This document provides 20 multiple choice questions related to maternal and child nursing. The questions cover topics such as the menstrual cycle, fertilization, pregnancy, labor and delivery, postpartum care, and breastfeeding. Scenarios are provided for some questions to give context. The document appears to be from a review center and is intended to help examinees prepare for nursing licensure exams on maternal and child health topics.

1. DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098 - 1 –
Pre board Exam
Maternal and Child Nursing
Local Nursing Licensure Examination
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The care of childbearing and childrearing families is a major focus of
nursing practice, because to have healthy adults you must have healthy
children. To have healthy children, it is important to promote health of
the childbearing woman and her family from the time before children are
born until they reach adulthood.
1. Mrs. Bicut, a clinical instructor from Mababang Pamantasan ng
Gonads, was teaching her group of students about menstrual cycle.
She provided factual information that the length of menstrual cycle
differs from woman to woman but mentioned that the accepted
average length is 28days. She had mentioned that generally
ovulation occurs at which of the following times?
A. 7 days after the last day of menstruation
B. 14 days after the last day of the menstrual cycle
C. 7 days before the end of the menstruation
D. 14 days before the end of the menstrual cycle
(E/HE)
2. Nurse Katniss is teaching a newly married couple about the
process of fertilization. Fertilization (also referred to as conception,
impregnation or fecundation) is the union of an ovum and a
spermatozoon. Which statement by the couple would indicate
understanding of fertilization?
A. “Fertilization takes place in the fimbria of the fallopian tube.”
B. “Fertilization takes place in the uterine cavity.”
C. “Fertilization takes place in the isthmus (inner third) of the
fallopain tube.”
D. “Fertilization takes place in the ampulla (outer third) of the
fallopian tube.”
(An/HE)
3. The placenta (latin for pancake, which is descriptive of its size and
appearance at term), arises out of trophoblast tissue. It serves as
the fetal lungs, kidneys, and gastrointestinal tract and as a separate
endocrine organ throughout pregnancy. By which of the following
does the placenta transport nutrients and oxygen to the fetus?
A. Capacitation C. Facilitated diffusion
B. Fecundability D. Simple diffusion
(An/SQC)
4. When assessing a pregnant client’s physical condition, the nurse is
aware that a normal adaptation of pregnancy is an increased blood
supply to the pelvic region that results in purplish discoloration of
the vaginal muscosa and is considered as a probable sign of
pregnancy – more reliable than presumptive signs and can be
documented by the examiner as:
A. Piskacek sign C. Hegar’s sign
B. Goodell’s sign D. Chadwick’s sign
(An/SQC)
5. Traditionally, this date has been referred to as the expected date of
confinement (EDC). Because women are no longer “confined” after
childbirth, the abbreviation EDB (estimated date of birth) or EDD
(estimated date of delivery) is more commonly used today. (Pillitteri,
2007, p. 197) When is the EDC, EDB or EDD of the client?
A. June 16, 2011 C. November 16, 2011
B. July 16, 2011 D. December 16, 2011
(Ap/SQC)
Situation: Nurse Mickey is teaching a student nurse, Anna Poblacion,
the proper way of performing Leopold’s Maneuver. It is a systemic
method of observation and palpation to determine fetal presentation and
position. (Pillitteri, 2007, p. 514) A client came to the Health Nurse
Assessment Clinic and was unsure of her age of gestation (AOG). Nurse
Mickey assessed the client and estimated that she appears to be 16
weeks pregnant. Based on this situation, answer the following questions:
6. In doing Leopold’s maneuver, which among the following is not
considered a good preparation in providing client’s comfort?
A. Be certain that your hands are warm (by washing them in
warm water first if necessary)
B. The woman empties her bladder before palpation
C. The woman should lie in a supine position with her knees
flexed slightly
D. The hands of the nurse should be cold so that abdominal
muscles would contract and tighten
(Ap/SQC)
7. While Nurse Mickey discusses the different maneuvers, the student
nurse asked her the purpose of the first maneuver. Nurse Mickey
correctly responds by stating which of the following:
A. Determine engagement
B. Determine fetal back
C. Determine presenting part
D. Determine degree of flexion and extension
(An/SQC)
8. Student nurse Anna knows that since the AOG is already
mentioned by her clinical instructor she explains to the client that
the fundus is:
A. Just above the symphysis pubis and the fetal heart tone can
be heard via Doppler
B. At the midway of syphysis pubis and umbilicus and fetal heart
tone can be heard via fetoscope
C. At the level of the umbilicus and the fetal heart tone can be
heard via Stethscope
D. At the level of the xiphoid process and fetal heart tone can be
heard even without a device
(E/SQC)
SITUATION: Amniocentesis is the aspiration of amniotic fluid from the
pregnant uterus for examination. Mrs. Perry is about to undergo
amniocentesis to check for fetal lung maturity.
