LEIFER'S INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING
EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
Core Domains:
Prenatal Development and Fetal Health Assessment
Labor, Delivery, and Intrapartum Nursing Interventions
Postpartum Adaptation and Newborn Care
Pediatric Growth, Development, and Nutritional Needs
Common Childhood Communicable and Chronic Illnesses
Pediatric Pharmacology and Safe Medication Administration
Family-Centered Care, Ethics, and Legal Responsibilities
Pediatric Emergency Management and Safety
Introduction:
This comprehensive examination serves to evaluate the critical knowledge,
clinical competence, and decision-making capabilities required in maternity and
pediatric nursing practice. Designed for nursing students and professionals, the
assessment rigorously tests core theoretical concepts, clinical judgment, and
evidence-based interventions across the lifespan of mother and child. Featuring
a dynamic blend of direct multiple-choice questions and complex clinical
scenarios, this test bank emphasizes real-world application, therapeutic
communication, safety compliance, and ethical standards. Successful
completion demonstrates mastery in fostering optimal health outcomes,
managing high-risk situations, and delivering compassionate, family-centered
care in diverse healthcare environments.
SECTION ONE: QUESTIONS 1–100
A nurse is assessing a pregnant client at 28 weeks gestation. Which
physiological change should the nurse expect to find?
A. Decreased cardiac output
B. Increased respiratory rate and tidal volume
C. Decreased blood volume
D. Elevated fasting blood glucose levels
🟢 B. Increased respiratory rate and tidal volume
🔴 Explanation: During pregnancy, hormonal changes (primarily
,progesterone) stimulate the respiratory center, leading to an increased
respiratory rate, tidal volume, and minute ventilation to meet the oxygen
demands of the mother and fetus. Cardiac output and blood volume
actually increase, while fasting blood glucose levels normally decrease
due to increased cellular utilization.
Which sign or symptom is considered a presumptive (subjective) indicator
of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones heard by Doppler
C. Amenorrhea
D. Goodell sign
🟢 C. Amenorrhea
🔴 Explanation: Amenorrhea is a presumptive (subjective) change of
pregnancy reported by the woman herself. A positive pregnancy test and
Goodell sign are probable (objective) signs, while hearing fetal heart tones
is a positive (diagnostic) sign of pregnancy.
A postpartum client on her first day after a vaginal delivery reports severe,
continuous perineal pain and a feeling of pressure. On inspection, the
perineum is edematous and bluish, but no hematoma is immediately
visible. What is the priority nursing action?
A. Apply warm moist compresses to the perineum
B. Administer prescribed oxycodone and notify the healthcare provider
C. Encourage early ambulation to the bathroom
D. Reassure the client that this is a normal finding after delivery
🟢 B. Administer prescribed oxycodone and notify the healthcare provider
🔴 Explanation: Severe, unrelenting perineal pain and pressure
accompanied by swelling and discoloration strongly suggest a concealed
perineal hematoma. Prompt medical evaluation is required, alongside pain
management and provider notification, as expanding hematomas can lead
to significant blood loss.
A nurse is educating the parents of a 6-month-old infant regarding the
introduction of solid foods. Which food should the nurse advise the
parents to introduce first?
A. Whole cow milk
B. Iron-fortified single-grain cereal
C. Scrambled eggs
D. Honey-glazed carrots
🟢 B. Iron-fortified single-grain cereal
🔴 Explanation: Iron-fortified single-grain infant cereal (such as rice or
oatmeal) is traditionally recommended as the first solid food because
infants deplete their congenital iron stores around 6 months of age, and
,cereals carry a low allergen risk. Cow milk should not be given before 12
months, and honey must be avoided due to the risk of infant botulism.
A 4-year-old child is admitted to the pediatric unit with acute
laryngotracheobronchitis (croup). Which clinical manifestation should the
nurse anticipate observing?
