2026 Women's Study Proctor

A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right- sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10. A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. Exhibits The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include. A. Instruct the parent to ensure the pneumococcal vaccine is current. B. Administer folic acid as prescribed. C. Monitor oxygen saturation continuously. D. Place the client on strict bed rest. E. Apply cold compresses to the affected joints. F. Administer meperidine IV for pain. G. Restrict oral intake. H. Give oral hydroxyurea. Explanation Correct Answer: A,B,C,F,H Solution Rationale: A. Clients with sickle cell disease are at increased risk for infections, including those caused by pneumococcus. Ensuring vaccination status helps prevent future complications. B. Folic acid supplementation may be part of the overall management of sickle cell disease, but it is not a priority intervention during a vaso-occlusive crisis. C. Vaso-occlusive crises can lead to tissue hypoxia due to impaired blood flow. Continuous monitoring of oxygen saturation helps in assessing tissue perfusion and detecting hypoxemia early. D. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation. E. Cold can cause vasoconstriction, worsening the pain and sickling process. Warm compresses are more appropriate for promoting comfort and improving circulation. F. Meperidine (Demerol) is a potent opioid analgesic that can help alleviate severe pain associated with vaso-occlusive crises. G. The nurse should not restrict oral intake, as hydration is important to prevent dehydration and further sickling. H. Hydroxyurea is used to prevent vaso-occlusive crises in patients with sickle cell disease but is not typically administered during an acute crisis. This is a medication that reduces the frequency and severity of vaso-occlusive crises by increasing the production of fetal hemoglobin, which prevents sickling. A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect? A. Decreased prothrombin time B. Increased Hgb level C. Increased RBC D. Decreased platelet count Explanation Correct Answer : D Disseminated intravascular coagulation (DIC) is associated with consumption of clotting factors, leading to prolonged clotting times, such as increased prothrombin time (PT) and activated partial thromboplastin time (aPTT), rather than decreased. DIC does not typically cause an increase in hemoglobin (Hgb) levels; in fact, it may lead to anemia due to blood loss and consumption of clotting factors. DIC does not typically cause an increase in red blood cell (RBC) count; if anything, it can lead to anemia due to blood loss. DIC is characterized by widespread activation of coagulation, leading to consumption of platelets and decreased platelet count, which can result in bleeding tendencies. Question 4: Report an IssueReport Wrong Answer A nurse is caring for a group of clients. Which of the following findings should the nurse report to the provider? A. An 18-month-old toddler who has a heart rate of 68/min B. A school-age child who has a rectal body temperature of 37.3° C (99.1° F) C. An adolescent who has a BP of 132/82 mm Hg D. A 3-month-old infant who has a respiratory rate of 30/min Explanation Correct Answer : A A toddler who has a heart rate of 68/min is likely to have bradycardia, a slow heart rate that can affect oxygen delivery. Bradycardia could be caused by hypoxia, hypothermia, or cardiac problems. The nurse should report this finding to the provider immediately. This temperature is within the normal range, so it does not require reporting. This blood pressure is within the normal range for an adolescent, so it does not require reporting. The normal respiratory rate for a 3-month-old infant is 25 to 40/min. Question 5: Report an IssueReport Wrong Answer A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching? A. Check clothing for loose buttons. B. Adjust the water heater temperature to 54° C (129.2° F). C. Place screens on all windows. D. Provide balloons for play. Explanation Correct Answer : A While it's important to ensure that clothing doesn't have small parts that could pose a choking hazard, loose buttons are not typically a significant safety concern. Water heater temperature should be set to around 120°F (approximately 49°C) to prevent scalding burns, so adjusting it to 54°C (129.2°F) would pose a safety risk rather than prevent injury. This is an important safety measure to prevent falls from windows, which can be a significant risk for toddlers. A. Checking clothing for loose buttons is essential to prevent choking hazards for toddlers, who tend to explore items by putting them in their mouths. B. Adjusting the water heater temperature to 54° C (129.2° F) is too high and increases the risk of scalding; the recommended temperature is typically set below 49° C (120° F). C. While placing screens on windows is important, it does not specifically address immediate choking risks and is less relevant than ensuring clothing safety. D. Providing balloons for play poses a choking hazard; therefore, it is not a recommended safety measure for toddlers. Question 6: Report an IssueReport Wrong Answer A nurse is providing discharge teaching to the guardian of a preschooler who had a tonsillectomy. Which of the following statements should the nurse include? A. "Notify the provider if your child has dark brown blood between their teeth." B. "Encourage your child to drink liquids