MCN 2 Sas Answers 1 46 NVGBFD

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MCN 2 SAS Answers 1 46 - NVGBFD
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NUR 145 | Maternal and Child Health Nursing

Name: Nikka N. Olita Section: BSN 2-A1 Date: 11/22/2021
SAS #1
CHECK FOR UNDERSTANDING
1. ANSWER: E
RATIO: The client has uncompromised heart disease because uncompromised is defined as
typical physical activity causing no discomfort. There were no signs of heart insufficiency or
anginal discomfort.
2. ANSWER: B
RATIO: The client has slightly compromised heart disease because slightly compromised is
described as ordinary physical activity causes excessive fatigue, palpitation, and dyspnea or
anginal pain.
3. ANSWER: C
RATIO: The patient belongs to Class 3, which is markedly compromised because she has
excessive fatigue, palpitations, dyspnea, or anginal pain during less than usual activities in
this class.
4. ANSWER: D
RATIO: Among the following statements, statement in option D is incorrect because
Nitroglycerin should be given within 5 minutes, up to 3 tablets, and if the chest discomfort is
not reduced after 15 minutes, the patient should proceed to the emergency room.
5. ANSWER: C
RATIO: An echocardiogram is a noninvasive ultrasound of the heart that gives detailed
information about heart structure and function.
6. ANSWER: D
RATIO: Among the following options, option D is not a common cause of cardiovascular
disorder during pregnancy because Pulmonary embolism is a blockage in one of the
pulmonary arteries in the lungs. In most cases, it is caused by blood clots that travel to the
lungs from deep veins in the legs or, rarely, from veins in other parts of the body (deep vein
thrombosis).
7. ANSWER: C
RATIO: The client requires immediate intervention since the signs displayed as she arrived
at the emergency room are severe which requires immediate attention and intervention.
8. ANSWER: A
RATIO: Among the following conditions, infection increases the workload of the heart since
an infection can cause inflammation or damage to your heart's inner lining, valves, outer
membrane, or the heart muscle itself.
9. ANSWER: A
RATIO: Among the following options, option A is not a side effect of potassium-wasting
diuretics since it is under potassium-sparing diuretics.
10. ANSWER: C
RATIO: The client has markedly compromised because in this class, during less than the
ordinary activity, a woman experiences excessive fatigue, palpitations, dyspnea, or anginal
pain.

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SAS #12
1. ANSWER: D
RATIO: The risk factors that increases the patient’s risk for developing gestational diabetes
includes maternal age which is 34 years old, Macrosomia (fetal) previous babies greater than
9 lbs, Multiple pregnancies, BMI of 28 which is considered as obese or overweight, and history
wherein in her case, she has a family history of type 2 diabetes.
2. ANSWER: D
RATIO: Option D is the correct answer because gestational diabetes is a kind of diabetes that
develops during the second or third trimester of pregnancy.
3. ANSWER: B C
RATIO: Options B and C are the correct answer because insulin is a hormone secreted by
the beta cells found in the pancreas. It influences or causes cells to take in glucose from the
blood. Options A and D are incorrect statements regarding insulin.
4. ANSWER: D
RATIO: Option D is the correct answer since a 3-hour glucose tolerance test is requested if a
patient has a positive 1-hour glucose tolerance test (which is given at roughly 24-28 weeks).
This test is used to determine gestational diabetes if it is abnormal.
5. ANSWER: B
RATIO: Option B is the only correct statement in the scenario. It is critical that the mother
constantly examines her blood glucose level and tries to maintain a euglycemic level (normal
blood glucose level) of 70-95 mg/dL fasting and 140 mg/dL 1 hour after meals.
6. ANSWER: A
RATIO: Among the following options, option A is incorrect regarding contraception in diabetes
Mellitus because diabetic women should not use intrauterine device (IUD) since it has high
incidence of pelvic inflammatory disease (PID). Option B, C and D are correct.
7. ANSWER: B
RATIO: The term "euglycemic" refers to a blood glucose level that is "normal." A normal blood
glucose level is between 70 and 140 mg/dL. Option B, which is 82 mg/dL, is the sole option
that represents a normal blood glucose level. Option A is Hypoglycemic, Option C is slightly
Hyperglycemic, and Option D is Hyperglycemic.
8. ANSWER: B C
RATIO: Options B and C are the correct answers. Preeclampsia is a risk factor for gestational
diabetes complications. It can cause hypertension (option B) and protein in the urine (option
C).
9. ANSWER: A
RATIO: Option A is the correct answer. Since glucose can escape into the urine and cause
infection, a patient with gestational diabetes is at risk for urinary tract infections. This
circumstance indicates that the patient has uncontrolled hyperglycemia, putting her at high
risk for glycosuria (glucose in the urine). If the patient complains of burning when urinating,
the physician should be alerted so that a urine analysis can be performed. All the other options
are normal findings in pregnancy at this stage.
10. ANSWER: B C
RATIO: The newborn is at risk for hypoglycemia and respiratory distress. There is a constant
high supply of glucose when a baby of a mother with gestational diabetes is still in the womb.
This leads the baby to store more fat (resulting in a larger infant) and produce a lot more

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insulin in order to deal with the high glucose from the mother. However, once the baby is out
of the womb, the glucose supply drops, but the newborn still has plenty of insulin. This can
result in hypoglycemia (low blood sugar) at birth. Furthermore, uncontrolled gestational
diabetes might damage a baby's lung maturity, increasing the likelihood of respiratory distress
after birth.
SAS #3
1. ANSWER: B
RATIO: The newborn has Fetal Alcohol Syndrome. It is a condition in a child that results from
alcohol exposure during the mother's pregnancy. It also causes brain damage and growth
problems.
2. ANSWER: D
RATIO: The pregnant client is using inhalants. Inhalant abuse refers to the “sniffing” or
“huffing” of aerosol substances. Most of these substances seem innocent; however, they
contain freon as a propellant, which can lead to severe respiratory and cardiac irregularities.
The effect of these substances during pregnancy is not well documented, but they appear to
have effects similar to alcohol dependency. The respiratory depression they can cause could
be enough to limit fetal oxygen supply to a serious level.
3. ANSWER: A
RATIO: The client is using Heroin. Heroin is a raw illicit opiate that is also increasing in
incidence in late adolescents. It may be administered intradermally (skin popping), through
inhalation (snorting), or intravenously (shooting). It produces an immediate and short-lived
feeling of euphoria immediately followed by sedation.
4. ANSWER: B
RATIO: The client is using marijuana. Marijuana when smoked, produce tachycardia and a
sense of well-being. Although not routinely advised, some women use marijuana to counteract
nausea in early pregnancy.
5. ANSWER: C
RATIO: The client is using Phencyclidine. Phencyclidine was developed in the 1950s as an
intravenous anesthetic; it is no longer used that way because, although it creates a sense of
euphoria, it also causes irritation and possibly long-term hallucinations, and it is now seen
most frequently as part of polysubstance use. Because the substance tends to leave the
maternal circulation and concentrate in fetal cells, it may be particularly injurious to a fetus.
6. ANSWER: A
RATIO: Withdrawal symptoms of Heroin includes nausea and vomiting, diarrhea, abdominal
pain, hypertension, restlessness, shivering, insomnia, body aches, and muscle jerks. Option
A, Intracranial hemorrhage is not included.
7. ANSWER: D
RATIO: Fetal withdrawal symptoms of cocaine includes tremulousness, irritability, muscle
rigidity, learning defects (later on in life), intracranial hemorrhage, and detected by urinalysis.
Restlessness is not included.
8. ANSWER: C
RATIO: Effects of marijuana when used in pregnant women and with the fetus includes loss
of short-term memory, reduced milk production, incidence or respiratory infection, and
excretion of drug in breast milk. Intracranial hemorrhage is not included.
9. ANSWER: D

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RATIO: Fetal effects of Narcotic includes Small for Gestational Age, increased incidence of
fetal distress, and meconium aspiration. Restlessness is not included.
10. ANSWER: C
RATIO: Effects of Phencyclidine (PCP) increase cardiac output & give a sense of euphoria,
cause hallucinations (flashback episodes), and tends to leave the maternal circulation &
concentrate in fetal cells. Loss of short-term memory is not included since it belongs to the
effects of marijuana.

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SAS #4
1. ANSWER: D
RATIO: Among the following statements, statement in option D is incorrect regarding ABO
incompatibility because the statement refers to RH incompatibility.
2. ANSWER: C
RATIO: All of the following statements are correct regarding RH incompatibility except for the
statement in option C because it refers to ABO incompatibility.
3. ANSWER: D
RATIO: Among the following options, option D is incorrect regarding the laboratory findings
of a newborn with ABO incompatibility because the Direct Coombs test is often weakly positive
(+) only, not negative (-).
4. ANSWER: E
RATIO: Hypothermia, Hypocalcemia, Hyperkalemia, and Hypoglycemia are all Exchange
Transfusion (ExTx) complications. Hypernatremia isn't taken into account.
5. ANSWER: D
RATIO: Fetal Complications of Erythroblastosis Fetalis include Anemia, Splenomegaly &
hepatomegaly, Hyperbilirubinemia, and Hydrops fetalis. Wilms Tumor is not included.
6. ANSWER: D
RATIO: Among the following statements, the statement in option D is incorrect regarding
HIV/AIDS because the disease is not transmitted through saliva. It can, however, be
transferred through the exchange of a range of body fluids, including blood, breast milk,
semen, and vaginal secretions, from infected people. During pregnancy and delivery, HIV can
be passed from a mother to her child.
7. ANSWER: D
RATIO: Options A, B, and C are all risk factors of HIV/AIDS. Option D is not a risk factor and
HIV is not transmitted through closed-mouth or “social” kissing with someone who has HIV.
8. ANSWER: B
RATIO: Seroconversion is the production of antibodies versus HIV that happens in 6 weeks
to a year after exposure.
9. ANSWER: C
RATIO: Pneumocystis Carinii Pneumonia pertains to the client’s condition because this
condition is a life-threatening lung infection that can affect people with weakened immune
systems, such as those infected with HIV, the virus that causes AIDS.
10. ANSWER: C
RATIO: Kaposi’s Sarcoma is cancer that causes patches of abnormal tissue to form beneath
the skin, in the mouth, nose, and throat linings, lymph nodes, and other organs. These lesions,
or patches, are usually red or purple in color. Thus, the patient is suffering from this ailment.

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SAS #5
1. ANSWER: D
RATIO: The most common types of anemia during pregnancy include Iron-deficiency Anemia,
Vitamin B12 Anemia, Anemia due to Blood Loss, and Folate Deficiency. Thalassemia is not
included.
2. ANSWER: E
RATIO: Risk factors of anemia include poor nutrition, excess alcohol consumption, illnesses
that reduce the absorption of nutrients, use of anticonvulsant drugs (Tegretol, Lithium,
Carbamazepine, etc.), previous use of oral contraceptives, and G6PD deficiency. Option E is
not one of the risk factors.
3. ANSWER: B
RATIO: Folate is the common form of vitamin B9 present in many whole foods, including leafy
greens, beans, eggs, citrus fruit, avocados, and beef liver, while Folic acid is a synthesized
version of vitamin B9 that is added to processed foods and the common version used in
supplements. Thus, option B is the correct definition of folic acid and folate.
4. ANSWER: D
RATIO: Iron Deficiency Anemia is most often seen in multiple pregnancies because of the
increased fetal demand, women with secondary hemolytic illness, women who are taking
Hydantoin, and poor gastric absorption due to gastric bypass for morbid obesity. Iron
Deficiency Anemia cannot be seen in woman at 36 years of age, thus option D is the answer.
5. ANSWER: D
RATIO: Complications of anemia include premature labor, intrauterine growth retardation
(IUGR), dangerous anemia from normal blood loss during labor, requiring transfusions, and
increased susceptibility to maternal infection after childbirth. Poor diet & poor nutrition is not
part of the complications.
6. ANSWER: E
RATIO: All of the following options are true regarding Hyperemesis Gravidarum.
7. ANSWER: D
RATIO: All of the following options are part of the management for Hyperemesis Gravidarum
except for option D. In addition, NPO; IVF (3L Ringer’s lactated solution+ vitamin B) to control
vomiting must be included in the management for this condition.
8. ANSWER: D
RATIO: The fallopian tube is the most prevalent location of ectopic pregnancy (it accounts for
about 95% of all such pregnancies). Approximately 80% of these fallopian tube locations are
in the ampullar part, 12% in the isthmus, and 8% in the interstitial or fimbrial portion.
9. ANSWER: C
RATIO: Karlie is experiencing Kehr’s Sign. Kehr's sign also referred as shoulder pain is due
to blood in the peritoneum irritating the phrenic nerve.
10. ANSWER: A
RATIO: Option A is the correct answer. Cullen’s sign is an ecchymotic blueness around the
umbilicus indicating blood pooling in the peritoneum. It is named for gynecologist Thomas
Stephen Cullen (1869–1953), who first described the sign of ruptured ectopic pregnancy in
1916.

