Hondros 166 Final Exam: Concepts of Family-Centered Nursing
for the Practical Nurse Actual Exam 2026/2027: Complete
Exam-Style Questions with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Total questions: 100 multiple-choice, single best answer
Recommended time: 2 hours 15 minutes (135 minutes) – typical time allotment
Difficulty distribution: Easy (20%), Moderate (65%), Difficult (15%)
Passing threshold: 80% (80 correct) – mirroring Hondros NUR 166 course requirement
Exam Questions (numbered 1–100)
1. A 28-year-old woman at her first prenatal visit states her last menstrual period began
on March 10. Using Naegele's rule, the practical nurse calculates the estimated date of
delivery as:
A. November 17
B. December 17 ✓ CORRECT
C. January 17
D. February 17
Correct answer: B
Rationale: Naegele's rule states: first day of LMP, add 7 days, subtract 3 months, add 1
year. March 10 + 7 days = March 17; subtract 3 months = December 17. Option A
incorrectly adds 8 months instead of subtracting 3 months. Option C adds 10 months.
Option D adds 11 months. This calculation is fundamental for establishing gestational
age and scheduling prenatal care.
2. A practical nurse is caring for a postpartum patient on day 2 after vaginal delivery.
The patient asks why her vaginal discharge is still red and heavy. The nurse explains
that this type of lochia is called:
A. Lochia alba
,B. Lochia serosa
C. Lochia rubra ✓ CORRECT
D. Lochia purulenta
Correct answer: C
Rationale: Lochia rubra is red, bloody discharge present during the first 3 days
postpartum. Option A (lochia alba) is white/yellow and appears after day 10. Option B
(lochia serosa) is pinkish-brown and occurs days 4–10. Option D is not a recognized
lochia stage. Accurate lochia assessment is critical for detecting postpartum
hemorrhage and infection.
3. A practical nurse is assessing a newborn at 1 minute after birth. The infant is pink
with blue extremities, has a heart rate of 110 bpm, cries weakly, pulls away when
suctioned, and has some flexion of extremities. What is the APGAR score?
A. 5
B. 6
C. 7 ✓ CORRECT
D. 8
Correct answer: C
Rationale: Appearance (pink with blue extremities = 1), Pulse (110 bpm = 2), Grimace
(pulls away = 2), Activity (some flexion = 1), Respiration (weak cry = 1). Total = 7. Option
A incorrectly scores respiration as 0. Option B incorrectly scores appearance as 0.
Option D incorrectly scores activity as 2. APGAR scoring is performed at 1 and 5
minutes to assess newborn transition.
4. A 16-year-old pregnant patient at 24 weeks gestation tells the practical nurse she has
been smoking half a pack of cigarettes daily. The nurse recognizes that smoking during
pregnancy increases the risk of:
A. Macrosomia
B. Preterm birth and low birth weight ✓ CORRECT
,C. Polyhydramnios
D. Post-term pregnancy
Correct answer: B
Rationale: Maternal smoking is a major risk factor for preterm birth, low birth weight,
placental abruption, and intrauterine growth restriction due to vasoconstriction and
reduced oxygen delivery. Option A (macrosomia) is associated with maternal diabetes.
Option C (polyhydramnios) is not associated with smoking. Option D (post-term) is not a
smoking-related risk. Smoking cessation counseling is a key nursing intervention.
5. A practical nurse is teaching a new mother about umbilical cord care. Which
instruction is most appropriate?
A. Apply alcohol to the cord stump with every diaper change
B. Clean the base with water, keep it dry, and fold the diaper below the stump ✓
CORRECT
C. Cover the stump with a bandage to prevent infection
D. Bathe the baby in a tub until the cord falls off
Correct answer: B
Rationale: Current evidence supports cleaning the umbilical cord base with water,
keeping it dry, and exposing it to air; the diaper should be folded below to prevent
irritation. Option A is outdated practice. Option C traps moisture and delays healing.
