NR325 Family Nursing Care
Final Exam with 150 NCLEX-Style Practice Questions with Answers & Rationales
Has questions covering typical Maternal-Newborn & Pediatric nursing content areas (antepartum, high-risk
pregnancy, intrapartum, postpartum, newborn care, growth & development, pediatric respiratory, cardiac, GI,
infectious disease, neuro/musculoskeletal, endocrine/heme/genetic, safety & family-centered care, women's health,
and pediatric oncology/GU).
Contents
1.Antepartum Care (Questions 1–10)
2.High-Risk Pregnancy Complications (Questions 11–20)
3.Intrapartum Care (Questions 21–30)
4.Postpartum Care (Questions 31–40)
5.Newborn Care (Questions 41–50)
6.Growth & Development (Questions 51–60)
7.Pediatric Respiratory (Questions 61–70)
8.Pediatric Cardiac & Congenital Disorders (Questions 71–80)
9.Pediatric GI, Fluid & Nutrition (Questions 81–90)
10.Pediatric Infectious Disease & Immunizations (Questions 91–100)
11.Pediatric Neuro & Musculoskeletal (Questions 101–110)
12.Pediatric Endocrine, Hematology & Genetic Disorders (Questions 111–120)
13.Pediatric Safety, Medication Administration & Family-Centered Care (Questions 121–130)
14.Women's Health & Family Planning (Questions 131–140)
15.Pediatric Pain, Genitourinary & Oncology (Questions 141–150)
,Antepartum Care
1. Using Naegele's rule, if a client's LMP was June 10, what is the estimated due date?
A. March 3
B. March 17
C. April 17
D. May 10
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months, add 7 days, adjust year. June 10 → March 17.
2. Which finding at a prenatal visit requires immediate follow-up?
A. Mild ankle edema at end of day
B. BP 150/98 with new proteinuria
C. Fetal heart rate 140
D. Weight gain of 1 lb this week
Correct Answer: B
Rationale: Hypertension with proteinuria after 20 weeks indicates preeclampsia, requiring prompt evaluation.
3. A pregnant client is Rh-negative and her partner is Rh-positive. Rhogam is administered to:
A. Treat active Rh sensitization
B. Prevent maternal antibody formation against fetal Rh-positive blood
C. Cure fetal anemia
D. Increase maternal iron levels
Correct Answer: B
Rationale: RhoGAM is prophylactic, preventing maternal sensitization to Rh-positive fetal blood.
4. Which is a priority teaching point for a pregnant client regarding nutrition?
A. Avoid all seafood entirely
B. Increase folic acid intake to prevent neural tube defects
C. Limit protein intake
D. Restrict fluid intake
Correct Answer: B
Rationale: Folic acid supplementation reduces the risk of neural tube defects, ideally started pre-conception.
5. A client at 28 weeks gestation has a 1-hour glucose challenge test result of 155 mg/dL. Nurse anticipates:
A. No further testing needed
B. A 3-hour glucose tolerance test
C. Immediate insulin therapy
D. Delivery within 24 hours
Correct Answer: B
Rationale: An elevated 1-hour GCT (>140) requires a follow-up 3-hour GTT to diagnose gestational diabetes.
6. Which danger sign should a pregnant client be taught to report immediately?
A. Increased vaginal discharge, non-odorous
B. Vaginal bleeding, severe headache, or visual changes
C. Round ligament pain
D. Braxton Hicks contractions
Correct Answer: B
Rationale: Bleeding, severe headache, and visual disturbances can indicate placental abruption or preeclampsia
— emergencies.
7. A client at 32 weeks gestation is diagnosed with placenta previa. Priority nursing action?
A. Perform a vaginal exam to assess cervical dilation
B. Avoid vaginal exams; monitor for bleeding and fetal status
C. Encourage ambulation and pelvic exams weekly
D. Administer oxytocin to induce labor
, Correct Answer: B
Rationale: Vaginal exams are contraindicated with placenta previa due to hemorrhage risk; monitor bleeding
and fetal wellbeing.
8. Which client teaching is correct regarding fetal movement (kick counts)?
A. Fewer than 3 movements in 1 hour is normal and requires no action
B. Report significantly decreased fetal movement to the provider promptly
C. Kick counts are unnecessary after 20 weeks
D. Movement should decrease steadily throughout pregnancy
Correct Answer: B
Rationale: Decreased fetal movement can indicate compromise and should be reported for further evaluation
(e.g., NST).
9. A client with a history of preterm labor is prescribed progesterone therapy. The purpose is to:
A. Induce labor
B. Reduce the risk of recurrent preterm birth
C. Treat gestational diabetes
D. Lower blood pressure
Correct Answer: B
Rationale: Progesterone supplementation can help reduce the risk of recurrent preterm birth in high-risk clients.
