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NRNP6552 ADVANCED NURSE PRACTICE
MIDTERM EXAM LATEST UPDATE (2025)
QUESTIONS AND ANSWERS
- Sheila is pregnant and fearful of getting cervical cancer as her sister recently did. She asks about receiving the HPV vaccine. How do you respond? A. "As long as you're in your first trimester, the HPV vaccine is safe and effective." B. "Research has not shown this vaccine to be effective against preventing cervical cancer." C. "After the age of 20, the HPV vaccine is not recommended." D. "You should not receive the vaccination when you are pregnant." - ANSWER>>D. "You should not receive the vaccination when you are pregnant."
- Jack and Jill present for a preconception health counseling session. Jack is 34, Jill is 33, and they have a 5 year old son, Jake. Jake is the product of an uncomplicated pregnancy and labor. At birth, Jake had an open neural tube defect and now has spina bifida with a loss of function of his lower extremities. Jack and Jill want another child and ask if there is anything they can do to prevent the recurrence of a neural tube defect in future pregnancies. What is your best response to this couple? A. "Jill should take 60 mg/day of an iron supplement to enhance stores to support fetal development." B. "It is a matter of genetics, and there is nothing you can do." C. "Have a CVS performed at 12 to 14 weeks gestation to determine the health of the fetus." D. "Jill should take 4 mg/day of folic acid, beginning before conception." - ANSWER>>D. "Jill should take 4 mg/day of folic acid, beginning before conception."
- You are invited to speak to a group of public school administrators about recent outbreaks of head lice. As an advocate for children and families you share A. "no nit" policies that exclude children until all nits are removed are essential to eradicate this problem B. the American Academy of Pediatrics and the National Association of
School Nurses discourage "no nit" policies that exclude children from school
A. 5 to 16 years B. 11 to 16 years C. 8 to 16 years D. over 10 years - ANSWER>>B. 11 to 16 years
- Hegar's sign, a physiological sign of pregnancy is A. cervical blueness B. softness of the uterus and ballottement at the isthmus C. cervical softness D. quickening - ANSWER>>B. softness of the uterus and ballottement at the isthmus
- Carrie, of Irish descent, is due to deliver her second baby. During your work-up, you note that she hemorrhaged after delivering her first baby 2 years ago, has always had menorrhagia, and bruises easily. Her lab work reveals a normal blood workup, including a normal prothrombin time and activated partial thromboplastin time. What do you suspect? A. Von Willebrand's disease B. Hemophilia C. Sickle cell anemia D. Beta thalassemia - ANSWER>>A. Von Willebrand's disease 10.Koplik spots are small, white spots that occur on the inside of the cheeks early in the course of A. measles B. varicella C. fifth disease D. rheumatic fever - ANSWER>>A. measles 11.Aida, who is 29 weeks pregnant, received a blunt trauma to the abdomen during an argument with her boyfriend. She has no obvious injuries and denies pain. Aida needs to be monitored for the occurrence of
A. abruptio placentae B. liver hemorrhage C. ruptured spleen D. placenta previa - ANSWER>>A. abruptio placentae 12.Growth hormone treatment for short stature in children remains controversial. The clinician should be aware of the following regarding the assessment of growth problems and idiopathic short stature A. identification of a growth problem can be made based on one measurement B. dysmorphic facial features will be present C. identification of growth problems is usually made by an auxological evaluation, which compares the child's growth to standardized norms D. measurements of children lying on the exam table paper are most accurate - ANSWER>>C. identification of growth problems is usually made by an auxological evaluation, which compares the child's growth to standardized norms 13.Nancy is concerned that her new breastfed baby is not getting enough fluid. What do you tell her so that she can assess for an adequate intake? A. weigh the infant every other day to see the weight gain in ounces B. if the infant is drinking and sleeping normally, an adequate intake is assumed C. if there are 6 to 10 wet diapers a day, intake is adequate D. if the infant is not irritable, an intake problem does not exist - ANSWER>>C. if there are 6 to 10 wet diapers a day, intake is adequate 14.Marci has had several abortions in the past and has been unable to carry a pregnancy to full term because of an incompetent cervix. She states that the physician mentioned cerclage to her and asks you what that means. You tell her that cerclage is A. a treatment of bedrest with frequent pelvic exams to make sure the cervix is not dilated B. a method in which an apparatus resembling a diaphragm is placed over the cervix to help it stay "tight"
