1Question
A client at her first prenatal visit reports that the first day of her last menstrual period was March 10. Her cycles are regular and 28 days long. Using Naegele's rule, which estimated date of birth should the nurse record?
- December 3
- December 10
- December 17
- January 17
Show the answer and explanation
Answer: C. December 17
Topic: Naegele's rule
Naegele's rule takes the first day of the last menstrual period, subtracts 3 months and adds 7 days (and a year when needed). March 10 minus 3 months is December 10; adding 7 days gives December 17.
Why the others are wrong
- A – This subtracts 7 days instead of adding them.
- B – This subtracts the 3 months but leaves out the 7 days.
- D – This adds the 7 days but subtracts only 2 months.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
2Question
A nurse is teaching a client at 30 weeks of gestation which changes need to be reported right away rather than at the next visit. Which reports by the client should the nurse identify as needing immediate evaluation?
Select all that apply.
- A headache that does not ease with acetaminophen, with blurred vision
- Ankle swelling at the end of the day that is gone by morning
- Bright red vaginal bleeding
- A sudden gush of clear fluid from the vagina
- Passing urine more often, without burning or fever
- Noticeably fewer fetal movements than usual
Show the answers and explanation
Answers: A, C, D and F.
- A – A headache that does not ease with acetaminophen, with blurred vision
- C – Bright red vaginal bleeding
- D – A sudden gush of clear fluid from the vagina
- F – Noticeably fewer fetal movements than usual
Topic: danger signs in pregnancy
A persistent headache with visual changes suggests preeclampsia, vaginal bleeding suggests a placental problem, a gush of fluid suggests rupture of membranes before term, and decreased fetal movement can signal fetal compromise. Each needs assessment the same day.
Why the others are wrong
- B – Dependent ankle edema that resolves with rest is an expected effect of venous pressure in late pregnancy.
- E – Frequency without burning or fever is expected as the uterus presses on the bladder.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
3Question
Four hours after a vaginal birth the nurse finds the client's fundus firm, 2 cm above the umbilicus and displaced to the right. Lochia is moderate and the client has not voided since the birth. Which action should the nurse take first?
- Massage the fundus vigorously until it returns to the midline.
- Help the client to the bathroom to empty her bladder.
- Ask the provider for an additional dose of oxytocin.
- Record the findings as expected for this time after birth.
Show the answer and explanation
Answer: B. Help the client to the bathroom to empty her bladder.
Topic: fundal assessment
A firm fundus that sits high and to one side is being pushed out of place by a full bladder. Emptying the bladder lets the uterus return to the midline and contract well; a full bladder left alone leads to uterine atony and bleeding.
Why the others are wrong
- A – The fundus is already firm; massage does not move it past a full bladder and overmassage tires the muscle.
- C – A uterotonic treats a soft uterus, which this is not.
- D – At this time the fundus should be in the midline at about the level of the umbilicus.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
4Question
A nurse is taking telephone calls from clients who gave birth vaginally. Which report needs follow-up the same day?
- Day 2: a brief heavier flow of dark red blood on getting out of bed in the morning
- Day 5: pinkish-brown discharge that is lighter than before
- Day 12: a small amount of yellowish-white discharge
- Day 9: bright red bleeding that soaks a pad in an hour after the flow had turned pink
Show the answer and explanation
Answer: D. Day 9: bright red bleeding that soaks a pad in an hour after the flow had turned pink
Topic: lochia progression
Lochia moves from red (rubra) in the first days, to pinkish-brown (serosa), to yellowish-white (alba), and lessens steadily. A return to bright red bleeding heavy enough to soak a pad in an hour suggests late postpartum hemorrhage, often from retained placental tissue or subinvolution.
Why the others are wrong
- A – Blood pools in the vagina during sleep and flows out on standing; this is expected in the first days.
- B – Pinkish-brown lochia serosa is expected at this point.
- C – Lochia alba is expected in the second week.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
5Question
A breastfeeding client 3 weeks after birth is diagnosed with mastitis of the right breast and is prescribed an oral antibiotic. Which instructions should the nurse include?
Select all that apply.
- Continue breastfeeding on demand from both breasts.
- Finish all of the antibiotic even after the symptoms improve.
- Stop nursing from the right breast until the antibiotic is finished.
- Rest and drink plenty of fluids.
- Wear a tight binder to limit milk production.
