OB PEDIATRIC TEST PAPER 2026 QUESTIONS
AND SOLUTIONS GRADED A+
▶ A client has a wound on his left trochanter that is 4 inches in diameter,
with black tissue at the perimeter, and bone is exposed. Which is the
nurse's best action?
A) Document as a stage I pressure ulcer and apply a transparent dressing.
B) Document as a stage II pressure ulcer and start wet-to-dry gauze
treatments.
C) Document as a stage IV pressure ulcer and prepare the client for
débridement.
D) Document as a stage III pressure ulcer and start antibiotic therapy..
Answer: C
A stage IV ulcer is one in which skin loss is full thickness, with extensive
destruction, tissue necrosis, and/or damage to muscle, bone, or supporting
structures. Eschar may be present. When the bone of the trochanter area is
visible, tissue loss includes muscle loss. A potential intervention consists of
débridement of the necrotic tissue and a possible graft to promote healing.
▶ After initial placement of NG tubes is confirmed, how often must
placement be checked? SELECT ALL THAT APPLY?
A) before medication administration
B) it is not necessary to recheck placement
C) every 4-8 hours during feeding
D) before intermittent feeding
E) according to facility policy. Answer: A,C,E
▶ The nurse is preparing to administer tube feedings through a client's new
Salem sump nasogastric tube. The nurse is unable to withdraw any fluid
from the tube before starting the feeding. Which is the priority action of the
nurse?
A) Start the tube feeding as ordered and check the residual in 30 minutes.
B) Inject air into the nasogastric tube while auscultating the client's
epigastric area.
,C) Lower the head of the client's bed and attempt to aspirate fluid again.
D) Obtain orders for a chest x-ray to confirm placement before starting the
feeding.. Answer: D
The nurse must verify tube placement before beginning any tube feeding or
administering any medications through a tube. The most accurate way to
determine placement is via chest x-ray. The nurse could cause the client to
aspirate if she or he started the feeding then checked later for placement.
Insufflation does not provide accurate results and should not be used to
verify tube placement. The nurse must keep the client's head elevated at
least 30 degrees.
▶ A client has a urinary tract infection. Which assessment by the nurse is
most helpful?
A) Palpating and percussing the kidneys and bladder
B) Performing a bladder scan to assess post-void residual
C) Assessing medical history and current medical problems
D) Inquiring about recent travel to foreign countries. Answer: C
Clients who are severely immune compromised or who have diabetes
mellitus are more prone to fungal urinary tract infection. The nurse should
assess for these factors. A physical examination and a post-void residual
may be needed, but not until further information is obtained. Travel to
foreign countries probably would not be as important, because even if
exposed, the client needs some degree of immune compromise to develop
a fungal urinary tract infection.
▶ When a diabetic patient asks about maintaining adequate blood glucose
levels, which of the following statements by the nurse relates most directly
to the necessity of maintaining blood glucose levels no lower than about 74
mg/dl?
A) "Without a minimum level of glucose circulating in the blood,
erythrocytes cannot produce ATP."
B) "The presence of glucose in the blood counteracts the formation of lactic
acid and prevents acidosis."
C) "The central nervous system cannot store glucose and needs a
continuous supply of glucose for fuel."
,D) "Glucose is the only type of fuel used by body cells to produce the
energy needed for physiologic activity.". Answer: C
The brain cannot synthesize or store significant amounts of glucose; thus a
continuous supply from the body's circulation is needed to meet the fuel
demands of the central nervous system.
▶ The nurse is caring for an overweight client who gained 10 pounds
during the previous 2 weeks. The client states that she is hungry all the
time and doesn't understand why. Which assessment finding could explain
the client's weight gain and hunger?
A) The client's glycosylated hemoglobin level is 6%.
B) The client started taking dexamethasone (Decadron) daily.
C) The client started taking naproxen sodium (Naprosyn) daily.
D) The client's thyroxine (T4) level is 8 mcg/dL.. Answer: B
Dexamethasone is a corticosteroid. These drugs alter carbohydrate,
protein, and lipid metabolism, predisposing the client to obesity when taken
on a long-term basis. In addition, corticosteroids increase the client's
appetite. Naprosyn is an NSAID, which can lead to gastric upset and
ulceration and decreased appetite and weight loss. The client's
glycosylated hemoglobin and thyroid levels are within normal limits and
would not explain the hunger and weight gain.
▶ The nurse is prioritizing care to prevent pressure sores for a client who is
immobilized. Which interventions are appropriate? (Select all that apply.)
A) Use a rubber ring to decrease sacral pressure when up in the chair.
B) Place a small pillow between bony surfaces.
C) Keep the heels off the bed surfaces.
