thighs) (Correct answer)
- Left lateral decubitus position
- Lithotomy position with leg abduction
Correct answer: McRoberts maneuver (hyperflexion of thighs)
The McRoberts maneuver involves hyperflexing the maternal thighs onto the abdomen, which flattens the lumbar lordosis and rotates the pubic symphysis to dislodge the impacted shoulder.
Question 2: A child with sickle cell disease presents in a vaso-occlusive crisis. Which nursing intervention is the priority?
- Restrict fluid intake to prevent overload
- Administer analgesics and encourage IV hydration (Correct answer)
- Prepare for immediate blood transfusion
- Apply ice packs to painful extremities
Correct answer: Administer analgesics and encourage IV hydration
Vaso-occlusive crisis requires adequate pain management with analgesics and vigorous hydration to reduce blood viscosity and restore flow to ischemic tissue.
Question 3: The neonatal screening test (heel prick) routinely tests for which condition among others in Saudi Arabia?
- Down syndrome
- Phenylketonuria (PKU) (Correct answer)
- Cerebral palsy
- Congenital hip dysplasia
Correct answer: Phenylketonuria (PKU)
Phenylketonuria (PKU) is included in Saudi Arabia's national newborn screening program via heel prick blood sample to allow early dietary intervention.
Question 4: A primigravida at 37 weeks presents with sudden onset severe headache, visual disturbances, and BP of 162/110 mmHg. The nurse should prepare for which condition?
- Gestational hypertension
- Severe preeclampsia (Correct answer)
- Chronic hypertension exacerbation
- Hypertensive urgency unrelated to pregnancy
Correct answer: Severe preeclampsia
Severe headache, visual disturbances, and BP ≥160/110 mmHg in a pregnant woman meet criteria for severe preeclampsia, requiring immediate antihypertensive and magnesium sulfate therapy.
Question 5: According to the growth chart, a child's weight falls at the 3rd percentile for age. This finding indicates:
- Severe acute malnutrition requiring hospitalization
- The child is below the normal range and needs further assessment (Correct answer)
- A normal variant within two standard deviations
- Morbid obesity risk
Correct answer: The child is below the normal range and needs further assessment
A weight at the 3rd percentile is at the lowest boundary of normal; it warrants further assessment for growth faltering, feeding issues, or underlying illness.
Question 6: A breastfeeding mother asks when she should introduce complementary foods to her infant. The nurse's best response is:
- At 3–4 months, when the baby shows interest in food
- At 6 months, alongside continued breastfeeding (Correct answer)
- At 4 months to prevent iron deficiency
- Only after the infant has all milk teeth
Correct answer: At 6 months, alongside continued breastfeeding
WHO and Saudi MOH recommend introducing complementary foods at 6 months while continuing breastfeeding, as breast milk alone meets nutritional needs for the first 6 months.
Question 7: A nurse administers vitamin K to a newborn immediately after birth to prevent:
- Neonatal jaundice
- Hemorrhagic disease of the newborn (Correct answer)
- Retinopathy of prematurity
- Group B Streptococcus infection
Correct answer: Hemorrhagic disease of the newborn
Newborns have low vitamin K levels due to limited placental transfer and a sterile gut; vitamin K prophylaxis prevents hemorrhagic disease of the newborn (vitamin K deficiency bleeding).
Saudi Prometric Nursing Maternal and Child Health 5
Which position is recommended for a woman experiencing shoulder dystocia during delivery?