NR 603 EXAM: PRIMARY CARE OF
CHILDBEARING & CHILDREARING
FAMILY (ADVANCED PRACTICE)
1. A 28-year-old G1P0 at 28 weeks gestation is Rh-negative. Her antibody screen is negative.
Which of the following is the correct management regarding Rho(D) immune globulin
(RhoGAM)?
A. Administer 300 mcg RhoGAM now and again within 72 hours of delivery if the infant is
Rh-positive.
B. RhoGAM is not indicated unless the patient experiences abdominal trauma or vaginal
bleeding.
C. Administer 50 mcg RhoGAM now to prevent sensitization.
D. Wait until delivery to determine the infant’s blood type before administering RhoGAM.
Answer: A
Conceptual Explanation: RhoGAM (300 mcg) is routinely administered to Rh-negative,
unsensitized women at 28 weeks gestation and again within 72 hours postpartum if the
neonate is Rh-positive to prevent isoimmunization.
,2. A 4-week-old infant presents with projectile, non-bilious vomiting after every feeding. On
physical examination, an olive-shaped mass is palpated in the epigastrium. What is the most
likely diagnosis?
A. Gastroesophageal Reflux Disease (GERD)
B. Hypertrophic Pyloric Stenosis
C. Intussusception
D. Hirschsprung’s Disease
Answer: B
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents in infants aged
3-6 weeks with projectile non-bilious vomiting and a palpable ‘olive’ mass in the upper
abdomen.
3. Which of the following laboratory findings is most characteristic of HELLP syndrome in a
pregnant patient?
A. Elevated serum creatinine, hypoglycemia, and leukopenia.
B. Elevated white blood cell count, low hemoglobin, and high glucose.
C. Hypernatremia, hypokalemia, and elevated bilirubin.
D. Hemolysis, elevated liver enzymes, and low platelets.
Answer: D
, Conceptual Explanation: HELLP syndrome is a severe variant of preeclampsia defined by
Hemolysis (H), Elevated Liver enzymes (EL), and Low Platelets (LP).
4. A 3-year-old child presents with a high fever for 6 days, strawberry tongue, bilateral
conjunctival injection without exudate, and erythema of the palms and soles. What is the
primary concern if left untreated?
A. Acute glomerulonephritis
B. Rheumatic heart disease
C. Coronary artery aneurysm
D. Splenic rupture
Answer: C
Conceptual Explanation: These are classic signs of Kawasaki Disease. The most serious
complication is the development of coronary artery aneurysms, which requires treatment
with IVIG and aspirin.
5. According to the American College of Obstetricians and Gynecologists (ACOG), what is the
diagnostic threshold for gestational diabetes using a 3-hour 100g Oral Glucose Tolerance Test
(OGTT) for the fasting value?
A. 126 mg/dL
B. 95 mg/dL
C. 140 mg/dL
CHILDBEARING & CHILDREARING
FAMILY (ADVANCED PRACTICE)
1. A 28-year-old G1P0 at 28 weeks gestation is Rh-negative. Her antibody screen is negative.
Which of the following is the correct management regarding Rho(D) immune globulin
(RhoGAM)?
A. Administer 300 mcg RhoGAM now and again within 72 hours of delivery if the infant is
Rh-positive.
B. RhoGAM is not indicated unless the patient experiences abdominal trauma or vaginal
bleeding.
C. Administer 50 mcg RhoGAM now to prevent sensitization.
D. Wait until delivery to determine the infant’s blood type before administering RhoGAM.
Answer: A
Conceptual Explanation: RhoGAM (300 mcg) is routinely administered to Rh-negative,
unsensitized women at 28 weeks gestation and again within 72 hours postpartum if the
neonate is Rh-positive to prevent isoimmunization.
,2. A 4-week-old infant presents with projectile, non-bilious vomiting after every feeding. On
physical examination, an olive-shaped mass is palpated in the epigastrium. What is the most
likely diagnosis?
A. Gastroesophageal Reflux Disease (GERD)
B. Hypertrophic Pyloric Stenosis
C. Intussusception
D. Hirschsprung’s Disease
Answer: B
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents in infants aged
3-6 weeks with projectile non-bilious vomiting and a palpable ‘olive’ mass in the upper
abdomen.
3. Which of the following laboratory findings is most characteristic of HELLP syndrome in a
pregnant patient?
A. Elevated serum creatinine, hypoglycemia, and leukopenia.
B. Elevated white blood cell count, low hemoglobin, and high glucose.
C. Hypernatremia, hypokalemia, and elevated bilirubin.
D. Hemolysis, elevated liver enzymes, and low platelets.
Answer: D
, Conceptual Explanation: HELLP syndrome is a severe variant of preeclampsia defined by
Hemolysis (H), Elevated Liver enzymes (EL), and Low Platelets (LP).
4. A 3-year-old child presents with a high fever for 6 days, strawberry tongue, bilateral
conjunctival injection without exudate, and erythema of the palms and soles. What is the
primary concern if left untreated?
A. Acute glomerulonephritis
B. Rheumatic heart disease
C. Coronary artery aneurysm
D. Splenic rupture
Answer: C
Conceptual Explanation: These are classic signs of Kawasaki Disease. The most serious
complication is the development of coronary artery aneurysms, which requires treatment
with IVIG and aspirin.
5. According to the American College of Obstetricians and Gynecologists (ACOG), what is the
diagnostic threshold for gestational diabetes using a 3-hour 100g Oral Glucose Tolerance Test
(OGTT) for the fasting value?
A. 126 mg/dL
B. 95 mg/dL
C. 140 mg/dL