D) Use a lift sheet to assist with repositioning.
E) Reposition the client who is in a chair every 2 hours.
F) Elevate the head of the bed to 45 degrees.
G) Limit fluids and proteins in the diet.. Answer: B,C,D
A small pillow decreases the risk for pressure between bony prominences,
a lift sheet decreases friction and shear, and heels have poor circulation
and are at high risk for pressure sores, so they should be kept off hard
surfaces. Head of the bed elevation greater than 30 degrees increases
, pressure on pelvic soft tissues. Fluids and proteins are important for
maintaining tissue integrity. Clients should be repositioned every hour while
sitting in a chair. A rubber ring impairs capillary blood flow, increasing the
risk for a pressure sore.
▶ A client who first experienced symptoms related to a confirmed
thrombotic stroke 2 hours ago is brought to the intensive care unit. Which
prescribed medication does the nurse prepare to administer?
A) Tissue plasminogen activator
B) Heparin sodium
C) Warfarin (Coumadin)
D) Gabapentin (Neurontin). Answer: A
The client who has had a thrombotic stroke has a 3-hour time frame from
the onset of symptoms to receive recombinant tissue plasminogen activator
(rt-PA) to dissolve the cerebral artery occlusion and re-establish blood flow.
Clients must meet eligibility criteria for administration of this therapy. The
other medications do not assist in the re-establishment of blood flow for a
client with a confirmed thrombotic stroke.
▶ A nurse is about to administer the first dose of captopril (Capoten) to a
client with hypertension. Which is the priority nursing intervention?
A) Place the client in Trendelenburg position to facilitate blood flow to the
heart.
B) Take the client's apical pulse for 1 full minute before drug administration.
C) Instruct the client to drink 3 L of fluid daily when taking this medication.
D) Educate the client to sit on the side of the bed for a few minutes before
rising.. Answer: D
Angiotensin-converting enzyme (ACE) inhibitors such as captopril can
cause severe hypotension with initial use. The client should be instructed to
rise slowly and sit on the side of the bed for a few minutes to prevent
hypotension-induced falls. No indication is known for assessment of the
apical pulse for 1 full minute before taking captopril. Placing the client in a
Trendelenburg position is not indicated. In case of a precipitous drop in
blood pressure, a modified Trendelenburg position may be used. Adequate
fluid intake is necessary but is not the priority in this situation.
AND SOLUTIONS GRADED A+
▶ A client has a wound on his left trochanter that is 4 inches in diameter,
with black tissue at the perimeter, and bone is exposed. Which is the
nurse's best action?
A) Document as a stage I pressure ulcer and apply a transparent dressing.
B) Document as a stage II pressure ulcer and start wet-to-dry gauze
treatments.
C) Document as a stage IV pressure ulcer and prepare the client for
débridement.
D) Document as a stage III pressure ulcer and start antibiotic therapy..
Answer: C
A stage IV ulcer is one in which skin loss is full thickness, with extensive
destruction, tissue necrosis, and/or damage to muscle, bone, or supporting
structures. Eschar may be present. When the bone of the trochanter area is
visible, tissue loss includes muscle loss. A potential intervention consists of
débridement of the necrotic tissue and a possible graft to promote healing.
▶ After initial placement of NG tubes is confirmed, how often must
placement be checked? SELECT ALL THAT APPLY?
A) before medication administration
B) it is not necessary to recheck placement
C) every 4-8 hours during feeding
D) before intermittent feeding
E) according to facility policy. Answer: A,C,E
▶ The nurse is preparing to administer tube feedings through a client's new
Salem sump nasogastric tube. The nurse is unable to withdraw any fluid
from the tube before starting the feeding. Which is the priority action of the
nurse?
A) Start the tube feeding as ordered and check the residual in 30 minutes.
B) Inject air into the nasogastric tube while auscultating the client's
epigastric area.
,C) Lower the head of the client's bed and attempt to aspirate fluid again.
D) Obtain orders for a chest x-ray to confirm placement before starting the
feeding.. Answer: D
The nurse must verify tube placement before beginning any tube feeding or
administering any medications through a tube. The most accurate way to
determine placement is via chest x-ray. The nurse could cause the client to
aspirate if she or he started the feeding then checked later for placement.
Insufflation does not provide accurate results and should not be used to
verify tube placement. The nurse must keep the client's head elevated at
least 30 degrees.
▶ A client has a urinary tract infection. Which assessment by the nurse is
most helpful?
