NRNP 6552 MIDTERM EXAM LATEST 2025/2026 /NRNP6552 WEEK 6
MIDTERM EXAM QUESTIONS AND ANSWERS| VERIFIED ANSWERS
WITH RATIONALES/GRADE A+ ASSURED
Question 1
During a pelvic exam of a client at her 8-week prenatal visit, the nurse practitioner notes a
bluish discoloration of the cervix and vaginal mucosa. This probable sign of pregnancy is known
as:
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign
D. McDonald's sign
Correct Answer: C) Chadwick's sign
Rationale: Chadwick's sign is the bluish or purplish discoloration of the cervix, vagina, and
vulva due to increased vascular congestion in early pregnancy. Goodell's sign is the softening
of the cervix, and Hegar's sign is the softening of the lower uterine segment.
Question 2
A new mother is concerned because her 2-day-old infant, Leo, violently flings his arms and legs
outward and then pulls them toward his body after being startled by a loud noise. The clinician
should explain that this is a normal newborn reflex known as the:
A. Rooting reflex
B. Tonic neck reflex
C. Babinski reflex
D. Moro reflex
Correct Answer: D) Moro reflex
Rationale: The Moro reflex, or startle reflex, is a normal response in infants to a sudden loss of
support or a loud noise. The infant abducts and extends the arms, opens the hands, and then
adducts the arms in an embrace-like motion. It typically disappears by 3 to 6 months of age.
Question 3
Maria's last menstrual period (LMP) began on June 10, 2023. Using Naegele's rule, the nurse
,practitioner calculates her estimated date of delivery (EDD) to be:
A. March 17, 2024
B. March 3, 2024
C. September 17, 2024
D. April 7, 2024
Correct Answer: A) March 17, 2024
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP
and adding 7 days. June 10 minus 3 months is March 10. March 10 plus 7 days is March 17.
The year is adjusted accordingly.
Question 4
A 4-week-old infant, Ben, presents with forceful, non-bilious vomiting immediately after
feeding. His mother reports he seems hungry all the time. On physical examination, the clinician
palpates an olive-shaped mass in the epigastric region. These findings are most suggestive of:
A. Gastroesophageal reflux
B. Intussusception
C. Pyloric stenosis
D. Malrotation
Correct Answer: C) Pyloric stenosis
Rationale: Pyloric stenosis is characterized by hypertrophy of the pyloric muscle, causing
gastric outlet obstruction. This leads to the classic presentation of progressive, projectile, non-
bilious vomiting in an infant who remains hungry. The palpable "olive" is the hypertrophied
pylorus.
Question 5
At a 28-week prenatal visit, a client's blood pressure is 148/96 mmHg, and her urine dipstick is
positive for proteinuria. She also complains of a persistent headache. These findings are most
indicative of:
A. Gestational diabetes
B. Chronic hypertension
,C. Preeclampsia
D. Eclampsia
Correct Answer: C) Preeclampsia
Rationale: Preeclampsia is a multisystem disorder of pregnancy characterized by the new
onset of hypertension (≥140/90 mmHg on two occasions) and proteinuria after 20 weeks of
gestation. The presence of a headache is a symptom of severe features.
Question 6
An 18-month-old child, Ava, is brought to the clinic with a history of a high fever (103°F) for
three days, which has just resolved. This morning, she developed a diffuse, pink maculopapular
rash that started on her trunk and is spreading to her face and extremities. The child appears
well and is playful. This presentation is classic for:
A. Measles (Rubeola)
B. Roseola infantum (Exanthem subitum)
C. Varicella (Chickenpox)
D. Scarlet fever
Correct Answer: B) Roseola infantum (Exanthem subitum)
Rationale: Roseola is a common viral illness in young children, typically caused by human
herpesvirus 6. It is characterized by 3 to 5 days of high fever that resolves abruptly, followed
by the appearance of a maculopapular rash that starts on the trunk and spreads outwards.
Question 7
A pregnant client at 34 weeks' gestation presents to the emergency department with sudden,
painless, bright red vaginal bleeding. What is the most likely diagnosis?
A. Placenta previa
B. Placental abruption
C. Vasa previa
D. Cervical insufficiency
Correct Answer: A) Placenta previa
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the hallmark
, sign of placenta previa, a condition where the placenta partially or completely covers the
cervical os. In contrast, placental abruption typically presents with painful bleeding and
uterine tenderness.
Question 8
A 9-month-old infant presents with episodes of sudden, loud crying and pulling his knees to his
chest. During these episodes, his mother notes that he passes a stool that looks like "currant
jelly." Between episodes, the infant seems comfortable. These findings strongly suggest:
A. Gastroenteritis
B. Pyloric stenosis
C. Intussusception
D. Appendicitis
Correct Answer: C) Intussusception
Rationale: Intussusception is the telescoping of one segment of the intestine into another,
causing obstruction and vascular compromise. This leads to intermittent, colicky abdominal
pain. The "currant jelly" stool is a classic sign, consisting of a mixture of blood and mucus.
Question 9
A pregnant client at 32 weeks with severe preeclampsia is being monitored. Her recent lab work
shows a platelet count of 80,000/mm³, elevated liver enzymes (AST and ALT), and evidence of
hemolysis on a peripheral smear. These findings are characteristic of:
A. Acute fatty liver of pregnancy
B. Disseminated intravascular coagulation (DIC)
C. HELLP syndrome
D. Cholecystitis
Correct Answer: C) HELLP syndrome
Rationale: HELLP syndrome is a life-threatening complication of severe preeclampsia. The
acronym stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. It represents a
severe form of the disease with widespread endothelial and microvascular injury.
