ESTUDYR
NRNP 6552 WEEK 6 MIDTERM NEWEST VERSION
Maternal–Newborn & Pediatrics
1. Sheila is pregnant and fearful of getting cervical cancer. She asks about the HPV vaccine. How
do you respond?
A. “As long as you’re in your first trimester, the HPV vaccine is safe and effective.”
B. “Research has not shown this vaccine to be effective against preventing cervical cancer.”
C. “After the age of 20, the HPV vaccine is not recommended.”
D. “You should not receive the vaccination when you are pregnant.”
Rationale: Live or recombinant vaccines like HPV are contraindicated in pregnancy.
2. To reduce recurrence of neural-tube defects, Jack & Jill should be counseled that Jill take:
A. 60 mg/day of iron
B. Nothing—it’s purely genetic
C. CVS at 12–14 weeks
D. 4 mg/day of folic acid, beginning before conception
Rationale: High-dose folic acid preconception reduces NTD risk.
3. Regarding “no-nit” policies for head lice in schools, you share that:
A. Exclusion until all nits removed is essential
B. AAP & NASN discourage excluding children for nits alone
C. Occlusive petroleum/herbal suffocation shows best RCT results
D. Lindane is AAP’s recommended first choice
Rationale: Exclusion harms attendance; treatment without exclusion is advised.
4. Simplest, safest method to suppress lactation once established?
A. Hormonal injections
B. Breast binders
C. Gradual weaning to bottle/cup over 3 weeks
D. “Cold‐turkey” stopping
Rationale: Slow weaning minimizes engorgement and mastitis.
5. With a conventional fetoscope, fetal heart tones are heard at:
A. 7–8 weeks
B. 10–12 weeks
C. 18–20 weeks
D. > 20 weeks
Rationale: Leopold maneuvers/fetoscope pick up FHT starting ~18–20 weeks.
6. Top reason women stop breastfeeding before 8 weeks postpartum:
A. Return to work/school
B. Perceived insufficient milk supply
,ESTUDYR
C. Convenience of formula
D. Maternal/infant illness
Rationale: Maternal confidence about supply is the main barrier.
7. To prescribe OxyContin in pediatric patients (Oxycodone ≥ 20 mg/day), a child must be:
A. 5–16 years
B. 11–16 years
C. 8–16 years
D. > 10 years
Rationale: FDA label limits new pediatric use to ages 11–16 on prior opioid tolerance.
8. Hegar’s sign in pregnancy is:
A. Cervical blueness
B. Softening of uterine isthmus & ballottement
C. Cervical softness only
D. Quickening
Rationale: Hegar’s sign = softening of lower uterine segment.
9. Irish-descent Carrie with menorrhagia & normal PT/aPTT likely has:
A. von Willebrand disease
B. Hemophilia
C. Sickle cell anemia
D. Beta thalassemia
Rationale: vWD presents with mucocutaneous bleeding despite normal PT/aPTT.
10. Koplik spots inside the cheeks are pathognomonic for:
A. Measles
B. Varicella
C. Fifth disease
D. Rheumatic fever
Rationale: Early measles produces Koplik spots.
11. At 29 weeks after blunt abdominal trauma, you monitor for:
A. Abruptio placentae
B. Liver hemorrhage
C. Ruptured spleen
D. Placenta previa
Rationale: Trauma increases placental abruption risk.
12. Best method to identify growth problems/idiopathic short stature is:
A. Single measurement
B. Dysmorphic facial features
C. Auxologic evaluation vs. standardized norms
, ESTUDYR
D. Supine measurement on paper
Rationale: Serial growth plotted on growth charts reveals deviation.
13. To assess adequate intake in a breastfed neonate, look for:
A. Daily weight gain in ounces
B. Infant drinking + sleeping normally
C. 6–10 wet diapers/day
D. No irritability
Rationale: 6–10 wet diapers indicate sufficient fluid intake.
14. Cerclage for incompetent cervix is:
A. Bedrest + pelvic exams
B. Diaphragm-like device
C. Purse-string stitch around cervix
D. Intravaginal medicated sponge
Rationale: Cervical cerclage reinforces the cervix mechanically.
15. Pinworm treatment with pyrantel pamoate requires treating:
A. Randy + siblings only
B. Randy + siblings sharing bathroom
C. Randy + siblings sharing bedroom
D. Entire household
Rationale: High transmissibility warrants whole-family treatment.
16. Vigorous exercise postpartum may resume in:
A. 1 week
B. 3 weeks
C. 6 weeks
D. 8 weeks
Rationale: By 3 weeks most women with uncomplicated births can gentle return.
17. An innocent murmur becomes suspicious if:
A. Grade I–II/VI
B. Changes with position
C. Musical quality
D. Diastolic timing
Rationale: Diastolic murmurs in children suggest pathology.
18. To meet prenatal calcium needs, a woman should drink:
A. 1 quart of cow’s milk
B. 2 cups yogurt
C. 4 slices cheese
D. 1 cup cottage cheese
Rationale: 1 qt milk = ~1,200 mg Ca ≈ RDA in pregnancy.