- Wash the hands before handling the breasts.
Show the answers and explanation
Answers: A, B, D and F.
- A – Continue breastfeeding on demand from both breasts.
- B – Finish all of the antibiotic even after the symptoms improve.
- D – Rest and drink plenty of fluids.
- F – Wash the hands before handling the breasts.
Topic: mastitis teaching
Mastitis is treated by continuing to breastfeed on demand from both breasts (stopping feeds on one side causes milk stasis, while extra feeding or pumping increases inflammation), completing the antibiotic, and supporting recovery with rest and fluids. The milk remains safe for the infant, and hand washing limits the spread of bacteria.
Why the others are wrong
- C – Milk left in the breast prolongs the infection and raises the risk of abscess.
- E – Tight binding obstructs the ducts and promotes milk stasis.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
6Question
One minute after birth a newborn has a heart rate of 110/min, slow and irregular respirations with a weak cry, some flexion of the arms and legs, a grimace when the nose is suctioned, and a pink body with blue hands and feet. Which Apgar score should the nurse record?
- 5
- 6
- 7
- 8
Show the answer and explanation
Answer: B. 6
Topic: Apgar scoring
Each of the five signs is scored 0, 1 or 2. Heart rate above 100/min scores 2; slow, irregular breathing 1; some flexion 1; a grimace 1; and a pink body with blue extremities 1. The total is 6.
Why the others are wrong
- A – This gives the heart rate only 1 point, but a rate of 100/min or more scores 2.
- C – This gives 2 points to one of the signs that earns only 1.
- D – This would need two more signs to earn full points, such as a vigorous cry and active movement.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
7Question
A term newborn has just been born and is crying vigorously with good muscle tone. Which action should the nurse take first?
- Dry the newborn and place the newborn skin-to-skin on the mother's chest under a warm blanket.
- Give the vitamin K injection.
- Weigh and measure the newborn.
- Bathe the newborn to remove blood and vernix.
Show the answer and explanation
Answer: A. Dry the newborn and place the newborn skin-to-skin on the mother's chest under a warm blanket.
Topic: newborn thermoregulation
A wet newborn loses heat quickly by evaporation, and cold stress raises oxygen and glucose use. Drying and skin-to-skin contact under a warm cover prevent heat loss and take priority in a vigorous newborn; other routine care can wait.
Why the others are wrong
- B – Vitamin K is given within the first hours and can follow the first period of skin-to-skin contact.
- C – Measurements on a cold scale add heat loss and are not urgent.
- D – Bathing is delayed until the temperature is stable because it causes marked heat loss.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
8Question
A nurse is evaluating the discharge teaching given to the parents of a healthy term newborn. Which statements by the parents show that they understand safe sleep?
Select all that apply.
- We will lay her on her back for every nap and every night.
- We will prop her on her side with a wedge so she does not choke.
- She will sleep on a firm, flat mattress with only a fitted sheet.
- We will tuck a soft quilt loosely over her to keep her warm.
- She will sleep in our bed so that night feedings are easier.
- We will raise the head of her mattress in case she spits up.
Show the answers and explanation
Answers: A and C.
- A – We will lay her on her back for every nap and every night.
- C – She will sleep on a firm, flat mattress with only a fitted sheet.
Topic: safe sleep
The risk of sudden infant death is lowest when the infant sleeps on the back, alone, on a firm, flat, non-inclined surface with nothing else in the sleep space. Sharing the parents' room, but not their bed, is advised.
Why the others are wrong
- B – Side position is unstable, and positioners are a suffocation hazard; healthy infants protect their airway on the back.
- D – Loose bedding can cover the face; a wearable blanket is used instead.
- E – Bed-sharing raises the risk of suffocation and entrapment.
- F – An inclined surface lets the infant slide into a position that blocks the airway.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
9Question
A nurse is assessing a quiet, alert term newborn who is 8 hours old. Which findings are expected and need no intervention?
Select all that apply.
- Heart rate of 142/min
- Respiratory rate of 46/min with occasional pauses of about 5 seconds
- Axillary temperature of 35.8 C (96.4 F)
- Umbilical cord stump that is drying, with no redness of the skin around it
- Grunting and nasal flaring with each breath
- Blue hands and feet with a pink trunk and lips
Show the answers and explanation
Answers: A, B, D and F.
