Maternal and Child

1. Among her pediatric patient’s a LPN must care for a hospitalized fifteen-year-old girl by monitoring her weight gain as well a her food intake during meals. The patient’s weight and height are 48 kg and 1.67 m, respectively. While cheking vital signs, the LPN, who had already advised the nurse, permanently installs a nasal cannula at 2L/min. The patient never answers questions, but keeps on requesting laxatives for what she says is chronic constipation. When it’s time to change her nightgown, which is soiled from food, the patient refuses help because she does not want the LPN to see her naked, saying she is too fat. The LPN discovers small snack bags under the patient’s pillow, which are filled with food that’s been chewed and spat out. Which intervention would be appropriate to attenuate the patient’s disruptive behaviour? *
2. During inter-departmental reporting, an LPN is informed that a 24-year-old woman, with fractures on both wrists, was discharged from the hospital but refused to leave. The LPN enters the semi-private room to inquire about the situation with the patient. The patient, looking frightened, begins to cry. She confesses to the LPN that she threw herself from the balcony on the second floor to save herself from her violent partner. She does not want to go back home because she feels she is in danger. She threatens to commit suicide if she doesn’t receive help. Which intervention would be appropriate for controlling the patient’s disruptive behaviour? *
3. Ms. Aurélie Gendron, 24, 10 weeks pregnant, arrives at the clinic reporting persistent vomiting for several days. She appears weak and says she “cannot keep anything down.” The LPN notes dry mucous membranes and a weight loss of 3 kg since her last visit. Urine dipstick shows ketones ++. Which intervention is the priority? *
4. Mrs. Élise Poirier, 31, at 9 weeks’ gestation, presents with light vaginal spotting but no cramping. Ultrasound shows fetal heartbeat present. She is emotionally distressed and asks if she caused this by lifting her toddler. Which teaching is most appropriate? *
5. Ms. Noémie Cloutier, 28, is now 26 weeks pregnant with her first child. She arrives for a routine prenatal visit and appears visibly tense. She explains to the LPN that her mother had type 2 diabetes and that she herself has never tolerated sugary drinks well. She worries she “might faint” during the glucose tolerance test scheduled for next week.
She has gained 7 kg so far, fetal movements are regular, and her blood pressure is normal at 112/68 mmHg. Fundal height corresponds to gestational age. She keeps asking if the test means that something is already wrong with her pregnancy. Which response by the LPN is most therapeutic and accurate? *
6. Mrs. Caroline Létourneau, 35, G2P1 at 32 weeks, comes to the prenatal clinic complaining of a sudden, intense headache, “flashing lights” in her vision, and feeling “puffy.” She works long hours on her feet and thought the swelling was normal.
The LPN assesses her vital signs and finds BP 154/96 mmHg, mild tachycardia, and +2 pedal edema. Her reflexes are slightly hyperactive, and she reports minimal fetal movements this morning. She did not take any medication. What is the most appropriate next step for the LPN? *
7. Ms. Jasmine Roy, 30, G1 at 29 weeks, has a known diagnosis of placenta previa, confirmed by ultrasound. She arrives at the triage unit reporting a sudden episode of painless, bright-red vaginal bleeding while sitting on the couch. She denies contractions and fetal movement is felt normally. Vital signs are stable. She is anxious and keeps asking if the baby is “in danger.” Which nursing action is appropriate? *
8. Mrs. Stéphanie Vézina, 29, at 33 weeks, reports back discomfort and abdominal tightening every 10 minutes since the morning. She works outdoors and admits she “barely drank water today.” On assessment, the LPN notes mild uterine irritability and a soft, non-tender abdomen. Fetal heart rate is normal. There is no vaginal bleeding or fluid leakage. Which intervention should the LPN prioritize? *
9. Mrs. Audrey Tremblay, 33, at 38 weeks, recently tested positive for Group B Streptococcus. She arrives for her routine visit, anxious about how this will affect her labor. She fears her baby will become “very sick” and asks whether she needs antibiotics now. What should the LPN explain? *
10. Ms. Laurence Dufresne, 27, in early labor, suddenly develops a fever of 38.5°C. The fetal heart rate rises to 170 bpm. She reports feeling chills and her membranes have been ruptured for 14 hours. The LPN completes her assessment and notes warm skin and a maternal pulse of 120 bpm. What is the most likely cause of the fetal tachycardia? *
11. Mrs. Valérie Deschamps, 36, delivered vaginally one hour ago after a prolonged second stage. She tells the LPN she feels “dizzy.” On assessment, the LPN finds a boggy uterus, moderate lochia, and a distended bladder visible above the symphysis pubis.
The mother has not voided since delivery. Which action should the LPN take first? *
12. Ms. Delphine Poisson, 25, breastfeeding her 3-week-old infant, reports fatigue, chills, and a painful, red area on the upper outer quadrant of her left breast. She says feeding on that side is “excruciating,” and she’s unsure whether she should stop. What should the LPN teach? *
13. Mrs. Maude Richard, 29, 4 days postpartum, arrives for a newborn weight check. She looks tearful and explains she “cries for no reason,” feels overwhelmed, and worries she’s “not a good mom.” She still enjoys holding her baby and denies feelings of harm.
Her partner confirms she has been sleeping when possible. Which response is most appropriate? *
14. Mrs. Sandra Lamothe, 34, postpartum day 2 after a vaginal birth, reports increasing severe perineal pain, unrelieved by analgesics. She avoids sitting and has difficulty walking. The LPN notes unilateral swelling of the vulva, normal lochia, and stable vital signs. What complication should be suspected? *
15. Ms. Catherine Brodeur, 32, who is Rh-negative, delivered a healthy Rh-positive baby 12 hours ago. She asks why she needs “another shot” since she already received one at 28 weeks. What teaching must the LPN reinforce? *
16. Mrs. Sofia Léger, 30, 36 weeks pregnant, comes for a routine check-up. The LPN notes her fundal height has decreased compared with the prior visit. Mrs. Léger reports urinary frequency and pelvic pressure. What should the LPN check first? *
17. Ms. Stéphanie Cadieux, 26, is 12 hours postoperative from a C-section. She reports pain that makes it hard to take deep breaths. The LPN notes shallow breathing and decreased air entry at lung bases. She has been mostly lying still in bed. What should the LPN encourage? *
18. Mrs. Danika Morin, 34, G2P1, had significant shoulder dystocia in her previous birth. She expresses fear that it will “definitely happen again.”
Her current pregnancy is low-risk, fetal size normal, and glucose screening results are normal. What information should the LPN provide? *
19. Ms. Mireille Fortin, 22, at 28 weeks, presents with fatigue, dizziness, and pallor. Labs show Hgb 94 g/L. She reports that iron tablets cause stomach upset and she often takes them with a glass of milk. Which teaching is essential? *
20. Mrs. Amélie Goupil, 30, at 37 weeks, presents with irregular contractions that stop when she rests. She is worried she “won’t recognize real labor.” Her cervix is unchanged from last visit, and fetal movements remain strong. Which explanation is accurate? *
21. Mrs. Rosalie Martin, 33, is being discharged with mild preeclampsia. Her blood pressure is controlled and labs are stable. Before leaving, the LPN reviews warning signs.
Mrs. Martin states she still has mild ankle swelling sometimes. Which symptom requires urgent evaluation? *
22. Ms. Marianne Dupuis, 27, is in active labor after receiving an epidural 20 minutes ago. She suddenly reports nausea and dizziness. The LPN rechecks her vital signs: BP 88/50 mmHg. Fetal tracing shows decreased variability. She appears pale and anxious. What is the priority intervention? *