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SAS #6
1. ANSWER: D
RATIO: The nurse should instruct the woman to come to the health facility with any vaginal
material passed. This is a common period for gestational trophoblastic illness to appear during
pregnancy. It would be vital to ask the woman to bring any vaginally passed material so that
it may be evaluated.
2. ANSWER: A
RATIO: Option A is the correct answer. Poor blood coagulation is a symptom of HELLP
syndrome. When blood coagulation is in doubt, epidural anesthesia is not recommended.
3. ANSWER: D
RATIO: All of the following statements describe the Gestational trophoblastic disease or
Hydatidiform Mole.
4. ANSWER: B
RATIO: Option B is the correct answer. With a complete mole, all trophoblastic villi swell and
become cystic. If an embryo forms, it dies early at only 1 to 2 mm in size, with no fetal blood
present in the villi.
5. ANSWER: C
RATIO: Option C is the correct answer. With a partial mole, some of the villiform normally.
The syncytiotrophoblastic layer of villi, however, appears swollen and misshapen. The embryo
may grow for about 9 weeks but then macerates; some fetal blood may be present in the villi.
In contrast to complete moles, partial moles rarely lead to choriocarcinoma.
6. ANSWER: A
RATIO: When the cervix dilates prematurely, the fetus cannot be retained until the baby is
born. After a child is lost due to premature cervical dilatation, a surgical procedure known as
cervical cerclage can be performed to prevent this from happening again in a subsequent
pregnancy. Purse-string sutures are inserted into the cervix to strengthen it and keep it from
dilating until the end of the pregnancy. The client delivering a full-term fetus at 39 weeks
gestation would be evidence that the procedure is successful.
7. ANSWER: B
RATIO: Option B is the correct answer. In a McDonald procedure, nylon sutures are placed
horizontally and vertically across the cervix and pulled tight to reduce the cervical canal to a
few millimeters in diameter.
8. ANSWER: C
RATIO: Shirodkar technique or procedure is when a sterile tape is threaded in a purse-string
manner under the submucous layer of the cervix and sutured in place to achieve a closed
cervix. Although routinely accomplished by a vaginal route, sutures may be placed by a
transabdominal route.
9. ANSWER: D
RATIO: All of the following statements are true regarding Premature Cervical Dilation except
for option D because when uterine contractions begin & after a short labor, the fetus is born,
not stillbirth.
10. ANSWER: D
RATIO: All of the following are the management for Premature Cervical Dilation except for
option D. Chest X-ray is not among the following management.

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SAS #7
CHECH FOR UNDERSTANDING
1. ANSWER: C
RATIO: All of the following are causes of spontaneous miscarriage except for option C. Other
causes include implantation abnormalities, corpus luteum, infection, trauma, and maternal
systemic diseases: DM, thyroid problems, severe anemia.
2. ANSWER: D
RATIO: Option D is the correct answer because bleeding and especially passing clots during
pregnancy can be a sign of miscarriage, preterm labor, or other complications, so the nurse
should seek immediate medical attention if the patient experiences bleeding.
3. ANSWER: A
RATIO: Symptoms of Threatened Miscarriage include vaginal bleeding- scant, usually bright
red, slight cramping or backache, but there is no cervical dilatation. Option B is for Complete
Miscarriage. Option C is for Incomplete Miscarriage. Option D is for Missed Miscarriage/Early
Pregnancy Failure.
4. ANSWER: C
RATIO: In an incomplete miscarriage, part of the conceptus (usually the fetus) is expelled,
but the membranes or placenta are retained in the uterus. Option A describes Threatened
Miscarriage. Option B describes Complete Miscarriage. Option D describes Missed
Miscarriage/ Early Pregnancy Failure.
5. ANSWER: D
RATIO: In a missed miscarriage, also commonly referred to as early pregnancy failure, the
fetus dies in utero but is not expelled. Option A is a symptom of Threatened Miscarriage.
Option B is for Complete Miscarriage. Option C is for Incomplete Miscarriage.
6. ANSWER: B
RATIO: In a complete miscarriage, the entire products of conception (fetus, membranes, and
placenta) are expelled spontaneously without any assistance and there is bleeding, cramping
& expulsion of conceptus. Option A is for Threatened Miscarriage. Option C is for Incomplete
Miscarriage. Option D is for Missed Miscarriage/ Early Pregnancy Failure.
7. ANSWER: D
RATIO: All of the following are management of Threatened Miscarriage, except for option D
since it is for Imminent or Inevitable Miscarriage.
8. ANSWER: C
RATIO: The patient is experiencing infection as evidenced by the signs displayed as she
arrived at the hospital. Signs of infection include fever higher than 100.4°F (38.0°C),
abdominal pain or tenderness, and foul-smelling vaginal discharge.
9. ANSWER: A
RATIO: The patient is experiencing septic abortion or an abortion complicated by infection.
Infection can occur after a spontaneous miscarriage, but more frequently, it occurs in women
who have tried to self-abort or whose pregnancy was aborted illegally using a nonsterile
instrument such as a knitting needle.

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10. ANSWER: D
RATIO: The patient is experiencing a Hemorrhage. Bleeding also called hemorrhage, is the
name used to describe blood loss. It can refer to blood loss inside the body, called internal
bleeding, or to blood loss outside of the body, called external bleeding.
SAS #8
1. ANSWER: A
RATIO: Placenta previa is a condition of pregnancy in which the placenta is implanted
abnormally in the lower part of the uterus. Option A refers to placenta previa. Option B refers
to abruptio placenta. Option C refers to marginal abruption. Option D refers to couvelaire
uterus or uteroplacental apoplexy.
2. ANSWER: B
RATIO: The patient has a grade 1 abruptio placenta as evidenced by vaginal bleeding and
no fetal movement. There is minimal separation, but enough to cause vaginal bleeding and
changes in the maternal vital signs; no fetal distress or hemorrhagic shock occurs.
3. ANSWER: C
RATIO: The patient has a grade 2 abruptio placenta. At this level, there is evidence of fetal
distress; the uterus is tense and painful on palpation.
4. ANSWER: A
RATIO: The patient has a grade 0 abruptio placenta. At this level, no symptoms of separation
are apparent from maternal or fetal signs; the diagnosis is made after birth when the placenta
is examined, and a segment of the placenta shows a recent adherent clot on the maternal
surface.
5. ANSWER: B
RATIO: The patient has a grade 1 abruptio placenta. At this level, there is minimal separation,
but enough to cause vaginal bleeding and changes in the maternal vital signs; no fetal distress
or hemorrhagic shock occurs.
6. ANSWER: B
RATIO: Premature separation of the placenta, also called abruptio placentae, is the
premature separation of the normally implanted placenta after the 20th week of pregnancy,
typically with severe hemorrhage. Option A refers to placenta previa. Option C refers to
marginal abruption. Option D refers to couvelaire uterus or uteroplacental apoplexy.
7. ANSWER: D
RATIO: In couvelaire uterus or uteroplacental apoplexy, the placenta separates first at the
center, blood pools under the placenta & is hidden from view. Option A refers to placenta
previa. Option B refers to abruptio placenta. Option C refers to marginal abruption.
8. ANSWER: D
RATIO: The placenta previa occurs in four degrees, namely: low-lying placenta, marginal
implantation, partial placenta previa, and total placenta previa. Total Placenta Previa is the
implantation that totally obstructs the cervical os which the patient has.
9. ANSWER: C
RATIO: The patient has a marginal implantation, wherein the placenta edge approaches that
of the cervical os.

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10. ANSWER: B
RATIO: The patient has a low-lying placenta. Among the four degrees, the low-lying placenta
refers to implantation in the lower rather than upper portion of the uterus.
SAS #9
1. ANSWER: B
RATIO: All of the following options are true regarding Premature Rupture of Membrane
(PROM), except for option B, because in PROM, nitrazine paper turns to blue, not red.
2. ANSWER: C
RATIO: Among the following options, option C is true regarding Premature Rupture of
Membrane (PROM). Option A is incorrect because loss of amniotic fluid occurs before 37
weeks AOG. Option B is incorrect because PROM is strongly associated with infections of
membranes (Chorioamnionitis). Option D is also incorrect because PROM is associated with
vaginal infection (Neisseria Gonorrhea, Group B streptococcus and chlamydia).
3. ANSWER: A
RATIO: Option A is incorrect regarding the management of Premature Rupture of Membrane
(PROM) among the following options because, in PROM, preterm babies require immediate
delivery.
4. ANSWER: C
RATIO: Susceptibility to infection is the most typical condition for PROM because PROM is
strongly associated with infections of membranes and vaginal infections.
5. ANSWER: D
RATIO: Premature Rupture of Membrane (PROM) is associated with vaginal infection
(Neisseria Gonorrhea, Group B streptococcus, and chlamydia). Mycobacterium Tuberculosis
is not included.
6. ANSWER: D
RATIO: The pregnant woman is classified into gestational hypertension. Signs of gestational
hypertension include BP of 140/90 mm Hg or systole elevated 30 mm Hg or diastole elevated
15 mm Hg above pre-pregnancy level; returns to normal after childbirth, and has no proteinuria
or edema.
7. ANSWER: C
RATIO: The pregnant woman is diagnosed with severe preeclampsia because of the
displayed BP of 210/180 mm Hg and seizure. A BP of 160/110 mm Hg or higher at least 2
times, 6 hours apart, and while on bed rest indicates severe preeclampsia. People who have
this type of hypertension during pregnancy are more likely to have seizures, hence seizure
precautions should be used.
8. ANSWER: A
RATIO: All of the following are management for a pregnant woman who is diagnosed with
Eclampsia who had a seizure, except for option A. Other management includes administering
O2; assessing oxygenation, monitoring FHT, contractions, vaginal bleeding (q 15 mins), and
medications: MgSO4, diazepam.
9. ANSWER: C

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RATIO: Calcium Gluconate should be at the bedside when administering Magnesium Sulfate
because this is an antidote to MgSO4.
10. ANSWER: D
RATIO: Option D is the correct answer because symptoms of MgSO4 toxicity include BURP
– Blood pressure low, Urine output low (< 100 ml in 4 hours), RR < 12 breaths/min, and
Patellar reflexes absent.

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SAS #10
CHECK FOR UNDERSATNDING
1. ANSWER: E
RATIO: Predisposing factors of Cord Prolapse include Premature rupture of membranes, fetal
presentation other than cephalic, placenta previa, intrauterine tumors preventing the
presenting part from engaging, a small fetus, CPD preventing firm engagement, Hydramnios
(not Oligohydramnios), and multiple gestations.
2. ANSWER: C
RATIO: All of the following are the assessment findings for Cord Prolapse, except for option
C because it should be variable (not late) deceleration pattern becomes apparent.
3. ANSWER: B
RATIO: All of the following are nursing considerations with Cord Prolapse, except for option
B. Remember to never replace the cord back into the vagina as it may result in kinking and
knotting obstructing blood flow.
4. ANSWER: A
RATIO: All of the following are fetal complications of Cephalopelvic Disproportion, except for
option A because Postpartum hemorrhage is a maternal risk or complications along with
lacerations.
5. ANSWER: D
RATIO: Option D is the correct statement regarding Cephalopelvic Disproportion. Option A
refers to the prolapse of the umbilical cord. Option B refers to inlet contraction. Option C refers
to outlet contraction.
6. ANSWER: B
RATIO: Inlet contraction is the narrowing of the anteroposterior diameter of the pelvis to less
than 11 cm or of the transverse diameter to 12 cm or less. It usually is caused by rickets in
early life or by an inherited small pelvis.
7. ANSWER: D
RATIO: A placenta succenturiata is a placenta that has one or more accessory lobes
connected to the main placenta by blood vessels. No fetal abnormality is associated with this
type. However, it is important to be recognized because the small lobes may be retained in
the uterus after birth, leading to severe maternal hemorrhage.
8. ANSWER: C
RATIO: In the placenta circumvallata, the fetal side of the placenta is covered to some extent
with the chorion. In this type of anomaly, the placenta is cup-shaped with raised margins with
the whitish opaque chorion covering the periphery.
9. ANSWER: A
RATIO: In a battledore placenta, the cord is inserted marginally rather than centrally giving
the appearance of a tennis racket. This anomaly is rare and has no known clinical significance
either.
10. ANSWER: B
RATIO: Velamentous insertion of the cord is a situation in which the cord, instead of entering
the placenta directly, separates into small vessels that reach the placenta by spreading across

