Maternal and Paediatric Health

Question 1

Which of the following represents a recommended weight gain during pregnancy?
A. 6-11 kgs
B. 11-16 kgs
C. 13-18 kgs
D. 18-20 kgs

Answer 1

B. 11-16 kgs

Question 2

Larry and Mary Smith had planned their first pregnancy for some time, but when it was confirmed, Mary felt conflicting emotions. She comes to the clinic for her first prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings about the pregnancy with the midwife. The midwife’s best response would be to:
A. Encourage her to consider abortion counselling
B. Encourage her to seek support from Larry
C. Reassure her that when she feels the baby move, her mixed feelings will disappear completely
D. Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned

Answer 2

D. Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned

Question 3

Mary’s last menstrual period was 11 April. Her EDD (expected date of delivery) would be:
A. 4 January
B. 18 January
C. 25 January
D. 4 February

Answer 3

B. 18 January

Negele’s Rule - this is used for estimating the expected date of delivery (EDD) based on LMP (last menstrual period).

Last menstrual period - 3 months + 7 days + 1 year = expected date of delivery

Question 4

Which of the following statements can be used as a guideline for planning diets during pregnancy?
A. An increase of 300 calories per day beginning in the first trimester
B. A ten percent increase in protein above daily requirements
C. Iron supplementation is recommended for women whose diets are lacking in iron
D. The requirement for folic acid is increased by 50 percent

Answer 4

C. Iron supplementation is recommended for women whose diets are lacking in iron

Question 5

During a subsequent visit, Mary states she has begun to feel foetal movement. Foetal movement is usually felt by the pregnant woman when the foetus is approximately
A. 12 weeks gestation
B. 16 weeks gestation
C. 22 weeks gestation
D. 26 weeks gestation

Answer 5

B. 16 weeks gestation

Question 6

During Tui’s sixth week of pregnancy, she experienced a small episode of vaginal bleeding. You should suspect?
A. Placenta previa
B. Urinary tract infection
C. Threatened abortion
D. Abruption placenta

Answer 6

C. Threatened abortion

Question 7

Four purposes of chromosomal studies, amniocentesis is most commonly performed:
A. Anytime in early pregnancy
B. Usually not until after the 12th week
C. Usually not until after the 20th week
D. Anytime during pregnancy

Answer 7

B. Usually not until after the 12th week

Amniocentesis is a medical procedure used primarily in the prenatal diagnosis of genetic conditions. It has other uses such as in the assessment of infection and foetal lung maturity.

Question 8

Tina, a midwife, tells an antenatal class that progesterone is considered the hormone most responsible for maintaining pregnancy. Where is the primary source of progesterone found throughout most of the pregnancy?
A. The placenta
B. The corpus luteum
C. The ovary
D. The pituitary gland

Answer 8

A. The placenta

Question 9

A preterm infant born at 32-weeks gestation and diagnosed with hyperbilirubinemia has a total serum bilirubin (TSB) level of 17 mg/dL on day 2 after birth. The next day, the TSB level is 25 mg/dL despite phototherapy treatment and frequent breastfeeding. Which intervention should the nurse anticipate next?
A. Transcutaneous bilirubin level
B. Continuous infusion of heparin
C. Exchange blood transfusion
D. Autologous transfusion of whole blood

Answer 9

C. Exchange blood transfusion

If phototherapy is ineffective and the condition is worsening, the objective is to remove damaged cells and excess bilirubin and replace it with normal blood.

Question 10

The nurse is obtaining a history from a 22-year old female client before administering the influenza vaccine. Which client statement should the nurse recognize as a contraindication to this vaccine and report to the healthcare provider?

Answer 10

“I took a pregnancy test last week and it was positive.”

Live vaccines, such as influenza, are not recommended during pregnancy, as the weakened pathogens could potentially cross the placenta and affect the fetus.

