NR 603 WEEK 6: PRIMARY CARE OF
CHILDBEARING & CHILDREARING
FAMILY QUESTIONS AND ANSWERS
1. A 24-week gestation patient presents with a blood pressure of 145/95 mmHg on two
occasions, 4 hours apart. She has no prior history of hypertension. Which diagnostic finding
would confirm a diagnosis of preeclampsia?
A. Trace protein on a random dipstick
B. Serum creatinine of 0.8 mg/dL
C. Proteinuria ≥ 300 mg in a 24-hour urine collection
D. Platelet count of 160,000/mcL
Answer: C
Conceptual Explanation: Preeclampsia is diagnosed by new-onset hypertension after 20
weeks gestation plus proteinuria (≥ 300 mg/24h or protein/creatinine ratio ≥ 0.3). In the
absence of proteinuria, new-onset systemic findings such as thrombocytopenia (<100,000)
or elevated creatinine (>1.1) are required.
,2. An 18-month-old is brought in for a wellness check. The mother mentions the child
primarily drinks whole cow’s milk, approximately 32 ounces per day. Which laboratory
finding is most expected?
A. High Mean Corpuscular Volume (MCV)
B. Low Ferritin and high Total Iron Binding Capacity (TIBC)
C. Low Red Cell Distribution Width (RDW)
D. Elevated Reticulocyte count
Answer: B
Conceptual Explanation: Excessive intake of cow’s milk (over 24 oz/day) in toddlers is a
major risk factor for iron deficiency anemia. Classic findings include microcytic anemia
with low ferritin and high TIBC.
3. A pregnant woman who is Rh-negative at 28 weeks gestation has a negative indirect
Coombs test. What is the next appropriate step in her management?
A. Order a paternal blood type and Rh factor
B. Repeat the Coombs test every 2 weeks until delivery
C. Administer Rho(D) immune globulin (RhoGAM)
D. Monitor for signs of hydrops fetalis via ultrasound
Answer: C
, Conceptual Explanation: Standard protocol for Rh-negative women with a negative
antibody screen is to administer Rho(D) immune globulin at 28 weeks gestation to prevent
sensitization.
4. A 7-year-old child presents with symptoms of asthma including coughing and wheezing
three times per week, and nighttime awakenings due to cough three times per month. How
should this patient’s asthma be classified?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Answer: B
Conceptual Explanation: Mild persistent asthma in children 5-11 involves symptoms > 2
days/week but not daily, and nighttime awakenings 3-4 times/month.
5. A 28-year-old female presents with acute lower abdominal pain and vaginal spotting. Her
last menstrual period was 7 weeks ago. What is the most critical first step in diagnostic
evaluation?
A. Pelvic examination
B. Transvaginal ultrasound
C. CBC and differential
CHILDBEARING & CHILDREARING
FAMILY QUESTIONS AND ANSWERS
1. A 24-week gestation patient presents with a blood pressure of 145/95 mmHg on two
occasions, 4 hours apart. She has no prior history of hypertension. Which diagnostic finding
would confirm a diagnosis of preeclampsia?
A. Trace protein on a random dipstick
B. Serum creatinine of 0.8 mg/dL
C. Proteinuria ≥ 300 mg in a 24-hour urine collection
D. Platelet count of 160,000/mcL
Answer: C
Conceptual Explanation: Preeclampsia is diagnosed by new-onset hypertension after 20
weeks gestation plus proteinuria (≥ 300 mg/24h or protein/creatinine ratio ≥ 0.3). In the
absence of proteinuria, new-onset systemic findings such as thrombocytopenia (<100,000)
or elevated creatinine (>1.1) are required.
,2. An 18-month-old is brought in for a wellness check. The mother mentions the child
primarily drinks whole cow’s milk, approximately 32 ounces per day. Which laboratory
finding is most expected?
A. High Mean Corpuscular Volume (MCV)
B. Low Ferritin and high Total Iron Binding Capacity (TIBC)
C. Low Red Cell Distribution Width (RDW)
D. Elevated Reticulocyte count
Answer: B
Conceptual Explanation: Excessive intake of cow’s milk (over 24 oz/day) in toddlers is a
major risk factor for iron deficiency anemia. Classic findings include microcytic anemia
with low ferritin and high TIBC.
3. A pregnant woman who is Rh-negative at 28 weeks gestation has a negative indirect
Coombs test. What is the next appropriate step in her management?
A. Order a paternal blood type and Rh factor
B. Repeat the Coombs test every 2 weeks until delivery
C. Administer Rho(D) immune globulin (RhoGAM)
D. Monitor for signs of hydrops fetalis via ultrasound
Answer: C
, Conceptual Explanation: Standard protocol for Rh-negative women with a negative
antibody screen is to administer Rho(D) immune globulin at 28 weeks gestation to prevent
sensitization.
4. A 7-year-old child presents with symptoms of asthma including coughing and wheezing
three times per week, and nighttime awakenings due to cough three times per month. How
should this patient’s asthma be classified?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Answer: B
Conceptual Explanation: Mild persistent asthma in children 5-11 involves symptoms > 2
days/week but not daily, and nighttime awakenings 3-4 times/month.
5. A 28-year-old female presents with acute lower abdominal pain and vaginal spotting. Her
last menstrual period was 7 weeks ago. What is the most critical first step in diagnostic
evaluation?
A. Pelvic examination
B. Transvaginal ultrasound
C. CBC and differential