10. Which finding on a non-stress test (NST) is reassuring?
A. Reactive: 2 or more accelerations of FHR in 20 minutes
B. Nonreactive with no accelerations
C. Late decelerations present
D. Absent variability
Correct Answer: A
Rationale: A reactive NST (accelerations with fetal movement) indicates fetal wellbeing.
, High-Risk Pregnancy Complications
11. A client with severe preeclampsia is receiving magnesium sulfate. Priority assessment before each dose?
A. Deep tendon reflexes, respiratory rate, urine output
B. Blood glucose only
C. Fundal height
D. Fetal position
Correct Answer: A
Rationale: Magnesium toxicity causes decreased DTRs, respiratory depression, and decreased urine output;
these must be assessed before each dose.
12. The antidote for magnesium sulfate toxicity is:
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Correct Answer: B
Rationale: Calcium gluconate reverses magnesium sulfate toxicity.
13. A client with suspected placental abruption presents with sudden, severe abdominal pain and a rigid,
board-like abdomen. Priority nursing action?
A. Prepare for immediate delivery and continuous fetal monitoring
B. Encourage ambulation
C. Delay intervention until bleeding is visible externally
D. Perform a vaginal exam immediately
Correct Answer: A
Rationale: Abruption is an obstetric emergency; concealed hemorrhage can occur, requiring urgent intervention
and monitoring.
14. Which client is at greatest risk for gestational diabetes?
A. BMI 20, no family history
B. BMI 35, family history of type 2 diabetes
C. First pregnancy, age 22
D. Previous vaginal delivery, no complications
Correct Answer: B
Rationale: Obesity and family history of diabetes are major risk factors for gestational diabetes.
15. A client with hyperemesis gravidarum is admitted for severe dehydration. Priority nursing intervention?
A. Encourage large meals frequently
B. IV fluid replacement and antiemetics
C. Restrict all oral intake permanently
D. Encourage high-fat foods
Correct Answer: B
Rationale: IV fluids correct dehydration/electrolyte imbalance; antiemetics control vomiting.
16. Which is an expected finding with an ectopic pregnancy?
A. Painless, bright red bleeding in third trimester
B. Unilateral abdominal pain with possible referred shoulder pain
C. Normal beta-hCG rise
D. No symptoms until term
Correct Answer: B
Rationale: Ectopic pregnancy classically presents with unilateral pain, possible referred shoulder pain (from
bleeding irritating the diaphragm), and abnormal hCG rise.
17. A client with a hydatidiform mole (molar pregnancy) should be monitored for:
A. Normal fetal heart tones
Final Exam with 150 NCLEX-Style Practice Questions with Answers & Rationales
Has questions covering typical Maternal-Newborn & Pediatric nursing content areas (antepartum, high-risk
pregnancy, intrapartum, postpartum, newborn care, growth & development, pediatric respiratory, cardiac, GI,
infectious disease, neuro/musculoskeletal, endocrine/heme/genetic, safety & family-centered care, women's health,
and pediatric oncology/GU).
Contents
1.Antepartum Care (Questions 1–10)
2.High-Risk Pregnancy Complications (Questions 11–20)
3.Intrapartum Care (Questions 21–30)
4.Postpartum Care (Questions 31–40)
5.Newborn Care (Questions 41–50)
6.Growth & Development (Questions 51–60)
7.Pediatric Respiratory (Questions 61–70)
8.Pediatric Cardiac & Congenital Disorders (Questions 71–80)
9.Pediatric GI, Fluid & Nutrition (Questions 81–90)
10.Pediatric Infectious Disease & Immunizations (Questions 91–100)
11.Pediatric Neuro & Musculoskeletal (Questions 101–110)
12.Pediatric Endocrine, Hematology & Genetic Disorders (Questions 111–120)
13.Pediatric Safety, Medication Administration & Family-Centered Care (Questions 121–130)
14.Women's Health & Family Planning (Questions 131–140)
15.Pediatric Pain, Genitourinary & Oncology (Questions 141–150)
,Antepartum Care
1. Using Naegele's rule, if a client's LMP was June 10, what is the estimated due date?
A. March 3
B. March 17
C. April 17
D. May 10
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months, add 7 days, adjust year. June 10 → March 17.
2. Which finding at a prenatal visit requires immediate follow-up?
A. Mild ankle edema at end of day
B. BP 150/98 with new proteinuria
C. Fetal heart rate 140
D. Weight gain of 1 lb this week
Correct Answer: B
Rationale: Hypertension with proteinuria after 20 weeks indicates preeclampsia, requiring prompt evaluation.
3. A pregnant client is Rh-negative and her partner is Rh-positive. Rhogam is administered to:
A. Treat active Rh sensitization
B. Prevent maternal antibody formation against fetal Rh-positive blood
C. Cure fetal anemia
D. Increase maternal iron levels
Correct Answer: B
Rationale: RhoGAM is prophylactic, preventing maternal sensitization to Rh-positive fetal blood.