9. Mrs. Perry asks you about the procedure. The least appropriate
response is:
A. The test can provide information about genetic disorders, and
fetal lung maturity.
B. Real-time ultrasound is used to identify fetal parts and locate
pockets of amniotic fluid.
C. A small amount of clear drainage from the client’s vagina is
expected.
D. The client is discouraged to take a deep breath and hold it
while the needle is being inserted.
(E/HE)
10. During the procedure, 15 cc of amniotic fluid was aspirated. You
noted that it has a strong yellow color. Base on your knowledge,
you know that this may be due to:
A. Fetal distress
B. Bladder puncture
C. Blood incompatibility
D. Normal fetal development
(An/SQC)
11. Andy, 31 years old, a primigravid client was sent home by the
physician because she was not yet in labor and was told to
comeback when she is in true labor. Andy asked you about true
labor, you answered her appropriately by giving her which of the
following teachings?
A. Her cervix is 10cm dilated
B. There is expulsion of bloody show and BOW ruptures
C. There is progressive increase in the frequency, duration and
intensity of the contractions, and is unrelieved by ambulation
D. Ease of difficulty of breathing felt during the third trimester
because of lightening or descent of the uterus
(An/SQC, HE)
SITUATION: Demi was brought to the hospital at 30 weeks of gestation
due to headache and blurred vision. Her V/S upon admission are as
follows: BP: 160/110 mmHg; HR: 110 beats/min; RR: 27 breaths/min.
She has non-pitting facial edema and upper extremity edema.
12. Pre-eclampsia is any status above gestational hypertension and
below a point of seizures. For a severely pre-eclamptic client, it is
unwise to:

2. DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098 - 2 –
A. Obtain daily weights at the same time each day
B. Maintain a quiet environment
C. Keep the room brightly-lit to avoid accidents
D. Inform the client that only her closest support people may visit her
(E/SQC)
13. Demi is receiving Magnesium sulfate 40 g via IV. As the nurse assigned
to care for her, you know that the following are expected, aside from:
A. Muscle weakness
B. Bradypnea
C. Feeling of warmth
D. Urine output of 28 mL/hr
(An/SQC)
14. In prioritizing the plan of care for pregnant mothers who have
prolonged difficult labor and/or delivery that may be due to these
factors, namely: passenger, passageway, power, and pelvis.
Which of the following nursing actions receives the highest priority?
A. Fetal heart rate monitoring
B. Frequent repositioning of the client to provide comfort
C. Facilitating client’s relief by encouraging DBE
D. Consistently asking client’s pain level for further evaluation of
the severity of pain
(E/SQC)
15. Mastitis (infection of the breast) may occur as early as the seventh
postpartal day or not until the baby is weeks or months old. Mrs.
Flores suffers from painful, swollen breast diagnosed as mastitis.
Nurse Briana is assigned to her and performs all the following, except:
A. Administers prescribed antibiotics.
B. Suggest to the mother to express her milk manually from the
affected breast if it’s too painful.
C. Advise the mother to stop breastfeeding because the infant
might ingest the bacteria.
D. Advise the mother to wear a good supportive bra.
(E/SQC, HE)
16. In planning nursing interventions to ensure the safety of the fetus
and the mother, it is important to assess the stage of labor the
mother is in. During the first stage of labor, you should:
a. Perform perineal cleaning
b. Encourage the client to void every two hours
c. Assist in amniotomy
d. Prepare the birthing room
(E/SQC)
17. There are two changes that occur in the cervix as labor
progresses—these are called effacement and dilatation. The
following does not hold true with regard to effacement:
A. It occurs because uterine contractions gradually increase the
diameter of the cervical lumen
B. Effacement occurs because of longitudinal traction from the
uterine fundus
C. It is the shortening and thinning of the cervical canal
D. In multiparas, dilatation may occur before effacement is
complete.
(An/SQC)
18. Mrs. Cruz, a postpartum patient was in labor for 28 hours and had
ruptured membranes for 24 hours. For which of the following would
Nurse Diana be alert?
A. Salpingitis C. Endometritis
B. Endometriosis D. Pelvic thrombophlebitis
(S/SQC)
19. Mrs. Alyson, 8 weeks pregnant, is diagnosed with Breast Cancer.
She tells Nurse Gary, “What will I do? I can’t have chemotherapy
while I’m pregnant. By the time I give birth, the cancer might have
advanced.” Nurse Suzie would best say:
A. “It’s really a difficult decision to make. You’ll have to choose
between you and your baby.”
B. “You could undergo chemotherapy on your 2nd or 3rd trimester
and it will not greatly affect your baby.”
