Maternal–Child Nursing

A pregnant patient at 30 weeks has painless bright-red vaginal bleeding. Fetal heart rate is reassuring. First nursing action?

Painful vaginal bleeding with firm, tender uterus and constant abdominal pain at 36 weeks suggests:

Fetal heart tracing shows recurrent late decelerations with minimal variability on oxytocin. Best first nursing actions?

Variable decelerations are most commonly due to:

A prolapsed umbilical cord is palpated on exam. Priority nursing action?

First-line medications to lower severe-range BP (≥160/110) in preeclampsia?

Eclampsia occurs. What is the immediate nursing priority?

Signs of magnesium sulfate toxicity include:

At 28 weeks, routine prevention for Rh-negative, unsensitized patient includes:

Postpartum hemorrhage with a boggy uterus after delivery. First interventions?

Methylergonovine is contraindicated in PPH for patients with:

A febrile laboring patient with tender uterus and foul amniotic fluid suggests chorioamnionitis. Nursing priorities?

PPROM at 32 weeks without infection. Usual bundle?

Term PROM (≥37 wks), afebrile, GBS unknown. Best plan?

GBS prophylaxis in labor first-line and allergy alternative?

VBAC candidate—absolute contraindication?

Shoulder dystocia occurs. Correct first maneuvers?

Postpartum uterine inversion is suspected (mass at introitus, hemorrhage). Priority?

Amniotic fluid embolism likely: sudden hypoxia, hypotension, DIC postpartum. Nursing actions?

A 24-week preterm labor patient is contracting with cervical change. Tocolysis of choice initially?

Antenatal corticosteroids are recommended at:

Teaching for iron supplementation in pregnancy:

A postpartum patient with fever, foul lochia, uterine tenderness likely has endometritis. Initial management?

Breastfeeding mastitis management:

Safe postpartum contraception during breastfeeding (early):

Newborn resuscitation: term infant apneic with HR 70 after initial steps. Next action?

In NRP, chest compressions are indicated when:

APGAR scores are used to:

Symptomatic neonatal hypoglycemia management (term infant, BG 30 mg/dL):

Jaundiced newborn at 48 hours with total bilirubin near phototherapy threshold. Nursing steps?

SIDS prevention teaching includes:

Croup (laryngotracheobronchitis) moderate–severe presentation. Evidence-based ED therapy?

Epiglottitis suspicion in child (drooling, tripod, stridor). Nursing priority?

Pediatric dehydration with poor perfusion. Initial bolus?

Ectopic pregnancy suspected (positive test, unilateral pain, spotting). Priority nursing action?

Complete molar pregnancy postoperative counseling:

Preeclampsia with severe features at 35 weeks. Usual plan?

GDM screening timing:

Contraindicated vaccines in pregnancy include:

Rubella non-immune mother postpartum asks about vaccination. Best advice?

Fetal heart tracing shows recurrent early decelerations with moderate variability during active labor. Best interpretation?

Tachysystole is defined as:

Category III fetal heart tracing requires which priority nursing action?

Meconium-stained amniotic fluid and vigorous newborn at birth. Next step?

Non-vigorous newborn with thick meconium. Priority?

Suspected uterine rupture during TOLAC: sudden pain, loss of station, abnormal FHR. First nursing action?

Epidural anesthesia is contraindicated in which finding?

Preeclampsia with severe features at 29 weeks—magnesium sulfate purpose?

Indomethacin as a tocolytic (<32 weeks) may cause which fetal effect with prolonged use?

Gestational diabetes intrapartum glucose target is typically:

Postpartum day 2: saturated pad every 15 minutes, firm fundus at umbilicus. Likely cause?

Postpartum blues vs depression—key nursing distinction?

Breastfeeding education: signs of a good latch include:

Absolute contraindication to breastfeeding:

Neonatal hypoglycemia in at-risk infant (jittery, BG 28 mg/dL). Best immediate step?

Neonatal sepsis red flags in first 24–48 hours include:

Hyperbilirubinemia: which feature suggests pathologic jaundice?

Phototherapy nursing priorities include:

Kawasaki disease acute phase—first-line therapy?

Child with Tetralogy of Fallot has “tet spell.” Immediate nursing position?

Coarctation of the aorta classic assessment finding:

Suspected duct-dependent congenital heart disease in a cyanotic newborn. Anticipated medication?

