NR 603 FINAL EXAM: PRIMARY CARE
OF CHILDBEARING & CHILDREARING
FAMILY
1. A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 155/95
mmHg and 1+ proteinuria. She denies headache or visual changes. What is the most
appropriate next step?
A. Immediate delivery
B. Prescribe Labetalol 100mg BID
C. Start Magnesium Sulfate infusion
D. Twice weekly non-stress tests and BP monitoring
Answer: D
Conceptual Explanation: For preeclampsia without severe features, the management
involves close monitoring including blood pressure checks and fetal surveillance (NSTs)
until 37 weeks gestation.
,2. When auscultating the heart of a 4-year-old child, the nurse practitioner notes a systolic
murmur heard best at the upper left sternal border with a fixed split second heart sound (S2).
This is most characteristic of:
A. Atrial Septal Defect
B. Patent Ductus Arteriosus
C. Ventricular Septal Defect
D. Tetralogy of Fallot
Answer: A
Conceptual Explanation: A fixed split S2 is the classic physical exam finding for an Atrial
Septal Defect (ASD) due to the delayed closure of the pulmonic valve.
3. At what age is it developmentally appropriate to expect a child to use a pincer grasp to pick
up small objects?
A. 9 months
B. 6 months
C. 4 months
D. 12 months
Answer: A
Conceptual Explanation: The fine motor skill of a pincer grasp (using the thumb and
forefinger) typically develops around 9 months of age.
, 4. A pregnant patient at 26 weeks gestation undergoes a 1-hour glucose challenge test with a
result of 150 mg/dL. What is the next management step?
A. Diagnose Gestational Diabetes Mellitus
B. Perform a 3-hour oral glucose tolerance test
C. Repeat the 1-hour test in two weeks
D. Initiate insulin therapy immediately
Answer: B
Conceptual Explanation: A 1-hour GTT result above 130-140 mg/dL is considered
positive/abnormal and requires a diagnostic 3-hour oral glucose tolerance test (OGTT).
5. Tanner Stage 2 development in females is characterized by:
A. No glandular tissue; areola follows skin contours
B. Projection of the areola and papilla to form a secondary mound
C. Further enlargement of breast and areola with no separation of contours
D. Breast bud formation with enlargement of the areolar diameter
Answer: D
Conceptual Explanation: Tanner Stage 2 (thelarche) is defined by the appearance of
breast buds and slight enlargement of the areola.
OF CHILDBEARING & CHILDREARING
FAMILY
1. A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 155/95
mmHg and 1+ proteinuria. She denies headache or visual changes. What is the most
appropriate next step?
A. Immediate delivery
B. Prescribe Labetalol 100mg BID
C. Start Magnesium Sulfate infusion
D. Twice weekly non-stress tests and BP monitoring
Answer: D
Conceptual Explanation: For preeclampsia without severe features, the management
involves close monitoring including blood pressure checks and fetal surveillance (NSTs)
until 37 weeks gestation.
,2. When auscultating the heart of a 4-year-old child, the nurse practitioner notes a systolic
murmur heard best at the upper left sternal border with a fixed split second heart sound (S2).
This is most characteristic of:
A. Atrial Septal Defect
B. Patent Ductus Arteriosus
C. Ventricular Septal Defect
D. Tetralogy of Fallot
Answer: A
Conceptual Explanation: A fixed split S2 is the classic physical exam finding for an Atrial
Septal Defect (ASD) due to the delayed closure of the pulmonic valve.
3. At what age is it developmentally appropriate to expect a child to use a pincer grasp to pick
up small objects?
A. 9 months
B. 6 months
C. 4 months
D. 12 months
Answer: A
Conceptual Explanation: The fine motor skill of a pincer grasp (using the thumb and
forefinger) typically develops around 9 months of age.
, 4. A pregnant patient at 26 weeks gestation undergoes a 1-hour glucose challenge test with a
result of 150 mg/dL. What is the next management step?
A. Diagnose Gestational Diabetes Mellitus
B. Perform a 3-hour oral glucose tolerance test
C. Repeat the 1-hour test in two weeks
D. Initiate insulin therapy immediately
Answer: B
Conceptual Explanation: A 1-hour GTT result above 130-140 mg/dL is considered
positive/abnormal and requires a diagnostic 3-hour oral glucose tolerance test (OGTT).
5. Tanner Stage 2 development in females is characterized by:
A. No glandular tissue; areola follows skin contours
B. Projection of the areola and papilla to form a secondary mound
C. Further enlargement of breast and areola with no separation of contours
D. Breast bud formation with enlargement of the areolar diameter
Answer: D
Conceptual Explanation: Tanner Stage 2 (thelarche) is defined by the appearance of
breast buds and slight enlargement of the areola.
