Maternal and Child

1. Mrs. Laramée, 32, G2P1 at 34 weeks’ gestation, arrives at the birthing unit complaining of a severe frontal headache that began this morning. She reports swelling in her hands and face that worsened over the last two days. Her urine dip shows +3 protein. During assessment, she suddenly says the lights “look blurry” and her vision feels “spotty.” Her BP reads 168/104 mmHg. Which clinical manifestation BEST supports the suspected diagnosis? *
2. A 29-year-old woman at 31 weeks arrives with bright-red vaginal bleeding. She denies contractions and reports no abdominal pain. Fetal heart rate is stable. She mentions that the bleeding started suddenly while resting in bed. Which manifestation is MOST associated with placenta previa? *
3. Ms. Francine, 24, presents with sudden sharp pain in the right lower abdomen. She reports light vaginal spotting and dizziness when standing. Her last menstrual period was eight weeks ago. She states the pain radiates to her right shoulder tip. Which clinical finding most strongly suggests ectopic pregnancy? *
4. One hour after vaginal delivery, the LPN notices heavy bleeding saturating pads within minutes. The patient feels dizzy and weak. On palpation, the uterus is high and soft to the touch. Which finding is MOST characteristic of postpartum hemorrhage due to uterine atony? *
5. A breastfeeding mother, 3 weeks postpartum, reports feeling “flu-like” with chills and fatigue. Her left breast is warm, tender, and reddened in one quadrant. She states feeding on that breast is very painful. Which manifestation MOST supports mastitis? *
6. A 7-month-old infant with diarrhea for 2 days appears lethargic and cries without tears. The mother states the baby has had fewer wet diapers and seems “floppy.” Skin turgor is delayed, and capillary refill is 4 seconds. Which clinical finding BEST confirms moderate dehydration? *
7. A 2-year-old boy is brought to the clinic after waking suddenly at night with a loud, seal-like cough. The parents say he struggles more when crying and the room air feels “cool and damp.” He has mild inspiratory stridor but is alert and playful. Which manifestation is MOST consistent with croup? *
8. A 4-year-old girl comes with persistent fever for 5 days, swollen hands, red conjunctiva, and a rash on her torso. The nurse notices her tongue appears bright red with enlarged papillae. Which finding supports Kawasaki disease? *
9. A newborn of a diabetic mother is noted to be irritable and jittery. The baby is pale, has a weak cry, and is difficult to soothe. Glucose checks were ordered but not yet performed. Which manifestation is MOST suggestive of neonatal hypoglycemia? *
10. A 10-year-old boy arrives with abdominal pain that began near the bellybutton and gradually migrated to the lower right quadrant. He refuses to walk, holding his abdomen protectively. Rebound tenderness is present, and he reports nausea and decreased appetite. Which manifestation MOST supports appendicitis? *
11. Ms. Éliane Morin, 32 weeks pregnant (G2P1), presents with severe headaches, facial swelling, and visual disturbances. BP is 164/102 mmHg, reflexes are 3+, and urine shows 3+ protein. After several hours of monitoring, she develops intense epigastric pain, nausea, and vomiting. Laboratory values reveal: AST 240, ALT 260, platelets 82,000, elevated LDH. Which complication is developing? *
12. A patient is admitted to the surgical unit for a hysterectomy caused by a uterine fibroid. She explains to the LPN that a few months after giving birth, her menstrual periods have become very heavy and abnormally long (15 days out of 30), and that her stools are hard and dry. The patient mentions that she also feels a lump on her left abdominal region and feels dizziness and shortness of breath. Which of the following clinical manifestations relates to the patient’s condition? *