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a fold of amnion. This form of cord insertion is most frequently found with multiple gestations.
Because the fetal blood supply may not be as generous as usual, this type of placenta is
associated with fetal anomalies. An infant born with this type of placenta needs to be
examined carefully at birth.
SAS #11
1. ANSWER: D
RATIO: All of the following choices are the common causes of dysfunctional labor, except for
option D. Other common causes include pelvic bone contraction that has narrowed the pelvic
diameter so that a fetus cannot pass (rickets), overdistention of the uterus, as with multiple
pregnancy, hydramnios, or an excessively oversized fetus, cervical rigidity (unripe), presence
of a full rectum or urinary bladder that impedes fetal descent, mother becomes exhausted
from labor, and primigravida status.
2. ANSWER: A
RATIO: With hypotonic uterine contractions, the number of contractions is unusually
infrequent (not more than two or three occurring in 10 minutes). This occur during the active
phase of labor and tend to occur after the administration of analgesia, especially if the cervix
is not dilated to 3 to 4 cm or if bowel or bladder distention is preventing descent or firm
engagement.
3. ANSWER: B
RATIO: Option B is the correct answer. Hypertonic uterine contractions are marked by an
increase in resting tone to more than 15 mmHg. The contraction may, however, be no more
intense than hypotonic contractions. If a woman's discomfort is out of proportion to the quality
of her contractions, a uterine and fetal external monitor can be used to determine whether the
resting phase between contractions is appropriate and the FHR is not exhibiting late
deceleration.
4. ANSWER: A
RATIO: Option A is the correct answer. A contraction ring forms across the uterus at the
intersection of the upper and lower uterine segments, interfering with fetal descent.
5. ANSWER: B
RATIO: A protracted active phase is usually associated with fetal malposition or cephalopelvic
disproportion (CPD) (the diameter of the fetal head is larger than the woman’s pelvic
diameters), although it may reflect the ineffective myometrial activity.
6. ANSWER: D
RATIO: Preterm/Premature Labor is associated with Dehydration, Urinary tract infection,
Periodontal disease, Chorioamnionitis, Large fetal size, Strenuous jobs during pregnancy,
Shift work, Intimate partner violence, and trauma. Option D, Cephalopelvic Disproportion, is
not included.
7. ANSWER: A
RATIO: Causes of precipitate labor include grand multiparity, Large Pelvis, Small Fetus, and
induction of labor by OXYTOCIN or AMNIOTOMY. Option A, Chorioamnionitis, is not a cause
of precipitate labor.
8. ANSWER: C

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RATIO: The condition that the patient has is Uterine Inversion. Uterine inversion occurs
following delivery. With uterine inversion, there is a large gush of blood from the vagina, and
the uterus is no longer palpable in the abdomen.
9. ANSWER: C
RATIO: A deceleration phase has become prolonged when it extends beyond 3 hours in a
nullipara or 1 hour in a multipara. A prolonged deceleration phase most often results from the
abnormal fetal head position. Cesarean birth is frequently required.
10. ANSWER: D
RATIO: The client is experiencing Secondary Arrest of Dilatation. A secondary arrest of
dilatation has occurred if there is no progress in cervical dilatation for longer than 2 hours. In
this case, cesarean birth is necessary.
SAS #12
1. ANSWER: A
RATIO: Option A is the correct answer. Occipitoposterior Position occurs in approximately
one-tenth of all labors, and the fetal position is posterior rather than anterior. That is, the
occiput is directed diagonally and posteriorly, either to the right (right occipitoposterior [ROP])
or to the left (left occipitoposterior [LOP]). In these positions, during internal rotation, the fetal
head must rotate not through a 90-degree arc but through an arc of approximately 135
degrees.
2. ANSWER: B
RATIO: Option B is the correct answer. Occiput Transverse Position occurs due to ineffective
contractions or a flattened bony pelvis. Vaginal delivery is possible with oxytocin
administration and the application of forceps for delivery.
3. ANSWER: C
RATIO: The three types of breech presentation are the Complete Breech, Frank Breech, and
Footling Breech. Compound is not a type of breech presentation.
4. ANSWER: A
RATIO: Option A is the correct answer. Shoulder Presentation or Transverse Lie occurs in
women with pendulous abdomens, with uterine fibroid tumors that obstruct the lower uterine
segment, with contraction of the pelvic brim, with congenital abnormalities of the uterus, or
with polyhydramnios. It may occur in infants with hydrocephalus or another abnormality that
prevents the head from engaging. It may also occur in prematurity if the infant has room for
free movement, in multiple gestations (particularly in a second twin), or if there is a short
umbilical cord.
5. ANSWER: C
RATIO: Option C is the correct answer. A brow presentation is the rarest of the presentations.
It occurs in a multipara or a woman with relaxed abdominal muscles. It almost invariably
results in obstructed labor because the head becomes jammed in the brim of the pelvis as the
occipitomental diameter presents.
6. ANSWER: B
RATIO: Option B is the correct answer. Compound presentation occurs when more than 1
part of the fetus presents, most commonly hand or arm prolapsing with the head, and has a

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high risk of cord compression and prolapse. The method of delivery for this type of
presentation depends on size, presence of distress, and progress of labor.
7. ANSWER: D
RATIO: Option D is the correct answer. Fetal presentation occurs when the fetal head is
presenting at a different angle than expected, termed as asynclitism. Face and brow
presentations are examples of asynclitism.
8. ANSWER: C
RATIO: Option C is the correct answer. Severe variable deceleration pattern is when FHR
slows following the peak of a contraction & slowly returns to baseline rate during the resting
phase. It is due to the interference of blood flow from cord compression and can lead to fetal
hypoxia and low APGAR scores.
9. ANSWER: A
RATIO: Option A is the correct answer. Early decelerations normally occur late in labor, when
the head has descended fairly low; they are viewed as innocent. If they occur early in labor,
before the head has fully descended, the head compression causing the waveform change
could be the result of cephalopelvic disproportion and is a cause to investigate.
10. ANSWER: B
RATIO: Option B is the correct answer. Late decelerations are those in which the onset, nadir,
and recovery of the deceleration occur after the beginning, peak, and ending of the
contraction, respectively, and slowly returns to baseline rate during the resting phase. This is
an ominous pattern in labor because it suggests uteroplacental insufficiency or decreased
blood flow through the intervillous spaces of the uterus during uterine contractions.

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SAS #13
1. ANSWER: D
RATIO: The four main reasons for postpartum hemorrhage are uterine atony, trauma
(lacerations, hematomas, uterine inversion, or uterine rupture), retained placental fragments,
and the development of disseminated intravascular coagulation (DIC). Chorioamnionitis is not
included.
2. ANSWER: B
RATIO: Uterine atony, or relaxation of the uterus, is the most frequent cause of postpartum
hemorrhage; it tends to occur most often in Asian, Hispanic, and Black women. Hemostasis
is due to the contraction of the muscles occluding the open vessels.
3. ANSWER: D
RATIO: All of the following options are predisposing factors of Uterine Atony, except for option
D, forceps delivery. Other predisposing factors include large infant, multiple gestations,
hydramnios, precipitous labor, MgSO4, tocolytics, and low platelet count.
4. ANSWER: D
RATIO: A perineal hematoma is a blood collection in the perineum's subcutaneous layer of
tissue. In most cases, the underlying skin is undamaged and shows no signs of trauma. Injury
to blood vessels in the perineum after birth, however, causes blood to pool beneath the skin.
5. ANSWER: C
RATIO: Retained Placental Fragments refer to a placenta that does not completely detach
from the uterus; instead, fragments of it separate and remain attached to the uterus. Uterine
bleeding occurs because the part retained prevents the uterus from fully contracting. Although
a succenturiate placenta—one with an additional lobe—is more likely to cause this, it can
happen in any situation.
6. ANSWER: A
RATIO: Contributing factors of uterine inversion include prolonged labor, abnormal
presentation, multiple gestations, unwise use of oxytocin, obstructed labor, and traumatic
maneuvers of forceps or traction. Perineal varicosities are not included in the list.
7. ANSWER: C
RATIO: The failure of the uterus to revert to its pre-pregnancy size and form after pregnancy
is known as uterine subinvolution. Because of retained placental fragments, it produces
bleeding and occurs frequently within 1 to 2 weeks after childbirth; blood loss is substantial
but less hazardous than immediate postpartal hemorrhage.
8. ANSWER: D
RATIO: In fourth-degree laceration, the entire perineum, rectal sphincter, and some of the
mucous membrane of the rectum are lacerated.
9. ANSWER: A
RATIO: In first-degree laceration, the vaginal mucous membrane and skin of the perineum to
the fourchette are lacerated.
10. ANSWER: C

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RATIO: In third-degree laceration, the entire perineum, extending to reach the external
sphincter of the rectum, is lacerated.
SAS #14
1. ANSWER: D
RATIO: The common infective agents that cause puerperal sepsis are Group B
streptococci, Aerobic gram (-) bacilli like E. coli, and Staphylococcus aureus. Helicobacter
Pylori is not included in the list.
2. ANSWER: E
RATIO: All of the following options are conditions that increase the risk of post-partal
infection, except for option E. Other conditions include preexisting anemia-lowers body
defense, internal fetal heart monitoring, local vaginal infection at the time of birth, and the
uterus was explored after birth for a retained placenta or abnormal bleeding site.
3. ANSWER: A
RATIO: All of the following options are conditions that affect the prognosis for complete
recovery from Puerperal Sepsis, except for option A, local vaginal infection at the time of
birth. Other condition includes the presence of lacerations in the reproductive tract.
4. ANSWER: E
RATIO: All of the following are correct assessments for Endometriosis, except for option
E. Other assessments include an increase in temperature of > 100.4F (38C) for 2
consecutive 24-hour periods, excluding the 1st 24 hours, and UTZ to check for retained
placental fragments.
5. ANSWER: A
RATIO: Assessment for infection of the perineum only includes usually localized, may or
may not have a fever, and 1 or 2 stitches may be sloughed from the suture line, or an area
of the suture line may be open with purulent drainage present. Chills, anorexia, and
general malaise are not included. These are only applicable for the assessment of
endometritis.
6. ANSWER: A
RATIO: Management for a client who is diagnosed with an infection of the perineum
includes all of the following options, except for option A. Other management includes
analgesic to relieve discomfort, Sitz baths, moist, warm compresses, Hubbard tank
treatments to hasten drainage & cleanse the area and to remind women to change
perineal pads frequently to prevent recontamination or vaginal infection.
7. ANSWER: A
RATIO: Among the following health teachings, drainage of the infected site and packed
with iodoform gauze on the open lesion is the only one that cannot be done at home
because it should be done at the hospital with the assistance of healthcare professionals.
8. ANSWER: D
RATIO: Localized infections involve lesions of the perineum, vulva, vagina, and
endometrium. Chorioamnionitis is not a part of local infections.
9. ANSWER: D
RATIO: Among the following statements, the statement in option D is incorrect regarding
Endometriosis because the statement is an assessment for an infection of the perineum.
10. ANSWER: D

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RATIO: Options A, B and C are all assessments for Endometriosis. Option D is incorrect
since it is an assessment for an infection in the perineum.
SAS #15
1. ANSWER: B
RATIO: Options A, C, and D, are therapeutic management for Mastitis. Option B, early
ambulation following birth, is not included.
2. ANSWER: D
RATIO: Options A, B, and C are the assessments or findings of Mastitis. Option D is not
included since it is a finding for Superficial Thrombophlebitis.
3. ANSWER: B
RATIO: Option B is the correct answer. In Epidemic mastitis or epidemic breast abscess, the
infant has usually acquired Staphylococcus aureus, a methicillin-resistant S. aureus infection
(MRSA), or candidiasis while in the hospital. This is termed epidemic mastitis or epidemic
breast abscess because this spreads from one person to another. When it occurs, it is
common to find that numerous women who were discharged from the hospital at the same
time have the same infections.
4. ANSWER: D
RATIO: Deep vein thrombosis (DVT) is a type of edema that affects the leg and ankle and
causes a white or drained appearance, formerly called MILK LEG. It also causes pain in the
lower leg or lower abdomen, as well as a low-grade temperature followed by chills and a high
fever.
5. ANSWER: C
RATIO: Septic Pelvic thrombophlebitis develops in conjunction with infections of the
reproductive tract. It is common in CS and predisposes to pulmonary embolism.
6. ANSWER: B
RATIO: Pelvic thrombophlebitis involves the ovarian, uterine, or hypogastric veins. It
frequently follows mild endometritis and develops later in the puerperium than femoral
thrombophlebitis, usually around the 14th or 15th day. Inflammation of the blood arteries in
the pelvic area creates a partial obstruction, resulting in slower blood flow and the formation
of clots in the stagnant blood.
7. ANSWER: A
RATIO: The femoral, saphenous, or popliteal veins are involved in femoral thrombophlebitis.
Although the thrombophlebitis inflammation begins in a vein, an associated arterial spasm
frequently develops, reducing arterial circulation to the leg. The leg appears white or drained
because of the diminished circulation and edema.
8. ANSWER: A
RATIO: Postpartum Blues occurs during the 1st 10 days postpartum. Many women suffer
extreme melancholy or "baby blues" during the postpartum period, and they may cry easily or
feel let down and irritated. This phenomenon may be caused by hormonal changes,
particularly the reduction in estrogen and progesterone that occurs with the delivery of the
placenta.
9. ANSWER: B
RATIO: Postpartum Depression affects up to 20% of women, however in certain cases,
especially in women who are dissatisfied with some element of their newborn or who have a

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lack of family support, these normal symptoms can last longer than a year or indicate a more
serious condition than typical "baby blues."
10. ANSWER: C
RATIO: In Postpartal Psychosis, one out of every 500 women has enough symptoms a year
after giving birth to be deemed psychiatrically sick. Postpartal psychosis is defined as an
illness that arises during the postpartum period or within the first year after childbirth. This
could be caused by the reactivation of past mental disease, hormonal changes, or a family
history of bipolar disorder.