C. Four slices of cheese D. One cup of cottage cheese - ANSWER>>A. One quart of cow's milk 19.Allie, who has asthma, just found out she is pregnant. She is wondering whether she should continue taking her medications. Which of the following is true regarding asthma and pregnancy? A. only inhaled (rather than oral) medications should be used B. in the event of an acute exacerbation, glucocorticoids should not be used C. management differs little from management in nonpregnant women D. all medications may be used except for theophylline - ANSWER>>C. management differs little from management in nonpregnant women 20.Mrs. Nelms shares with you that her husband is on active duty with the National Guard. She states, "I'm left alone to care for three children." You know that children of active duty service members face many stressors. These stressors can lead to A. increased academic performance in children B. decreased behavior problems in children C. child maltreatment D. decreased incidence of depression in children - ANSWER>>C. child maltreatment 21.Sandra, who is 5 months pregnant and of average height and weight, asks you how many extra calories she should be adding to her diet per day. You tell her to add A. 200 calories B. 300 calories C. 500 calories D. 700 calories - ANSWER>>B. 300 calories 22.At birth, the anterior fontanelle has what shape? A. triangle B. oval
C. round D. diamond - ANSWER>>D. diamond 23.You see a G5P4015 written on a client's history form. You surmise that: A. the woman has been pregnant five times and has five living children B. the woman has five living children, including a set of twins, and she has had one abortion C. the woman has four living children and had one abortion, for a total of five pregnancies D. the woman is pregnant now and has five living children, including a set of twins - ANSWER>>B. the woman has five living children, including a set of twins, and she has had one abortion 24.Susie, who is 16 weeks pregnant, is having mild cramps with persistent and excessive bleeding. On exam, you find that some portion of the products of conception (placental) remains in the uterus, but the fetus has been expelled. What type of abortion is Susie having? A. incomplete B. threatened C. inevitable D. missed - ANSWER>>A. incomplete 25.Mr. Davis states, "I've had high cholesterol most of my life. I'm concerned about my daughter having it as well." The clinician knows that according to the National Cholesterol Education Program (NCEP) guidelines for children and adolescents, the acceptable range of total cholesterol for children 2 to 19 years old is: A. less than 200 B. less than 190 C. less than 180 D. less than 170 - ANSWER>>D. less than 170
C. wait for the physician to return a telephone call to the client D. go to the nearest emergency room immediately to be evaluated - ANSWER>>D. go to the nearest emergency room immediately to be evaluated 30.What is the best description of Bishop's score? A. It is a series of four maneuvers to determine fetal position B. It is a multiparameter evaluation of fetal condition following a nonreactive nonstress test C. It is an assessment of the cervix's readiness for elective induction D. It is an evaluation of fetal lung maturity and readiness for birth - ANSWER>>C. It is an assessment of the cervix's readiness for elective induction 31.When does the American Academy of Pediatrics recommend that children be screened for cholesterol? A. over 5 years old B. 9 to 11 years old C. over 8 years old D. 12 to 15 years old - ANSWER>>B. 9 to 11 years old 32.Which screening test has the highest sensitivity and specificity for diagnosing iron deficiency in anemic clients? A. ferritin B. hemoglobin C. hematocrit D. reticulocyte count - ANSWER>>A. ferritin 33.Risperidone (Risperdal) has been approved by the FDA for the treatment of the behaviors associated with autism in children over 5 years old. The clinician should be aware of the following common side effect A. weight loss B. diarrhea
