WGU D447
Women's & Children's Health
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢160+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢100+ OA PRACTICE QUESIONS
➢OA Study Guide & Clinical Prioritization
➢D447 Concept Map
, Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study resources,
feel free to Message me."
Digital preview sample
,Table of Contents
D447 OA EXAM SET 1 ....................................................................... 2
D447 OA EXAM SET 2 ..................................................................... 47
D447 OA PRACTICE TEST (100 QS) ................................................ 133
D447 OA STUDY GUIDE ................................................................. 174
D447 Concept Map ....................................................................... 184
D447 OA EXAM SET 1
1. A mother brings her male preschooler to the clinic because he has had
diarrhea, vomiting, and high fevers for the past three days. The child begins to
cry and cling to his mother when the nurse enters the examination room. Which
action should the nurse implement to get the child to cooperate?
A. Tell the child he is being silly and needs to be brave
B. Immediately begin the physical assessment while the mother holds him
C. Ask the mother to leave the room so the child learns independence
D. Talk to the mother and gradually focus on the child's toy
Correct Answer: D
Rationale: Preschoolers (ages 3–5 years) experience separation anxiety and fear of
strangers, especially when ill. The nurse should use therapeutic communication
techniques appropriate for this developmental stage. Talking to the mother first while
gradually engaging the child through his toy reduces anxiety by not forcing immediate
interaction. This approach respects the child's need for security (mother's presence)
,while building rapport indirectly. Option A dismisses the child's feelings and increases
fear. Option B forces interaction too quickly. Option C increases separation anxiety and
is inappropriate for a sick preschooler who needs parental support for coping.
2. A 38-year-old primiparous client is 2 weeks postpartum. She was discharged on
day 2 and is exclusively breastfeeding. The client informs the nurse she is
breastfeeding 7 to 8 times a day for 10 minutes each feeding. The baby has been
fussier and wants to nurse all the time. The client went out shopping for 5 hours
while her mother watched the baby; the baby was fed pumped milk. The client
noticed a red, warm, firm spot on her breast. She also notes she feels chills, achy,
fatigued, and dizzy. She is bleeding a small amount of foul-smelling lochia. Temp:
101.2°F, HR: 105 bpm, BP: 138/72. Discharge Hgb: 9.2 g/dL (on admission: 12
g/dL). Select the findings that will help determine the cause of the client's
condition.
Table
Finding Relevance
A. Breastfeeding 7 to 8 Correct — Inadequate frequency and duration;
times a day for 10 breastfeeding should occur 8–12 times per 24 hours or
minutes every 2–3 hours for 15–20 minutes to ensure adequate
emptying
B. Discharge Correct — Indicates postpartum anemia (normal >11
hemoglobin of 9.2 g/dL g/dL), which explains fatigue, dizziness, and chills
C. Current vital signs Correct — Fever and tachycardia indicate infection;
(Temp 101.2°F, HR temperature elevation supports mastitis or endometritis
105)
, Finding Relevance
D. Shopping yesterday Correct — Prolonged absence leads to milk stasis, a
for 5 hours primary risk factor for mastitis
E. Foul-smelling lochia Correct — Lochia rubra should be odorless; foul odor
rubra indicates possible endometritis
Rationale: Breastfeeding should occur 8–12 times in a 24-hour period, or every 2–3
hours for 15–20 minutes. Less frequent or shorter feeding sessions result in inadequate
emptying of the breasts, leading to milk stasis and bacterial overgrowth that causes
mastitis. Any breastfeeding client with a fever should have a breast exam to determine if
mastitis is the cause of the elevated temperature. Going for prolonged periods without
feeding or pumping increases milk stasis risk. A discharge hemoglobin less than 11 g/dL
signals anemia, which may indicate greater-than-anticipated blood loss; this anemia
explains the client's fatigue, dizziness, and feeling chilled. Lochia rubra at 2 weeks
postpartum should not have an odor—the foul smell may indicate endometritis, a uterine
infection requiring evaluation.
3. (NGN: Drop-Down/Select All That Apply Hybrid)
For each assessment finding, indicate whether the finding is generally associated
with mastitis, endometritis, or signs of both.
