NR 602 – Primary Care of the Childbearing &
Childrearing Family
Final Exam — 2026/2027
,Question 1 A 26-year-old G1P0 presents for her first prenatal visit at 9 weeks gestation by LMP.
Which finding would the nurse practitioner expect to confirm the estimated gestational age most
accurately? A. Fundal height measurement B. First-trimester crown-rump length on ultrasound
C. Quickening reported by the patient D. Chadwick sign on pelvic exam
Correct Answer: B A first-trimester crown-rump length is the most accurate method for dating a
pregnancy because early fetal growth is highly consistent across pregnancies. Fundal height
and quickening are unreliable in the first trimester, and Chadwick sign only confirms pregnancy,
not dating.
Question 2 A pregnant patient at 28 weeks gestation has a 1-hour glucose challenge test result
of 145 mg/dL. What is the appropriate next step? A. Diagnose gestational diabetes and begin
insulin B. Reassure the patient that this is a normal result C. Order a 3-hour oral glucose
tolerance test D. Repeat the 1-hour test in 4 weeks
Correct Answer: C A 1-hour glucose challenge result above the threshold (commonly 130–140
mg/dL depending on institutional cutoff) requires a follow-up 3-hour OGTT for definitive
diagnosis. A single elevated screening value does not confirm gestational diabetes.
Question 3 Which of the following is a classic triad of findings in severe preeclampsia? A.
Hypertension, proteinuria, hyperglycemia B. Hypertension, proteinuria, thrombocytopenia C.
Hypotension, proteinuria, tachycardia D. Hypertension, glucosuria, edema alone
Correct Answer: B Severe preeclampsia is characterized by new-onset hypertension after 20
weeks, proteinuria, and often thrombocytopenia or other end-organ involvement such as
elevated liver enzymes. Edema alone is no longer a required diagnostic criterion, and
hyperglycemia is not part of the preeclampsia spectrum.
Question 4 A postpartum patient develops a fundus that is boggy and displaced above and to
the right of the umbilicus 2 hours after delivery. What is the priority nursing action? A. Administer
a stool softener B. Encourage ambulation immediately C. Assist the patient to void or
catheterize if unable D. Apply a cold compress to the fundus
, Correct Answer: C A boggy, displaced fundus above and to the right of the umbilicus
classically indicates a full bladder preventing uterine contraction. Emptying the bladder allows
the uterus to contract and reduces hemorrhage risk.
Question 5 Which newborn reflex is expected to disappear by approximately 4–6 months of
age? A. Babinski reflex B. Moro reflex C. Blink reflex D. Rooting reflex persisting beyond 4
months while awake is expected
Correct Answer: B The Moro (startle) reflex typically disappears between 4 and 6 months as
the central nervous system matures. Persistence beyond this age may warrant further
neurologic evaluation.
Question 6 A term newborn's bilirubin level rises rapidly within the first 24 hours of life. This
pattern is most concerning for which cause of jaundice? A. Physiologic jaundice B.
Breastfeeding jaundice C. Hemolytic disease (e.g., ABO or Rh incompatibility) D. Breast milk
jaundice
Correct Answer: C Jaundice appearing within the first 24 hours of life is considered pathologic
and is most concerning for a hemolytic process such as Rh or ABO incompatibility. Physiologic
and breast milk jaundice typically appear after 24 hours and follow a slower course.
Question 7 At what age should an infant typically be able to sit unsupported? A. 2 months B. 4
months C. 6 months D. 10 months
Correct Answer: C Most infants achieve unsupported sitting by approximately 6 months of age
as trunk and core muscle control develops, a key gross motor milestone.
Question 8 According to the current immunization schedule, which vaccine series is typically
initiated at birth? A. MMR B. Hepatitis B C. Varicella D. DTaP
Correct Answer: B The hepatitis B vaccine series begins at birth, with the first dose ideally
given within 24 hours of delivery, particularly important for infants born to hepatitis B surface
antigen–positive mothers.