Option D increases infection risk. The cord typically falls off within 10–14 days.
6. A practical nurse is caring for a postpartum patient whose fundus is at the level of
the umbilicus and firm 2 hours after delivery. The nurse recognizes this finding as:
A. Abnormal; the fundus should be below the umbilicus by now
B. Normal; the fundus remains at the umbilicus for the first 24 hours ✓ CORRECT
C. Abnormal; the fundus should be above the umbilicus
D. Normal; the fundus rises to the xiphoid process immediately postpartum
Correct answer: B
, Rationale: The fundus remains at the level of the umbilicus for approximately the first 24
hours postpartum, then descends approximately 1 cm per day. Option A incorrectly
states it should be below. Option C is physiologically incorrect. Option D describes an
abnormal condition (uterine inversion or atony). Fundal assessment is critical for
detecting hemorrhage.
7. A practical nurse is assessing a 6-month-old infant during a well-child visit. The
mother reports the infant can sit with support, reaches for toys, and babbles. The nurse
recognizes these milestones as:
A. Delayed; the infant should be sitting independently
B. Normal for a 6-month-old infant ✓ CORRECT
C. Advanced; these are 9-month milestones
D. Concerning; the infant should be crawling
Correct answer: B
Rationale: At 6 months, infants typically sit with support, reach for objects, and babble
consonant sounds. Independent sitting usually occurs by 7–8 months, and crawling by
8–10 months. Option A is incorrect because independent sitting is not expected at 6
months. Option C is incorrect because these are not 9-month milestones. Option D is
incorrect because crawling is a later milestone.
8. A practical nurse is caring for a newborn whose mother is Rh-negative and whose
father is Rh-positive. The infant's blood type is determined to be Rh-positive. The nurse
anticipates that the mother will receive:
A. Rhogam within 72 hours of delivery ✓ CORRECT
B. Rhogam at the 6-week postpartum visit
C. No Rhogam because she already received it at 28 weeks
D. A blood transfusion
Correct answer: A
for the Practical Nurse Actual Exam 2026/2027: Complete
Exam-Style Questions with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Total questions: 100 multiple-choice, single best answer
Recommended time: 2 hours 15 minutes (135 minutes) – typical time allotment
Difficulty distribution: Easy (20%), Moderate (65%), Difficult (15%)
Passing threshold: 80% (80 correct) – mirroring Hondros NUR 166 course requirement
Exam Questions (numbered 1–100)
1. A 28-year-old woman at her first prenatal visit states her last menstrual period began
on March 10. Using Naegele's rule, the practical nurse calculates the estimated date of
delivery as:
A. November 17
B. December 17 ✓ CORRECT
C. January 17
D. February 17
Correct answer: B
Rationale: Naegele's rule states: first day of LMP, add 7 days, subtract 3 months, add 1
year. March 10 + 7 days = March 17; subtract 3 months = December 17. Option A
incorrectly adds 8 months instead of subtracting 3 months. Option C adds 10 months.
Option D adds 11 months. This calculation is fundamental for establishing gestational
age and scheduling prenatal care.
2. A practical nurse is caring for a postpartum patient on day 2 after vaginal delivery.
The patient asks why her vaginal discharge is still red and heavy. The nurse explains
that this type of lochia is called:
A. Lochia alba
,B. Lochia serosa
C. Lochia rubra ✓ CORRECT
D. Lochia purulenta
Correct answer: C
Rationale: Lochia rubra is red, bloody discharge present during the first 3 days
postpartum. Option A (lochia alba) is white/yellow and appears after day 10. Option B
(lochia serosa) is pinkish-brown and occurs days 4–10. Option D is not a recognized
lochia stage. Accurate lochia assessment is critical for detecting postpartum
hemorrhage and infection.
3. A practical nurse is assessing a newborn at 1 minute after birth. The infant is pink
with blue extremities, has a heart rate of 110 bpm, cries weakly, pulls away when
suctioned, and has some flexion of extremities. What is the APGAR score?