C. nausea D. fatigue - ANSWER>>D. fatigue 34.When asking a family member if the family generally gets the things they want out of life, if there are any "rules" in the family that everyone believes are important, and what role religion plays in the family, you are trying to assess which functional health pattern? A. role-relationship pattern B. cognitive-perceptual pattern C. value-belief pattern D. health-perception/health-management pattern - ANSWER>>C. value-belief pattern 35.During nursery rounds, you examine a 12 hour old newborn. The infant has a yellow tint to the skin and sclera. What lab test will you order to further evaluate this infant? A. blood glucose B. Direct Coombs' test C. blood cultures D. arterial blood gas - ANSWER>>B. Direct Coombs' test 36.Marta asks you how pregnancy will affect her RA. You respond A. "There is a one-third rule: One-third get better, one-third remain the same, and one- third get worse" B. "Pregnancy will have no effect on your RA." C. "75% of women experience remission of the disease during pregnancy." D. "It is advised that you don't get pregnant with this condition." - ANSWER>>C. "75% of women experience remission of the disease during pregnancy." 37.Mr. Johnson calls your office from the soccer field. His 10 year old son, Joshua, was hit in the mouth during the game. One of Joshua's front teeth was knocked out. The clinician advises Mr. Johnson to A. rinse the tooth gently in cold milk, saline, or room temperature water and then replant it
B. glyburide C. glipizide D. metformin - ANSWER>>A. insulin 42.According to Naegele's rule, if a woman's last normal menstrual period was September 23, what is her estimated date of delivery? A. June 30 B. June 16 C. June 1 D. May 30 - ANSWER>>A. June 30 43.Children with Williams' syndrome typically have problems related to A. brittle bones B. CV disease C. fear of strangers D. cleft lip and palate - ANSWER>>B. CV disease 44.Mrs. Sullivan shares concerns about her 5 year old son's frequent bedwetting. She asks you about medication she has read about on the Internet. The clinician knows that desmopressin acetate can be used for primary nocturnal enuresis in children older than A. 6 years B. 5 years C. 4 years D. 3 years - ANSWER>>A. 6 years 45.Cydney, who is 30 weeks pregnant, is planning to travel outside of the U.S. She asks you which immunizations she should or should not have. Which immunization would be harmful for Cydney to receive? A. Pooled gamma globulin
B. Chloroquine for malaria prophylaxis C. Yellow fever D. Inactivated polio virus - ANSWER>>C. Yellow fever 46.A poorly defined, flat, blue-black macule present at birth and usually on the trunk and buttocks is A. blue nevus B. drug-induced blue macule C. Mongolian spot D. malignant melanoma - ANSWER>>C. Mongolian spot 47.A low risk woman who is 16 weeks pregnant should be instructed to return to the prenatal clinic in A. 1 week B. 2 weeks C. 3 weeks D. 4 weeks - ANSWER>>D. 4 weeks 48.Glenda gave birth to Jack 4 weeks ago. Her postpartum course was complicated by an intrauterine infection that was successfully treated with antibiotics. Today Glenda calls the office because Jack has white patches on his tongue and gums. She is concerned that her milk has become "sour" and is causing the white patches in Jack's mouth. Based on these data, what diagnosis do you suspect on Jack? A. oral chlamydia infection B. oral candidiasis C. mastitis D. epstein's pearls - ANSWER>>B. oral candidiasis 49.Typically, treatment of a 4 year old with nursemaid's elbow involves A. surgery
C. vitamin K D. vitamin C - ANSWER>>B. iron 54.Shana shares concerns about her unborn child. She states, "My sister's child was diagnosed with autism." The clinician knows the following to be true about autism spectrum disorder A. there is no genetic predisposition to ASD B. females are four times more likely to have an ASD than males C. 20-30% of children with an ASD develop epilepsy by the time they reach adulthood D. mental retardation occurs in all cases of ASD - ANSWER>>C. 20-30% of children with an ASD develop epilepsy by the time they reach adulthood 55.A newborn delivered by a mother with no prenatal care exhibits dysmorphic facial features, including short palpebral fissures, a thin upper lip, an elongated and flattened philtrum, and a flattened midface region. You suspect that the mother engaged in what behavior during pregnancy? A. excessive alcohol intake B. cocaine abuse C. chain smoking D. methamphetamine exposure - ANSWER>>A. excessive alcohol intake 56.When counseling a pregnant woman about the use of drugs, alcohol, and teratogenic agents, you share that the brain configuration of a fetus is roughly complete at A. 4 weeks gestation B. 12 weeks C. 20 weeks D. 24 weeks - ANSWER>>B. 12 weeks 57.Talya is 2 years old and presents with signs and symptoms of acute otitis media. Mom reports that Talya experienced a rash after the administration of penicillin in the