Intussusception classic triad?

Hypertrophic pyloric stenosis hallmark labs?

Acute otitis media first-line therapy in most children without allergy?

Pertussis suspected (paroxysmal cough, whoop). Isolation and treatment?

RSV bronchiolitis management in infant with mild–moderate disease?

Febrile seizure in a 2-year-old lasting 2 minutes. Nursing advice?

Scarlet fever findings and treatment?

Acute rheumatic fever prevention after strep throat?

Hemolytic uremic syndrome classic triad?

Nephrotic vs post-strep glomerulonephritis distinguishing feature?

Adolescent with suspected appendicitis—nursing priority before imaging?

Testicular torsion suspected (sudden pain, high-riding testis). Nursing action?

Normal developmental milestone at 9 months:

Vaccine given at 12 months (typical schedule, if not contraindicated):

Child ingests a button battery. Priority?

Nurse calculates pediatric maintenance fluids using the 4–2–1 rule. For a 22-kg child, hourly rate?

Iron-deficiency anemia prevention in infants:

Varicella exposure in a susceptible pregnant patient. Best plan?

A 32-week pregnant patient has intense nocturnal pruritus of palms/soles and dark urine; bile acids are elevated. Best plan?

RUQ pain, thrombocytopenia 70,000/µL, and high AST/ALT in a patient with preeclampsia most likely indicates:

Reactive nonstress test (NST) criteria at ≥32 weeks:

Biophysical profile (BPP) components:

Contraction stress test (oxytocin challenge) is contraindicated in:

Postpartum screening after gestational diabetes:

Folic acid prevention of neural tube defects:

Vaccination in pregnancy—what is recommended?

Asymptomatic bacteriuria in pregnancy (≥10^5 CFU/mL). Best approach?

Pyelonephritis during pregnancy—management:

Is warfarin compatible with breastfeeding?

Vitamin K prophylaxis for the newborn:

Ophthalmia neonatorum prophylaxis:

Gonococcal conjunctivitis (day 2–5 of life). Management?

Critical congenital heart disease (CCHD) pulse-ox screening:

Developmental dysplasia of the hip screening and risk:

Normal neonatal weight change:

“Breastfeeding jaundice” vs “breast milk jaundice”:

Empiric therapy for early-onset neonatal sepsis:

NRP—epinephrine indication and route:

Classic posture with Erb palsy after shoulder dystocia:

Severe first-trimester vomiting with ketonuria, weight loss—management?

Occiput posterior labor commonly causes:

Post-term pregnancy (>41 weeks):

Fetal growth restriction (IUGR) typical finding/management:

Molar pregnancy—signs and approach:

Suspected ovarian torsion in pregnancy (sudden unilateral pain, nausea). What to do?

Suppressing lactation if not breastfeeding:

Suspected breast abscess after mastitis (fluctuance, fever). Management?

Postpartum depression screening:

Postpartum psychosis:

Neonatal abstinence syndrome—first-line nursing care?

Congenital hypothyroidism signs and treatment:

Infants under 1 year should not consume:

Lead poisoning—risk and approach:

Pediatric anaphylaxis (child 20 kg). Epinephrine IM dose?

Fever in children—what to avoid?

Candidal diaper dermatitis—correct statement:

Positive pregnancy test with unilateral pelvic pain and spotting—before ectopic is excluded:

Postpartum urinary retention—first-line care?

Term labor with persistent variable decelerations despite repositioning and O₂. Amniotic membranes intact. Best next step?

Postpartum day 0, heavy bleeding with soft, enlarged uterus above umbilicus. Priority nursing actions?

Postpartum day 5, sudden heavy bleeding; uterus is firm and at or below umbilicus. Most likely cause?

Pregnant trauma patient (Rh-negative, unsensitized) after minor MVC at 28 weeks. What prophylaxis?

Category III tracing with persistent late decelerations despite intrauterine resuscitation. Next best action?

Known HSV-2; painful genital lesions at onset of labor. Delivery plan?

Severe preeclampsia on magnesium sulfate; urine output falls to 15 mL/hr, DTRs absent, RR 8/min. Priority?

Risk factors for uterine atony include:

39-week pregnancy with isolated oligohydramnios (low AFI), reassuring NST/BPP otherwise. Usual plan?