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SAS #16
1. ANSWER: A
RATIO: Subfertility is said to exist when a pregnancy has not occurred after at least 1 year of
engaging in unprotected coitus. Because most couples have the potential to conceive but are
less able to do so without support, the term subfertility is used more frequently than infertility.
It affects as many as 8% to 12% of couples who want to start a family.
2. ANSWER: D
RATIO: The inability to conceive due to a recognized ailment, such as the lack of a uterus, is
known as sterility. 50 percent of couples who engage in coitus four times a week will conceive
within six months, and 85 percent will conceive within a year.
3. ANSWER: C
RATIO: Sperm Penetration Assay and Antisperm Antibody Testing is done to test if the sperm
can penetrate the ovum. The sperm must be mobile enough to navigate the vagina, uterus,
and fallopian tube to reach the ova for impregnation to occur. Although sperm penetration
studies are rarely required, they may be arranged to see if a man's sperm can effectively
penetrate an ovum once they reach it.
4. ANSWER: E
RATIO: Option E is the correct answer. Commercial tests for measuring the LH surge that
occurs soon before ovulation is available from a variety of brands and can be used instead of
BBT monitoring. A woman puts a test strip into a mid-morning urine sample and compares
the color change to the kit instructions.
5. ANSWER: F
RATIO: The Ferrel testing kit includes materials to test both FSH on the third day of a woman's
menstrual cycle (an excessively high level indicates her ovaries aren't responding well to
ovulation) and male sperm motility. The result for a woman is available in 30 minutes, whereas
the result for a man is available in 10 minutes. The kits are expensive, but they might be useful
as a first step in self-fertility testing for a couple.
6. ANSWER: E
RATIO: Surrogate embryo transfer is a method of assisted reproduction for women who are
unable to generate oocytes. The donor's ovum is removed at ovulation via a transvaginal,
ultrasound-guided technique. The recipient woman's partner's sperm (or donor sperm)
fertilizes the oocyte in the laboratory, and the embryo is then transferred to the recipient
woman's uterus via embryonic transfer. When pregnancy happens, it proceeds normally as if
it were an unassisted pregnancy.
7. ANSWER: A
RATIO: Therapeutic Insemination is the insertion of sperm into the female reproductive
system to facilitate conception.
8. ANSWER: C
RATIO: Gamete intrafallopian transfer (GIFT) techniques extract eggs from ovaries in the
same way that IVF does. Instead of waiting for fertilization in the lab, both eggs and sperm

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are instilled into the open end of a patent fallopian tube utilizing a laparoscopic method in a
matter of hours.
9. ANSWER: D
RATIO: Zygote intrafallopian transfer (ZIFT) is similar to IVF in that the egg is fertilized in the
laboratory, but unlike GIFT, the fertilized egg is put into the end of a waiting fallopian tube via
a laparoscopic method. Despite its availability, due to the significant laparoscopic skill
required, this treatment is rarely utilized nowadays.
10. ANSWER: B
RATIO: In vitro fertilization (IVF) is most commonly performed for couples who have been
unable to conceive due to the woman's fallopian tubes being clogged or damaged. One or
more mature oocytes are retrieved from a woman's ovary by laparoscopy and fertilized in a
laboratory by exposure to sperm.
SAS #17
1. ANSWER: A
RATIO: All of the following are factors predisposing infants to respiratory difficulty in the 1st
few days of life, except for option A. Prevention of infection is not a factor, instead, it is a need
of newborns in the first few days of life that take priority.
2. ANSWER: D
RATIO: All of the following are Newborn Priorities in the First Day of Life, except for option D.
Chest, heart or, respiratory tract anomalies are a factor predisposing infants to respiratory
difficulty in the 1st few days of life, not a newborn priority.
3. ANSWER: B
RATIO: Infants who fall below the 10th percentile of weight for their age are considered small
for gestational age (SGA). SGA infants are small for their age because they have experienced
intrauterine growth restriction (IUGR) or failed to grow at the expected rate in utero.
4. ANSWER: C
RATIO: An infant is LGA (also termed macrosomia) if the birth weight is above the 90th
percentile on an intrauterine growth chart for that gestational age. Such a baby appears
deceptively healthy at birth because of the weight, but a gestational age examination will
reveal immature development.
5. ANSWER: A
RATIO: Infants who fall between the 10th and 90th percentiles of weight for their age
regardless of gestational age are considered appropriate for gestational age (AGA).
6. ANSWER: D
RATIO: Periventricular/Intraventricular Hemorrhage is the bleeding into the tissue
surrounding the ventricles or into the ventricles. These conditions occur in as many as 50%
of infants with very low birth weight. This occurs because preterm infants have both fragile
capillaries and immature cerebral vascular development.
7. ANSWER: B
RATIO: Kernicterus is the destruction of brain cells by the invasion of indirect bilirubin. This
invasion results from the high concentrations of indirect bilirubin in the blood from the
excessive breakdown of red blood cells.
8. ANSWER: A

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RATIO: In anemia of prematurity, the infant will appear pale and may be lethargic and
anorectic. The fault appears to be the immaturity of the hematopoietic system combined with
the destruction of red blood cells because of low levels of vitamin E, which normally protects
red blood cells against oxidation.
9. ANSWER: C
RATIO: Persistent Patent Ductus Arteriosus leads to pulmonary artery hypertension, which
may interfere with the closure of the ductus arteriosus. To avoid increasing blood pressure
and further compounding this problem, administer intravenous therapy cautiously to preterm
infants.
10. ANSWER: A
RATIO: The infant has anemia of prematurity. In this complication, the reticulocyte count is
low because the bone marrow does not increase its production until approximately 32 weeks.
SAS #18
1. ANSWER: E
RATIO: Respiratory distress syndrome (RDS) of the newborn, formerly termed hyaline
membrane disease, most often occurs in preterm infants, infants of diabetic mothers, infants
born by cesarean birth, or those who for any reason have decreased blood perfusion of the
lungs, such as occurs with meconium aspiration.
2. ANSWER: A
RATIO: The infant is experiencing Transient Tachypnea of the Newborn. In this condition, at
birth, a newborn may have a rapid rate of respirations, up to 80 breaths per minute when
crying, caused by retained lung fluid. Within 1 hour, however, this rapid rate slows to between
30 and 60 breaths per minute. The infant does not appear to be in a great deal of distress,
aside from the tiring effort of breathing so rapidly.
3. ANSWER: B
RATIO: Sudden Infant Death Syndrome (SIDS) is sudden unexplained death in infancy. It
tends to occur at a higher-than-usual rate in infants of adolescent mothers, infants of closely
spaced pregnancies, and underweight and preterm infants.
4. ANSWER: C
RATIO: Apnea is a pause in respirations longer than 20 seconds, with accompanying
bradycardia. It tends to occur in preterm infants who have secondary stresses such as
infection, hyperbilirubinemia, hypoglycemia, or hypothermia.
5. ANSWER: D
RATIO: Hyperbilirubinemia results from the destruction of red blood cells, owing either to a
normal physiologic response or abnormal destruction of red blood cells.
6. ANSWER: D
RATIO: Necrotizing Enterocolitis (NEC) is a condition that develops in approximately 5% of
all infants in intensive care nurseries. The bowel develops necrotic patches, interfering with
digestion and possibly leading to paralytic ileus. Perforation and peritonitis may follow.
7. ANSWER: C
RATIO: Some infants have been discovered cyanotic and limp in their beds but have survived
after mouth-to-mouth resuscitation by parents. An episode of this kind is called an apparent
life-threatening event.
8. ANSWER: E

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RATIO: Periventricular leukomalacia (PVL) is a condition in which the white matter of the brain
develops abnormally. It is caused by an ischemic episode that interferes with circulation to a
portion of the brain. To remove away necrotic tissue, phagocytes, and macrophages infiltrate
the area.
9. ANSWER: A
RATIO: Hemorrhagic disease of the newborn results from a deficiency of vitamin K. Vitamin
K is essential for the formation of prothrombin by the liver. Lack of it causes decreased
prothrombin function and impaired blood coagulation.
10. ANSWER: B
RATIO: Twin-to-twin transfusion is a phenomenon that can occur if twins are monozygotic
(identical; share the same placenta) or if abnormal arteriovenous shunts occur that direct more
blood to one twin than the other. The process occurs in as many as one-third of all identical
twin pregnancies.

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SAS #19
1. ANSWER: C
RATIO: The child has Intussusception. Intussusception is the invagination of one portion of
the intestine into another which usually occurs in the second half of the first year of life. Blood
occurs in the stool and potentially in vomitus after around 12 hours, giving it a "currant jelly"
appearance.
2. ANSWER: C
RATIO: Intussusception is the invagination of one portion of the intestine into another, most
frequently occurring in the second half of the first year of life, with 90% of cases occurring by
2 years of age.
3. ANSWER: A
RATIO: Hirschsprung disease, also known as aganglionic megacolon, is a condition in which
the muscle of a segment of the gut lacks ganglionic innervation—in most cases, the lower
region of the sigmoid colon right above the anus.
4. ANSWER: B
RATIO: The baby is experiencing a condition called Colic. Colic is a type of paroxysmal
stomach pain that affects babies under the age of three months and is characterized by
intense. The legs are pulled up against the tummy while the baby sobs loudly. The baby's face
flushes, his hands' clench, and his abdomen tightens. Though a bottle is supplied, the infant
will suck aggressively for a few minutes as if starving, then stop when another wave of
intestinal agony hits.
5. ANSWER: D
RATIO: Gastroesophageal reflux disease (also known as achalasia in newborns) is a
neuromuscular disorder in which the gastroesophageal (cardiac) sphincter and the lower
section of the esophagus are flexible, allowing stomach contents to regurgitate easily into the
esophagus. It is fairly common in infancy, affecting about 70% of infants, and it normally does
not require treatment. It usually begins within one week of birth and is linked to a hiatal hernia.
6. ANSWER: D
RATIO: Failure to thrive is a rare condition in which an infant's weight and height fall below
the 5th percentile on a standard growth chart, or the percentiles on a growth chart are
declining Sometimes, both physical and emotional factors play a role in the failure to thrive.
7. ANSWER: C
RATIO: The newborn has a condition called Imperforate Anus. This condition is the stricture
of the anus and may be may be detected by a prenatal sonogram. Occasionally, the condition
may be revealed because a membrane filled with black meconium can be seen protruding
from the anus. A “wink” reflex will not be present if sensory nerve endings in the rectum are
not intact. If these methods fail to detect the condition, it can be discovered in a newborn by
the inability to insert a rubber catheter into the rectum.
8. ANSWER: B

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RATIO: A cleft palate is an opening in the palate that forms when the palatal process fails to
complete properly between weeks 9 and 12 of pregnancy. The midline is usually where the
incomplete closure occurs, and it might affect the anterior hard palate, posterior soft palate,
or both. It can happen on its own or in conjunction with a cleft lip.
9. ANSWER: A
RATIO: The cleft lip is when the nose is generally flattened because the incomplete fusion of
the upper lip has allowed it to expand in a horizontal dimension. It is more prevalent among
boys than girls and occurs at a rate of approximately 1 in every 750 live births.
10. ANSWER: C
RATIO: The newborn has a condition called Imperforate Anus. In this condition, no stool will
be passed, and abdominal distention will become evident. A radiograph or sonogram will
reveal the disorder if the infant is held in a head-down position to allow swallowed air to rise
to the end of the blind pouch of the bowel.
SAS #20
1. ANSWER: B
RATIO: The nurse should concentrate on the risk of infection since infection could spread into
the CNS via the meningeal sac, posing a life-threatening threat.
2. ANSWER: C
RATIO: Option C is the correct answer because the sac should be kept moist to maintain
integrity of the sac prior to surgery.
3. ANSWER: A
RATIO: Option A is the correct answer. The nurse should position the baby with the hips
abducted and feet in a neutral position as this position maintains proper alignment of the hips
and lower extremities. Options B, C, and D will pull the hips out of alignment.
4. ANSWER: B
RATIO: The primary reason for surgical repair is to reduce the risk of infection as this condition
is can be associated with the risk of infection because the infection could spread into the CNS
through the meningeal sac, posing a life-threatening threat.
5. ANSWER: B
RATIO: If the parents stated that head elevation increases intrathoracic pressure, nurse
Charlie needs to reexplain the purpose for elevating the head of the bed at a 10 to 20- degree
angle because head elevation decreases, not increases, intrathoracic pressure.
6. ANSWER: B
RATIO: An electroencephalogram (EEG) is a brain test that detects aberrant electrical activity.
Multiple spike patterns can aid in the diagnosis of specific seizure diseases.
7. ANSWER: C
RATIO: Option C is the correct answer. Seizure problems do not always result in cognitive
deficits in children. Options A, B, and D might add to a child's stress as he or she tries to
comprehend and manage a chronic condition.
8. ANSWER: D
RATIO: The meningocele is a protrusion of a spinal fluid-filled sac of meninges through a
bony defect in the posterior elements of the spine without associated neural tissue herniation.
This is the mildest form of spina bifida cystica.