A) Palpating and percussing the kidneys and bladder
B) Performing a bladder scan to assess post-void residual
C) Assessing medical history and current medical problems
D) Inquiring about recent travel to foreign countries. Answer: C
Clients who are severely immune compromised or who have diabetes
mellitus are more prone to fungal urinary tract infection. The nurse should
assess for these factors. A physical examination and a post-void residual
may be needed, but not until further information is obtained. Travel to
foreign countries probably would not be as important, because even if
exposed, the client needs some degree of immune compromise to develop
a fungal urinary tract infection.
▶ When a diabetic patient asks about maintaining adequate blood glucose
levels, which of the following statements by the nurse relates most directly
to the necessity of maintaining blood glucose levels no lower than about 74
mg/dl?
A) "Without a minimum level of glucose circulating in the blood,
erythrocytes cannot produce ATP."
B) "The presence of glucose in the blood counteracts the formation of lactic
acid and prevents acidosis."
C) "The central nervous system cannot store glucose and needs a
continuous supply of glucose for fuel."
,D) "Glucose is the only type of fuel used by body cells to produce the
energy needed for physiologic activity.". Answer: C
The brain cannot synthesize or store significant amounts of glucose; thus a
continuous supply from the body's circulation is needed to meet the fuel
demands of the central nervous system.
▶ The nurse is caring for an overweight client who gained 10 pounds
during the previous 2 weeks. The client states that she is hungry all the
time and doesn't understand why. Which assessment finding could explain
the client's weight gain and hunger?
A) The client's glycosylated hemoglobin level is 6%.
B) The client started taking dexamethasone (Decadron) daily.
C) The client started taking naproxen sodium (Naprosyn) daily.
D) The client's thyroxine (T4) level is 8 mcg/dL.. Answer: B
Dexamethasone is a corticosteroid. These drugs alter carbohydrate,
protein, and lipid metabolism, predisposing the client to obesity when taken
on a long-term basis. In addition, corticosteroids increase the client's
appetite. Naprosyn is an NSAID, which can lead to gastric upset and
ulceration and decreased appetite and weight loss. The client's
glycosylated hemoglobin and thyroid levels are within normal limits and
would not explain the hunger and weight gain.
▶ The nurse is prioritizing care to prevent pressure sores for a client who is
immobilized. Which interventions are appropriate? (Select all that apply.)
A) Use a rubber ring to decrease sacral pressure when up in the chair.
B) Place a small pillow between bony surfaces.
C) Keep the heels off the bed surfaces.
D) Use a lift sheet to assist with repositioning.
E) Reposition the client who is in a chair every 2 hours.
F) Elevate the head of the bed to 45 degrees.
G) Limit fluids and proteins in the diet.. Answer: B,C,D
A small pillow decreases the risk for pressure between bony prominences,
a lift sheet decreases friction and shear, and heels have poor circulation
and are at high risk for pressure sores, so they should be kept off hard
surfaces. Head of the bed elevation greater than 30 degrees increases
, pressure on pelvic soft tissues. Fluids and proteins are important for
maintaining tissue integrity. Clients should be repositioned every hour while
sitting in a chair. A rubber ring impairs capillary blood flow, increasing the
risk for a pressure sore.
▶ A client who first experienced symptoms related to a confirmed
thrombotic stroke 2 hours ago is brought to the intensive care unit. Which
prescribed medication does the nurse prepare to administer?
A) Tissue plasminogen activator
B) Heparin sodium
C) Warfarin (Coumadin)
D) Gabapentin (Neurontin). Answer: A
The client who has had a thrombotic stroke has a 3-hour time frame from
the onset of symptoms to receive recombinant tissue plasminogen activator
(rt-PA) to dissolve the cerebral artery occlusion and re-establish blood flow.
Clients must meet eligibility criteria for administration of this therapy. The
other medications do not assist in the re-establishment of blood flow for a
client with a confirmed thrombotic stroke.
▶ A nurse is about to administer the first dose of captopril (Capoten) to a
client with hypertension. Which is the priority nursing intervention?
A) Place the client in Trendelenburg position to facilitate blood flow to the
heart.
B) Take the client's apical pulse for 1 full minute before drug administration.
C) Instruct the client to drink 3 L of fluid daily when taking this medication.
D) Educate the client to sit on the side of the bed for a few minutes before
rising.. Answer: D
Angiotensin-converting enzyme (ACE) inhibitors such as captopril can
cause severe hypotension with initial use. The client should be instructed to
rise slowly and sit on the side of the bed for a few minutes to prevent
hypotension-induced falls. No indication is known for assessment of the
apical pulse for 1 full minute before taking captopril. Placing the client in a
Trendelenburg position is not indicated. In case of a precipitous drop in
blood pressure, a modified Trendelenburg position may be used. Adequate
fluid intake is necessary but is not the priority in this situation.