Childrearing Family
Final Exam — 2026/2027
,Question 1 A 26-year-old G1P0 presents for her first prenatal visit at 9 weeks gestation by LMP.
Which finding would the nurse practitioner expect to confirm the estimated gestational age most
accurately? A. Fundal height measurement B. First-trimester crown-rump length on ultrasound
C. Quickening reported by the patient D. Chadwick sign on pelvic exam
Correct Answer: B A first-trimester crown-rump length is the most accurate method for dating a
pregnancy because early fetal growth is highly consistent across pregnancies. Fundal height
and quickening are unreliable in the first trimester, and Chadwick sign only confirms pregnancy,
not dating.
Question 2 A pregnant patient at 28 weeks gestation has a 1-hour glucose challenge test result
of 145 mg/dL. What is the appropriate next step? A. Diagnose gestational diabetes and begin
insulin B. Reassure the patient that this is a normal result C. Order a 3-hour oral glucose
tolerance test D. Repeat the 1-hour test in 4 weeks
Correct Answer: C A 1-hour glucose challenge result above the threshold (commonly 130–140
mg/dL depending on institutional cutoff) requires a follow-up 3-hour OGTT for definitive
diagnosis. A single elevated screening value does not confirm gestational diabetes.
Question 3 Which of the following is a classic triad of findings in severe preeclampsia? A.
Hypertension, proteinuria, hyperglycemia B. Hypertension, proteinuria, thrombocytopenia C.
Hypotension, proteinuria, tachycardia D. Hypertension, glucosuria, edema alone
Correct Answer: B Severe preeclampsia is characterized by new-onset hypertension after 20
weeks, proteinuria, and often thrombocytopenia or other end-organ involvement such as
elevated liver enzymes. Edema alone is no longer a required diagnostic criterion, and
hyperglycemia is not part of the preeclampsia spectrum.
Question 4 A postpartum patient develops a fundus that is boggy and displaced above and to
the right of the umbilicus 2 hours after delivery. What is the priority nursing action? A. Administer
a stool softener B. Encourage ambulation immediately C. Assist the patient to void or
catheterize if unable D. Apply a cold compress to the fundus
, Correct Answer: C A boggy, displaced fundus above and to the right of the umbilicus
classically indicates a full bladder preventing uterine contraction. Emptying the bladder allows
the uterus to contract and reduces hemorrhage risk.
Question 5 Which newborn reflex is expected to disappear by approximately 4–6 months of
age? A. Babinski reflex B. Moro reflex C. Blink reflex D. Rooting reflex persisting beyond 4
months while awake is expected
Correct Answer: B The Moro (startle) reflex typically disappears between 4 and 6 months as
the central nervous system matures. Persistence beyond this age may warrant further
neurologic evaluation.
Question 6 A term newborn's bilirubin level rises rapidly within the first 24 hours of life. This
pattern is most concerning for which cause of jaundice? A. Physiologic jaundice B.
Breastfeeding jaundice C. Hemolytic disease (e.g., ABO or Rh incompatibility) D. Breast milk
jaundice
Correct Answer: C Jaundice appearing within the first 24 hours of life is considered pathologic
and is most concerning for a hemolytic process such as Rh or ABO incompatibility. Physiologic
and breast milk jaundice typically appear after 24 hours and follow a slower course.
Question 7 At what age should an infant typically be able to sit unsupported? A. 2 months B. 4
months C. 6 months D. 10 months
Correct Answer: C Most infants achieve unsupported sitting by approximately 6 months of age
as trunk and core muscle control develops, a key gross motor milestone.
Question 8 According to the current immunization schedule, which vaccine series is typically
initiated at birth? A. MMR B. Hepatitis B C. Varicella D. DTaP
Correct Answer: B The hepatitis B vaccine series begins at birth, with the first dose ideally
given within 24 hours of delivery, particularly important for infants born to hepatitis B surface
antigen–positive mothers.