through a straw." C. "Notify the provider if your child is swallowing frequently." D. "Encourage your child to clear their throat as needed." Explanation Correct Answer : C Dark brown blood indicates old blood and is not a sign of active bleeding. Drinking through a straw can increase the risk of bleeding after tonsillectomy, so it should be avoided. Frequent swallowing may indicate discomfort or bleeding and should prompt notification of the healthcare provider. Clearing the throat can also increase the risk of bleeding and should be discouraged after tonsillectomy. Question 7: Report an IssueReport Wrong Answer A nurse is providing teaching to the parent of a toddler who is scheduled for an electrocardiogram. Which of the following statements should the nurse make? A. "Your child can rest on your lap during the procedure." B. "An alarm will sound if your child has an abnormal heart rhythm." C. "Leads will be placed on your child's back prior to the procedure." D. "This procedure will take at least 30 minutes to complete." Explanation Correct Answer : A Allowing the child to sit on the parent's lap can provide comfort and support during the procedure. While the electrocardiogram (ECG) machine may have alarms, they are not typically related to abnormal heart rhythms during the procedure. ECG leads are typically placed on the chest, not the back. The duration of an ECG is relatively short, usually only a few minutes, so stating that it will take at least 30 minutes may cause unnecessary concern for the parents Question 8: Report an IssueReport Wrong Answer A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first? A. Check the pH of the gastric secretions. B. Set the administration rate on the feeding pump. C. Flush the tube with water. D. Attach the feeding bag tubing to the end of the NG tube. Explanation Correct Answer : A This is the priority action to confirm the correct placement of the NG tube in the stomach before administering the enteral feeding. This should only be done after confirming proper tube placement. Flushing the tube is necessary, but it should occur after confirming placement. This should occur after confirming proper tube placement. Question 9: Report an IssueReport Wrong Answer A nurse is teaching a newly licensed nurse about infant safety. Which of the following information should the nurse include in the teaching? A. Place an infant who is 5 months old in a high chair to feed. B. Position a 1-month-old infant supine on a soft mattress. C. Provide an infant with a one-piece pacifier for non-nutritive sucking. D. Secure the infant's car seat behind an airbag Explanation Correct Answer : C Placing an infant who is 5 months old in a high chair to feed is unsafe because the infant might fall or choke. Positioning a 1-month-old infant supine on a soft mattress increases the risk of sudden infant death syndrome (SIDS). Providing a one-piece pacifier is a safe practice since it prevents the pacifier from breaking apart and causing a choking hazard. Infants should be secured in car seats that are away from airbags. Securing the infant's car seat behind an airbag is dangerous because the airbag could injure or kill the infant in a crash. Question 10: Report an IssueReport Wrong Answer A nurse in an emergency department is caring for a toddler who has manifestations of epiglottitis. Which of the following actions should the nurse take first? A. Obtain an x-ray of the child's neck B. Administer intravenous antibiotics C. Initiate droplet precautions D. Place intubation equipment at the bedside. Explanation Correct Answer : D Obtaining an x-ray of the child's neck may be necessary for diagnosis, but ensuring immediate safety and infection control measures take precedence. Administering intravenous antibiotics is important in the treatment of epiglottitis but is not the immediate priority. Initiating droplet precautions is crucial in this case to prevent the spread of infection to others but is not as important as securing the airway. Placing intubation equipment at the bedside is the first priority because epiglottitis can cause airway obstruction and respiratory distress. A nurse is caring for a school-age child who underwent a tuberculin skin test 3 days ago and has a 3-mm induration at the test site. The nurse should identify this finding as which of the following? A. Disseminated disease B. A negative result C. Active tuberculosis D. An allergic reaction Explanation Correct Answer : B Disseminated disease: Disseminated tuberculosis refers to widespread infection affecting multiple organs and is diagnosed through clinical findings, imaging, and laboratory tests. A small localized induration on a tuberculin skin test does not indicate disseminated disease. A negative result: An induration of 3 mm is considered negative in most populations, including school-age children without specific risk factors. Positive results generally require larger induration measurements depending on risk status, so this finding indicates no significant immune response to the test. Active tuberculosis: Active tuberculosis is diagnosed based on symptoms, radiographic findings, and microbiologic evidence. A minimal induration on a tuberculin skin test alone does not confirm active disease. An allergic reaction: Allergic reactions typically present with redness, itching, or swelling without firm induration. The measurement of induration, not redness, is used to interpret the tuberculin skin test result. Question 3: Report