C. “You should opt for radiation treatment because it’s allowed
during pregnancy.”
D. “Do you want me to call your doctor, she can explain it to you.”
(E/SQC, HE)
20. Lynette was told that the fetal presentation was left occiput
posterior, which was resulting in prolonged labor and intense pain.
The physician ordered that an epidural block be done. You as the
nurse taking care of Lynette would administer nursing care post-
epidural block by doing all of the following but:
A. Check for bladder fullness regularly since the client may not
feel the urge to urinate and could cause complications
B. Ask client to stay in bed
C. Monitor vital signs, especially watching out for fever and low
blood pressure
D. Aid client in ambulation
(E/SQC)
21. Anette is now in her third stage of labor. As you are waiting for the
placenta to be expelled, you know that the following signs would be
observed once placenta has detached from the uterine wall, except:
A. Uterus is boggy and non-tender
B. There is sudden gush of blood from the vagina
C. You observe that the fundus returns up the abdomen
D. The umbilical cord lengthens
(An/SQC)
Situation: Feliciana, your 30-week pregnant client, was rushed to the
emergency room, complaining that she expelled blood-tinged mucus 24
hours ago. She also reports that some twenty minutes ago, a heavy
gush of warm liquid suddenly flowed. This was followed by regular, more
intense and more painful uterine contractions. Feliciana informs you that
her BOW has ruptured.
22. Knowing Nurse Feliciana’s status, you know that at this point she is
at high risk for which of the following conditions:
A. Precipitate labor
B. Intrauterine Infection
C. Prolonged dry labor due to fluid loss from BOW rupture
D. Bleeding
(An/SQC)
23. It is crucial to closely evaluate Felicity and her preterm baby’s
health. Upon expulsion, which should you immediately do?
A. Dry the infant and removing the cheesy material from the
newborn’s skin
B. Clamp and cut the umbilical cord
C. With a pre-warmed, dry blanket, receive the newborn to
prevent heat loss
D. Hold the newborn upside down to promote drainage of any
mucus from the airway
(E/SQC)
24. Delayed postpartal hemorrhage usually occurs within one to two
weeks after childbirth, most frequently as a result of subinvolution of
the placental site. Most often, subinvolution is due to:
A. Infected episiotomy site C. Uterine inversion
B. Uterine hematoma D. Retained placental fragments
(An/SQC)
25. Rubin identified three restorative phases that the mother undergoes
to regain energy lost during labor and to attain comfort in the
maternal role. In which phase is it ideal to conduct client teaching
regarding care of the infant?
A. Letting-go phase C. Taking-hold phase
B. Taking-in phase D. Letting-in phase
(An/HE)
26. Children of 7-12 years of age become aware of the concept of
conservation, which is constancy despite of transformation. The
nurse is about to test a school-ager's sense of conservation. The
most appropriate intervention to perform this is by:
A. Giving the child a group of numbered blocks and have him
arrange them according to some ordinal scale.
B. Giving the child a mixture of stamps, wrappers, and shells and
have him group them according to some classification system.
C. Showing the child two equal-length pencils side by side, then
move them out of alignment to see if he realizes they are still
the same length.
D. Stating a situation to the child, then have him anticipate the
consequences and rethink the action in a different direction.
(E/SQC)

3. DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098 - 3 –
27. Safety is vital to young children and problems arise when there is
lack of safety measures in the environment surrounding the child.
As a nurse, you reviewed infant safety procedures with a child’s
mother. You must discuss to the child’s parents that the two most
common accidents that happen in infants are:
A. Aspiration and Falls
B. Falls and auto Accidents
C. Poisoning and Burns
D. Drowning and Homicide
(S/SQC, HE)
28. Play is the universal language of the child, and it varies depending
on the stage of development. The American Academy of Pediatrics
suggests that caregivers do which of the following things in regard
to physical activities for preschoolers?
A. Push the child to practice sports activities while they are more
flexible
B. Encourage a variety of physical activities in a non-competitive
environment
C. Have the child engage in competitive sports to see where they
excel
D. Keep physical activities to a minimum until the child is in grade
school.
(E/SQC, HE)
29. Selly, an 8 month old infant is brought to the clinic for routine check-
up. The nurse is aware that the most appropriate toy for an 8 month
old infant is?
A. Finger paint
B. Cuddly bear
C. Small rubber ball
D. Play gym strung across the crib
(An/SQC)
30. Cognitive theory is founded by a Swiss psychologist, Jean Piaget.
There are several stages of cognitive theory depending on the age
of the child. Nurse Mika observed that a 4-year-old sibling of a
sudden infant death syndrome victim believes that she caused her
sibling's death because she wished for it. She understands that this
is a result of:
A. Abstract thinking
B. Concrete thinking
C. Magical thinking
D. Formal operational thinking
(S/SQC)
31. Tetralogy of Fallot (TOF) is a cyanotic congenital heart defect which
is classically understood to involve four anatomical abnormalities.