Table
Assessment Finding Classification
A. Pain rating of 4 on a 0–10 Both — Pain occurs with mastitis (breast
scale tenderness) and endometritis (uterine cramping)
,Rationale:
Folic acid supplementation is the primary preventive measure for neural tube defects
(NTDs), including anencephaly and spina bifida. The U.S. Public Health Service and
CDC recommend that all women of childbearing age consume 400 mcg (0.4 mg) of folic
acid daily, beginning at least 1 month before conception and continuing through the first
trimester. For women with a previous pregnancy affected by an NTD, a higher dose of 4
mg daily is recommended. Folic acid is crucial for DNA synthesis, cell division, and
proper neural tube closure, which occurs between days 21 and 28 post-conception—
often before a woman knows she is pregnant. Iron (Option B) prevents anemia, calcium
(Option C) supports bone development, and vitamin D (Option D) aids calcium
absorption and immune function, but none of these prevent neural tube defects. The
nurse should emphasize that folic acid must be taken before conception for maximum
protective effect.
,Table
Severity Fluid Signs
Loss
Mild (3– 30–50 Slightly dry mucous membranes, slightly decreased
5%) mL/kg urine output
Moderate 60–90 Sunken fontanel, decreased tears, dry mucous
(6–9%) mL/kg membranes, tachycardia, capillary refill 2–3 seconds,
irritability/lethargy
Severe ≥100 Sunken fontanel, capillary refill >3 seconds, markedly
(≥10%) mL/kg decreased/absent urine output,
tachycardia/hypotension, altered mental status,
mottled skin, anuria
A. Sunken anterior fontanel indicates decreased extracellular fluid volume. B. Capillary
refill >3 seconds signals poor peripheral perfusion and shock. C. Decreased urine output
(<1 mL/kg/hour) reflects inadequate renal perfusion; infants normally have 6–8 wet
diapers/day. D. Tachycardia is an early compensatory mechanism for decreased stroke
volume; hypotension is a late, pre-arrest sign in pediatrics. Treatment: isotonic IV fluids
(normal saline or lactated Ringer's) 20 mL/kg boluses, with reassessment between
boluses.
,protein is important, but excessive sodium is avoided. High-sodium diets worsen fluid
retention and hypertension.
105. A nurse is caring for a child with a suspected diagnosis of bacterial
meningitis caused by Neisseria meningitidis. Which isolation precautions are
required?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct Answer: C
Rationale: Neisseria meningitidis (meningococcal) meningitis requires droplet
precautions due to respiratory transmission. Standard precautions are always used.
Contact precautions are for direct contact transmission. Airborne precautions are for
airborne pathogens.
106. A nurse is caring for a client with a positive CST. Which fetal heart rate
pattern is most concerning?
A. Early decelerations
B. Variable decelerations
C. Late decelerations
D. Accelerations
Correct Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency and are the
concerning pattern in a positive CST. Early decelerations are benign (head
compression). Variable decelerations indicate cord compression. Accelerations are
reassuring.
, Hydrocephalus: Accumulation of fluid in the spaces of the brain.
Cryptorchidism: Undescended testicles.
Hypospadias: Abnormal congenital opening of the male urethra on the
undersurface of the penis.
Duchenne Muscular Dystrophy: Condition with symmetrical weakness and
wasting of pelvic, shoulder, and proximal limb muscles.
Becker Muscular Dystrophy: Very similar to, but less severe than, Duchenne
muscular dystrophy.
Osgood-Schlatter Disease: Inflammation or irritation of the tibia at its point of
attachment with the patellar tendon.
Hirschsprung's Disease: Congenital megacolon with absence of ganglion cells in
rectum. Intestine does not propel stool, which builds up; risk of intestinal
rupture. S/S: newborn - failure to pass meconium in first 24 hrs, reluctance to
ingest fluids, bile-stained vomitus, distended abdomen, 'ribbon-like' stools.
Older: failure to thrive, distended abdomen, constipation. Treatment: surgery,
temporary ostomy for 3-6 months then re-anastomosis.
Pyloric Stenosis: Can cause metabolic alkalosis in infants.