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9. ANSWER: C
RATIO: Option C is the correct answer since signs and symptoms of increased intracranial
pressure (ICP) are not associated with seizure activity and therefore would be the lowest
priority.
10. ANSWER: D
RATIO: If a child has increased ICP, an older child may be able to report symptoms such as
diplopia as a sign of an early clinical manifestation. On funduscopic examination, papilledema
may be detected.
SAS #21
1. ANSWER: C
RATIO: The family may be able to use community resources to help with anger management
and the development of parenting skills.
2. ANSWER: B
RATIO: Risk factors of child abuse include most parents who were abused as children, some
have less self-control than other parents, are unfamiliar with normal growth and development
of children, and have unrealistic expectations, the parents may be socially isolated with no
support people and excessive use of alcohol or drugs.
3. ANSWER: C
RATIO: Option C is not a poisoning safety measure, but it is a burns safety measure. Thus,
option C is the correct answer.
4. ANSWER: D
RATIO: Option D is not a safety measure for burns, but it is a safety measure for poisoning.
Therefore, option D is not included and is the correct answer.
5. ANSWER: C
RATIO: The shaken baby syndrome is caused by repetitive, violent shaking of a small infant
by the arms or shoulders, which causes a whiplash injury to the neck, edema to the brainstem,
and distinct retinal hemorrhages. This is a particularly insidious form of child abuse because
the damage inflicted on the infant is not readily apparent.
6. ANSWER: D
RATIO: Factitious disorder, formally known as Munchausen syndrome by proxy refers to a
parent who repeatedly brings a child to a health care facility and reports symptoms of illness
when, in fact, the child is well.
7. ANSWER: B
RATIO: Molestation is a vague term that includes “indecent liberties” such as oral-genital
contact, genital fondling, and viewing, or masturbation. Physical Neglect is defined as a child
who is dirty, skinny, and malnourished, or who is dressed inadequately in cold weather, such
as without mittens, coat, or shoes. Sexual activity amongst family members is referred to as
incest. Photographing or depicting sexual behaviors in any medium involving children, or
distributing such material in person, through the mail, fax, or over the internet, is referred to
as pornography and prostitution.
8. ANSWER: A
RATIO: Physical neglect is a more subtle form of abuse than physical abuse, but it can be
just as damaging to a child’s welfare. Failing to bring a child for immunizations and failing to

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seek early medical care for infection, keeping a child out of school, or allowing a child to go
unsupervised are other signs of neglect.
9. ANSWER: D
RATIO: The child is experiencing pornography and prostitution. Photographing or describing
sexual acts in children through any medium, or disseminating such material in person, by mail,
fax, or over the Internet, is considered child pornography. Arranging or participating in sexual
actions with children is considered child prostitution.
10. ANSWER: C
RATIO: Incest is sexual activity between family members. It often involves an older man and
a young girl, although it may involve an older woman and a younger boy, a brother and sister,
or same-sex partners. It may involve foster, adopted, and stepchildren.

lOMoARcPSD|35074610

SAS #22
1. ANSWER: B
RATIO: Urinary Tract Infection (UTI) tend to occur more often in girls than in boys because
the urethra is shorter in girls and because it is located close to the vagina (allowing the spread
of vulvovaginitis) and close to the anus, from which E. coli spread.
2. ANSWER: C
RATIO: Asthma tends to occur in children with atopy or those who tend to be hypersensitive
to allergens of inflammation, bronchoconstriction, and increased mucus production. Most
children with asthma can be shown to have sensitization to inhalant antigens such as pollens,
molds, or house dust.
3. ANSWER: A
RATIO: Status Asthmaticus is a severe and prolonged asthma attack that is not responsive
to asthma therapy. It requires hospital evaluation and close cardiopulmonary monitoring.
When children fail to respond and an attack continues, they are in status asthmaticus.
4. ANSWER: B
RATIO: Nephroblastoma (Wilms tumor) is a malignant tumor that rises from the metanephric
mesoderm cells of the upper pole of the kidney. It is usually unilateral and encapsulated at
the time of diagnosis.
5. ANSWER: C
RATIO: Acute Lymphocytic Leukemia (ALL) accounts for 75% of leukemias and involves
lymphoblasts or immature lymphocytes. With the rapid proliferation of immature lymphocytes,
the production of red blood cells (RBCs) and platelets falls, and invasion of body organs by
the rapidly increasing WBC elements begins.
6. ANSWER: A
RATIO: Acute myeloid leukemia (AML) involves the over proliferation of granulocytes
(neutrophils, basophils, and eosinophils). It is most often seen in adults so accounts for only
about 20% of all childhood leukemias. The frequency of the disorder increases in late
adolescence as children reach adulthood.
7. ANSWER: C
RATIO: Testicular Invasion is a complication of Acute Lymphocytic Leukemia wherein the
leukemic cells in the testes will not destroyed by chemotherapy, therefore, irradiation is done
leading to sterility.
8. ANSWER: A
RATIO: CNS involvement is a complication of Acute Lymphocytic Leukemia wherein if it
occurs, it can become severe and intense. Blindness, hydrocephalus, recurrent seizures,
nuchal rigidity, headache, and irritability are possible for this complication.
9. ANSWER: B
RATIO: Renal involvement, resulting from invasion of leukemia cells, is a second serious
complication. In this condition, the kidneys may enlarge, and their function will be impaired.
10. ANSWER: D

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RATIO: There are 3 goals in managing asthma and these goals are avoidance of allergen by
environmental control, skin testing, hypo-sensation to identified allergens and relief of
symptoms by pharmacologic agents.
SAS #23
1. ANSWER: D
RATIO: Hypoglycemia is defined as a blood glucose level of less than 70 mg/dL (4 mmol/L)
caused by too much insulin, insufficient meals, or excessive exercise. Hypoglycemia could be
avoided by eating an extra snack of 15 to 30 g of carbohydrates before activities like soccer
practice. 15 to 30 g carbs are found in a small package of raisins or a cup of orange juice. The
dose or timing of insulin administration should not be changed by the child or his or her
parents. It's not a good idea to double the amount of food you eat.
2. ANSWER: C
RATIO: If a child is ill, the mother should test for urine ketones every time she voids. It is
necessary to consume liquids to clear ketones if they are present. It is also appropriate to
encourage the child to drink liquids. Urgent medical attention to the child is unnecessary. The
doses of insulin should not be modified or adjusted.
3. ANSWER: D
RATIO: Electrolyte loss outnumbers water loss in hypotonic dehydration. The state of the
urine output should be assessed first before providing potassium chloride intravenously. In
the case of oliguria or anuria, potassium chloride should never be given. Potassium chloride
should not be given if the urine output is less than 1 to 2 mL/kg/hour. Although choices A, B,
and C are reasonable assessments for a child with dehydration, they are not explicitly related
to potassium chloride IV treatment.
4. ANSWER: D
RATIO: Diabetic Ketoacidosis is a type of diabetic ketoacidosis that happens when there is a
severe insulin shortage. In diabetic ketoacidosis, hyperglycemia develops. Fruity breath odor
and a lower degree of consciousness are also sign of hyperglycemia. Hypertension is not an
indication of diabetic ketoacidosis, but hunger might be a sign of hypoglycemia or
hyperglycemia. Hypotension develops as a result of a drop-in blood volume caused by
dehydration in diabetic ketoacidosis. Hypoglycemia manifests itself in the form of cold, clammy
skin, agitation, perspiration, and tremors.
5. ANSWER: D
RATIO: Diabetic ketoacidosis is a diabetic complication that arises when there is a severe
insulin shortage. Diabetic ketoacidosis causes hyperglycemia. The first step in addressing
diabetic ketoacidosis is rehydration. The first IV rehydration fluid is normal saline. The IV
method is never used to give NPH insulin. When the blood glucose level falls to an appropriate
level, dextrose solutions are added to the treatment. Depending on the potassium level,
intravenously injected potassium may be required, although this would not be part of the
original treatment.
6. ANSWER: C
RATIO: Impetigo is a highly contagious skin infection caused by -hemolytic streptococci,
staphylococci, or both. During the hot, humid summer months, impetigo is most common.
Impetigo can start in a damaged skin region caused by an insect bite or atopic dermatitis. It is

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a very contagious disease. Lesions are most commonly found around the mouth and nose,
however, they can also be found on the hands and extremities.
7. ANSWER: D
RATIO: Rheumatic fever is an inflammatory autoimmune disease affecting the heart, joints,
skin (subcutaneous tissues), blood vessels, and central nervous system. According to the
Jones criteria, rheumatic fever can be diagnosed with two major or two minor symptoms.
Moreover, evidence of recent streptococcal infection can be confirmed by a positive anti-
streptolysin O titer, a positive Streptozyme assay, or a positive anti-DNase B assay. Options
A, B, and C will not help confirm a diagnosis of rheumatic fever.
8. ANSWER: D
RATIO: Rheumatic fever is an autoimmune disease that causes inflammation in organs like
the heart, joints, skin (subcutaneous tissues), blood vessels, and the nervous system. The
symptoms of rheumatic fever usually appear 2 to 6 weeks after an untreated or partially
treated upper respiratory tract infection caused by group A b-hemolytic streptococcal bacteria.
The nurse first examines whether the patient has had a sore throat or an unexplained fever
within the past 2 months.
9. ANSWER: C
RATIO: Juvenile idiopathic arthritis (JIA) is a disease characterized by the presence of
autoimmune inflammation that affects tissues such as cartilage in the joints. As a way to
reduce pain associated with juvenile idiopathic arthritis, hot or cold packs, splinting, and
positioning the affected joint in a neutral position are helpful. Even though resting the extremity
is important, simple isometric or tensing exercises should be initiated as soon as the child is
capable. This type of exercise does not involve the movement of joints.
10. ANSWER: A
RATIO: Lindane is a topical pediculicide that can be used to treat scabies. It is not
recommended for children under the age of two since their skin is more porous, resulting in
increased systemic absorption, putting them at risk for central nervous system toxicity and
seizures. Lindane should also be used with caution in children aged 2 to 10 years. Siblings
and other family members should be treated at the same time.
SAS #24
1. ANSWER: D
RATIO: After a bone fracture, an absence pulse to one extremity of the injured limb could
indicate that the child is developing or experiencing compartment syndrome. This is a medical
emergency, and the HCP should be notified right away. Analgesics would have no effect on
circulation. Without a prescription from an HCP, the skin traction should not be released. It's
not a good idea to apply ice to an extremity that isn't getting enough blood. When perfusion is
sufficient to reduce edema, ice may be administered.
2. ANSWER: D
RATIO: When a child is in traction, the nurse will check the HCP's prescription to ensure that
the amount of traction weight given is correct. The nurse would ensure that the correct amount
of weight was being used, that the weights were hanging freely, ropes were not fraying and
that they were properly attached to the pulleys, the neurovascular status of the involved