- A – Heart rate of 142/min
- B – Respiratory rate of 46/min with occasional pauses of about 5 seconds
- D – Umbilical cord stump that is drying, with no redness of the skin around it
- F – Blue hands and feet with a pink trunk and lips
Topic: normal newborn findings and cord
A newborn at rest has a heart rate of about 110 to 160/min and breathes 30 to 60 times a minute, often irregularly with short pauses. A cord stump that is drying without redness is healing normally, and acrocyanosis is expected during the first day.
Why the others are wrong
- C – An axillary temperature below 36.5 C is low, and 35.8 C is hypothermia; the newborn needs warming (skin-to-skin or radiant warmer) and a recheck.
- E – Grunting and nasal flaring are signs of respiratory distress and must be reported.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
10Question
A nurse is evaluating teaching about food safety and nutrition with a client at 9 weeks of gestation who has a normal body mass index and a pet cat. Which statements by the client show that the teaching was effective?
Select all that apply.
- "I will ask my partner to empty the litter box, or wear gloves and wash my hands if I have to do it."
- "I will heat deli meats until they are steaming and skip soft cheeses made from unpasteurized milk."
- "Since I am eating for two, I should about double what I normally eat."
- "I will stop eating all fish and seafood until the baby is born."
- "I will take my iron tablet with orange juice instead of with milk."
Show the answers and explanation
Answers: A, B and E.
- A – "I will ask my partner to empty the litter box, or wear gloves and wash my hands if I have to do it."
- B – "I will heat deli meats until they are steaming and skip soft cheeses made from unpasteurized milk."
- E – "I will take my iron tablet with orange juice instead of with milk."
Topic: prenatal nutrition and infection prevention
Cat feces and undercooked meat can carry Toxoplasma, and unheated deli meats and unpasteurized dairy can carry Listeria; both infections can harm the fetus and are prevented by simple hygiene. Vitamin C improves iron absorption while calcium reduces it. Pregnancy needs only a modest increase in energy in the later trimesters, and low-mercury cooked fish is encouraged.
Why the others are wrong
- C – Energy needs rise only modestly, and not in the first trimester; doubling intake causes excessive weight gain.
- D – Only high-mercury fish and raw or undercooked seafood are avoided; two to three servings a week of low-mercury cooked fish are recommended.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
11Question
A client at 34 weeks of gestation telephones the clinic. She says her baby has been much quieter today. After eating she lay on her side and counted 4 movements in 2 hours. Which response by the nurse is best?
- "Drink a glass of cold juice and count again tomorrow morning."
- "Please come in now so that we can check on your baby."
- "Babies move less near the end of pregnancy because they have less room."
- "Mention it at your appointment next week so we can listen to the heartbeat."
Show the answer and explanation
Answer: B. "Please come in now so that we can check on your baby."
Topic: fetal movement counting
A perceived decrease in fetal movement, confirmed by fewer than 10 movements in 2 hours of focused counting, can be an early sign of fetal compromise. The client needs fetal assessment the same day, usually starting with a nonstress test.
Why the others are wrong
- A – She has already eaten, rested and counted; waiting until tomorrow delays assessment of a possibly compromised fetus.
- C – The type of movement may change near term, but the number should not fall; this false reassurance is unsafe.
- D – A week's delay is unsafe; decreased movement is evaluated the same day.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
12Question
A primigravida at 39 weeks of gestation has had contractions every 5 to 8 minutes for 3 hours. Which finding best indicates that she is in true labor?
- The contractions are felt only in the lower abdomen and groin
- The contractions become weaker when she walks around
- The cervix has changed from 2 cm to 4 cm and has thinned over 2 hours
- She passed blood-tinged mucus several days ago
Show the answer and explanation
Answer: C. The cervix has changed from 2 cm to 4 cm and has thinned over 2 hours
Topic: true versus false labor
True labor is defined by progressive effacement and dilation of the cervix. Contraction pattern, location of discomfort and show are supporting signs only.
Why the others are wrong
- A – False labor is typically felt in the abdomen and groin; true labor usually starts in the back and sweeps forward.
- B – Contractions that ease with walking are Braxton Hicks contractions; true contractions intensify with activity.
- D – Bloody show may appear days before labor begins and does not confirm it.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
13Question
A term newborn is born through thick, green, meconium-stained amniotic fluid. At birth the newborn cries loudly, has good muscle tone and a heart rate of 150/min. Which action should the nurse take?