Herpetic Gingivostomatitis: Infection of oropharynx in young children; fever,
sore throat, swollen lymph nodes.
Kawasaki Disease
Description: Inflammation of blood vessels causing coronary artery aneurysms.
Signs/Symptoms: Red tongue/eyes/soles, unrelieved fever, peeling skin, rash
on trunk ('strawberry tongue').
Treatment: IVIG and high-dose aspirin.
Complications: Myocardial infarction, heart failure. Monitor for decreased
urinary output, increased heart rate, and new gallop on cardiac auscultation.
, Quick Reference - Key Numbers & Facts
Topic Key Fact
AFP Screening 15-20 weeks (ideally 16-18 weeks)
Miscarriage Rate 10-15% of pregnancies
Miscarriage Definition Before 20 weeks gestation
CVS Timing 10-13 weeks gestation
Amniocentesis Timing At or after 15 weeks gestation
Gestational Diabetes Screening 24-28 weeks
RhoGAM Timing 28 weeks and again after delivery
HAART Viral Load Goal <20 copies/mL
Vaginal Birth Viral Load Threshold <1,000 copies/mL
Cesarean Birth Viral Load Threshold >1,000 copies/mL at 38 weeks
Gestational Hypertension BP ≥140/90 mm Hg on 2 occasions ≥4
hours apart after 20 weeks
Magnesium Sulfate Therapeutic Level 4-7
Magnesium Sulfate Contraindication Myasthenia gravis (MG)
Betamethasone Dosage 12 mg IM, repeated in 24 hours
Corticosteroid Timing ≤34 weeks gestation
Target BP with Antihypertensives Systolic 140-155, Diastolic 90-105
mm Hg
Normal HCO3 Range 21-28
Terbutaline Tachycardia Threshold >130 bpm
Fourth Stage of Labor Duration Up to 1 hour post-delivery
Hirschsprung's Meconium Passage Failure to pass in first 24 hours
Women's & Children's Health
Objective Assessment
(2 Full Exams)
Actual Questions with Verified Answers
Take and pass the OA :)
What You Will Get:
➢160+ OA Exam Questions w/ Answers
➢Expert Rationales included.
➢100+ OA PRACTICE QUESIONS
➢OA Study Guide & Clinical Prioritization
➢D447 Concept Map
, Preview Pages Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study resources,
feel free to Message me."
Digital preview sample
,Table of Contents
D447 OA EXAM SET 1 ....................................................................... 2
D447 OA EXAM SET 2 ..................................................................... 47
D447 OA PRACTICE TEST (100 QS) ................................................ 133
D447 OA STUDY GUIDE ................................................................. 174
D447 Concept Map ....................................................................... 184
D447 OA EXAM SET 1
1. A mother brings her male preschooler to the clinic because he has had
diarrhea, vomiting, and high fevers for the past three days. The child begins to
cry and cling to his mother when the nurse enters the examination room. Which
action should the nurse implement to get the child to cooperate?
A. Tell the child he is being silly and needs to be brave
B. Immediately begin the physical assessment while the mother holds him
C. Ask the mother to leave the room so the child learns independence
D. Talk to the mother and gradually focus on the child's toy
Correct Answer: D
Rationale: Preschoolers (ages 3–5 years) experience separation anxiety and fear of
strangers, especially when ill. The nurse should use therapeutic communication
techniques appropriate for this developmental stage. Talking to the mother first while
gradually engaging the child through his toy reduces anxiety by not forcing immediate
interaction. This approach respects the child's need for security (mother's presence)
,while building rapport indirectly. Option A dismisses the child's feelings and increases
fear. Option B forces interaction too quickly. Option C increases separation anxiety and
is inappropriate for a sick preschooler who needs parental support for coping.
2. A 38-year-old primiparous client is 2 weeks postpartum. She was discharged on
day 2 and is exclusively breastfeeding. The client informs the nurse she is
breastfeeding 7 to 8 times a day for 10 minutes each feeding. The baby has been
fussier and wants to nurse all the time. The client went out shopping for 5 hours
while her mother watched the baby; the baby was fed pumped milk. The client
noticed a red, warm, firm spot on her breast. She also notes she feels chills, achy,
fatigued, and dizzy. She is bleeding a small amount of foul-smelling lochia. Temp:
101.2°F, HR: 105 bpm, BP: 138/72. Discharge Hgb: 9.2 g/dL (on admission: 12
g/dL). Select the findings that will help determine the cause of the client's
condition.