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extremity was being monitored, and that there were no signs or symptoms of immobilization.
The nurse would engage the youngster in rehabilitative and recreational play activities.
3. ANSWER: B
RATIO: To avoid difficulties from the cast, it is critical to teach about how to care for it. Parents
should be told not to apply lotion or powder to the skin around the cast borders or within the
cast. Skin irritation can occur when lotions or powders become sticky or caked. The
statements in options A, C, and D are appropriate.
4. ANSWER: D
RATIO: Scoliosis is a three-dimensional spinal malformation characterized by lateral
curvature, a spinal rotation that causes rib asymmetry, and thoracic hypokyphosis. Superior
mesenteric artery syndrome is a problem that can occur following scoliosis surgery.
Mechanical changes in the position of the child's abdominal contents as a result of the child's
body lengthening create this condition. Emesis and abdominal distention are symptoms of the
disease, which are comparable to those of intestinal obstruction or paralytic ileus. Because of
the risk of superior mesenteric artery syndrome, postoperative vomiting in children wearing
body casts or children who have undergone spinal fusion requires special attention. Option A
is erroneous, as are options B and C.
5. ANSWER: C
RATIO: Scoliosis may necessitate the use of a brace. Braces are not curative however, they
can help to delay the course of the curvature and allow for bone maturation. Lotions and
powders should not be used under a brace because they can become sticky and cake behind
the brace, causing irritation. In the care of a child wearing a brace, options A, B, and D are
appropriate approaches.
6. ANSWER: B
RATIO: Men-who-have-sex-with-men (MSM) are at an increased risk of contracting HIV and
developing the Acquired Immunodeficiency Syndrome (AIDS). Although anyone who is
sexually active should be informed on the prevention of sexually transmitted infection, the
other groups are not at an increased risk of HIV/AIDS.
7. ANSWER: B
RATIO: The Body Mass Index (BMI) is the most often used metric for determining obesity.
The BMI is a calculation that compares our weight to our height. Because BMI is a measure
of extra weight rather than excess body fat, it is a proxy for body fatness. Obesity is defined
as a BMI of 30.0 or greater, which increases the risk of a variety of medical conditions.
8. ANSWER: A
RATIO: Obesity persists throughout adulthood, which is the most common problem of
adolescent obesity. Obese teenagers are more likely to have gastrointestinal and orthopedic
disorders, such as Legg-Calvé-Perthes disease and genu valgum (knock knees), however,
they are not the most prevalent complications. Psychosocial issues do exist, but they aren't
the most common side effect.
9. ANSWER: D
RATIO: Asking whether the client is thinking about killing herself is the most direct and
therefore the best way to assess suicide risk. Knowing whether the client has recently watched
movies on suicide and death, what the client feels about suicide, or about previous suicides
of family members will not tell the nurse whether the client is considering suicide right now.
10. ANSWER: B
RATIO: Major risk factors for suicide include: prior suicide attempt(s), misuse and abuse of
alcohol or other drugs, mental disorder or conditions like depression, anxiety, and other mood
disorder and substance problems, especially when unaddressed, increases the risk for

lOMoARcPSD|35074610
suicide. Thus, option B which states that “The risk of suicide increases during adolescence,
with those who have recently suffered a loss, abuse, or family discord being most at risk,” is
the correct answer.

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SAS #25
1. ANSWER: B
RATIO: The increased respiratory rate indicates airway obstruction (breathing faster because
less air is being received with each breath).
2. ANSWER: D
RATIO: Bronchodilators widen the airways, thus assisting with racemic epinephrine nebulizer
therapy would be the most effective option.
3. ANSWER: A
RATIO: Moist environments aid in preventing respiratory secretions from drying out and
making it difficult to raise them.
4. ANSWER: C
RATIO: Some strains of streptococci can cause rheumatic fever or glomerulonephritis as a
result of hypersensitivity reactions.
5. ANSWER: C
RATIO: As the tonsils are removed, an area of large denudation remains, and a simple suture
line is not visible. As a result, bleeding may occur following surgery.
6. ANSWER: B
RATIO: Bringing the child's head down slightly and placing it on their stomach will allow their
mouth and throat secretions to drain, avoiding possible aspiration and allowing the surgeon
to examine the bleeding.
7. ANSWER: C
RATIO: Running the shower or hot water tap in the bathroom until the room is filled with steam
is one emergency approach of easing croup symptoms, and then keeping the child in this
warm, moist environment relaxes the airway tissues and opens the bronchi lumens. If the
symptoms persist, parents should take their child to an emergency room for additional
examination and treatment. Parents should be advised not to provide cough syrup to their
children on a regular basis because many of them have little impact and the risk of overdosing
inappropriate dosing, and side events outweigh the benefit of the syrup. Analgesics may assist
relieve pain from coughing-induced inflammation and irritation of the throat, but they are not
the first line of treatment in this circumstance. For this child, drinking would most likely be
painful and would not bring long-term benefits.
8. ANSWER: C
RATIO: Wheezing is a sound made when air is forced through a restricted airway.
9. ANSWER: D
RATIO: Epiglottitis is an acute inflammation of the epiglottis that affects children between the
ages of two and seven. Before developing a sore throat (difficulty swallowing) and a high
temperature of 102.2 to 104 degrees Fahrenheit, the youngster may have been healthy or
have had a small upper respiratory infection. The worried child wants to breathe by sitting up
and leaning forward, mouth open and tongue out. The "tripod" position is what it is termed. It
is critical to get immediate medical help.
10. ANSWER: C

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RATIO: Laryngitis and pharyngitis usually accompany an upper respiratory infection

accompanied by acute laryngotracheobronchitis. With a fever of 104 to 105 degrees
Fahrenheit, the child may develop hoarseness, a barking cough, and hoarseness. Gradually,
marked laryngeal edema develops, and breathing becomes difficult; the pulse becomes rapid,
and cyanosis may occur. The child must be treated right away. Humidified air can assist to
relieve laryngospasm; humidifiers can be utilized in the child's room to maintain a high level
of humidity. Humidifiers that are cool are preferable, but vaporizers can also be utilized. If the
water is hot enough, taking the youngster into the bathroom and opening the hot water faucets
with the door closed is a quick way to provide moist air. The spasm can sometimes be
alleviated by exposure to cold air, such as when the youngster is carried out late at night to
go to the emergency room or see the doctor.
SAS #26
1. ANSWER: A
RATIO: Pneumonia usually leaves children feeling tired during the illness and the immediate
aftermath.
2. ANSWER: A
RATIO: Pancreatic enzymes are available in capsules which children can swallow or open
and sprinkle over food.
3. ANSWER: A
RATIO: Children who experience fear, anxiety, or stress may have tachypnea (rapid breathing
or panting). Normal breathing is shallow, slow, or regular. Tachycardia means an increase in
heart rate.
4. ANSWER: D
RATIO: Aspiration can result in localized wheezing that arises from only a small portion of the
lung.
5. ANSWER: A
RATIO: Parents are often afraid of pneumonia because the disease was fatal to children
before antibiotics were available. Supporting them when they visit can increase their self-
esteem and reduce their anxiety.
6. ANSWER: B
RATIO: When a child has pneumonia, a high fluid intake is necessary to maintain moisture in
the respiratory system. Small frequent meals prevent exhaustion and breathing pressure due
to distended stomachs.
7. ANSWER: B
RATIO: Pneumonia usually leaves children feeling tired during the illness and the immediate
aftermath.
8. ANSWER: A
RATIO: An inhaler (Salmeterol) is administered first in order to open up the airways. A
corticosteroid (Fluticasone) is then administered after waiting five minutes. As a result of the
bronchodilator, the corticosteroids can easily enter the airways to decrease inflammation.
9. ANSWER: C
RATIO: During an asthma attack, the patient requires medication that opens the airways
immediately. Short-acting bronchodilators, such as Albuterol and short-acting beta-agonists
are the best medications for this. Ipratropium, an anticholinergic bronchodilator, is another

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form of short-acting bronchodilator (given if a patient cannot tolerate short-acting beta-

agonists like Albuterol). Theophylline is a bronchodilator that is taken orally and is NOT
intended to provide immediate relief. Tiotropium is a bronchodilator as well, although it is an
anticholinergic bronchodilator with a LONG-ACTING action. Cromolyn is a nonsteroidal anti-
allergy medicine that is breathed but does not provide immediate relief.
10. ANSWER: C
RATIO: Budesonide is a corticosteroid that is used to treat inflammation. Thrush can be
caused by inhaled corticosteroids. To help prevent the patient from acquiring thrush, a spacer
should be connected to the inhaler before use, and the patient should gargle and rinse their
mouth with water.
SAS #27
1. ANSWER: B
RATIO: During the course of the disease, Aortic Stenosis can progress, and a child may
experience exercise intolerance, which is sometimes better when they are resting.
2. ANSWER: C
RATIO: Fortunately, the Norwood procedure or heart transplant can be used to treat
hypoplastic left heart syndrome.
3. ANSWER: A
RATIO: The patent ductus arteriosus (PDA) is an additional blood vessel that develops in
newborns soon before and after birth. The PDA will shrink and close on its own in most babies
with a normal heart in the first few days of life. If it remains open for a longer period of time, it
may produce an increase in blood flow to the lungs.
4. ANSWER: B
RATIO: The pressures in the left side of the heart are greater, causing the flow of blood to be
from an area of higher pressure to lower pressure, or left to right, increasing the pulmonary
blood flow with the extra blood.
5. ANSWER: A
RATIO: CHD is found often in children with Down syndrome. All babies that have been
diagnosed with Down syndrome should have a cardiology evaluation because of the high
incidence of associated congenital heart defects.
6. ANSWER: A
RATIO: The child's rubbing of her eyes could indicate that she is seeing halos around the
lights, which could indicate digoxin toxicity. Her heart rate is low for her age, which could
indicate digoxin toxicity. Because of the furosemide, a fall in serum potassium can increase
the risk of digoxin toxicity.
7. ANSWER: A
RATIO: Extra calories can be added to formula through the use of a commercial supplement
such as Polycose or corn syrup. Calories in formula may rise from 20 kcal/oz to 30 kcal/oz or
even more.
8. ANSWER: D
RATIO: Increased SVR would result in increased afterload and blood return to the pulmonary
artery.
9. ANSWER: C

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RATIO: By occluding venous flow from the lower extremities and raising afterload, the child
will instinctively assume this position to reduce preload. In this position, increasing SVR
increases pulmonary blood flow.
10. ANSWER: C
RATIO: Indomethacin is indicated for patent ductus arteriosus (PDA) closure, as it promotes
closure of the PDA and generally has an onset of action within minutes. Prostaglandins,
especially E-type prostaglandins, maintain the patency of the ductus.

lOMoARcPSD|35074610

SAS #28
1. ANSWER: D
RATIO: Kawasaki disease damages the blood vessels and is a rare childhood ailment. If
untreated, aneurysms can arise in 20% to 25% of children. Treatment varies depending on
the severity of the disease, although it usually involves rapid IV gamma globulin or aspirin
administration. In some cases, corticosteroids can help prevent issues from occurring.
Children with the illness will almost always require lifelong follow-up appointments to monitor
their heart health.
2. ANSWER: C
RATIO: Appropriate weight for height indicates proper nutrient intake and the absence of
edema. Antibiotics should not be taken on a daily basis if you have heart failure. Digoxin
toxicity is most likely indicated by a pulse rate of less than 50 beats per minute, known as
bradycardia. Polycythemia is indicated by an increased RBC count. Therefore, option C is the
correct answer.
3. ANSWER: A
RATIO: Rheumatoid fever is caused by group beta-hemolytic streptococcal infections, most
commonly pharyngitis, that are not effectively treated. As a result, treating streptococcal throat
infections with antibiotics as soon as possible is crucial for prevention.
4. ANSWER: B
RATIO: The tissues that surround and protect the heart, as well as the heart valves, are
impacted. The cardiac muscle and the mitral valve are frequently involved in this condition.
5. ANSWER: C
RATIO: Kawasaki disease is the leading cause of acquired heart disease in children. Children
can remain irritable for up to two months after the disease's symptoms appear.
6. ANSWER: D
RATIO: Polyarthritis is characterized by warm, swollen, and painful joints, and is one of the
major manifestations of RF. Erythema marginatum is another common RF symptom, but it is
not a vesicular rash. It's a macular rash with well-defined borders that appears on the thorax
and inner surfaces of the extremities. Abdominal masses and yellow pigmentation of the
sclerae are not associated with RF.
7. ANSWER: B
RATIO: All small and medium-sized blood arteries are affected by Kawasaki Disease. Small
vascular inflammation spreads to medium-sized muscle arteries, potentially weakening the
walls and resulting in coronary artery aneurysms.
8. ANSWER: A
RATIO: Prolonged fever, conjunctivitis (reddened and crusty eyes), strawberry tongue, rash
on the palms and soles that desquamates, and heart abnormalities are all signs and
symptoms of Kawasaki disease. Option B, C, and D are not typical Kawasaki illness
symptoms.
9. ANSWER: B