A. Drooling and severe dysphagia
B. Inspiratory stridor, barky cough, and hoarseness
C. High fever and cherry-red epiglottis
D. Expiratory wheezing and thick frothy sputum
🟢 B. Inspiratory stridor, barky cough, and hoarseness
🔴 Explanation: Croup is characterized by classic upper airway
inflammation presenting with a seal-like barky cough, inspiratory stridor,
and hoarseness. Drooling, severe dysphagia, and a cherry-red epiglottis
are hallmarks of acute epiglottitis, which is a medical emergency.
During a prenatal visit, a client at 32 weeks gestation complains of
dependent edema in her lower extremities at the end of the day. What is
the best initial nursing response?
A. Advise complete bed rest in the left lateral position for the remainder of
the pregnancy
B. Explain that mild dependent edema is common due to decreased
venous return from the lower extremities
C. Immediately collect a 24-hour urine sample for protein analysis
D. Instruct the client to restrict all sodium and fluid intake immediately
🟢 B. Explain that mild dependent edema is common due to decreased
venous return from the lower extremities
🔴 Explanation: Mild physiological dependent edema is a normal finding
in late pregnancy caused by the pressure of the enlarging uterus on pelvic
veins, which slows venous return. Reassurance and comfort measures
(such as elevation and left lateral positioning) are appropriate unless
accompanied by hypertension and proteinuria (preeclampsia).
A nurse is caring for a newborn immediately after birth. Which nursing
intervention takes highest priority?
A. Administering Vitamin K intramuscularly
B. Applying erythromycin ophthalmic ointment to both eyes
C. Maintaining a patent airway and thermoregulation
D. Obtaining footprints for identification records
🟢 C. Maintaining a patent airway and thermoregulation
🔴 Explanation: The immediate priority for any newborn is stabilization,
which involves maintaining a patent airway and preventing cold stress
through effective thermoregulation. Prophylactic medications and
identification procedures are performed only after stabilization is achieved.
, A 2-month-old infant is brought to the clinic for routine immunizations.
Which vaccine should the nurse expect to administer according to the
standard CDC schedule?
A. Measles, mumps, and rubella (MMR)
B. Diphtheria, tetanus, and acellular pertussis (DTaP)
C. Hepatitis A (first dose)
D. Varicella vaccine
🟢 B. Diphtheria, tetanus, and acellular pertussis (DTaP)
🔴 Explanation: The DTaP vaccine series begins at 2 months of age,
along with inactivated poliovirus (IPV), Haemophilus influenzae type b
(Hib), pneumococcal conjugate (PCV13), and rotavirus (RV) vaccines.
MMR and Varicella are contraindicated before 12 months of age.
A laboring client at 39 weeks gestation suddenly experiences severe
abdominal pain, a rigid board-like abdomen, and dark red vaginal
bleeding. Fetal heart monitoring shows late decelerations. What
complication does the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Vasa previa
🟢 C. Abruptio placentae
🔴 Explanation: Abruptio placentae (premature separation of a normally
implanted placenta) classically presents with painful dark red bleeding,
uterine tenderness, and a hypertonic, board-like abdomen. Placenta
previa typically manifests with painless bright red bleeding.
A nurse is evaluating a school-age child diagnosed with type 1 diabetes
mellitus. Which symptom indicates hypoglycemia?
A. Flushed face, fruity breath odor, and lethargy
B. Tremors, sweating, tachycardia, and confusion
C. Polyuria, polydipsia, and polyphagia
D. Kussmaul respirations and severe abdominal pain
🟢 B. Tremors, sweating, tachycardia, and confusion
🔴 Explanation: Hypoglycemia triggers an adrenergic response, causing
tremors, sweating, tachycardia, nervousness, and altered mental status.
Options A, C, and D describe manifestations of hyperglycemia and
diabetic ketoacidosis (DKA).
A nurse is teaching a group of adolescent girls about reproductive health.
Which statement by an adolescent demonstrates a correct understanding
of dysmenorrhea?
A. "Primary dysmenorrhea is caused by an underlying pelvic pathology
like endometriosis."