- Assist with immediate intubation so that the trachea can be suctioned
- Start positive-pressure ventilation with a bag and mask
- Dry the newborn, place skin-to-skin with the mother and continue to observe
- Suction the stomach to remove swallowed meconium
Show the answer and explanation
Answer: C. Dry the newborn, place skin-to-skin with the mother and continue to observe
Topic: meconium-stained fluid at birth
A vigorous newborn - crying or breathing, with good tone - receives routine care even when the fluid is meconium-stained. Routine tracheal suctioning is not recommended; ventilation is for a newborn who is not breathing or whose heart rate is below 100/min.
Why the others are wrong
- A – Routine intubation and tracheal suction for meconium is no longer recommended and can cause injury and delay.
- B – Positive-pressure ventilation is for apnea, gasping or a heart rate below 100/min; this newborn is breathing well.
- D – Gastric suction is not a routine step and can cause vagal bradycardia; it does not prevent aspiration.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
14Question
A multiparous client arrives at the triage desk saying, "The baby is coming." The nurse sees the fetal head crowning. No provider is in the room. Which action should the nurse take first?
- Place a hand on the fetal head with gentle pressure and coach the client to pant
- Hold the client's legs together until the provider arrives
- Leave to bring the provider and the delivery cart
- Apply firm pressure on the fundus to complete the birth quickly
Show the answer and explanation
Answer: A. Place a hand on the fetal head with gentle pressure and coach the client to pant
Topic: precipitous birth
When birth is imminent the nurse stays with the client and controls the speed of delivery of the head. Gentle pressure on the head with panting prevents an explosive birth, which can tear the perineum and cause sudden pressure changes in the fetal head.
Why the others are wrong
- B – Holding the legs together or delaying the birth can injure the fetus and the mother.
- C – The client must not be left alone during an imminent birth; help is summoned from the bedside.
- D – Fundal pressure speeds expulsion, and risks uterine injury and perineal tears.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
15Question
A nurse is observing a client breastfeed her 2-day-old newborn. Which observations indicate an effective latch?
Select all that apply.
- The newborn's mouth is wide open with the lips turned outward
- The newborn's cheeks dimple inward with each suck
- Swallowing can be heard after the first few sucks
- A clicking or smacking sound is heard during sucking
- The newborn's chin is touching the breast
- The client reports a pinching pain that lasts through the whole feeding
Show the answers and explanation
Answers: A, C and E.
- A – The newborn's mouth is wide open with the lips turned outward
- C – Swallowing can be heard after the first few sucks
- E – The newborn's chin is touching the breast
Topic: breastfeeding latch
With a deep latch the newborn takes the nipple and much of the areola, the mouth is wide with flanged lips, the chin presses into the breast, and rhythmic sucking with audible swallowing follows. Dimpled cheeks, clicking and persistent pain mean a shallow latch on the nipple alone.
Why the others are wrong
- B – Cheeks should stay rounded; dimpling shows the newborn is sucking on the nipple only.
- D – Clicking means suction is being broken repeatedly, a sign of poor attachment.
- F – Pain that persists through the feeding indicates a shallow latch and nipple damage; the newborn should be taken off and relatched.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
16Question
The parent of a newborn who was circumcised two days ago with a clamp technique calls to say that a yellowish film has formed on the tip of the penis. The newborn is feeding well and has wet diapers. Which instruction should the nurse give?
- "Wipe the film away with an alcohol pad at each diaper change."
- "This is normal healing tissue. Leave it in place and keep cleaning gently with warm water."
- "Bring your baby in today, because this is a sign of infection."
- "Soak your baby in a tub bath twice a day until the film comes off."
Show the answer and explanation
Answer: B. "This is normal healing tissue. Leave it in place and keep cleaning gently with warm water."
Topic: circumcision care
A soft yellow exudate over the glans in the first days after circumcision is granulation tissue and part of normal healing. It is not removed; the area is cleaned gently with water. Signs to report are bleeding that does not stop, spreading redness or swelling, foul-smelling drainage, fever, or no urine output.
Why the others are wrong
- A – Alcohol is painful and damages new tissue, and removing the film can cause bleeding.
- C – A yellow film alone is not infection; infection shows spreading redness, swelling, purulent foul drainage or fever.
- D – Tub baths are delayed until the circumcision has healed; soaking and removing the film disturb healing.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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Nursing