1. C.
50 breaths per minute or more
- In IMCI, fast breathing is defined as ≥50 breaths per minute in infants aged 2–12 months.
2. B. Amoxicillin
- Amoxicillin is the first-line antibiotic for pneumonia in children under IMCI guidelines.
3. D. Perform dry wicking and give quinolone ear drops for 14 days
- Chronic suppurative otitis media (CSOM) lasting >14 days requires ear wicking and topical antibiotics.
4. B. Begin intravenous fluids and refer urgently
- Severe dehydration with sunken eyes, restlessness, and slow skin pinch requires IV rehydration.
5. D. Administer artesunate and oral antibiotics, then refer urgently
- Severe malaria with neurological symptoms requires immediate IV artesunate and hospital referral.
6. C. Luteinizing hormone
- LH surge triggers ovulation around day 14.
7. B. Menorrhagia
- Menorrhagia is excessive menstrual bleeding (>80 mL per cycle or soaking pads frequently).
8. A. Pregnancy has likely occurred.
- Elevated progesterone supports implantation and prevents menstruation.
9. D. Progesterone
- Progesterone maintains the endometrial lining for implantation.
10. B. 40-70 mL
- Normal menstrual blood loss ranges from 30-80 mL, with an average of 40-70 mL.
11. A. BSE should be done annually beginning at the age of 20
- BSE should be done monthly, not annually.
12. B. A week after menstruation
- Best time for BSE is a week after menstruation when breasts are least tender.
13. C. A 25-year-old client who has 2 consecutive negative smears
- Pap smears should continue every 3 years despite negative results.
14. A. Sexual intercourse within 24-48 hours of the test
- Sexual activity can alter Pap smear results.
15. A. After a hot shower
- Warmth relaxes the scrotum, making examination easier.
16. B. May 22, 2025
- Naegele’s Rule: LMP (Aug 15, 2024) → Subtract 3 months (May) → Add 7 days (22) → May 22, 2025.
17. B. Mesoderm
- The mesoderm forms the reproductive system.
18. A. Fetal movement felt by examiner
- Only the mother’s perception of fetal movement is a probable sign; examiner’s confirmation is positive.
19. C. "Avoid lying flat on your back; try left lateral position instead."
- Supine position causes vena cava compression, leading to hypotension.
20. D. G4 P2 (T1 P1 A1 L1)
- G4: 4 pregnancies, T1: 1 term, P1: 1 preterm, A1: 1 abortion, L1: 1 living child.
21. A. Inevitable abortion
- Cervical dilation with bleeding and cramping at 12 weeks indicates inevitable abortion.
22. B. Ampulla
- The ampulla is the most common site for ectopic pregnancies.
23. B. Shrink and destroy the products of conception
- Methotrexate is used for medical management of early ectopic pregnancy.
24. D. Blood pressure decreases from 120/80 to 80/60 mmHg
- Hypotension indicates hemorrhagic shock and requires urgent intervention.
25. B. "I can start trying for a pregnancy as soon as my HCG levels normalize."
- Pregnancy should be avoided for at least one year to monitor for GTD recurrence.
26. C. A soft, washable rattle
- Infants at 6 months need soft, safe toys for sensory stimulation.
27. A. Child is able to sit on toilet for 1 to 2 minutes without fussing or getting off
- Sitting for a short time is helpful, but not a readiness sign for toilet training.
28. C. Centering
- Preschoolers focus on one aspect of an object while ignoring others (centration).
29. D. Provide choices.
- Offering choices gives toddlers a sense of autonomy and reduces resistance.
30. B. Industry vs. Inferiority
- In this stage, children seek approval for accomplishments.
31. A. Serum potassium level of 3.2 mEq/L
- Hypokalemia increases the risk of digoxin toxicity; digoxin should be held.
32. B. Respiratory rate of 10 breaths per minute
*Rationale:* A respiratory rate below 12 breaths per minute is a sign of magnesium toxicity.