Table
Finding Relevance
A. Breastfeeding 7 to 8 Correct — Inadequate frequency and duration;
times a day for 10 breastfeeding should occur 8–12 times per 24 hours or
minutes every 2–3 hours for 15–20 minutes to ensure adequate
emptying
B. Discharge Correct — Indicates postpartum anemia (normal >11
hemoglobin of 9.2 g/dL g/dL), which explains fatigue, dizziness, and chills
C. Current vital signs Correct — Fever and tachycardia indicate infection;
(Temp 101.2°F, HR temperature elevation supports mastitis or endometritis
105)
, Finding Relevance
D. Shopping yesterday Correct — Prolonged absence leads to milk stasis, a
for 5 hours primary risk factor for mastitis
E. Foul-smelling lochia Correct — Lochia rubra should be odorless; foul odor
rubra indicates possible endometritis
Rationale: Breastfeeding should occur 8–12 times in a 24-hour period, or every 2–3
hours for 15–20 minutes. Less frequent or shorter feeding sessions result in inadequate
emptying of the breasts, leading to milk stasis and bacterial overgrowth that causes
mastitis. Any breastfeeding client with a fever should have a breast exam to determine if
mastitis is the cause of the elevated temperature. Going for prolonged periods without
feeding or pumping increases milk stasis risk. A discharge hemoglobin less than 11 g/dL
signals anemia, which may indicate greater-than-anticipated blood loss; this anemia
explains the client's fatigue, dizziness, and feeling chilled. Lochia rubra at 2 weeks
postpartum should not have an odor—the foul smell may indicate endometritis, a uterine
infection requiring evaluation.
3. (NGN: Drop-Down/Select All That Apply Hybrid)
For each assessment finding, indicate whether the finding is generally associated
with mastitis, endometritis, or signs of both.
Table
Assessment Finding Classification
A. Pain rating of 4 on a 0–10 Both — Pain occurs with mastitis (breast
scale tenderness) and endometritis (uterine cramping)
,Rationale:
Folic acid supplementation is the primary preventive measure for neural tube defects
(NTDs), including anencephaly and spina bifida. The U.S. Public Health Service and
CDC recommend that all women of childbearing age consume 400 mcg (0.4 mg) of folic
acid daily, beginning at least 1 month before conception and continuing through the first
trimester. For women with a previous pregnancy affected by an NTD, a higher dose of 4
mg daily is recommended. Folic acid is crucial for DNA synthesis, cell division, and
proper neural tube closure, which occurs between days 21 and 28 post-conception—
often before a woman knows she is pregnant. Iron (Option B) prevents anemia, calcium
(Option C) supports bone development, and vitamin D (Option D) aids calcium
absorption and immune function, but none of these prevent neural tube defects. The
nurse should emphasize that folic acid must be taken before conception for maximum
protective effect.
,Table
Severity Fluid Signs
Loss
Mild (3– 30–50 Slightly dry mucous membranes, slightly decreased
5%) mL/kg urine output
Moderate 60–90 Sunken fontanel, decreased tears, dry mucous
(6–9%) mL/kg membranes, tachycardia, capillary refill 2–3 seconds,
irritability/lethargy
Severe ≥100 Sunken fontanel, capillary refill >3 seconds, markedly
(≥10%) mL/kg decreased/absent urine output,
tachycardia/hypotension, altered mental status,
mottled skin, anuria
A. Sunken anterior fontanel indicates decreased extracellular fluid volume. B. Capillary
refill >3 seconds signals poor peripheral perfusion and shock. C. Decreased urine output
(<1 mL/kg/hour) reflects inadequate renal perfusion; infants normally have 6–8 wet
diapers/day. D. Tachycardia is an early compensatory mechanism for decreased stroke
volume; hypotension is a late, pre-arrest sign in pediatrics. Treatment: isotonic IV fluids
(normal saline or lactated Ringer's) 20 mL/kg boluses, with reassessment between
boluses.