Question 11

A 6-month-old with croup presents to the emergency department with nasal flaring, intercostal retractions, and agitation. Which complication is priority for the nurse to monitor?
A. Hypoxia
B. Pleural effusion
C. Poor feeding
D. Dehydration

Answer 11

A. Hypoxia

The nurse’s priority is to monitor the client for hypoxia. Hypoxia occurs when there is inadequate tissue oxygenation. Hypoxia can cause respiratory arrest resulting from inadequate oxygenation of the lungs.

Question 12

Judy visits her lead maternity carer (LMC) and she orders various blood tests. One of the tests is a VDRL test. Judy asks what this test is for. Your best reply would be:
A. Chlamydia
B. Venereal disease
C. Gonorrhoea
D. Syphillis

Answer 12

D. Syphillis

The VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, which your body may produce if you have been infected with the bacteria that cause syphilis

Question 13

A patient asks the healthcare provider about the benefits of receiving th human papillomavirus (HPV) vaccine. Which statement is the most appropriate response by the healthcare provider?
A. “You will need to have a booster vaccination each year”
B. “You will no longer need to get a routine cervical exam”
C. “The HPV vaccine will protect you from all types of the virus”
D. “The HPV vaccine can help prevent cervical cancer”

Answer 13

D. “The HPV vaccine can help prevent cervical cancer”

Question 14

In which of the following conditions can the causative agent pass through the placenta and affect the foetus in utero?
A. Candidiasis
B. Gonorrhoea
C. Moniliasis
D. Rubella

Answer 14

D. Rubella

Question 15

Ali was treated for chlamydia during her pregnancy. If untreated, what is one of the effects it could have on the neonate?
A. Skin rashes
B. Eye infections
C. Brain damage
D. Urinary tract infections

Answer 15

B. Eye infections

Question 16

The neonate nurse is caring for a new born diagnosed with a gonococcal infection. Which of the following will the nurse expect to observe?
A. Purulent conjunctivitis
B. Hard and fixed lymph nodes
C. Generalised maculopapular rash
D. Changes in skin pigmentation

Answer 16

A. Purulent conjunctivitis

A woman with untreated gonorrhoea can pass the bacteria to her baby during childbirth. Symptoms usually include red eyes, thick pus in the eyes, and swelling of the eyelids.

Question 17

During her first prenatal visit, a woman asks why she is being screened for syphilis. Which of the following is the best response by the healthcare provider?
A. “If you have the infection, the safest time to treat you is during the first trimester”
B. “Syphilis can be transferred from you to your baby through the placenta”
C. “We must report all cases of syphilis to the health department”
D. “If you test positive you may need to be admitted to the hospital for care”

Answer 17

B. “Syphilis can be transferred from you to your baby through the placenta”

Question 18

The healthcare provider is assessing a female patient diagnosed with trichomoniasis. Which of the following characteristics would the healthcare provider use to describe the vaginal discharge of this patient?
A. White and curd-like
B. Frothy and malodorous
C. Clear and watery
D. Scant and blood-tinged

Answer 18

B. Frothy and malodorous

Question 19

At 35 weeks pregnant, Ali is diagnosed with Hypertension of Pregnancy (HOP). The signs and symptoms of HOP include:
A. Oedema and hypertension
B. Vomiting and headache
C. Proteinuria and hypertension
D. Oedema, proteinuria and hypertension

Answer 19

D. Oedema, proteinuria and hypertension

Question 20

Which of the following is most correct in Rh incompatibility?
A. Every pregnancy of an Rh negative mother with result in erythroblastosis
B. RhoGam is given only during the first pregnancy to prevent incompatibility
C. The condition can occur if the mother is Rh positive and the fetus is Rh negative
D. On the first pregnancy of the Rh negative mother, the fetus will not be affected

Answer 20

D. On the first pregnancy of the Rh negative mother, the fetus will not be affected

Question 21

Which of the following symptoms occurs with hydatidiform mole?
A. Fetal cardiac motion after 6 weeks gestation
B. Negative pregnancy test result
C. No foetal movements and foetal parts
D. No signs of bleeding

