NR 602 PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING
FAMILY FINAL EXAM QUESTIONS AND
ANSWERS
1. A 24-year-old G1P0 at 28 weeks gestation presents for a routine visit. Her glucose challenge
test (GCT) result is 155 mg/dL. What is the next most appropriate step in her management?
A. Diagnose her with Gestational Diabetes Mellitus (GDM)
B. Repeat the 1-hour GCT in two weeks
C. Initiate insulin therapy immediately
D. Perform a 3-hour glucose tolerance test (GTT)
Answer: D
Conceptual Explanation: A 1-hour GCT result above 140 mg/dL is considered positive and
requires a diagnostic 3-hour GTT to confirm Gestational Diabetes.
2. Which of the following findings in a 4-month-old infant would be considered a ‘red flag’
requiring further developmental evaluation?
A. Failure to roll from back to stomach
,B. Lack of pincer grasp
C. Inability to sit unsupported
D. Persistent primitive reflexes such as the Moro reflex
Answer: D
Conceptual Explanation: Primitive reflexes should begin to disappear by 4 months.
Persistence of the Moro reflex or ATNR at this age can indicate neurological delay.
3. A 32-year-old female presents with a BMI of 31 and asks about starting combined oral
contraceptives (COCs). She smokes 10 cigarettes a day. Which of the following is the most
significant contraindication?
A. Her BMI
B. Her age
C. Her history of tension headaches
D. The combination of age and smoking status if she were over 35
Answer: D
Conceptual Explanation: While not yet 35, the combination of smoking and COCs
increases cardiovascular risk. However, strict CDC U.S. MEC guidelines state smoking and
age >35 is a Category 4 (unacceptable health risk).
, 4. A 2-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. The clinician suspects Croup. What is the first-line pharmacological treatment for mild
to moderate Croup?
A. Single dose of oral Dexamethasone
B. Oral Amoxicillin
C. Albuterol nebulizer
D. Inhaled Salmeterol
Answer: A
Conceptual Explanation: Dexamethasone is the gold standard for reducing airway
inflammation in Croup, regardless of severity.
5. During a prenatal visit at 36 weeks, a patient’s Group B Streptococcus (GBS) rectovaginal
culture returns positive. What is the recommended management plan?
A. Start oral Penicillin immediately
B. Schedule a Cesarean section at 39 weeks
C. Wait until the onset of labor to administer IV antibiotics
D. Treat the partner with a one-time dose of Azithromycin
Answer: C
Conceptual Explanation: Intrapartum antibiotic prophylaxis (IAP) is required once labor
starts or membranes rupture for GBS-positive women to prevent neonatal sepsis.
CHILDBEARING AND CHILDREARING
FAMILY FINAL EXAM QUESTIONS AND
ANSWERS
1. A 24-year-old G1P0 at 28 weeks gestation presents for a routine visit. Her glucose challenge
test (GCT) result is 155 mg/dL. What is the next most appropriate step in her management?
A. Diagnose her with Gestational Diabetes Mellitus (GDM)
B. Repeat the 1-hour GCT in two weeks
C. Initiate insulin therapy immediately
D. Perform a 3-hour glucose tolerance test (GTT)
Answer: D
Conceptual Explanation: A 1-hour GCT result above 140 mg/dL is considered positive and
requires a diagnostic 3-hour GTT to confirm Gestational Diabetes.
2. Which of the following findings in a 4-month-old infant would be considered a ‘red flag’
requiring further developmental evaluation?
A. Failure to roll from back to stomach
,B. Lack of pincer grasp
C. Inability to sit unsupported
D. Persistent primitive reflexes such as the Moro reflex
Answer: D
Conceptual Explanation: Primitive reflexes should begin to disappear by 4 months.
Persistence of the Moro reflex or ATNR at this age can indicate neurological delay.
3. A 32-year-old female presents with a BMI of 31 and asks about starting combined oral
contraceptives (COCs). She smokes 10 cigarettes a day. Which of the following is the most
significant contraindication?
A. Her BMI
B. Her age
C. Her history of tension headaches
D. The combination of age and smoking status if she were over 35
Answer: D
Conceptual Explanation: While not yet 35, the combination of smoking and COCs
increases cardiovascular risk. However, strict CDC U.S. MEC guidelines state smoking and
age >35 is a Category 4 (unacceptable health risk).
, 4. A 2-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. The clinician suspects Croup. What is the first-line pharmacological treatment for mild
to moderate Croup?
A. Single dose of oral Dexamethasone
B. Oral Amoxicillin
C. Albuterol nebulizer
D. Inhaled Salmeterol
Answer: A
Conceptual Explanation: Dexamethasone is the gold standard for reducing airway
inflammation in Croup, regardless of severity.
5. During a prenatal visit at 36 weeks, a patient’s Group B Streptococcus (GBS) rectovaginal
culture returns positive. What is the recommended management plan?
A. Start oral Penicillin immediately
B. Schedule a Cesarean section at 39 weeks
C. Wait until the onset of labor to administer IV antibiotics
D. Treat the partner with a one-time dose of Azithromycin
Answer: C
Conceptual Explanation: Intrapartum antibiotic prophylaxis (IAP) is required once labor
starts or membranes rupture for GBS-positive women to prevent neonatal sepsis.