an IssueReport Wrong Answer A nurse is performing a physical assessment for a school-age child. Which of the following actions should the nurse take? A. Obtain a vertical height measurement. B. Remove the child's eyeglasses before performing a visual acuity exam. C. Inspect the ear by pulling the pinna down and back. D. Observe abdominal movement to determine the respiratory rate. Explanation Correct Answer : A Obtain a vertical height measurement: School-age children are measured standing upright to accurately assess linear growth and compare it with age-appropriate growth charts. Vertical height measurement reflects skeletal growth and is a key component of routine physical assessment in this age group. Remove the child's eyeglasses before performing a visual acuity exam: Visual acuity testing should be performed with the child wearing corrective lenses if they are normally used. Removing eyeglasses would not reflect the child’s functional vision and may lead to inaccurate assessment findings. Inspect the ear by pulling the pinna down and back: For school-age children and adults, the pinna should be pulled up and back to straighten the ear canal. Pulling the pinna down and back is appropriate only for children under 3 years of age. Observe abdominal movement to determine the respiratory rate: Respiratory rate in schoolage children is best assessed by observing chest movement. Abdominal observation is more appropriate in infants, who primarily use diaphragmatic breathing. Question 6: Report an IssueReport Wrong Answer A nurse is teaching an adolescent about the procedure for completing a 24-hr urine test. Which of the following statements by the adolescent indicates an understanding of the teaching? A. "I will include toilet paper that falls into the urine as part of the collected sample." B. "I will throw out my first urine sample when I start the urine collection." C. "I can stop the urine test earlier than 24 hours if I fill up the collection container." D. "I can discard urine while I am at school if I keep track of the number of times I void." Explanation Correct Answer : B "I will include toilet paper that falls into the urine as part of the collected sample.": Contamination of the urine specimen with toilet paper or other foreign material can alter test results and compromise accuracy. The collection container should receive urine only, and any contaminated sample should be discarded and reported. "I will throw out my first urine sample when I start the urine collection.": A 24-hour urine collection begins after discarding the first void to ensure the bladder is empty at the start time. All urine produced after that point, including the final void at 24 hours, is collected to provide an accurate measurement. "I can stop the urine test earlier than 24 hours if I fill up the collection container.": Stopping the collection early results in incomplete data and invalid test results. If the container becomes full, an additional container should be obtained so the full 24-hour collection can be completed. "I can discard urine while I am at school if I keep track of the number of times I void.": Every void during the 24-hour period must be collected regardless of location. Missing any urine output makes the test inaccurate, even if the number of voids is recorded. Question 7: Report an IssueReport Wrong Answer A nurse is caring for a child who has bacterial meningitis. Which of the following findings should indicate to the nurse that the child can be removed from droplet precautions? A. Negative cerebrospinal fluid culture B. Absent nuchal rigidity C. Antibiotics initiated 24 hr ago D. Temperature below 37.4° C (99.3° F) Explanation Correct Answer : C Negative cerebrospinal fluid culture: A negative CSF culture does not immediately indicate that the child is no longer infectious, as cultures can be affected by prior antibiotic therapy or sampling timing. Droplet transmission risk is based on organism viability rather than culture results alone. Absent nuchal rigidity: Improvement or resolution of meningeal signs reflects clinical recovery but does not determine infectiousness. A child may still harbor and transmit the causative bacteria despite reduced neurological symptoms. Antibiotics initiated 24 hr ago: Children with bacterial meningitis are considered noninfectious after receiving at least 24 hours of appropriate antibiotic therapy. At this point, droplet precautions can be safely discontinued according to infection control guidelines. Temperature below 37.4° C (99.3° F): Normalization of temperature indicates improvement but does not correlate with the elimination of transmission risk. Fever resolution alone is insufficient to determine when isolation precautions can be stopped. Question 8: Report an IssueReport Wrong Answer A nurse is preparing a 4-year-old child for a tonsillectomy. Which of the following statements should the nurse make? A. "You will have a special sleep so you won't feel anything." B. "Your mom will be there throughout the procedure." C. "Your throat will feel better when you wake up." D. "You will be put to sleep for your surgery." Explanation Correct Answer : A "You will have a special sleep so you won't feel anything.": Preschool-age children benefit from simple, nonthreatening explanations that use familiar language. Referring to anesthesia as a “special sleep” helps reduce fear and avoids concrete or frightening details that could increase anxiety at this developmental