MIDTERM EXAM QUESTIONS AND ANSWERS| VERIFIED ANSWERS
WITH RATIONALES/GRADE A+ ASSURED
Question 1
During a pelvic exam of a client at her 8-week prenatal visit, the nurse practitioner notes a
bluish discoloration of the cervix and vaginal mucosa. This probable sign of pregnancy is known
as:
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign
D. McDonald's sign
Correct Answer: C) Chadwick's sign
Rationale: Chadwick's sign is the bluish or purplish discoloration of the cervix, vagina, and
vulva due to increased vascular congestion in early pregnancy. Goodell's sign is the softening
of the cervix, and Hegar's sign is the softening of the lower uterine segment.
Question 2
A new mother is concerned because her 2-day-old infant, Leo, violently flings his arms and legs
outward and then pulls them toward his body after being startled by a loud noise. The clinician
should explain that this is a normal newborn reflex known as the:
A. Rooting reflex
B. Tonic neck reflex
C. Babinski reflex
D. Moro reflex
Correct Answer: D) Moro reflex
Rationale: The Moro reflex, or startle reflex, is a normal response in infants to a sudden loss of
support or a loud noise. The infant abducts and extends the arms, opens the hands, and then
adducts the arms in an embrace-like motion. It typically disappears by 3 to 6 months of age.
Question 3
Maria's last menstrual period (LMP) began on June 10, 2023. Using Naegele's rule, the nurse
,practitioner calculates her estimated date of delivery (EDD) to be:
A. March 17, 2024
B. March 3, 2024
C. September 17, 2024
D. April 7, 2024
Correct Answer: A) March 17, 2024
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP
and adding 7 days. June 10 minus 3 months is March 10. March 10 plus 7 days is March 17.
The year is adjusted accordingly.
Question 4
A 4-week-old infant, Ben, presents with forceful, non-bilious vomiting immediately after
feeding. His mother reports he seems hungry all the time. On physical examination, the clinician
palpates an olive-shaped mass in the epigastric region. These findings are most suggestive of:
A. Gastroesophageal reflux
B. Intussusception
C. Pyloric stenosis
D. Malrotation
Correct Answer: C) Pyloric stenosis
Rationale: Pyloric stenosis is characterized by hypertrophy of the pyloric muscle, causing
gastric outlet obstruction. This leads to the classic presentation of progressive, projectile, non-
bilious vomiting in an infant who remains hungry. The palpable "olive" is the hypertrophied
pylorus.
Question 5
At a 28-week prenatal visit, a client's blood pressure is 148/96 mmHg, and her urine dipstick is
positive for proteinuria. She also complains of a persistent headache. These findings are most
indicative of:
A. Gestational diabetes
B. Chronic hypertension
,C. Preeclampsia
D. Eclampsia
Correct Answer: C) Preeclampsia
Rationale: Preeclampsia is a multisystem disorder of pregnancy characterized by the new
onset of hypertension (≥140/90 mmHg on two occasions) and proteinuria after 20 weeks of
gestation. The presence of a headache is a symptom of severe features.
Question 6
An 18-month-old child, Ava, is brought to the clinic with a history of a high fever (103°F) for
three days, which has just resolved. This morning, she developed a diffuse, pink maculopapular
rash that started on her trunk and is spreading to her face and extremities. The child appears
well and is playful. This presentation is classic for:
A. Measles (Rubeola)
B. Roseola infantum (Exanthem subitum)
C. Varicella (Chickenpox)
D. Scarlet fever
Correct Answer: B) Roseola infantum (Exanthem subitum)
Rationale: Roseola is a common viral illness in young children, typically caused by human
herpesvirus 6. It is characterized by 3 to 5 days of high fever that resolves abruptly, followed
by the appearance of a maculopapular rash that starts on the trunk and spreads outwards.
Question 7
A pregnant client at 34 weeks' gestation presents to the emergency department with sudden,
painless, bright red vaginal bleeding. What is the most likely diagnosis?
A. Placenta previa
B. Placental abruption
C. Vasa previa
D. Cervical insufficiency
Correct Answer: A) Placenta previa
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the hallmark
, sign of placenta previa, a condition where the placenta partially or completely covers the
cervical os. In contrast, placental abruption typically presents with painful bleeding and
uterine tenderness.
Question 8
A 9-month-old infant presents with episodes of sudden, loud crying and pulling his knees to his
chest. During these episodes, his mother notes that he passes a stool that looks like "currant
jelly." Between episodes, the infant seems comfortable. These findings strongly suggest:
A. Gastroenteritis
B. Pyloric stenosis
C. Intussusception
D. Appendicitis
Correct Answer: C) Intussusception
Rationale: Intussusception is the telescoping of one segment of the intestine into another,
causing obstruction and vascular compromise. This leads to intermittent, colicky abdominal
pain. The "currant jelly" stool is a classic sign, consisting of a mixture of blood and mucus.
Question 9
A pregnant client at 32 weeks with severe preeclampsia is being monitored. Her recent lab work
shows a platelet count of 80,000/mm³, elevated liver enzymes (AST and ALT), and evidence of
hemolysis on a peripheral smear. These findings are characteristic of:
A. Acute fatty liver of pregnancy
B. Disseminated intravascular coagulation (DIC)
C. HELLP syndrome
D. Cholecystitis
Correct Answer: C) HELLP syndrome
Rationale: HELLP syndrome is a life-threatening complication of severe preeclampsia. The
acronym stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. It represents a
severe form of the disease with widespread endothelial and microvascular injury.