,protein is important, but excessive sodium is avoided. High-sodium diets worsen fluid
retention and hypertension.
105. A nurse is caring for a child with a suspected diagnosis of bacterial
meningitis caused by Neisseria meningitidis. Which isolation precautions are
required?
A. Standard precautions only
B. Contact precautions
C. Droplet precautions
D. Airborne precautions
Correct Answer: C
Rationale: Neisseria meningitidis (meningococcal) meningitis requires droplet
precautions due to respiratory transmission. Standard precautions are always used.
Contact precautions are for direct contact transmission. Airborne precautions are for
airborne pathogens.
106. A nurse is caring for a client with a positive CST. Which fetal heart rate
pattern is most concerning?
A. Early decelerations
B. Variable decelerations
C. Late decelerations
D. Accelerations
Correct Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency and are the
concerning pattern in a positive CST. Early decelerations are benign (head
compression). Variable decelerations indicate cord compression. Accelerations are
reassuring.
, Hydrocephalus: Accumulation of fluid in the spaces of the brain.
Cryptorchidism: Undescended testicles.
Hypospadias: Abnormal congenital opening of the male urethra on the
undersurface of the penis.
Duchenne Muscular Dystrophy: Condition with symmetrical weakness and
wasting of pelvic, shoulder, and proximal limb muscles.
Becker Muscular Dystrophy: Very similar to, but less severe than, Duchenne
muscular dystrophy.
Osgood-Schlatter Disease: Inflammation or irritation of the tibia at its point of
attachment with the patellar tendon.
Hirschsprung's Disease: Congenital megacolon with absence of ganglion cells in
rectum. Intestine does not propel stool, which builds up; risk of intestinal
rupture. S/S: newborn - failure to pass meconium in first 24 hrs, reluctance to
ingest fluids, bile-stained vomitus, distended abdomen, 'ribbon-like' stools.
Older: failure to thrive, distended abdomen, constipation. Treatment: surgery,
temporary ostomy for 3-6 months then re-anastomosis.
Pyloric Stenosis: Can cause metabolic alkalosis in infants.
Herpetic Gingivostomatitis: Infection of oropharynx in young children; fever,
sore throat, swollen lymph nodes.
Kawasaki Disease
Description: Inflammation of blood vessels causing coronary artery aneurysms.
Signs/Symptoms: Red tongue/eyes/soles, unrelieved fever, peeling skin, rash
on trunk ('strawberry tongue').
Treatment: IVIG and high-dose aspirin.
Complications: Myocardial infarction, heart failure. Monitor for decreased
urinary output, increased heart rate, and new gallop on cardiac auscultation.
, Quick Reference - Key Numbers & Facts
Topic Key Fact
AFP Screening 15-20 weeks (ideally 16-18 weeks)
Miscarriage Rate 10-15% of pregnancies
Miscarriage Definition Before 20 weeks gestation
CVS Timing 10-13 weeks gestation
Amniocentesis Timing At or after 15 weeks gestation
Gestational Diabetes Screening 24-28 weeks
RhoGAM Timing 28 weeks and again after delivery
HAART Viral Load Goal <20 copies/mL
Vaginal Birth Viral Load Threshold <1,000 copies/mL
Cesarean Birth Viral Load Threshold >1,000 copies/mL at 38 weeks
Gestational Hypertension BP ≥140/90 mm Hg on 2 occasions ≥4
hours apart after 20 weeks
Magnesium Sulfate Therapeutic Level 4-7
Magnesium Sulfate Contraindication Myasthenia gravis (MG)
Betamethasone Dosage 12 mg IM, repeated in 24 hours
Corticosteroid Timing ≤34 weeks gestation
Target BP with Antihypertensives Systolic 140-155, Diastolic 90-105
mm Hg
Normal HCO3 Range 21-28
Terbutaline Tachycardia Threshold >130 bpm
Fourth Stage of Labor Duration Up to 1 hour post-delivery
Hirschsprung's Meconium Passage Failure to pass in first 24 hours