Answer 21

C. No foetal movements and foetal parts

Question 22

Kiri, a diabetic client is on the post natal ward after having a caesarean birth last evening for fetal distress. After the delivery from the diabetic mother, the baby is usually monitored closely because the baby often develops:
A. Hyperglycaemia
B. Anaemia
C. Rhesus problems
D. Hypoglycaemia

Answer 22

D. Hypoglycaemia

Question 23

Reading through the babies notes, you see that baby Zac had an Apgar score of 9 at one minute and 10 at five minutes. Which five characteristics are evaluated using this system?
A. The Babinski, Moro, stepping, swimming and grasping reflexes
B. Length, weight, suckling, breathing reflexes and disease symptoms
C. Heart rate, breathing, muscle tone, colour and reflex irritability
D. Reaction to cuddling, startling, irritability, vocal and visual response

Answer 23

C. Heart rate, breathing, muscle tone, colour and reflex irritability

Question 24

A term new born should pass the first meconium stool no later than how many hours after birth?
A. 6
B. 12
C. 24
D. 36

Answer 24

C. 24

Question 25

Baby Karyn has developed physiological jaundice on day two, which is the most likely due to:
1. ABO incompatibility
2. Immaturity of the neonatal liver
3. Breakdown of foetal red blood cells
4. Insufficient fluid intake in the first 24 hours
A. 1 and 2
B. 3 and 4
C. 2 and 4
D. 2 and 3

Answer 25

D. 2 and 3

Question 26

Karyn is placed in a biliwrap as part of phototherapy. What is the rationale for this?
A. Prevention of hypothermia
B. Promotion of neutral thermal environment
C. Promotion of rest and to reduce movement
D. Reduction of serum bilirubin levels

Answer 26

D. Reduction of serum bilirubin levels

Question 27

Judy is concerned that her baby has lost weight during the first few days of life. Baby Karyn weighed 3400 grams at birth and on day three weighed 3220 grams. You could best explain this to Judy by telling her the weight loss is:
A. A direct result of early poor milk supply
B. Abnormal and probably caused by neonatal infection
C. Normal as most babies lose weight in the first few days of life
D. A good indication to increase the feeding time at the breast

Answer 27

C. Normal as most babies lose weight in the first few days of life

Question 28

A single dose of Vitamin K was administered to Karyn after birth to promote:
A. Blood clotting
B. Coagulation of bilirubin
C. Foramen ovule closure
D. Digestion of complex proteins

Answer 28

A. Blood clotting

Question 29

Which of the following best describes the purpose of hysterosalpingograms?
A. Procedure to determine if the fallopian tubes are open or blocked
B. Procedure to introduce hormones into the fallopian tubes
C. Procedure to measure the amount of mucus in the fallopian tubes
D. Procedure to move the fertilised ovum from the fallopian tube to uterus

Answer 29

A. Procedure to determine if the fallopian tubes are open or blocked

Question 30

Greta has suffered from menorrhagia in the past. Menorrhagia is:
A. Infrequent menstruation
B. An excessive menstruation
C. Bleeding between periods
D. Cessation of menstruation

Answer 30

B. An excessive menstruation

Question 31

A female adolescent, who has pelvic inflammatory disease (PID), inquires about the effects of the disease on her ability to bear children. Which is the pediatric nurses’ best response?
A. “The occurrence of spontaneous abortion during pregnancy increases with PID”
B. “There is an increased risk of ectopic pregnancy or infertility”
C. “There is an increased risk of placenta previa”
D. “There should be no problems with your ability to conceive”

Answer 31

B. “There is an increased risk of ectopic pregnancy or infertility”

Question 32

The nurse is teaching a class in the community on common myths regarding fertility and infertility. Which statement made by a class participant indicates teaching has been successful?
A. “If my husband works out everyday, he won’t be able to make a baby”
B. “If we have intercourse standing up, we won’t be able to conceive”
C. “If we have intercourse on the even days after ovulation, we will conceive a girl”
D. “If my husband sits in the hot tub every night, his sperm count will decrease”