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RATIO: All small and medium-sized blood arteries are affected by Kawasaki Disease. Small
vascular inflammation spreads to medium-sized muscle arteries, potentially weakening the
walls and resulting in coronary artery aneurysms.
10. ANSWER: B
RATIO: Inflammation of the joints is common in RF, and aspirin treatment can help reduce
inflammation and pain.
SAS #29
1. ANSWER: B
RATIO: Hydronephrosis occurs when the outflow of urine is blocked or when urine already in
the bladder flows back into the bladder (reflux), causing the renal pelvis to become enlarged.
2. ANSWER: C
RATIO: Hypospadias is a birth defect in boys in which the opening of the urethra is not located
at the tip of the penis but is located on the inferior or ventral (under) surface of the penis.
3. ANSWER: A
RATIO: Patent Urachus is a narrow tube (urachus) that connects the bladder and umbilicus
fails to close during embryonic development. It occurs more commonly in males than females.
4. ANSWER: D
RATIO: After surgical repair, a urethral urinary drainage catheter will be inserted to allow urine
output without putting tension against the urethral sutures. The child may notice painful
bladder spasms as long as the catheter is in place (3 to 7 days).
5. ANSWER: D
RATIO: A urethral catheter can produce uncomfortable bladder spasms. An antispasmodic
medication such as oxybutynin (Ditropan) may be prescribed for pain relief.
6. ANSWER: B
RATIO: Meatotomy is a surgical procedure in which the urethra is extended to a normal
position—may initially be performed to establish better urinary function.
7. ANSWER: A
RATIO: Chordee repair/procedure is a penis straightening method. It is done to cure chordee,
which is a fibrous band that causes the penis to curve downward (often called a cobra-head
appearance) and is most evident during an erection. The chordee repair is performed by a
pediatric urologist. When a child reaches the age of six months, the surgery is frequently
performed.
8. ANSWER: C
RATIO: Bladder Neck Reconstruction is an alternate continence procedure that reconstructs
bladder capacity, pelvic floor function, and bladder contractility. A BNR reconstructs the
bladder neck and urethra and allows the child to void via the urethra and achieve continence.
9. ANSWER: D
RATIO: All of the following are management of Exstrophy of the Bladder, except for option D
because it is a management for Hydronephrosis.
10. ANSWER: A
RATIO: Among the following options, option A is not a postoperative management of
Exstrophy of the Bladder. It is a therapeutic management for Hypospadias.

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SAS #30
1. ANSWER: A
RATIO: Abdominal Circumference is the most appropriate measurement to be used in order
to determine if ascites is increasing in an amount in a child with nephrotic syndrome.
2. ANSWER: C
RATIO: Acute glomerulonephritis may result as an autoimmune response to the invasion of
group A beta-hemolytic streptococcus.
3. ANSWER: A
RATIO: Nephrotic syndrome patients have an increased risk of infection because they lose
protein (immunoglobulins) in their urine that helps fight infection. In addition, corticosteroids
and immune suppressors can also be used in the treatment of the nephrotic syndrome.
4. ANSWER: D
RATIO: Nephrotic syndrome is a concern for patients in options A, B, and C. Acute
glomerulonephritis is a possibility for the patient in option D.
5. ANSWER: A
RATIO: The nurse educator should re-educate the nursing student that a patient with
nephrotic syndrome will have severe proteinuria (not slight), as well as low albumin levels in
the blood (hypoalbuminemia), edema, and elevated cholesterol and triglyceride levels.
6. ANSWER: B
RATIO: Due to the loss of proteins in the urine that prevent blood clots, patients with nephrotic
syndrome have a higher risk of hypercoagulability (blood clotting). Option B denotes a deep
vein thrombosis, which will appear as a reddened, warm, and swollen area on the extremity.
Options A, C, and D are all typical findings in nephrotic syndrome.
7. ANSWER: B
RATIO: Hyperlipidemia can occur in patients with nephrotic syndrome. This is because there
will be low levels of albumin in the blood when the patient has this condition. As a result of the
decrease in albumin levels in the blood, the liver produces more albumin, but it also makes
more cholesterol and triglycerides, which increases lipid levels. Therefore, the patient should
follow a low-sodium and low-fat diet as well.
8. ANSWER: D
RATIO: Most acute glomerulonephritis cases are caused by infection with beta-hemolytic
Streptococcus 3 weeks prior to symptoms arising. Aside from bacteria, viruses, fungi, and
parasites may also trigger the condition. Myocardial infarction, blood clots, and bleeding ulcers
aren't precipitating factors.
9. ANSWER: A
RATIO: Edema, hypoalbuminemia, and proteinuria are all common symptoms of nephrotic
syndrome. During the nursing assessment of the client's fluid balance, weight, intake and
output, edema, and girth measurements are carefully monitored. BUN and creatinine levels
are also monitored as they are ordered. Depending on the amount of edema and water
retention, the client's activity level is modified. The client's activity level should be limited as
the edema worsens.
10. ANSWER: C
RATIO: Edema is a common clinical symptom in people with nephrotic syndrome and human
albumin has been widely used in the treatment of edema by increasing vascular volume and
this inducing diuresis. Thus, administration of intravenous albumin is expected to be included
in the treatment plan to reduce edema.

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SAS #31
1. ANSWER: C
RATIO: For any malignancy involving the central nervous system, radiation therapy to the
head and scalp is the preferred treatment. Chemotherapy has short-term adverse effects,
whereas radiation therapy has longer-term ones. The hair follicles will not regrow if the
radiation therapy damages them.
2. ANSWER: D
RATIO: Because of the increased risk of bleeding or hemorrhage in children who are
extremely thrombocytopenic and have a platelet count of less than 20,000/ul, bleeding
precautions must be taken. Options A, B, and C are more concerned with infection prevention
than with bleeding.
3. ANSWER: A
RATIO: Acute lymphocytic leukemia and thrombocytopenia may possess a potential risk for
injury as low platelet counts make even small injuries more likely to bleed.
4. ANSWER: D
RATIO: Hodgkin's disease is characterized by swollen lymph nodes that are usually painless.
Lymphocytic node biopsy is used to make the diagnosis.
5. ANSWER: C
RATIO: Thrombocytopenia is a platelet deficit that makes a patient more vulnerable to
hemorrhage. As a result, avoiding invasive procedures reduces the chance of hemorrhage.
Hard, brittle toothbrushes should be avoided, while stool softeners should be promoted. In
this patient, the temperature is not the most crucial vital to monitor.
6. ANSWER: C
RATIO: Chemotherapy and radiation therapy are more effective against cells that proliferate
quickly. Chemotherapy is less effective against nondividing and slow-growing cells.
Chemotherapy is used to kill nondividing cells as they initiate active cell division in a series of
cycles.
7. ANSWER: B
RATIO: This client would be of greatest importance to radiation therapy since radiation
therapy often results in sterility in male clients. Due to the client's age and life choices, it is
important to address their psychosocial needs. When discovered early, Hodgkin's disease, on
the other hand, has a favorable prognosis.
8. ANSWER: B
RATIO: Enlargement of lymph nodes with progression to extra lymphatic sites, such as the
spleen and liver, is the hallmark of Hodgkin's disease, a chronic progressive neoplastic
disease of lymphoid tissue. In this condition, weight loss is most likely to be observed. Fatigue
and weakness are common, but they are unrelated to the condition.
9. ANSWER: A
RATIO: Sleeplessness, weakness, fatigue, and tachycardia are some of the symptoms of
Hodgkin's disease. The condition is characterized by swollen lymph nodes in the neck that

lOMoARcPSD|35074610
are painless. Early in the disease, weight loss happens. Nausea and vomiting are not common
Hodgkin's disease symptoms.
10. ANSWER: C
RATIO: A nursing assistant's job description and education include skincare. Registrants are
best suited to handling assessments and client education, which are more complex tasks.
Lotions should not be applied to the irradiated area during radiation therapy.
SAS #32
1. ANSWER: A
RATIO: It is important to allow the parents of children with cancer to express their feelings,
and they need significant emotional support. Prevention and self-blame are not helpful, nor is
informing parents that their child is one of many with cancer.
2. ANSWER: D
RATIO: There are several ways to encourage nutrition, but choosing what preschoolers
should eat addresses both nutrition and developmental needs.
3. ANSWER: A
RATIO: Although all of the nursing diagnoses described here are relevant, this client's primary
concern is dehydration and fluid and electrolyte loss due to vomiting.
4. ANSWER: A
RATIO: Except for the platelet count, all of the lab results are within normal limits. When a
child's platelet count drops, he or she is at a higher risk for hemorrhage.
5. ANSWER: D
RATIO: Dosing is normally based on the total Body Surface Area (BSA), which necessitates
proper height and weight prior to each drug administration to guarantee that the client receives
adequate chemotherapy doses. Simply inquiring about the client's height and weight may
result in BSA errors. The data needed is not provided by calculating BMI and measuring
abdominal girth.
6. ANSWER: B
RATIO: Chemotherapy and radiation therapy are more sensitive to faster-growing cells.
Chemotherapy is less effective in slow-growing, non-dividing cells.
7. ANSWER: D
RATIO: Malignant tumors are made up of unorganized cells that can spread to other parts of
the body. The growth rate of benign tumor cells is normally sluggish. When benign tumors
grow large enough to impinge on or obstruct vital organs, they can cause tissue harm. Unlike
benign tumors, which are normally encapsulated, malignant tumors can take on any shape.
8. ANSWER: B
RATIO: The patient is at a much higher risk of becoming infected. Because bacteria in fresh
food might cause infection, the apple and orange should be removed from the tray.
9. ANSWER: A
RATIO: The client's initial step in coping with the situational crisis is to express his or her
sentiments. It also aids the healthcare staff in gaining insight into the client's feelings, which
may then be used to drive psychosocial therapy.
10. ANSWER: C
RATIO: Impaired balance, altered gait, and incoordination are all possible side effects of a
cerebellar brain tumor. Visual field deficiencies, swallowing difficulties, and psychomotor

lOMoARcPSD|35074610
seizures can all be caused by the pituitary gland, pons, occipital lobe, parietal lobe, or
temporal lobe malfunction, not by a cerebellar brain tumor. Medullary dysfunction is indicated
by difficulty swallowing. Temporal lobe impairment is indicated by psychomotor seizures.
SAS #33
1. ANSWER: B
RATIO: Celiac disease is an inflammatory bowel illness that affects the small intestine. It
prevents the body from absorbing nutrients from the diet.
2. ANSWER: B
RATIO: Taking the pills with a full glass of water increases the chances of the pill making it all
the way down the esophagus to the stomach and not getting stuck, causing localized damage
and esophagitis symptoms.
3. ANSWER: B
RATIO: Magnesium hydroxide is an osmotic laxative that normally takes 15 to 3 hours to
create a soft, semisolid stool. The patient who hasn't had a bowel movement in three days
would benefit from this drug. It would not be prescribed for bloating and abdominal pain, a
loss of appetite, or indications of hypomagnesemia.
4. ANSWER: D
RATIO: Bisacodyl is a stimulant laxative that works by irritating the colon wall and stimulating
the enteric nerves to help you have a bowel movement. The bulk of the feces is increased by
fiber and bulk-forming medications. Feces are softened by water and stool softeners, while
saline and osmotic treatments cause fluid retention in the intestine.
5. ANSWER: C
RATIO: The intestinal villi are little projections that resemble fingers in appearance. By
expanding the surface area for absorption, the villi help with nutrient absorption. The villi, on
the other hand, are DAMAGED (attacked by the immune system) and appear FLAT when
Celiac Disease is present. This reduces the surface area available for absorption, causing the
patient to become malnourished.
6. ANSWER: D
RATIO: All of the disorders listed, as well as celiac disease, are autoimmune diseases. Other
autoimmune diseases that may occur along with celiac disease include dermatitis
herpetiformis, collagen vascular disease, and Sjogren's syndrome.
7. ANSWER: C
RATIO: To avoid the recurrence of clinical signs of celiac disease, patients must follow dietary
restrictions for the rest of their lives. Other solutions are inappropriate because if the patient
consumes restricted items, signs and symptoms will recur.
8. ANSWER: C
RATIO: Gluten cannot be tolerated or digested by children with celiac disease. Wheat and
wheat-containing goods must therefore be avoided because of their gluten level. Rice, milk,
and chicken are gluten-free and don't need to be avoided.
9. ANSWER: C
RATIO: Infections, gluten consumption, prolonged fasting, or exposure to anticholinergic
medications can all trigger celiac crises. Severe watery diarrhea is a common symptom of
celiac disease.
10. ANSWER: D

lOMoARcPSD|35074610
RATIO: A gluten-free diet should be followed by the child with celiac disease. Options A, B,
and C all include gluten, whereas option D is the only option for gluten-free items.

