NR 667 Advanced Practice Nursing: Care of
the Childbearing & Childrearing Family –
Comprehensive Practice Exam
EXAM OVERVIEW
NR 667 focuses on the advanced practice nursing care of the childbearing
and childrearing family. The course emphasizes comprehensive care
across the prenatal, intrapartum, postpartum, and newborn periods, as
well as primary care for infants, children, and adolescents. Key concepts
include normal pregnancy and childbirth, high-risk pregnancy
complications, newborn assessment, pediatric growth and development,
common childhood illnesses, immunizations, and anticipatory guidance
for families. This exam simulates the content and structure of the NR 667
final examination.
Key Content Areas
• Antepartum Care: Prenatal assessment, prenatal testing,
complications of pregnancy (gestational diabetes, preeclampsia,
preterm labor, placenta previa, abruption)
• Intrapartum Care: Stages of labor, fetal monitoring, pain
management, complications (dystocia, shoulder dystocia, prolapsed
cord)
• Postpartum Care: Uterine involution, lochia, breastfeeding,
postpartum complications (hemorrhage, infection, DVT, postpartum
depression)
• Newborn Care: APGAR scoring, newborn screening,
thermoregulation, feeding, jaundice, congenital anomalies
• Pediatric Primary Care: Well-child visits, developmental milestones
(Denver II), nutrition, immunizations, common pediatric illnesses
, • Adolescent Care: Pubertal development, mental health, substance
use, sexual health, immunizations
SECTION 1: Antepartum Care & Prenatal Assessment (Questions 1-20)
Q1. A client at 12 weeks gestation reports nausea and vomiting. Which
intervention should the NP recommend FIRST?
• A) Drink fluids with meals
• B) Eat small, frequent meals
• C) Lie flat after eating
• D) Take prenatal vitamins on an empty stomach
Answer: B – Small, frequent meals help prevent the hypoglycemia that can
trigger nausea. High-protein snacks (cheese, nuts) are especially helpful
before bed and upon awakening. Drinking fluids with meals can cause early
satiety and aggravate nausea.
Q2. A client at 10 weeks gestation asks about the recommended weight
gain during pregnancy. Which response is correct?
• A) 15-25 pounds for women of normal weight
• B) 25-35 pounds for women of normal weight
• C) 20-30 pounds for all women
• D) 10-20 pounds for overweight women
Answer: B – The recommended weight gain for a woman with a normal BMI
is 25-35 pounds. Overweight women (BMI 25-29.9) should gain 15-25
pounds. Underweight women (BMI <18.5) should gain 28-40 pounds.
Q3. A client at 16 weeks gestation is scheduled for a maternal serum
alpha-fetoprotein (MSAFP) screening. The NP should explain that this
test screens for:
, • A) Gestational diabetes
• B) Neural tube defects and chromosomal abnormalities
• C) Rh incompatibility
• D) Placental abruption
Answer: B – Maternal serum alpha-fetoprotein (MSAFP) screening is
performed at 15-20 weeks to screen for neural tube defects (elevated AFP)
and chromosomal abnormalities such as Down syndrome (low AFP).
Q4. A client at 28 weeks gestation is diagnosed with gestational
diabetes. Which finding is MOST concerning?
• A) Fasting blood glucose of 95 mg/dL
• B) Polyhydramnios on ultrasound
• C) Fetal macrosomia
• D) Urinary frequency
Answer: B – Polyhydramnios (excessive amniotic fluid) is a complication of
gestational diabetes associated with fetal anomalies and preterm labor.
Fasting blood glucose of 95 mg/dL is within target range (60-95 mg/dL).
Macrosomia is a common complication but polyhydramnios indicates
more immediate risk.
Q5. A client at 24 weeks gestation is diagnosed with a urinary tract
infection. Which antibiotic should the NP prescribe?
• A) Doxycycline
• B) Ciprofloxacin
• C) Nitrofurantoin
• D) Tetracycline
Answer: C – Nitrofurantoin is a safe antibiotic for UTIs during pregnancy.
Doxycycline and tetracycline are contraindicated (discoloration of fetal
, teeth). Ciprofloxacin is generally avoided during pregnancy due to concern
for fetal cartilage damage.
Q6. A client at 28 weeks gestation with gestational diabetes has a blood
glucose of 120 mg/dL 2 hours after a meal. What is the appropriate
action?
• A) Notify the healthcare provider
• B) Administer sliding-scale insulin
• C) Document the finding
• D) Encourage the client to walk
Answer: C – This blood glucose is within the target range for gestational
diabetes (<120 mg/dL 2 hours postprandial). Documentation is appropriate;
no intervention is needed.
Q7. A client at 30 weeks gestation reports severe headache, blurred
vision, and epigastric pain. The NP should suspect:
• A) Normal pregnancy symptoms
• B) Preeclampsia
• C) Gestational diabetes
• D) Placental abruption
Answer: B – Headache, visual disturbances, and epigastric pain (hepatic
capsule distension) are classic signs of severe preeclampsia. These
symptoms require immediate evaluation and treatment to prevent seizures.
Q8. The NP is assessing a client at 32 weeks gestation. Which finding is
MOST suggestive of preterm labor?