Answer 32

D. “If my husband sits in the hot tub every night, his sperm count will decrease”

Question 33

A cause for male infertility is known as dry orgasm or retrograde ejaculation which occurs when:
A. Testosterone level decreases
B. Semen enters the bladder instead of emerging through the penis
C. The semen’s passage to the urethra is blocked
D. Sperm continuously dies while stored in epididymitis

Answer 33

B. Semen enters the bladder instead of emerging through the penis

Question 34

How an chlamydia or gonorrhea infections result in infertility or an ectopic pregnancy?
A. They cause abnormal hormonal stimulation in the tube
B. The sperm motility is reduced in the tube
C. There is scarring of the tube
D. The matured oval is enlarged and blocked in the tube

Answer 34

C. There is scarring of the tube

Question 35

Leila asks you when she should stop having cervical smears. It is recommended until she is:
A. 70 years old
B. At menopause
C. Not sexually active
D. 65 years old

Answer 35

A. 70 years old

Question 36

Leila has a family history of breast cancer and asks about breast screening. Breast screening is provided free of charge to New Zealand women from the age of:
A. 45-69 years
B. 45-70 years
C. 40-50 years
D. 40-60 years

Answer 36

A. 45-69 years

Question 37

Why should another form of contraception be used for about one month following vasectomy?
A. This is a temporary contraception method
B. Sperm could still be present distal to the area of ligation
C. To stop the production of sperm
D. The secretion of seminal fluid increases the changes of fertilisation

Answer 37

B. Sperm could still be present distal to the area of ligation

Question 38

A young female client visits a clinic for guidance on using barrier method of contraception. Which method would be most appropriate method to recommend to the client?
A. Diaphragm
B. Copper IUD
C. Depo Provera
D. Emergency pills

Answer 38

A. Diaphragm

Question 39

A nurse is instructing a patient on birth control methods. The patent asks about the cervical mucus method. When should the nurse tell the patient she is fertile in relation to her mucus?
A. Cervical mucus is not a reliable indicator
B. When it is thick
C. When it is clear, slippery and stretches
D. When it does not stretch

Answer 39

C. When it is clear, slippery and stretches

Question 40

A woman who chooses to take the emergency contraceptive pill (Levonorgestrel) must do so within how many hours of unprotected sexual intercourse?
A. 24 hours after sexual intercourse
B. 72 hours after sexual intercourse
C. 14 hours after sexual intercourse
D. Two weeks after sexual intercourse

Answer 40

B. 72 hours after sexual intercourse

Question 41

Julie’s last menstrual period (LMP) was January 19th 2019. Using Naegales rule her expected date of delivery (EDD) is:

Answer 41

October 27th

Question 42

A positive sign of pregnancy is:
A. A positive pregnancy test
B. Ballottement
C. Increase in abdominal size
D. Hearing foetal heart

Answer 42

D. Hearing foetal heart

Question 43

Judy’s friend Mia has been admitted to the maternity ward in labour. A probable sign of labour is:
A. Bleeding
B. Pain
C. Cervical dilation
D. Braxton-Hicks contractions

Answer 43

D. Braxton-Hicks contractions

Question 44

Which of the following signs should be reported promptly during the antenatal period?
A. Nasal stuffiness
B. Leaking amniotic fluid
C. Breast tenderness
D. Constipation

Answer 44

B. Leaking amniotic fluid

Question 45

At each clinic, the midwife checks the foetal heart. The normal foetal heart rate ranges from:
A. 140-180 beats per minute
B. 80-120 beats per minute
C. 120-160 beats per minute
D. 70-100 beats per minute