Polyhydramnios is commonly associated with:

Sinusoidal fetal heart pattern most suggests:

Intra-amniotic infection (chorioamnionitis) typical signs:

Contraindications to tocolysis include:

Candidate for methotrexate in ectopic pregnancy typically has:

Post-term pregnancy with meconium-stained fluid; FHR shows recurrent variables. Helpful intrapartum measure?

GBS prophylaxis is indicated when status unknown and:

34-week preterm rupture of membranes, afebrile. Evidence-based bundle?

First-trimester dating ultrasound is important because:

Late decelerations pathophysiology:

Breastfeeding mastitis first-line management includes:

Newborn with jaundice in first 24 hours, positive direct antiglobulin test. Likely cause?

Term infant with tachypnea shortly after elective cesarean; clear breath sounds; improves within 24–48 hours. Diagnosis?

Preterm infant with respiratory distress and ground-glass appearance on CXR. Initial therapy?

PDA in a preterm neonate—pharmacologic closure agent?

Prolonged ROM (>18 hours) at term; newborn at risk for:

Nursing priority to prevent neonatal hypothermia:

Breastfeeding and maternal medications—preferred SSRI if needed postpartum?

Umbilical cord prolapse is discovered during cervical exam. First actions?

Placenta previa at 30 weeks with bleeding stopped. Teaching point?

Suspected placental abruption: painful bleeding, rigid uterus, fetal distress. Priority nursing step?

Combined hormonal contraception postpartum in non-breastfeeding patient:

Teen pregnancy counseling should include:

PUPPP (pruritic urticarial papules and plaques of pregnancy) features:

Fetal growth restriction surveillance commonly includes:

Suspected postpartum endometritis risk is highest after:

Newborn screening returns congenital hypothyroidism. First-line action?

Safe sleep education for exhausted parents:

Umbilical granuloma with persistent moist drainage at 2 weeks. Nursing guidance?

Adolescent with primary dysmenorrhea and normal exam. First-line management?

Breastfed newborn with weight loss of 8% by day 3, low urine/stool output. Best nursing action?

Imminent preterm birth at 28–31+6 weeks. What neuroprotective medication is indicated?

Postpartum hemorrhage persists; carboprost is being considered. Which condition is a contraindication?

Persistent uterine atony after oxytocin. Most appropriate misoprostol route?

Induction at term in a patient with prior low-transverse cesarean. Which cervical ripening method is contraindicated?

Breech presentation at 37 weeks, reassuring status. Recommended management?

ECV is contraindicated in which scenario?

Umbilical cord arterial gas after delivery shows pH 6.98 and base deficit −14. Interpretation?

HBsAg-positive mother delivers a term infant. Immediate newborn prophylaxis?

HIV-positive pregnant patient with viral load >1,000 copies/mL near term. Delivery plan?

Parvovirus B19 infection in pregnancy raises risk of:

Nonreactive NST improves to accelerations after fetal scalp stimulation during labor. Significance?

Intrapartum GBS prophylaxis is NOT indicated when:

Oxytocin-associated uterine tachysystole with recurrent late decels. First action?

Postpartum hypertension and headache on day 5 after an uncomplicated birth. Priority education?

Infant of a diabetic mother (IDM) is at risk for which immediate complication?

IDM typical findings include:

RDS prevention strategy for threatened preterm birth at 30 weeks:

Safe sleep teaching to reduce SIDS includes:

12-month developmental milestone:

2-year developmental milestone:

Car seat safety—rear-facing recommendation:

Early childhood caries prevention:

Intimate partner violence screening in pregnancy—nursing role?

TORCH prevention—toxoplasmosis:

CMV prevention counseling for pregnant daycare workers:

Breastfeeding and codeine/tramadol—key risk?

Antihypertensives compatible with breastfeeding:

Postpartum VTE prevention in high-risk patients includes:

Pediatric UTI in a toilet-trained child—clean-catch culture shows >100,000 CFU E. coli. First-line antibiotic?

Febrile infant 4 weeks old, well-appearing, temp 38.4°C (101.1°F). Usual approach?

Dehydration in a 10-month-old with diarrhea—best initial rehydration?

Preeclampsia seizure prophylaxis—therapeutic magnesium target sign at bedside?

Contraindication to vaginal birth after cesarean (VBAC):