stage. "Your mom will be there throughout the procedure.": Parents are usually not present during the surgical procedure itself. Providing inaccurate information can increase distress and reduce trust when the child realizes the statement is untrue. "Your throat will feel better when you wake up.": After a tonsillectomy, throat pain is expected and can be significant. Suggesting the throat will feel better immediately may create unrealistic expectations and increase anxiety or confusion postoperatively. "You will be put to sleep for your surgery.": Phrases like “put to sleep” can be misinterpreted by young children and may be associated with fear of not waking up. Using gentler, developmentally appropriate wording helps promote understanding and emotional comfort. Question 9: Report an IssueReport Wrong Answer A nurse is performing a dressing change for a child and notices that the gauze dressing is adhering to the wound bed. Which of the following actions should the nurse take? A. Apply firm pressure to the wound base while removing the gauze dressing. B. Saturate the gauze dressing with sterile saline solution prior to removing it. C. Continue to remove the gauze dressing by pulling it parallel to the skin. D. Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing. Explanation Correct Answer : B Apply firm pressure to the wound base while removing the gauze dressing: Applying firm pressure can disrupt newly formed granulation tissue and increase pain and bleeding. This approach may delay wound healing and cause unnecessary trauma, especially in pediatric clients. Saturate the gauze dressing with sterile saline solution prior to removing it: Moistening the dressing with sterile saline helps loosen adhered gauze from the wound bed. This reduces tissue trauma, minimizes pain, and preserves healthy granulation tissue during dressing removal. Continue to remove the gauze dressing by pulling it parallel to the skin: Pulling the dressing, even parallel to the skin, can still tear fragile tissue if the gauze is stuck. This method does not address the issue of the gauze being stuck to the internal wound bed.and may worsen wound injury. Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing: Hydrogen peroxide is cytotoxic to healthy tissue and can impair wound healing. Its use is generally avoided for routine wound care and is not appropriate for loosening an adhered dressing. Question 10: Report an IssueReport Wrong Answer A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following findings should the nurse identify as an indication of heart failure? A. Weight loss B. Decreased respirations C. Exercise intolerance D. Bradycardia Explanation Correct Answer : C Weight loss: Heart failure in children is more commonly associated with poor weight gain or weight gain due to fluid retention rather than weight loss. Weight loss may reflect inadequate nutrition or increased metabolic demand but is not a primary indicator of heart failure. Decreased respirations: Children with heart failure typically exhibit tachypnea due to pulmonary congestion and decreased cardiac output. Decreased respiratory rate is not consistent with the compensatory mechanisms seen in heart failure. Exercise intolerance: Exercise intolerance is a classic manifestation of heart failure in children, reflecting reduced cardiac output and inadequate oxygen delivery during activity. Postoperative children may fatigue easily, have dyspnea with exertion, or show decreased ability to engage in normal play. Bradycardia: Heart failure is usually associated with tachycardia as a compensatory response to maintain cardiac output. Bradycardia is uncommon and may indicate conduction abnormalities or medication effects rather than heart failure. A woman who is 37 weeks gestation is diagnosed with pre-eclampsia. She asks the nurse why she is getting Magnesium Sulfate. What is the best response? A. It provides neuroprotection to your baby B. It helps to lower your blood pressure. C. It decreases the risk of seizures D. It will decrease your symptoms of headache and blurred vision. Explanation Correct Answer : C Magnesium sulfate is not primarily used for neuroprotection in pre-eclampsia; it is used to prevent seizures, which are a complication of the condition. While magnesium sulfate may have some mild blood pressure-lowering effects, its main role in pre-eclampsia is seizure prevention. Magnesium sulfate is given to prevent seizures in women with pre-eclampsia or eclampsia, which are associated with the condition's severity. While magnesium sulfate may help with symptoms like headaches and blurred vision, its primary purpose is to reduce the risk of seizures. Question 2: Report an IssueReport Wrong Answer A newborn is diagnosed with jaundice at 48 hours when the nurse is doing the discharge teaching. The newborn is treated with a biliblanket and frequent feedings. What type of jaundice did the newborn probably have? A. Kernicterus B. Physiologic jaundice C. Pathological Jaundice D. Erythroblastosis Fetalis Explanation Correct Answer : B Kernicterus is a rare and severe form of jaundice-related brain damage, but it is not the typical type of jaundice diagnosed at 48 hours. Physiologic jaundice is common in newborns and typically appears around 48 hours of life, usually resolving with simple interventions like frequent feedings and phototherapy. Pathological jaundice occurs earlier than 48 hours and is often caused by blood group incompatibilities or other underlying