4. Which is a priority teaching point for a pregnant client regarding nutrition?
A. Avoid all seafood entirely
B. Increase folic acid intake to prevent neural tube defects
C. Limit protein intake
D. Restrict fluid intake
Correct Answer: B
Rationale: Folic acid supplementation reduces the risk of neural tube defects, ideally started pre-conception.
5. A client at 28 weeks gestation has a 1-hour glucose challenge test result of 155 mg/dL. Nurse anticipates:
A. No further testing needed
B. A 3-hour glucose tolerance test
C. Immediate insulin therapy
D. Delivery within 24 hours
Correct Answer: B
Rationale: An elevated 1-hour GCT (>140) requires a follow-up 3-hour GTT to diagnose gestational diabetes.
6. Which danger sign should a pregnant client be taught to report immediately?
A. Increased vaginal discharge, non-odorous
B. Vaginal bleeding, severe headache, or visual changes
C. Round ligament pain
D. Braxton Hicks contractions
Correct Answer: B
Rationale: Bleeding, severe headache, and visual disturbances can indicate placental abruption or preeclampsia
— emergencies.
7. A client at 32 weeks gestation is diagnosed with placenta previa. Priority nursing action?
A. Perform a vaginal exam to assess cervical dilation
B. Avoid vaginal exams; monitor for bleeding and fetal status
C. Encourage ambulation and pelvic exams weekly
D. Administer oxytocin to induce labor
, Correct Answer: B
Rationale: Vaginal exams are contraindicated with placenta previa due to hemorrhage risk; monitor bleeding
and fetal wellbeing.
8. Which client teaching is correct regarding fetal movement (kick counts)?
A. Fewer than 3 movements in 1 hour is normal and requires no action
B. Report significantly decreased fetal movement to the provider promptly
C. Kick counts are unnecessary after 20 weeks
D. Movement should decrease steadily throughout pregnancy
Correct Answer: B
Rationale: Decreased fetal movement can indicate compromise and should be reported for further evaluation
(e.g., NST).
9. A client with a history of preterm labor is prescribed progesterone therapy. The purpose is to:
A. Induce labor
B. Reduce the risk of recurrent preterm birth
C. Treat gestational diabetes
D. Lower blood pressure
Correct Answer: B
Rationale: Progesterone supplementation can help reduce the risk of recurrent preterm birth in high-risk clients.
10. Which finding on a non-stress test (NST) is reassuring?
A. Reactive: 2 or more accelerations of FHR in 20 minutes
B. Nonreactive with no accelerations
C. Late decelerations present
D. Absent variability
Correct Answer: A
Rationale: A reactive NST (accelerations with fetal movement) indicates fetal wellbeing.
, High-Risk Pregnancy Complications
11. A client with severe preeclampsia is receiving magnesium sulfate. Priority assessment before each dose?
A. Deep tendon reflexes, respiratory rate, urine output
B. Blood glucose only
C. Fundal height
D. Fetal position
Correct Answer: A
Rationale: Magnesium toxicity causes decreased DTRs, respiratory depression, and decreased urine output;
these must be assessed before each dose.
12. The antidote for magnesium sulfate toxicity is:
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Correct Answer: B
Rationale: Calcium gluconate reverses magnesium sulfate toxicity.
13. A client with suspected placental abruption presents with sudden, severe abdominal pain and a rigid,
board-like abdomen. Priority nursing action?
A. Prepare for immediate delivery and continuous fetal monitoring
B. Encourage ambulation
C. Delay intervention until bleeding is visible externally
D. Perform a vaginal exam immediately
Correct Answer: A
Rationale: Abruption is an obstetric emergency; concealed hemorrhage can occur, requiring urgent intervention
and monitoring.
14. Which client is at greatest risk for gestational diabetes?
A. BMI 20, no family history
B. BMI 35, family history of type 2 diabetes
C. First pregnancy, age 22
D. Previous vaginal delivery, no complications
Correct Answer: B
Rationale: Obesity and family history of diabetes are major risk factors for gestational diabetes.
15. A client with hyperemesis gravidarum is admitted for severe dehydration. Priority nursing intervention?
A. Encourage large meals frequently
B. IV fluid replacement and antiemetics
C. Restrict all oral intake permanently
D. Encourage high-fat foods
Correct Answer: B
Rationale: IV fluids correct dehydration/electrolyte imbalance; antiemetics control vomiting.
16. Which is an expected finding with an ectopic pregnancy?
A. Painless, bright red bleeding in third trimester
B. Unilateral abdominal pain with possible referred shoulder pain
C. Normal beta-hCG rise
D. No symptoms until term
Correct Answer: B
Rationale: Ectopic pregnancy classically presents with unilateral pain, possible referred shoulder pain (from
bleeding irritating the diaphragm), and abnormal hCG rise.
17. A client with a hydatidiform mole (molar pregnancy) should be monitored for:
A. Normal fetal heart tones