B. "Prostaglandins released during menstruation cause painful uterine
EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
Core Domains:
Prenatal Development and Fetal Health Assessment
Labor, Delivery, and Intrapartum Nursing Interventions
Postpartum Adaptation and Newborn Care
Pediatric Growth, Development, and Nutritional Needs
Common Childhood Communicable and Chronic Illnesses
Pediatric Pharmacology and Safe Medication Administration
Family-Centered Care, Ethics, and Legal Responsibilities
Pediatric Emergency Management and Safety
Introduction:
This comprehensive examination serves to evaluate the critical knowledge,
clinical competence, and decision-making capabilities required in maternity and
pediatric nursing practice. Designed for nursing students and professionals, the
assessment rigorously tests core theoretical concepts, clinical judgment, and
evidence-based interventions across the lifespan of mother and child. Featuring
a dynamic blend of direct multiple-choice questions and complex clinical
scenarios, this test bank emphasizes real-world application, therapeutic
communication, safety compliance, and ethical standards. Successful
completion demonstrates mastery in fostering optimal health outcomes,
managing high-risk situations, and delivering compassionate, family-centered
care in diverse healthcare environments.
SECTION ONE: QUESTIONS 1–100
A nurse is assessing a pregnant client at 28 weeks gestation. Which
physiological change should the nurse expect to find?
A. Decreased cardiac output
B. Increased respiratory rate and tidal volume
C. Decreased blood volume
D. Elevated fasting blood glucose levels
🟢 B. Increased respiratory rate and tidal volume
🔴 Explanation: During pregnancy, hormonal changes (primarily
,progesterone) stimulate the respiratory center, leading to an increased
respiratory rate, tidal volume, and minute ventilation to meet the oxygen
demands of the mother and fetus. Cardiac output and blood volume
actually increase, while fasting blood glucose levels normally decrease
due to increased cellular utilization.
Which sign or symptom is considered a presumptive (subjective) indicator
of pregnancy?
A. Positive pregnancy test
B. Fetal heart tones heard by Doppler
C. Amenorrhea
D. Goodell sign
🟢 C. Amenorrhea
🔴 Explanation: Amenorrhea is a presumptive (subjective) change of
pregnancy reported by the woman herself. A positive pregnancy test and
Goodell sign are probable (objective) signs, while hearing fetal heart tones
is a positive (diagnostic) sign of pregnancy.
A postpartum client on her first day after a vaginal delivery reports severe,
continuous perineal pain and a feeling of pressure. On inspection, the
perineum is edematous and bluish, but no hematoma is immediately
visible. What is the priority nursing action?
A. Apply warm moist compresses to the perineum
B. Administer prescribed oxycodone and notify the healthcare provider
C. Encourage early ambulation to the bathroom
D. Reassure the client that this is a normal finding after delivery
🟢 B. Administer prescribed oxycodone and notify the healthcare provider
🔴 Explanation: Severe, unrelenting perineal pain and pressure
accompanied by swelling and discoloration strongly suggest a concealed
perineal hematoma. Prompt medical evaluation is required, alongside pain
management and provider notification, as expanding hematomas can lead
to significant blood loss.
A nurse is educating the parents of a 6-month-old infant regarding the
introduction of solid foods. Which food should the nurse advise the
parents to introduce first?
A. Whole cow milk
B. Iron-fortified single-grain cereal
C. Scrambled eggs
D. Honey-glazed carrots
🟢 B. Iron-fortified single-grain cereal
🔴 Explanation: Iron-fortified single-grain infant cereal (such as rice or
oatmeal) is traditionally recommended as the first solid food because
infants deplete their congenital iron stores around 6 months of age, and
,cereals carry a low allergen risk. Cow milk should not be given before 12
months, and honey must be avoided due to the risk of infant botulism.
A 4-year-old child is admitted to the pediatric unit with acute
laryngotracheobronchitis (croup). Which clinical manifestation should the
nurse anticipate observing?
