NR602 PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING
FAMILY PRACTICUM EXAM STUDY
GUIDE
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine check-up. Her
glucose challenge test (GCT) result is 155 mg/dL. What is the most appropriate next step in
management?
A. Diagnose Gestational Diabetes Mellitus (GDM) and start insulin
B. Repeat the 1-hour GCT in two weeks
C. Perform a 3-hour glucose tolerance test (GTT)
D. Advise the patient to decrease sugar intake and retest at 32 weeks
Answer: C
Conceptual Explanation: A 1-hour GCT result above 130-140 mg/dL is considered a
positive screen and requires a diagnostic 3-hour GTT to confirm Gestational Diabetes
Mellitus.
,2. Which of the following findings is considered a ‘presumptive’ sign of pregnancy?
A. Hegar’s sign
B. Fetal heart tones heard via Doppler
C. Positive urine hCG test
D. Amenorrhea
Answer: D
Conceptual Explanation: Presumptive signs are subjective data reported by the patient,
such as amenorrhea, nausea, and breast tenderness. Hegar’s sign and positive hCG are
probable signs, while fetal heart tones are positive signs.
3. A 4-month-old infant is brought to the clinic. Which developmental milestone should the
nurse practitioner expect the infant to have achieved?
A. Sitting independently without support
B. Rolling from back to front
C. Bringing hands to midline
D. Pincer grasp development
Answer: C
Conceptual Explanation: At 4 months, infants typically bring hands to midline and begin
to reach for objects. Sitting independently occurs around 6 months, and the pincer grasp
occurs around 9-10 months.
, 4. In the management of a pediatric patient with acute otitis media, which clinical finding is
the most essential indicator for prescribing antibiotics rather than ‘watchful waiting’?
A. Tympanic membrane erythema without bulging
B. Bulging of the tympanic membrane with acute pain
C. Presence of fluid in the middle ear
D. Temperature of 99.5 degrees Fahrenheit
Answer: B
Conceptual Explanation: Acute Otitis Media (AOM) diagnosis requires bulging of the TM
or new onset of otorrhea not due to otitis externa. Significant bulging and severe pain are
indications for immediate antibiotic therapy.
5. A 32-week gestation patient presents with painless vaginal bleeding. What is the priority
contraindication in her physical assessment?
A. Abdominal ultrasound
B. Leopold maneuvers
C. Digital vaginal examination
D. External fetal monitoring
Answer: C
CHILDBEARING AND CHILDREARING
FAMILY PRACTICUM EXAM STUDY
GUIDE
1. A 26-year-old primigravida at 28 weeks gestation presents for a routine check-up. Her
glucose challenge test (GCT) result is 155 mg/dL. What is the most appropriate next step in
management?
A. Diagnose Gestational Diabetes Mellitus (GDM) and start insulin
B. Repeat the 1-hour GCT in two weeks
C. Perform a 3-hour glucose tolerance test (GTT)
D. Advise the patient to decrease sugar intake and retest at 32 weeks
Answer: C
Conceptual Explanation: A 1-hour GCT result above 130-140 mg/dL is considered a
positive screen and requires a diagnostic 3-hour GTT to confirm Gestational Diabetes
Mellitus.
,2. Which of the following findings is considered a ‘presumptive’ sign of pregnancy?
A. Hegar’s sign
B. Fetal heart tones heard via Doppler
C. Positive urine hCG test
D. Amenorrhea
Answer: D
Conceptual Explanation: Presumptive signs are subjective data reported by the patient,
such as amenorrhea, nausea, and breast tenderness. Hegar’s sign and positive hCG are
probable signs, while fetal heart tones are positive signs.
3. A 4-month-old infant is brought to the clinic. Which developmental milestone should the
nurse practitioner expect the infant to have achieved?
A. Sitting independently without support
B. Rolling from back to front
C. Bringing hands to midline
D. Pincer grasp development
Answer: C
Conceptual Explanation: At 4 months, infants typically bring hands to midline and begin
to reach for objects. Sitting independently occurs around 6 months, and the pincer grasp
occurs around 9-10 months.
, 4. In the management of a pediatric patient with acute otitis media, which clinical finding is
the most essential indicator for prescribing antibiotics rather than ‘watchful waiting’?
A. Tympanic membrane erythema without bulging
B. Bulging of the tympanic membrane with acute pain
C. Presence of fluid in the middle ear
D. Temperature of 99.5 degrees Fahrenheit
Answer: B
Conceptual Explanation: Acute Otitis Media (AOM) diagnosis requires bulging of the TM
or new onset of otorrhea not due to otitis externa. Significant bulging and severe pain are
indications for immediate antibiotic therapy.
5. A 32-week gestation patient presents with painless vaginal bleeding. What is the priority
contraindication in her physical assessment?
A. Abdominal ultrasound
B. Leopold maneuvers
C. Digital vaginal examination
D. External fetal monitoring
Answer: C