33. A. Serum magnesium level of 3.5 mEq/L
*Rationale:* Normal magnesium levels range from 1.5-2.5 mEq/L. A level of 3.5 mEq/L is elevated and
may indicate toxicity.
34. D. Calcium gluconate
*Rationale:* Calcium gluconate is the antidote for magnesium sulfate toxicity.
35. C. "I don't need to worry about seizures anymore since I've delivered."
*Rationale:* Seizures can still occur postpartum; the patient should continue monitoring for symptoms of
eclampsia.
36. C. Blood pressure of 140/90 mmHg or higher after the 20th week AOG
*Rationale:* Gestational hypertension is diagnosed based on elevated blood pressure without proteinuria
after 20 weeks.
37. B. Epigastric pain
*Rationale:* Epigastric pain in preeclampsia suggests severe disease and impending eclampsia.
38. B. "I need to avoid eating any salt-containing foods to avoid swelling."
*Rationale:* Sodium restriction should be moderate, not complete, as complete restriction may cause fluid
imbalance.
39. A. "This condition will resolve completely after delivery."
*Rationale:* Gestational hypertension usually resolves after delivery but may persist in some cases.
40. D. The absence of seizures is observed
*Rationale:* Magnesium sulfate is used primarily to prevent seizures in preeclampsia.
41. B. Place the patient in a lateral position.
*Rationale:* Late decelerations indicate uteroplacental insufficiency; repositioning improves blood flow.
42. C. Fetal cord compression
*Rationale:* Variable decelerations are commonly caused by umbilical cord compression.
43. A. Stop the oxytocin infusion.
*Rationale:* Late decelerations suggest fetal distress; stopping oxytocin reduces uterine contractions and
improves oxygenation.
44. B. Trendelenburg
*Rationale:* Trendelenburg position helps relieve pressure on the umbilical cord in cases of cord
compression.
45. C. Monitor closely and document the findings.
*Rationale:* Early decelerations are caused by head compression and are usually benign.
46. C. Lochia Serosa
*Rationale:* Lochia serosa appears pinkish-brown and occurs from days 4-10 postpartum.
47. B. "Lochia should be a yellowish color after the first few days."
*Rationale:* Lochia should transition from red (rubra) to pink (serosa) to white (alba), not yellow.
48. C. Lochia will be significantly reduced in quantity.
*Rationale:* Cesarean delivery usually results in less lochia compared to vaginal birth.
49. A. Taking-in phase
*Rationale:* The taking-in phase (first 1-2 days) is characterized by dependence and self-focus.
50. A. Level of umbilicus
*Rationale:* Immediately after placental delivery, the uterine fundus is at the umbilical level.
51. C. 12-18 months of age
*Rationale:* Cleft palate repair is typically done at 12-18 months to optimize speech development.
52. A. Allow the child to assume prone position.
*Rationale:* Prone positioning may put pressure on the surgical site; supine or side-lying is preferred.
53. B. Use soft elbow restraints to prevent touching the surgical site.
*Rationale:* Elbow restraints prevent the child from disrupting the surgical site.
54. B. Olive-shaped mass in the epigastrium, right of the umbilicus
*Rationale:* Pyloric stenosis is characterized by a palpable olive-shaped mass in the epigastric region.
55. C. During or immediately after feeding
*Rationale:* Visible peristalsis in pyloric stenosis is best observed after feeding.
56. D. "Rice and quinoa are excellent gluten-free alternatives."
*Rationale:* Rice and quinoa are safe for individuals with celiac disease.
57. B. Early bilious vomiting with no abdominal distention
*Rationale:* Duodenal atresia leads to bilious vomiting soon after birth due to obstruction.
58. C. Low-fiber, high-calorie, high-protein diet
*Rationale:* A low-fiber diet reduces bowel irritation postoperatively in Hirschsprung disease.
59. A. Cover the sac with sterile gauze soaked in normal saline.
*Rationale:* Keeping the omphalocele sac moist prevents drying and infection.
60. A. Failure to pass meconium within the first 24 hours of life
*Rationale:* Imperforate anus is suggested by the absence of meconium passage.