Answer 45

C. 120-160 beats per minute

Question 46

Ali has had her baby four hours ago and is now on the postnatal ward where you are helping to take care of her. While checking Ali’s fundus on day one post partum, you observe that the level of the fundus is at the umbilicus and displaced to the right. You evaluate that Ali probably has:
A. A full bladder
B. Overstretched uterine ligaments
C. A slow rate of involution
D. Retained placental products

Answer 46

A. A full bladder

Question 47

Judy is keen to breast feed baby. What does breast milk provide in addition to nourishment for the infant?
A. Maternal antibodies
B. Endorphins that soothe the infant
C. Stimulus for red blood cell production
D. Hormones that stimulate growth

Answer 47

A. Maternal antibodies

Question 48

Involution is the process by which:
A. The uterus progressively reduces in size
B. Milk is expressed from the breasts
C. The pelvic floor regains its muscle tone
D. The bladder returns to normal

Answer 48

A. The uterus progressively reduces in size

Question 49

The hormone responsible for the let-down reflex when breastfeeding is:
A. Oxytocin
B. Prolactin
C. Progesterone
D. Oestrogen

Answer 49

A. Oxytocin

Question 50

Kiri is now day four post partum and due to go home later today. She is concerned because her milk looks watery and blue in appearance. You explain this is:
A. A sign of immature breast milk
B. An indication to wean the baby
C. A normal variation in breast milk colour
D. A sign that the breast milk is of poor quality

Answer 50

C. A normal variation in breast milk colour

Question 51

Karyn’s umbilical cord was inspected at birth. Judy asks the nurse what the cord consists of? the nurse response that the umbilical cord was normal, which of the following is a normal umbilical cord structure?
A. Two veins and one artery
B. Two arteries and one vein
C. One artery and one vein
D. Wharton’s jelly, one artery and one vein

Answer 51

B. Two arteries and one vein

Question 52

Which of the following does the Guthrie test NOT screen for?
A. Cystic fibrosis
B. Icterus neonatorum
C. Phenylketonuria
D. Hypothyroidism

Answer 52

B. Icterus neonatorum

A blood sample is taken from your baby’s heel at or as soon as possible after 24 hours of age (the ‘heel prick’ or ‘Guthrie’ test). If a disorder is found, early treatment can prevent permanent damage or death.

Question 53

Pica is defined as:
A. Intolerance to milk products
B. Iron-deficiency anaemia
C. Ingestion of non food substances
D. Episodes of anorexia and vomiting

Answer 53

C. Ingestion of non food substances

Question 54

What lifestyle changes may reduce a woman’s risk of breast cancer?
A. Staying trim and exercising regularly
B. Drinking a glass of wine, preferably red, each day
C. Regular mammography screening
D. There is little you can do to lower your chances of developing breast cancer

Answer 54

A. Staying trim and exercising regularly

Question 55

The first sign of pregnancy is usually:
A. Thinning hair and excessive tiredness
B. Immediate weight gain
C. Amenorrhoea
D. Nausea and vomiting

Answer 55

C. Amenorrhoea

The absence of monthly menstrual periods.

Question 56

If untreated, gonorrhoea can result in what health problems for men?
A. Epididymitis
B. Benign polyps
C. Testicular cancer
D. Both A and B

Answer 56

A. Epididymitis

Inflammation of the tube at the back of the testicle that stores and carries sperm.

Question 57

Chelsea is a two year old who has been admitted to the children’s ward pre-operatively for a bilateral myringotomy an insertion of ventilation tubes due to chronic otitis media. You are the admitting student nurse and your Registered Nurse Mentor (RNM) asks you to complete the pre-operative checklist.

