NR 602 PRIMARY CARE OF THE CHILDBEARING AND
CHILDREARING FAMILY FINAL EXAM Actual Exam
Complete Questions and Answers Detailed Rationales
Pass Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Antepartum & Intrapartum Care | Q1 – Q10
Section 2 | Postpartum & Newborn Care | Q11 – Q20
Section 3 | Pediatric Growth, Development & Prevention | Q21 – Q30
Section 4 | Common Pediatric Acute & Chronic Conditions | Q31 – Q40
Section 5 | Women's Health & Family Planning | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: ANTEPARTUM & INTRAPARTUM CARE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 32-year-old G2P1 at 32 weeks gestation presents for a routine prenatal visit. Fundal
height measures 28 cm. Fetal heart rate is 150 bpm. The patient reports no vaginal
bleeding, contractions, or decreased fetal movement.
A. Document the measurement as normal and schedule the next visit in 2 weeks
B. Order a sonographic estimated fetal weight and amniotic fluid assessment ✓
CORRECT
C. Perform a nonstress test today to evaluate for fetal compromise
D. Begin antenatal corticosteroids for suspected preterm delivery
Correct Answer: B
Rationale: Fundal height should approximate gestational age within 2 cm, so 28 cm at
32 weeks suggests possible intrauterine growth restriction or oligohydramnios that
warrants ultrasound evaluation before further intervention. A nonstress test is not
,indicated without additional concerns such as decreased fetal movement or
hypertension, and corticosteroids are unnecessary without threatened preterm labor.
Lagging fundal height is a screening finding that requires imaging confirmation.
Question 2 of 50
A 28-year-old G1P0 at 36 weeks gestation reports a severe headache and right upper
quadrant pain for 6 hours. Blood pressure is 158/102 mmHg, urine dipstick shows 2+
protein, and deep tendon reflexes are 2+ without clonus. The fetal heart tracing is
reactive.
A. Gestational hypertension requiring home blood pressure monitoring
B. Chronic hypertension that has worsened in the third trimester
C. Preeclampsia without severe features managed expectantly until 37 weeks
D. Preeclampsia with severe features requiring delivery planning ✓ CORRECT
Correct Answer: D
Rationale: Headache, right upper quadrant pain, blood pressure of 158/102, and
proteinuria 2+ meet criteria for preeclampsia with severe features, which necessitates
delivery regardless of gestational age once maternal stabilization is achieved.
Gestational hypertension lacks proteinuria and severe features, and expectant
management is unsafe with these symptoms due to the risk of eclampsia and HELLP
syndrome. Magnesium sulfate for seizure prophylaxis should also be initiated.
Question 3 of 50
A 24-year-old G1P0 at 38 weeks gestation arrives in labor and delivery with contractions
every 3 minutes. Cervical exam reveals 5 cm dilation. Her membranes ruptured 1 hour
ago. Group B strep culture at 36 weeks was positive, and she has no penicillin allergy.
A. Administer intravenous penicillin G now ✓ CORRECT
B. Wait until delivery is imminent to give a single dose of antibiotics
C. Offer oral amoxicillin to take at home after discharge
,D. Give cefazolin because it provides broader coverage than penicillin
Correct Answer: A
Rationale: GBS prophylaxis should be initiated at the onset of labor or rupture of
membranes for colonized patients, with penicillin G as the first-line agent. Delaying
antibiotics until delivery misses the window for effective intrapartum prophylaxis, and
oral antibiotics are insufficient for intrapartum coverage. Cefazolin is an alternative for
penicillin-allergic patients without anaphylaxis risk, not a broader-spectrum
replacement.
Question 4 of 50
A 19-year-old G1P0 at 16 weeks gestation presents for a prenatal visit. Fundal height is
20 cm. Fetal heart tones are not audible with handheld Doppler after 5 minutes of
searching. The patient reports feeling recent fetal movement.