Nemo was scheduled for a palliative surgery, which creates
anastomosis of the subclavian artery to the pulmonary artery. This
procedure is known as:
A. Waterston-Cooley C. Brock Procedure
B. Rashkind Procedure D. Blalock-Taussig
(C/SQC)
32. Acute Lymphocytic Leukemia is a common type of cancer in
childhood. A toddler is suffering from ALL. The nurse is aware that
blood values may be decreased due to the condition. Which of the
following actions would be most appropriate when caring for a child
with leukemia who has a platelet count of 30,000/mm3?
A. Discouraging nose-blowing
B. Increasing iron-rich foods in the diet
C. Instituting strict isolation
D. Medicating for pain every 4 hours
(E/SQC)
33. An intussusception is a medical condition in which a part of the
intestine has invaginated into another section of intestine, similar to
the way in which the parts of a collapsible telescope slide into one
another. When assessing a child for possible intussusception, which
of the following would be least likely to provide valuable information?
A. Stool inspection C. Family history
B. Pain pattern D. Abdominal palpation
(E/SQC)
SITUATION: The birth of a baby with a congenital defect places both the
newborn and the family at risk. You were assigned to take care of Baby
Harry, an infant with myelomeningocoele.
34. Knowing this diagnosis, which of the following assessment data
would you expect to see in baby Harry?
A. Presence of a saclike cyst containing meninges only
B. Herniation of abdominal contents
C. No response to stimuli below the level of the sac
D. Retention of urine
(An/SQC)
35. In giving care to Baby Harry, the nurse should perform all of the
following, aside from:
A. Observe sac for oozing of fluid or pus
B. Obtain occipital-frontal circumference
C. Prevention of trauma and infection
D. Place the baby on supine position
(E/SQC)
36. Sickle cell anemia is the most common form of sickle cell disease
(SCD). SCD is a serious disorder in which the body makes sickle-
shaped red blood cells. “Sickle-shaped” means that the red blood
cells are shaped like a crescent. Nurse Joe is conducting health
education classes for parents of children with SCD. Which of the
following health teachings regarding sickle cell crisis should be
included by the nurse?
A. It results from altered metabolism and dehydration
B. Tissue hypoxia and vascular occlusion cause the primary
problems
C. Increased bilirubin levels will cause hypertension
D. There are decreased clotting factors with an increase in white
blood cells
(E/SQC, HE)
37. Hemophilia is a group of hereditary genetic disorders that impair the
body's ability to control blood clotting or coagulation. A client with
hemophilia has a very swollen knee after falling from bicycle riding.
As a nurse, which of the following is the first action?
A. Initiate an IV site to begin administration of cryoprecipitate
B. Type and cross-match for possible transfusion
C. Monitor the client's vital signs for the first 5 minutes
D. Apply ice pack and compression dressings to the knee
(E/SQC)
38. Poisons are substances that can cause disturbances to organisms,
usually by chemical reaction or other activity on the molecular scale,
when a sufficient quantity is absorbed by an organism. The nurse is
teaching the parents of a young client how to handle poisoning. If the
client ingests poison, what should the parents do first?
A. Administer ipecac syrup
B. Call an ambulance immediately
C. Call the poison control center
D. Inspect the home for other potential poisons
(E/SQC, HE)
39. A Tracheoesophageal Fistula (TEF) is an abnormal connection
(fistula) between the esophagus and the trachea. Which of the
following nursing diagnosis would the nurse identify as a priority for
the infant with Tracheoesophageal Fistula (TEF)?
A. Impaired parenting related to newborn's illness
B. Risk of injury related to increased potential for aspiration
C. Ineffective nutrition: less than body requirements, related to
poor sucking ability
D. Ineffective breathing pattern related to a weak diaphragm
(E/SQC)
40. Kawasaki disease (KD), also known as Kawasaki syndrome, lymph
node syndrome and Mucocutaneous lymph node syndrome, is an
autoimmune disease that manifests as a systemic necrotizing
medium-sized vessel vasculitis and is largely seen in children under
five years of age. The nurse is caring for a child who has Kawasaki
Disease (KD). The nurse should not implement which intervention?
A. Administer prescribed prophylactic anticonvulsant medication.
B. Provide mouth care using lubricated ointment.
C. Use passive range of motion (ROM) if arthritis develops.
D. Assess for signs of heart failure.
(E/SQC)
-END-
“Life’s challenges are not supposed to paralyze
you; they are supposed to help you discover who
you are."