A. 5
B. 6
C. 7 ✓ CORRECT
D. 8
Correct answer: C
Rationale: Appearance (pink with blue extremities = 1), Pulse (110 bpm = 2), Grimace
(pulls away = 2), Activity (some flexion = 1), Respiration (weak cry = 1). Total = 7. Option
A incorrectly scores respiration as 0. Option B incorrectly scores appearance as 0.
Option D incorrectly scores activity as 2. APGAR scoring is performed at 1 and 5
minutes to assess newborn transition.
4. A 16-year-old pregnant patient at 24 weeks gestation tells the practical nurse she has
been smoking half a pack of cigarettes daily. The nurse recognizes that smoking during
pregnancy increases the risk of:
A. Macrosomia
B. Preterm birth and low birth weight ✓ CORRECT
,C. Polyhydramnios
D. Post-term pregnancy
Correct answer: B
Rationale: Maternal smoking is a major risk factor for preterm birth, low birth weight,
placental abruption, and intrauterine growth restriction due to vasoconstriction and
reduced oxygen delivery. Option A (macrosomia) is associated with maternal diabetes.
Option C (polyhydramnios) is not associated with smoking. Option D (post-term) is not a
smoking-related risk. Smoking cessation counseling is a key nursing intervention.
5. A practical nurse is teaching a new mother about umbilical cord care. Which
instruction is most appropriate?
A. Apply alcohol to the cord stump with every diaper change
B. Clean the base with water, keep it dry, and fold the diaper below the stump ✓
CORRECT
C. Cover the stump with a bandage to prevent infection
D. Bathe the baby in a tub until the cord falls off
Correct answer: B
Rationale: Current evidence supports cleaning the umbilical cord base with water,
keeping it dry, and exposing it to air; the diaper should be folded below to prevent
irritation. Option A is outdated practice. Option C traps moisture and delays healing.
Option D increases infection risk. The cord typically falls off within 10–14 days.
6. A practical nurse is caring for a postpartum patient whose fundus is at the level of
the umbilicus and firm 2 hours after delivery. The nurse recognizes this finding as:
A. Abnormal; the fundus should be below the umbilicus by now
B. Normal; the fundus remains at the umbilicus for the first 24 hours ✓ CORRECT
C. Abnormal; the fundus should be above the umbilicus
D. Normal; the fundus rises to the xiphoid process immediately postpartum
Correct answer: B
, Rationale: The fundus remains at the level of the umbilicus for approximately the first 24
hours postpartum, then descends approximately 1 cm per day. Option A incorrectly
states it should be below. Option C is physiologically incorrect. Option D describes an
abnormal condition (uterine inversion or atony). Fundal assessment is critical for
detecting hemorrhage.
7. A practical nurse is assessing a 6-month-old infant during a well-child visit. The
mother reports the infant can sit with support, reaches for toys, and babbles. The nurse
recognizes these milestones as:
A. Delayed; the infant should be sitting independently
B. Normal for a 6-month-old infant ✓ CORRECT
C. Advanced; these are 9-month milestones
D. Concerning; the infant should be crawling
Correct answer: B
Rationale: At 6 months, infants typically sit with support, reach for objects, and babble
consonant sounds. Independent sitting usually occurs by 7–8 months, and crawling by
8–10 months. Option A is incorrect because independent sitting is not expected at 6
months. Option C is incorrect because these are not 9-month milestones. Option D is
incorrect because crawling is a later milestone.
8. A practical nurse is caring for a newborn whose mother is Rh-negative and whose
father is Rh-positive. The infant's blood type is determined to be Rh-positive. The nurse
anticipates that the mother will receive:
A. Rhogam within 72 hours of delivery ✓ CORRECT
B. Rhogam at the 6-week postpartum visit
C. No Rhogam because she already received it at 28 weeks
D. A blood transfusion
Correct answer: A