A. Reassure the patient that Doppler cannot detect heart tones until 20 weeks
B. Schedule a return visit in 2 weeks to reassess with Doppler
C. Perform a bedside ultrasound to confirm viability and assess gestational age ✓
CORRECT
D. Prepare the patient for a missed abortion and discuss dilation and evacuation
Correct Answer: C
Rationale: Fetal heart tones are typically audible by Doppler at 10 to 12 weeks, so
inability to detect them at 16 weeks with a fundal height of 20 cm warrants immediate
ultrasound to confirm viability, placental location, and dating. Assuming missed
abortion without imaging is premature, and delaying evaluation could miss conditions
like placenta previa or fetal demise that require immediate management. Bedside
ultrasound provides rapid diagnostic clarity.
Question 5 of 50
, A 30-year-old G2P1 at 24 weeks has a routine CBC drawn. Hemoglobin is 10.2 g/dL,
MCV 78 fL, and ferritin 15 ng/mL. She reports increased fatigue but no pica.
A. Start intravenous iron supplementation because oral iron is poorly absorbed in
pregnancy
B. Begin oral ferrous sulfate 325 mg daily with vitamin C and recheck in 4 weeks ✓
CORRECT
C. Recommend blood transfusion because hemoglobin below 11 is dangerous for the
fetus
D. Reassure her that this is physiological anemia and requires no intervention
Correct Answer: B
Rationale: Iron deficiency anemia in pregnancy is defined by low hemoglobin with
microcytic indices and low ferritin, and first-line management is oral iron
supplementation with follow-up monitoring. Intravenous iron is reserved for
malabsorption or intolerance, transfusion is unnecessary at this hemoglobin level
without symptoms of decompensation, and physiological anemia typically presents
with normocytic indices rather than microcytosis. Treatment improves maternal energy
and fetal iron stores.
Question 6 of 50
A 26-year-old G1P0 at 10 weeks gestation presents with persistent vomiting for 3
weeks. She has lost 8 pounds, has ketonuria, and shows dry mucous membranes. Vital
signs are stable.
A. Recommend small frequent meals and ginger supplements for morning sickness
B. Prescribe doxylamine-pyridoxine and schedule a follow-up in 2 weeks
C. Advise increased fluid intake and observation because vomiting is normal in early
pregnancy
D. Admit for intravenous hydration, antiemetics, and thiamine supplementation ✓
CORRECT
Correct Answer: D
CHILDREARING FAMILY FINAL EXAM Actual Exam
Complete Questions and Answers Detailed Rationales
Pass Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Antepartum & Intrapartum Care | Q1 – Q10
Section 2 | Postpartum & Newborn Care | Q11 – Q20
Section 3 | Pediatric Growth, Development & Prevention | Q21 – Q30
Section 4 | Common Pediatric Acute & Chronic Conditions | Q31 – Q40
Section 5 | Women's Health & Family Planning | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: ANTEPARTUM & INTRAPARTUM CARE Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 32-year-old G2P1 at 32 weeks gestation presents for a routine prenatal visit. Fundal
height measures 28 cm. Fetal heart rate is 150 bpm. The patient reports no vaginal
bleeding, contractions, or decreased fetal movement.
A. Document the measurement as normal and schedule the next visit in 2 weeks
B. Order a sonographic estimated fetal weight and amniotic fluid assessment ✓
CORRECT
C. Perform a nonstress test today to evaluate for fetal compromise
D. Begin antenatal corticosteroids for suspected preterm delivery
Correct Answer: B
Rationale: Fundal height should approximate gestational age within 2 cm, so 28 cm at
32 weeks suggests possible intrauterine growth restriction or oligohydramnios that
warrants ultrasound evaluation before further intervention. A nonstress test is not
,indicated without additional concerns such as decreased fetal movement or
hypertension, and corticosteroids are unnecessary without threatened preterm labor.
Lagging fundal height is a screening finding that requires imaging confirmation.
Question 2 of 50
A 28-year-old G1P0 at 36 weeks gestation reports a severe headache and right upper
quadrant pain for 6 hours. Blood pressure is 158/102 mmHg, urine dipstick shows 2+
protein, and deep tendon reflexes are 2+ without clonus. The fetal heart tracing is
reactive.