What is the rationale for ensuring Chelsea’s weight is accurately recorded in her medical documentation and patient identification label?
A. To ensure all paperwork is ticked off prior to sending her to the operating theatre
B. To ensure that the prescriber’s are calculating drug dosages correctly related to her weight
C. To indicate whether Chelsea has had food and/or fluids prior to surgery
D. To ensure that you are able to work out Chelsea’s weight percentile prior to surgery

Answer 57

B. To ensure that the prescriber’s are calculating drug dosages correctly related to her weight

Question 58

Chelsea’s father asks you to explain why she has continual ‘ear infections’. You explain:
A. All the children have ear infections, it is very common
B. When children attend childcare, they can pick up infections easily
C. The eustachian tubes in toddlers are shorter, wider and straighter which may contribute to the recurrent infections
D. It is probably because she is being fed with a bottle when she goes to bed

Answer 58

C. The eustachian tubes in toddlers are shorter, wider and straighter which may contribute to the recurrent infections

Question 59

Chelsea returns from the operating theatre and is sleepy but rousable. You complete a full set of vital signs and calculate the PEWS score as 0. As the student nurse your role is to:
A. Inform the Paediatric consultant
B. Inform the nurse in charge
C. Inform the medical officer and increase observations to half hourly
D. Report directly to your RNM to discuss what is the most appropriate clinical decision

Answer 59

D. Report directly to your RNM to discuss what is the most appropriate clinical decision

Question 60

When your RNM asks you to communicate with Chelsea, you understand that when a child has potential hearing deficit it is important to:
A. Establish eye contact with the parent so that they know you are caring
B. Establish eye contact with the child and speak without using exaggerated mouth movements
C. Talk in long sentences so that you can reduce the amount of time spent with interventions
D. Sit at face level with the child on the bed when talking to ensure you have their full attention

Answer 60

B. Establish eye contact with the child and speak without using exaggerated mouth movements

Question 61

Chelsea’s father comes to the nurse’s station and says he thinks Chelsea has some pain in her left ear, after completing a pain assessment and discussing this with your RNM, you decide to give paracetamol. Why is Paracetamol an appropriate medication to give to Chelsea?
A. It is commonly used analgesic agent used in paediatric patients, with few significant side effects
B. Incorrect: It is commonly used for mild to moderate pain relief and can be combined with opioid agents
C. Hepatotoxicity can result if prolonged prescribed doses are higher than 15mg/kg/dose
D. All of the above

Answer 61

D. All of the above

Question 62

When assessing Chelsea post-operatively for fever, which method for taking her temperature would be the most appropriate?
A. Using an axillary temperature probe due to her having aural surgery which may affect the reading or cause discomfort
B. Using a tympanic temperature probe
C. Using an oral temperature probe and asking Chelsea to be still while it reads
D. Asking Chelsea’s father to feel her forehead and see if it feel’s ‘normal’ for her

Answer 62

A. Using an axillary temperature probe due to her having aural surgery which may affect the reading or cause discomfort

Question 63

Your RNM has asked you to redress the wound on Manaia’s leg. While you are assessing the dressing, you notice that her left leg feels warmer than the right leg and Manaia tells you that the pain relief you gave her earlier is not working. This could be:
A. Potential post-operative complication of deep vein thrombosis or compartment syndrome
B. Complication of bleeding from the wound site
C. Complication of the wound dressing being too tight over the wound
D. Normal process in the post-operative period

Answer 63

A. Potential post-operative complication of deep vein thrombosis or compartment syndrome

Question 64

When looking at the menu for lunch, you check the ingredients. Which grain can Manaia have that will not affect her coeliac disease?
A. Oats
B. Barley
C. Wheat
D. Rice

Answer 64

D. Rice

Question 65

Which of the following symptoms are associated with coeliac disease? Choose three answers.
A. Rapid weight gain
B. Abdominal distention, pain and flatulence.
C. Chronic constipation
D. Diarrhoea

Answer 65

B. Abdominal distention, pain and flatulence.
C. Chronic constipation
D. Diarrhoea

Question 66

Manaia’s mother is concerned that the medication you are giving her daughter may have gluten in it which she is not allowed due to her coeliac disease. Your understanding of this condition is:
A. Stools are often unformed and are a liquid consistency
B. Is diagnosed through endoscopy only after gluten has been removed from the diet
C. It is an autoimmune disease also known as gluten enteropathy
D. Is a malabsorption syndrome due to the body’s ability to absorb wheat