• A) Braxton Hicks contractions
• B) Rupture of membranes
the Childbearing & Childrearing Family –
Comprehensive Practice Exam
EXAM OVERVIEW
NR 667 focuses on the advanced practice nursing care of the childbearing
and childrearing family. The course emphasizes comprehensive care
across the prenatal, intrapartum, postpartum, and newborn periods, as
well as primary care for infants, children, and adolescents. Key concepts
include normal pregnancy and childbirth, high-risk pregnancy
complications, newborn assessment, pediatric growth and development,
common childhood illnesses, immunizations, and anticipatory guidance
for families. This exam simulates the content and structure of the NR 667
final examination.
Key Content Areas
• Antepartum Care: Prenatal assessment, prenatal testing,
complications of pregnancy (gestational diabetes, preeclampsia,
preterm labor, placenta previa, abruption)
• Intrapartum Care: Stages of labor, fetal monitoring, pain
management, complications (dystocia, shoulder dystocia, prolapsed
cord)
• Postpartum Care: Uterine involution, lochia, breastfeeding,
postpartum complications (hemorrhage, infection, DVT, postpartum
depression)
• Newborn Care: APGAR scoring, newborn screening,
thermoregulation, feeding, jaundice, congenital anomalies
• Pediatric Primary Care: Well-child visits, developmental milestones
(Denver II), nutrition, immunizations, common pediatric illnesses
, • Adolescent Care: Pubertal development, mental health, substance
use, sexual health, immunizations
SECTION 1: Antepartum Care & Prenatal Assessment (Questions 1-20)
Q1. A client at 12 weeks gestation reports nausea and vomiting. Which
intervention should the NP recommend FIRST?
• A) Drink fluids with meals
• B) Eat small, frequent meals
• C) Lie flat after eating
• D) Take prenatal vitamins on an empty stomach
Answer: B – Small, frequent meals help prevent the hypoglycemia that can
trigger nausea. High-protein snacks (cheese, nuts) are especially helpful
before bed and upon awakening. Drinking fluids with meals can cause early
satiety and aggravate nausea.
Q2. A client at 10 weeks gestation asks about the recommended weight
gain during pregnancy. Which response is correct?
• A) 15-25 pounds for women of normal weight
• B) 25-35 pounds for women of normal weight
• C) 20-30 pounds for all women
• D) 10-20 pounds for overweight women
Answer: B – The recommended weight gain for a woman with a normal BMI
is 25-35 pounds. Overweight women (BMI 25-29.9) should gain 15-25
pounds. Underweight women (BMI <18.5) should gain 28-40 pounds.
Q3. A client at 16 weeks gestation is scheduled for a maternal serum
alpha-fetoprotein (MSAFP) screening. The NP should explain that this
test screens for:
, • A) Gestational diabetes
• B) Neural tube defects and chromosomal abnormalities
• C) Rh incompatibility
• D) Placental abruption
Answer: B – Maternal serum alpha-fetoprotein (MSAFP) screening is
performed at 15-20 weeks to screen for neural tube defects (elevated AFP)
and chromosomal abnormalities such as Down syndrome (low AFP).
Q4. A client at 28 weeks gestation is diagnosed with gestational
diabetes. Which finding is MOST concerning?
• A) Fasting blood glucose of 95 mg/dL
• B) Polyhydramnios on ultrasound
• C) Fetal macrosomia
• D) Urinary frequency
Answer: B – Polyhydramnios (excessive amniotic fluid) is a complication of
gestational diabetes associated with fetal anomalies and preterm labor.
Fasting blood glucose of 95 mg/dL is within target range (60-95 mg/dL).
Macrosomia is a common complication but polyhydramnios indicates
more immediate risk.
Q5. A client at 24 weeks gestation is diagnosed with a urinary tract
infection. Which antibiotic should the NP prescribe?
• A) Doxycycline
• B) Ciprofloxacin
• C) Nitrofurantoin
• D) Tetracycline
Answer: C – Nitrofurantoin is a safe antibiotic for UTIs during pregnancy.
Doxycycline and tetracycline are contraindicated (discoloration of fetal
, teeth). Ciprofloxacin is generally avoided during pregnancy due to concern
for fetal cartilage damage.
Q6. A client at 28 weeks gestation with gestational diabetes has a blood
glucose of 120 mg/dL 2 hours after a meal. What is the appropriate
action?
• A) Notify the healthcare provider
• B) Administer sliding-scale insulin
• C) Document the finding
• D) Encourage the client to walk
Answer: C – This blood glucose is within the target range for gestational
diabetes (<120 mg/dL 2 hours postprandial). Documentation is appropriate;
no intervention is needed.
Q7. A client at 30 weeks gestation reports severe headache, blurred
vision, and epigastric pain. The NP should suspect:
• A) Normal pregnancy symptoms
• B) Preeclampsia
• C) Gestational diabetes
• D) Placental abruption
Answer: B – Headache, visual disturbances, and epigastric pain (hepatic
capsule distension) are classic signs of severe preeclampsia. These
symptoms require immediate evaluation and treatment to prevent seizures.
Q8. The NP is assessing a client at 32 weeks gestation. Which finding is
MOST suggestive of preterm labor?
• A) Braxton Hicks contractions
• B) Rupture of membranes