A. Gestational hypertension requiring home blood pressure monitoring
B. Chronic hypertension that has worsened in the third trimester
C. Preeclampsia without severe features managed expectantly until 37 weeks
D. Preeclampsia with severe features requiring delivery planning ✓ CORRECT
Correct Answer: D
Rationale: Headache, right upper quadrant pain, blood pressure of 158/102, and
proteinuria 2+ meet criteria for preeclampsia with severe features, which necessitates
delivery regardless of gestational age once maternal stabilization is achieved.
Gestational hypertension lacks proteinuria and severe features, and expectant
management is unsafe with these symptoms due to the risk of eclampsia and HELLP
syndrome. Magnesium sulfate for seizure prophylaxis should also be initiated.
Question 3 of 50
A 24-year-old G1P0 at 38 weeks gestation arrives in labor and delivery with contractions
every 3 minutes. Cervical exam reveals 5 cm dilation. Her membranes ruptured 1 hour
ago. Group B strep culture at 36 weeks was positive, and she has no penicillin allergy.
A. Administer intravenous penicillin G now ✓ CORRECT
B. Wait until delivery is imminent to give a single dose of antibiotics
C. Offer oral amoxicillin to take at home after discharge
,D. Give cefazolin because it provides broader coverage than penicillin
Correct Answer: A
Rationale: GBS prophylaxis should be initiated at the onset of labor or rupture of
membranes for colonized patients, with penicillin G as the first-line agent. Delaying
antibiotics until delivery misses the window for effective intrapartum prophylaxis, and
oral antibiotics are insufficient for intrapartum coverage. Cefazolin is an alternative for
penicillin-allergic patients without anaphylaxis risk, not a broader-spectrum
replacement.
Question 4 of 50
A 19-year-old G1P0 at 16 weeks gestation presents for a prenatal visit. Fundal height is
20 cm. Fetal heart tones are not audible with handheld Doppler after 5 minutes of
searching. The patient reports feeling recent fetal movement.
A. Reassure the patient that Doppler cannot detect heart tones until 20 weeks
B. Schedule a return visit in 2 weeks to reassess with Doppler
C. Perform a bedside ultrasound to confirm viability and assess gestational age ✓
CORRECT
D. Prepare the patient for a missed abortion and discuss dilation and evacuation
Correct Answer: C
Rationale: Fetal heart tones are typically audible by Doppler at 10 to 12 weeks, so
inability to detect them at 16 weeks with a fundal height of 20 cm warrants immediate
ultrasound to confirm viability, placental location, and dating. Assuming missed
abortion without imaging is premature, and delaying evaluation could miss conditions
like placenta previa or fetal demise that require immediate management. Bedside
ultrasound provides rapid diagnostic clarity.
Question 5 of 50
, A 30-year-old G2P1 at 24 weeks has a routine CBC drawn. Hemoglobin is 10.2 g/dL,
MCV 78 fL, and ferritin 15 ng/mL. She reports increased fatigue but no pica.
A. Start intravenous iron supplementation because oral iron is poorly absorbed in
pregnancy
B. Begin oral ferrous sulfate 325 mg daily with vitamin C and recheck in 4 weeks ✓
CORRECT
C. Recommend blood transfusion because hemoglobin below 11 is dangerous for the
fetus
D. Reassure her that this is physiological anemia and requires no intervention
Correct Answer: B
Rationale: Iron deficiency anemia in pregnancy is defined by low hemoglobin with
microcytic indices and low ferritin, and first-line management is oral iron
supplementation with follow-up monitoring. Intravenous iron is reserved for
malabsorption or intolerance, transfusion is unnecessary at this hemoglobin level
without symptoms of decompensation, and physiological anemia typically presents
with normocytic indices rather than microcytosis. Treatment improves maternal energy
and fetal iron stores.
Question 6 of 50
A 26-year-old G1P0 at 10 weeks gestation presents with persistent vomiting for 3
weeks. She has lost 8 pounds, has ketonuria, and shows dry mucous membranes. Vital
signs are stable.
A. Recommend small frequent meals and ginger supplements for morning sickness
B. Prescribe doxylamine-pyridoxine and schedule a follow-up in 2 weeks
C. Advise increased fluid intake and observation because vomiting is normal in early
pregnancy
D. Admit for intravenous hydration, antiemetics, and thiamine supplementation ✓
CORRECT
Correct Answer: D