A. Drooling and severe dysphagia
B. Inspiratory stridor, barky cough, and hoarseness
C. High fever and cherry-red epiglottis
D. Expiratory wheezing and thick frothy sputum
🟢 B. Inspiratory stridor, barky cough, and hoarseness
🔴 Explanation: Croup is characterized by classic upper airway
inflammation presenting with a seal-like barky cough, inspiratory stridor,
and hoarseness. Drooling, severe dysphagia, and a cherry-red epiglottis
are hallmarks of acute epiglottitis, which is a medical emergency.
During a prenatal visit, a client at 32 weeks gestation complains of
dependent edema in her lower extremities at the end of the day. What is
the best initial nursing response?
A. Advise complete bed rest in the left lateral position for the remainder of
the pregnancy
B. Explain that mild dependent edema is common due to decreased
venous return from the lower extremities
C. Immediately collect a 24-hour urine sample for protein analysis
D. Instruct the client to restrict all sodium and fluid intake immediately
🟢 B. Explain that mild dependent edema is common due to decreased
venous return from the lower extremities
🔴 Explanation: Mild physiological dependent edema is a normal finding
in late pregnancy caused by the pressure of the enlarging uterus on pelvic
veins, which slows venous return. Reassurance and comfort measures
(such as elevation and left lateral positioning) are appropriate unless
accompanied by hypertension and proteinuria (preeclampsia).
A nurse is caring for a newborn immediately after birth. Which nursing
intervention takes highest priority?
A. Administering Vitamin K intramuscularly
B. Applying erythromycin ophthalmic ointment to both eyes
C. Maintaining a patent airway and thermoregulation
D. Obtaining footprints for identification records
🟢 C. Maintaining a patent airway and thermoregulation
🔴 Explanation: The immediate priority for any newborn is stabilization,
which involves maintaining a patent airway and preventing cold stress
through effective thermoregulation. Prophylactic medications and
identification procedures are performed only after stabilization is achieved.
, A 2-month-old infant is brought to the clinic for routine immunizations.
Which vaccine should the nurse expect to administer according to the
standard CDC schedule?
A. Measles, mumps, and rubella (MMR)
B. Diphtheria, tetanus, and acellular pertussis (DTaP)
C. Hepatitis A (first dose)
D. Varicella vaccine
🟢 B. Diphtheria, tetanus, and acellular pertussis (DTaP)
🔴 Explanation: The DTaP vaccine series begins at 2 months of age,
along with inactivated poliovirus (IPV), Haemophilus influenzae type b
(Hib), pneumococcal conjugate (PCV13), and rotavirus (RV) vaccines.
MMR and Varicella are contraindicated before 12 months of age.
A laboring client at 39 weeks gestation suddenly experiences severe
abdominal pain, a rigid board-like abdomen, and dark red vaginal
bleeding. Fetal heart monitoring shows late decelerations. What
complication does the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Abruptio placentae
D. Vasa previa
🟢 C. Abruptio placentae
🔴 Explanation: Abruptio placentae (premature separation of a normally
implanted placenta) classically presents with painful dark red bleeding,
uterine tenderness, and a hypertonic, board-like abdomen. Placenta
previa typically manifests with painless bright red bleeding.
A nurse is evaluating a school-age child diagnosed with type 1 diabetes
mellitus. Which symptom indicates hypoglycemia?
A. Flushed face, fruity breath odor, and lethargy
B. Tremors, sweating, tachycardia, and confusion
C. Polyuria, polydipsia, and polyphagia
D. Kussmaul respirations and severe abdominal pain
🟢 B. Tremors, sweating, tachycardia, and confusion
🔴 Explanation: Hypoglycemia triggers an adrenergic response, causing
tremors, sweating, tachycardia, nervousness, and altered mental status.
Options A, C, and D describe manifestations of hyperglycemia and
diabetic ketoacidosis (DKA).
A nurse is teaching a group of adolescent girls about reproductive health.
Which statement by an adolescent demonstrates a correct understanding
of dysmenorrhea?
A. "Primary dysmenorrhea is caused by an underlying pelvic pathology
like endometriosis."
B. "Prostaglandins released during menstruation cause painful uterine