health issues. Erythroblastosis Fetalis is a severe form of jaundice due to Rh incompatibility, typically presenting in the first 24 hours and requiring more intensive treatment. Question 3: Report an IssueReport Wrong Answer When caring for a laboring mother, late decelerations are noted on the fetal heart rate monitor. What actions should the nurse take? (Select all that apply A. Turn the patient to her side. B. Provide 2-3 liters of oxygen via mask C. Notify the health care provider. D. Stop the oxytocin Explanation Correct Answer: A,B,C,D Solution A. Turning the patient to her side can improve placental blood flow and alleviate pressure on the umbilical cord, which is often the cause of late decelerations. B. Providing oxygen can help improve oxygenation to the fetus, especially if the decelerations are due to uteroplacental insufficiency. C. Notifying the healthcare provider is essential to address the situation promptly and determine whether further interventions or a change in labor management is necessary. D. Stopping oxytocin can reduce uterine contractions and prevent further stress on the fetus, especially if the late decelerations are linked to uterine hyperstimulation. Question 4: Report an IssueReport Wrong Answer A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus influenzae type B. Which of the following actions should the nurse take? Select all that apply. A. Monitor oxygen saturation. B. Begin droplet precautions. C. Inspect the epiglottis. D. Obtain a throat culture. E. Initiate IV access. Explanation Correct Answer: A,B,E Solution A. Monitoring oxygen saturation is important to assess respiratory status, as epiglottitis can cause airway obstruction. B. Droplet precautions are required for Haemophilus influenzae type B to prevent transmission. C. Inspecting the epiglottis is contraindicated as it can trigger airway spasm and worsen obstruction. D. A throat culture is not appropriate in a child with suspected epiglottitis due to the risk of airway obstruction. The diagnosis is typically confirmed through other methods, such as imaging. E. IV access should be established to provide fluids and medications, especially if the child requires emergency interventions. Question 5: Report an IssueReport Wrong Answer This is a category _______ (answer numerically i.e 1, 2, 3, 4 etc.). Explanation Correct Answer (tracing) : 1 Solution The fetal heart rate is within normal ranges between 110 to 160 beats/minute. It also shows moderate variability with the amplitude ranging between 6 to 25 bmp. Both late and variable decelerations are absent. Therefore, based on the above findings this is a category 1 tracing. Discussion Section Question 6: Report an IssueReport Wrong Answer A patient had a vaginal birth 4 hours ago. Her hematocrit of 35% on admission for labor. Her current hematocrit is 25% which of the following statements by the nurse might best explain that A. “Because you're not eating enough iron-rich foods like meat." B. "Because you are hemoconcentrated the hematocrit dropped after delivery." C. "Because your blood volume has doubled, your hematocrit is lower." D. "This change in hematocrit indicates a postpartum hemorrhage." Explanation Correct Answer : C A decrease in hematocrit after delivery is more likely due to physiological changes rather than dietary factors alone, though iron intake is important for overall recovery. Hemoconcentration refers to an increase in hematocrit due to a decrease in plasma volume, but this is not the reason for a decreased hematocrit postpartum. During pregnancy, blood volume increases to support both the mother and fetus. After delivery, plasma volume returns to pre-pregnancy levels, which can cause a relative decrease in hematocrit. A significant drop in hematocrit could indicate postpartum hemorrhage, but a slight drop can be expected as part of normal post-delivery physiology. Question 7: Report an IssueReport Wrong Answer Place the cursor at where step #3 of Leopold's maneuver is performed. Explanation Solution Question 8: Report an IssueReport Wrong Answer The doctor writes an order for Terbutaline to be given 5Q. Which assessment finding will cause the nurse to question this order? A. BP 94/60 B. P 132 C. UCs are q 10 minutes D. FHR is category 1 Explanation Correct Answer : B A blood pressure of 94/60 is low but not typically a contraindication for Terbutaline administration. A pulse of 132 is high and could be a sign of tachycardia, which is a known side effect of Terbutaline, potentially making the use of this medication unsafe. Uterine contractions (UCs) every 10 minutes do not indicate any immediate concern or contraindication for Terbutaline. A category 1 FHR is reassuring and would not contraindicate the use of Terbutaline. Question 9: Report an IssueReport Wrong Answer The doctor writes an order for Terbutaline to be given 5Q. Which assessment finding will cause the nurse to question this order? A. BP 94/60 B. P 132 C. UCs are q 10 minutes D. FHR is category 1 Explanation Correct Answer : B A blood pressure of 94/60 is low but not typically a contraindication for Terbutaline administration. A pulse of 132 is high and could be a sign of tachycardia, which is a known side effect of Terbutaline, potentially making the use of this medication unsafe. Uterine contractions (UCs) every 10 minutes do not indicate any immediate concern or contraindication for Terbutaline. A category 1 FHR is reassuring and would not contraindicate the use of Terbutaline.