NRNP 6552 WEEK 6 MIDTERM NEWEST VERSION
Maternal–Newborn & Pediatrics
1. Sheila is pregnant and fearful of getting cervical cancer. She asks about the HPV vaccine. How
do you respond?
A. “As long as you’re in your first trimester, the HPV vaccine is safe and effective.”
B. “Research has not shown this vaccine to be effective against preventing cervical cancer.”
C. “After the age of 20, the HPV vaccine is not recommended.”
D. “You should not receive the vaccination when you are pregnant.”
Rationale: Live or recombinant vaccines like HPV are contraindicated in pregnancy.
2. To reduce recurrence of neural-tube defects, Jack & Jill should be counseled that Jill take:
A. 60 mg/day of iron
B. Nothing—it’s purely genetic
C. CVS at 12–14 weeks
D. 4 mg/day of folic acid, beginning before conception
Rationale: High-dose folic acid preconception reduces NTD risk.
3. Regarding “no-nit” policies for head lice in schools, you share that:
A. Exclusion until all nits removed is essential
B. AAP & NASN discourage excluding children for nits alone
C. Occlusive petroleum/herbal suffocation shows best RCT results
D. Lindane is AAP’s recommended first choice
Rationale: Exclusion harms attendance; treatment without exclusion is advised.
4. Simplest, safest method to suppress lactation once established?
A. Hormonal injections
B. Breast binders
C. Gradual weaning to bottle/cup over 3 weeks
D. “Cold‐turkey” stopping
Rationale: Slow weaning minimizes engorgement and mastitis.
5. With a conventional fetoscope, fetal heart tones are heard at:
A. 7–8 weeks
B. 10–12 weeks
C. 18–20 weeks
D. > 20 weeks
Rationale: Leopold maneuvers/fetoscope pick up FHT starting ~18–20 weeks.
6. Top reason women stop breastfeeding before 8 weeks postpartum:
A. Return to work/school
B. Perceived insufficient milk supply
,ESTUDYR
C. Convenience of formula
D. Maternal/infant illness
Rationale: Maternal confidence about supply is the main barrier.
7. To prescribe OxyContin in pediatric patients (Oxycodone ≥ 20 mg/day), a child must be:
A. 5–16 years
B. 11–16 years
C. 8–16 years
D. > 10 years
Rationale: FDA label limits new pediatric use to ages 11–16 on prior opioid tolerance.
8. Hegar’s sign in pregnancy is:
A. Cervical blueness
B. Softening of uterine isthmus & ballottement
C. Cervical softness only
D. Quickening
Rationale: Hegar’s sign = softening of lower uterine segment.
9. Irish-descent Carrie with menorrhagia & normal PT/aPTT likely has:
A. von Willebrand disease
B. Hemophilia
C. Sickle cell anemia
D. Beta thalassemia
Rationale: vWD presents with mucocutaneous bleeding despite normal PT/aPTT.
10. Koplik spots inside the cheeks are pathognomonic for:
A. Measles
B. Varicella
C. Fifth disease
D. Rheumatic fever
Rationale: Early measles produces Koplik spots.
11. At 29 weeks after blunt abdominal trauma, you monitor for:
A. Abruptio placentae
B. Liver hemorrhage
C. Ruptured spleen
D. Placenta previa
Rationale: Trauma increases placental abruption risk.
12. Best method to identify growth problems/idiopathic short stature is:
A. Single measurement
B. Dysmorphic facial features
C. Auxologic evaluation vs. standardized norms
, ESTUDYR
D. Supine measurement on paper
Rationale: Serial growth plotted on growth charts reveals deviation.
13. To assess adequate intake in a breastfed neonate, look for:
A. Daily weight gain in ounces
B. Infant drinking + sleeping normally
C. 6–10 wet diapers/day
D. No irritability
Rationale: 6–10 wet diapers indicate sufficient fluid intake.
14. Cerclage for incompetent cervix is:
A. Bedrest + pelvic exams
B. Diaphragm-like device
C. Purse-string stitch around cervix
D. Intravaginal medicated sponge
Rationale: Cervical cerclage reinforces the cervix mechanically.
15. Pinworm treatment with pyrantel pamoate requires treating:
A. Randy + siblings only
B. Randy + siblings sharing bathroom
C. Randy + siblings sharing bedroom
D. Entire household
Rationale: High transmissibility warrants whole-family treatment.
16. Vigorous exercise postpartum may resume in:
A. 1 week
B. 3 weeks
C. 6 weeks
D. 8 weeks
Rationale: By 3 weeks most women with uncomplicated births can gentle return.
17. An innocent murmur becomes suspicious if:
A. Grade I–II/VI
B. Changes with position
C. Musical quality
D. Diastolic timing
Rationale: Diastolic murmurs in children suggest pathology.
18. To meet prenatal calcium needs, a woman should drink:
A. 1 quart of cow’s milk
B. 2 cups yogurt
C. 4 slices cheese
D. 1 cup cottage cheese
Rationale: 1 qt milk = ~1,200 mg Ca ≈ RDA in pregnancy.