Answer 66

C. It is an autoimmune disease also known as gluten enteropathy

Question 67

Manaia is being discharged this afternoon, her wound clips need removal in approximately 12 days. As part of your discharge education, you advise:
A. Limit mobility to increase the chance of better wound healing
B. Monitor the wound daily for increased signs of pain, swelling, heat, odour or ooze that may indicate infection
C. Remove the wound dressing in one week to check how the wound is healing
D. Bath the wound daily in a normal saline solution

Answer 67

B. Monitor the wound daily for increased signs of pain, swelling, heat, odour or ooze that may indicate infection

Question 68

Manaia has been prescribed paracetamol and tramadol as part of her discharge medications. As adjuvant medications you know that:
A. Taking paracetamol regularly and tramadol when required can work well together to provide good pain control
B. Tramadol being a synthetic opioid should not be prescribed for children
C. Strong pain relievers can become addictive if used regularly when not required
D. Taking paracetamol regularly should reduce the requirement for taking tramadol

Answer 68

A. Taking paracetamol regularly and tramadol when required can work well together to provide good pain control

Question 69

What is multimodal analgesia?
A. The use of the same analgesic via different administering routes
B. The use of several different types of analgesic agents together for pain management
C. The use of analgesia multiple times during your shift
D. The use of analgesics and non-pharmacological interventions for pain management

Answer 69

B. The use of several different types of analgesic agents together for pain management

Question 70

Ben is a 14 year old boy with type 1 diabetes, he is admitted to the emergency department, he is flushed and drowsy and his skin is dry. His father states that Ben has been feeling progressively worse since the morning. What is Ben most likely experiencing?
A. Ketoacidosis
B. Somogyi phenomenon
C. Hypoglycaemia
D. Dawn syndrome

Answer 70

A. Ketoacidosis

Question 71

Ben has some of the symptoms of a cold. What signs and symptoms alert his parent to the likelihood of ketoacidosis?
A. Ear pain
B. Chest congestion
C. Fruity smelling breath, nausea
D. Hyperactivity

Answer 71

C. Fruity smelling breath, nausea

Question 72

Ketoacidosis is a life threatening condition resulting from the combination of dangerously high levels of ketones and blood glucose. This makes the blood too acidic, which can change the functioning of internal organs such as the liver and kidneys. Early signs and symptoms of ketoacidosis include:
A. Hypotension, altered level of consciousness and coma.
B. Polyuria, polydipsia and polyphagia.
C. Weight loss, abdominal pain and fruity smelling breath.
D. Polyuria, dehydration and shock.

Answer 72

B. Polyuria, polydipsia and polyphagia.

Question 73

What occurs as a result of inadequate secretion of insulin?
A. Serum glucose levels are markedly decreased
B. Protein synthesis is increased
C. More rapid conversion and storage of carbohydrates to glucose occurs
D. Increased fat breakdown leads to ketonemia

Answer 73

D. Increased fat breakdown leads to ketonemia

Question 74

You are talking to Ben about using the side of his finger for blood testing, he asks you why this is important. Your response is:
A. It is less likely to become infected
B. It is easier to puncture
C. It has fewer capillaries
D. It has fewer nerve endings

Answer 74

D. It has fewer nerve endings

Question 75

When discussing how to administer insulin, what do you instruct Ben to do?
A. Inject the needle into the subcutaneous level of the skin
B. Select an injection site that was recently used
C. Give the injection deep into the muscle
D. Make sure the injection sites are six inches apart

Answer 75

A. Inject the needle into the subcutaneous level of the skin

Question 76

Ben tells you that he often east foods that he knows he shouldn’t eat when he is out with his friends because he is tired of being different from everybody else. A strategy to manage this situation is:
A. Ben is developing his sense of identity with his friends and fitting in; in his part of the developmental stage and this should be acknowledged
B. Consult with a dietitian and document a list of recommended foods that Ben should follow
C. Tell his father the types of foods Ben is eating when with friends
D. Write a referral to the diabetes nurse specialist to deal with theses issues