past. If a "wait and see" approach is not indicated, which of the following antibiotics should be prescribed? A. augmentin B. amoxicillin C. omnicef D. trimox - ANSWER>>C. omnicef 58.Spontaneous abortion refers to the loss of a fetus less than A. 12 weeks B. 18 weeks C. 22 weeks D. 26 weeks - ANSWER>>C. 22 weeks 59.Heather is scheduled for a well-child visit. Her mother asks, "How much milk should she be drinking now?" The clinician states that the American Heart Association recommendation for milk intake after 12 months of age is A. 8 oz per day B. 12 oz per day C. 16 oz per day D. 24 oz per day - ANSWER>>C. 16 oz per day 60.Mrs. Garcia calls regarding her 18 month old son's cough and cold. She asks the clinician, "Which medication should I give him?" Which of the following cough and cold products do you recommend? A. sudafed PE B. dextromethorphan C. guaifenesin D. none - ANSWER>>D. none 61.What is the primary site of drowning for children younger than age 3?
A. stiff fines to manufacturers who do not provide flow restrictors B. a strong signal being sent to manufacturers that flow restrictors are considered an important safety feature to help reduce accidental overdoses C. uniform standards for manufacturing of flow restrictors D. FDA supervision of development and production of flow restrictors - ANSWER>>B. a strong signal being sent to manufacturers that flow restrictors are considered an important safety feature to help reduce accidental overdoses 66.Which of the following should be avoided by the pregnant woman who is constipated? A. bulk-forming laxatives B. mineral oil C. stool softeners such as docusate sodium (Colace) D. drinking warm fluids on arising - ANSWER>>B. mineral oil 67.An asymmetric, softened enlargement of the uterine corner caused by placental development is a probable sign of pregnancy. What is it called? A. Hegar's sign B. Chadwick's sign C. Goodrich's sign D. Piskacek's sign - ANSWER>>D. Piskacek's sign 68.A woman with hyperemesis gravidarum would most likely benefit from a plan of care designed to address which of the following nursing diagnoses? A. imbalanced nutrition, more than body requirements, related to pregnancy B. anxiety, related to effects of hyperemesis on fetal well-being C. anticipatory grieving, related to inevitable pregnancy loss D. ineffective coping, related to unwanted pregnancy - ANSWER>>B. anxiety, related to effects of hyperemesis on fetal well-being
69.Susan is keeping a basal body temperature graph as part of her fertility treatment. Today she shares the BBT graph with you. The BBT graph shows a nearly straight line. Which of the following is the best interpretation of her graph? A. she is not ovulating B. she is not having intercourse C. she is ovulating late in her menstrual cycle D. she is not taking her temperature correctly - ANSWER>>A. she is not ovulating 70.Which of the following dietary changes would you recommend to Heather, who is experiencing nausea during her first trimester? A. bland diet taken frequently and in small amounts B. increase in fat intake C. decrease in carb intake D. restriction of fluid intake after 7 pm - ANSWER>>A. bland diet taken frequently and in small amounts 71.According to the International Association of Diabetes and Pregnancy Study Group, screening for gestational diabetes should be done on which of the following women? A. all pregnant women at 24 to 28 weeks B. women aged 40 or older C. all women with threatened miscarriage D. women who report hypoglycemic symptoms - ANSWER>>A. all pregnant women at 24 to 28 weeks 72.Danger signs in the first trimester of pregnancy include A. vaginal bleeding and absence of fetal movement B. edema extending to the upper extremities and vomiting C. presence of proteinuria and elevated blood pressure D. vaginal bleeding and persistent vomiting - ANSWER>>D. vaginal bleeding and persistent vomiting