Answer 76

A. Ben is developing his sense of identity with his friends and fitting in; in his part of the developmental stage and this should be acknowledged

Question 77

The respiratory system in children differs from adults in several different ways. Select the most correct answer.
A. Oxygen consumption is low in children in proportion to body size; metabolic rate is lower than adults
B. Accessory muscles of respiration are not as strong in children, particularly infants
C. Airway diameter is larger in children, which reduces the potential for obstruction
D. Respiratory rates area lower than or equal to adults

Answer 77

B. Accessory muscles of respiration are not as strong in children, particularly infants

Question 78

Levi is a 5-year-old boy and diagnosed with cerebral palsy (CP) as an infant, when it was noted that he had spasticity which affects his muscle. While in hospital, Levi is trying to communicate with you about what he has been doing on the ward. How would you communicate with Levi?
A. Take you time and sit and listen
B. Ring the speech language therapist
C. Get his family to interpret for him
D. Talk to his mum, ensure his posture enhances his communication, and use a device such as a tablet or white board

Answer 78

D. Talk to his mum, ensure his posture enhances his communication, and use a device such as a tablet or white board

Question 79

Levi’s mum asks you to explain why he had a seizure last time when he had a ‘really high temperature’. Your response regarding febrile seizures is:
A. They occur when the body temperature exceeds 38.3 C
B. They usually lead to the development of epilepsy
C. They can be prevented by an anticonvulsant medication
D. They occur when the temperature rises too quickly

Answer 79

D. They occur when the temperature rises too quickly

Question 80

Corey is an 8 year old and has had increasing trouble with abdominal pain over the past 12 months. As the student nurse working with the RNM, you are responsible for providing care for Corey who has been admitted for assessment and treatment.

When assessing his gastrointestinal system, he complains of the following:

Pain while having a bowel movement
Dry and difficult stools to pass
Abdominal pain
Bowel movement twice a week
Traces of liquid stools in his underwear
You suspect the following diagnosis:
A. Constipation
B. Rectal prolapse
C. Coeliac disease
D. Anal fissures

Answer 80

A. Constipation

Question 81

Because Corey has small dry stools, you would recommend which foods to include in his diet?
A. Pretzels
B. Yoghurt
C. Cooked vegetables
D. Whole-grain cereal

Answer 81

D. Whole-grain cereal

Question 82

The treatment pathway for moderate croup is:
A. 6-8 puffs of Salbutamol via a spacer and discharge home
B. Dexamethasone 0.6mg/kg or 2-3 days of prednisolone and discharge home
C. 10 day course of oral Augmentin and discharge home
D. Admission, monitoring and symptoms management

Answer 82

B. Dexamethasone 0.6mg/kg or 2-3 days of prednisolone and discharge home

Question 83

Rose’s mother informs you that Rose’s Brother Sam has recently been diagnosed with asthma. Your understanding of asthma is:
A. It is a condition that requires patients to use an inhaler every day
B. Asthma is a respiratory condition that children usually grow out of by the time they are 16 years old
C. It is a chronic inflammation condition where inhaled drugs are the mainstay for all ages
D. It is a condition which increases work of breathing and is exacerbated by cold air

Answer 83

C. It is a chronic inflammation condition where inhaled drugs are the mainstay for all ages

Question 84

What are characteristic features of asthma:
A. Wheeze and cough
B. Dyspnoea
C. Chest tightness
D. All of the above

Answer 84

D. All of the above

Question 85

Which of the following statements are common fallacies (are not true) about pain in babies, children or adolescents?
A. Neonates and young children do not feel pain.
B. Nurses commonly underestimate pain levels in children.
C. Opioids can be safely used in children and adolescents, including low weight babies.
D. If children or young people report pain this must be treated.

Answer 85

A. Neonates and young children do not feel pain.