lOMoARcPSD|35074610

SAS #31
1. ANSWER: C
RATIO: For any malignancy involving the central nervous system, radiation therapy to the
head and scalp is the preferred treatment. Chemotherapy has short-term adverse effects,
whereas radiation therapy has longer-term ones. The hair follicles will not regrow if the
radiation therapy damages them.
2. ANSWER: D
RATIO: Because of the increased risk of bleeding or hemorrhage in children who are
extremely thrombocytopenic and have a platelet count of less than 20,000/ul, bleeding
precautions must be taken. Options A, B, and C are more concerned with infection prevention
than with bleeding.
3. ANSWER: A
RATIO: Acute lymphocytic leukemia and thrombocytopenia may possess a potential risk for
injury as low platelet counts make even small injuries more likely to bleed.
4. ANSWER: D
RATIO: Hodgkin's disease is characterized by swollen lymph nodes that are usually painless.
Lymphocytic node biopsy is used to make the diagnosis.
5. ANSWER: C
RATIO: Thrombocytopenia is a platelet deficit that makes a patient more vulnerable to
hemorrhage. As a result, avoiding invasive procedures reduces the chance of hemorrhage.
Hard, brittle toothbrushes should be avoided, while stool softeners should be promoted. In
this patient, the temperature is not the most crucial vital to monitor.
6. ANSWER: C
RATIO: Chemotherapy and radiation therapy are more effective against cells that proliferate
quickly. Chemotherapy is less effective against nondividing and slow-growing cells.
Chemotherapy is used to kill nondividing cells as they initiate active cell division in a series of
cycles.
7. ANSWER: B
RATIO: This client would be of greatest importance to radiation therapy since radiation
therapy often results in sterility in male clients. Due to the client's age and life choices, it is
important to address their psychosocial needs. When discovered early, Hodgkin's disease, on
the other hand, has a favorable prognosis.
8. ANSWER: B
RATIO: Enlargement of lymph nodes with progression to extra lymphatic sites, such as the
spleen and liver, is the hallmark of Hodgkin's disease, a chronic progressive neoplastic
disease of lymphoid tissue. In this condition, weight loss is most likely to be observed. Fatigue
and weakness are common, but they are unrelated to the condition.
9. ANSWER: A
RATIO: Sleeplessness, weakness, fatigue, and tachycardia are some of the symptoms of
Hodgkin's disease. The condition is characterized by swollen lymph nodes in the neck that

lOMoARcPSD|35074610
are painless. Early in the disease, weight loss happens. Nausea and vomiting are not common
Hodgkin's disease symptoms.
10. ANSWER: C
RATIO: A nursing assistant's job description and education include skincare. Registrants are
best suited to handling assessments and client education, which are more complex tasks.
Lotions should not be applied to the irradiated area during radiation therapy.
SAS #32
1. ANSWER: A
RATIO: It is important to allow the parents of children with cancer to express their feelings,
and they need significant emotional support. Prevention and self-blame are not helpful, nor is
informing parents that their child is one of many with cancer.
2. ANSWER: D
RATIO: There are several ways to encourage nutrition, but choosing what preschoolers
should eat addresses both nutrition and developmental needs.
3. ANSWER: A
RATIO: Although all of the nursing diagnoses described here are relevant, this client's primary
concern is dehydration and fluid and electrolyte loss due to vomiting.
4. ANSWER: A
RATIO: Except for the platelet count, all of the lab results are within normal limits. When a
child's platelet count drops, he or she is at a higher risk for hemorrhage.
5. ANSWER: D
RATIO: Dosing is normally based on the total Body Surface Area (BSA), which necessitates
proper height and weight prior to each drug administration to guarantee that the client receives
adequate chemotherapy doses. Simply inquiring about the client's height and weight may
result in BSA errors. The data needed is not provided by calculating BMI and measuring
abdominal girth.
6. ANSWER: B
RATIO: Chemotherapy and radiation therapy are more sensitive to faster-growing cells.
Chemotherapy is less effective in slow-growing, non-dividing cells.
7. ANSWER: D
RATIO: Malignant tumors are made up of unorganized cells that can spread to other parts of
the body. The growth rate of benign tumor cells is normally sluggish. When benign tumors
grow large enough to impinge on or obstruct vital organs, they can cause tissue harm. Unlike
benign tumors, which are normally encapsulated, malignant tumors can take on any shape.
8. ANSWER: B
RATIO: The patient is at a much higher risk of becoming infected. Because bacteria in fresh
food might cause infection, the apple and orange should be removed from the tray.
9. ANSWER: A
RATIO: The client's initial step in coping with the situational crisis is to express his or her
sentiments. It also aids the healthcare staff in gaining insight into the client's feelings, which
may then be used to drive psychosocial therapy.
10. ANSWER: C
RATIO: Impaired balance, altered gait, and incoordination are all possible side effects of a
cerebellar brain tumor. Visual field deficiencies, swallowing difficulties, and psychomotor

lOMoARcPSD|35074610
seizures can all be caused by the pituitary gland, pons, occipital lobe, parietal lobe, or
temporal lobe malfunction, not by a cerebellar brain tumor. Medullary dysfunction is indicated
by difficulty swallowing. Temporal lobe impairment is indicated by psychomotor seizures.
SAS #33
1. ANSWER: B
RATIO: Celiac disease is an inflammatory bowel illness that affects the small intestine. It
prevents the body from absorbing nutrients from the diet.
2. ANSWER: B
RATIO: Taking the pills with a full glass of water increases the chances of the pill making it all
the way down the esophagus to the stomach and not getting stuck, causing localized damage
and esophagitis symptoms.
3. ANSWER: B
RATIO: Magnesium hydroxide is an osmotic laxative that normally takes 15 to 3 hours to
create a soft, semisolid stool. The patient who hasn't had a bowel movement in three days
would benefit from this drug. It would not be prescribed for bloating and abdominal pain, a
loss of appetite, or indications of hypomagnesemia.
4. ANSWER: D
RATIO: Bisacodyl is a stimulant laxative that works by irritating the colon wall and stimulating
the enteric nerves to help you have a bowel movement. The bulk of the feces is increased by
fiber and bulk-forming medications. Feces are softened by water and stool softeners, while
saline and osmotic treatments cause fluid retention in the intestine.
5. ANSWER: C
RATIO: The intestinal villi are little projections that resemble fingers in appearance. By
expanding the surface area for absorption, the villi help with nutrient absorption. The villi, on
the other hand, are DAMAGED (attacked by the immune system) and appear FLAT when
Celiac Disease is present. This reduces the surface area available for absorption, causing the
patient to become malnourished.
6. ANSWER: D
RATIO: All of the disorders listed, as well as celiac disease, are autoimmune diseases. Other
autoimmune diseases that may occur along with celiac disease include dermatitis
herpetiformis, collagen vascular disease, and Sjogren's syndrome.
7. ANSWER: C
RATIO: To avoid the recurrence of clinical signs of celiac disease, patients must follow dietary
restrictions for the rest of their lives. Other solutions are inappropriate because if the patient
consumes restricted items, signs and symptoms will recur.
8. ANSWER: C
RATIO: Gluten cannot be tolerated or digested by children with celiac disease. Wheat and
wheat-containing goods must therefore be avoided because of their gluten level. Rice, milk,
and chicken are gluten-free and don't need to be avoided.
9. ANSWER: C
RATIO: Infections, gluten consumption, prolonged fasting, or exposure to anticholinergic
medications can all trigger celiac crises. Severe watery diarrhea is a common symptom of
celiac disease.
10. ANSWER: D

lOMoARcPSD|35074610
RATIO: A gluten-free diet should be followed by the child with celiac disease. Options A, B,
and C all include gluten, whereas option D is the only option for gluten-free items.

lOMoARcPSD|35074610

SAS #34
1. ANSWER: C
RATIO: Starting at the age of 18 months, the nurse should screen a child for lead poisoning
and repeat the screening at the ages of 24, 30, and 36 months.
2. ANSWER: B
RATIO: Activated Charcoal has been used as a 'universal antidote' for the majority of
poisons because of its potential to block the absorption of most poisonous compounds from
the gastrointestinal system and improve the elimination of those chemicals that have already
been absorbed.
3. ANSWER: A
RATIO: Deferoxamine is administered in patients with persistent but mild symptoms of iron
overdose, such as vomiting and diarrhea. Asymptomatic patients with a history of iron
overdose typically require supportive care only.
4. ANSWER: A
RATIO: The oral formulation of N-Acetylcysteine (Mucomyst) is the drug of choice for the
treatment of acetaminophen overdose.
5. ANSWER: C
RATIO: Digibind is used to treat digoxin toxicity, which can be fatal. Although it was meant
to treat life-threatening digoxin overdoses, it has also been used to treat life-threatening
digitoxin overdoses with success.
6. ANSWER: B
RATIO: Three structures within the skull can alter intracranial pressure. These structures
are the brain, cerebrospinal fluid (CSF), and blood.
7. ANSWER: D
RATIO: Seizures are diagnosed based on medical history. The nurse needs all the information
about what happened before, during, and after your seizures.
8. ANSWER: D
RATIO: A bulging or full fontanelle indicates that cerebrospinal fluid is accumulating in the
cerebral ventricle. An infant's apical pulse and blood pressure, as well as proteinuria, are not
specifically linked to an increase in cerebrospinal fluid.
9. ANSWER: B
RATIO: Symptoms of increased ICP include a significant decrease in LOC, bradycardia,
abnormal pupil responses, posturing, Cheyne-Stokes breathing, and coma. An increase in
ICP is accompanied by nausea. ICP symptoms such as a bulging fontanel and dilated scalp
veins are first noticed in infants, not in 5-year-olds.
10. ANSWER: A
RATIO: It is not recommended to administer lumbar punctures to patients with intracranial
pressure because they may cause brain herniation.

lOMoARcPSD|35074610
SAS #35
1. ANSWER: D
RATIO: "Mongolian spots" used to be the name given to hyperpigmented nevi. Dark-skinned
children are most likely to develop them, and they gradually disappear as they get older.
These spots are sometimes mistaken for bruises. It differs from Sturge-Weber syndrome in
that it is present at birth and is associated with port-wine stain birthmarks.
2. ANSWER: B
RATIO: An increase in intracranial pressure may be detected by a change in vital signs. The
most common signs are an increase in temperature and blood pressure along with a decrease
in pulse and breathing. There may also be irregularities in breathing.
3. ANSWER: B
RATIO: As a child grows, CP may manifest in a variety of ways. There is no progression of
the condition, but it may change in clinical manifestation.
4. ANSWER: C
RATIO: It is usually a sign of improvement when your child moves from decerebrate to
decorticate posture.
5. ANSWER: C
RATIO: Speech therapy is essential to strengthening the tongue and jaw movements to aid
feeding. The tongue and jaw motions of an infant at risk for CP may be weaker and
uncoordinated.
6. ANSWER: A
RATIO: The use of aspirin during the viral flu or sickness such as chickenpox (varicella) may
be linked to the development of Reye's syndrome.
7. ANSWER: C
RATIO: The best response from the nurse is that pain medicine is required to keep him
comfortable.
8. ANSWER: B
RATIO: Encephalitis is a bacterial infection that affects the brain and possibly the meninges.
Invasion by protozoa, bacteria, fungi, or viruses can lead to this condition. Arboviruses,
followed by enteroviruses, are the most common causes. The most common cause is
enteroviruses, which are followed by arboviruses.
9. ANSWER: A
RATIO: Acute encephalopathy with fatty infiltration of the liver, heart, lungs, pancreas, and
skeletal muscle is referred to as Reye syndrome. It affects both boys and girls between the
ages of one and eighteen. Although the etiology is unknown, symptoms such as lethargy,
vomiting, disorientation, and combativeness are common following a viral infection treated
with acetylsalicylic acids, such as varicella (chickenpox) or influenza (aspirin).
10. ANSWER: C
RATIO: Sturge-Weber syndrome (SWS) is a neurological (nervous system) condition. On the
skin of the upper portion of the face, it has a congenital port-wine birthmark that follows the
distribution of the first division of the fifth cranial nerve. The lesion is usually localized to the
top aspect of the face and is also limited to the ophthalmic branch of the fifth nerve.

lOMoARcPSD|35074610
SAS #36
1. ANSWER: B
RATIO: Absence seizures are one form of generalized seizures, formerly known as petit mal
seizures. They usually consist of a staring spell that lasts for a few seconds and occurs more
often in girls than boys, usually occurring in school-age children between 4 and 12 years.
2. ANSWER: D
RATIO: Precautions to avoid injury and improve safety should come first. Preparing for routine
laboratory studies isn't as important as avoiding injury and increasing safety. A cooling blanket
must be prescribed by a physician and is usually only used when other techniques of fever
control have failed.
3. ANSWER: C
RATIO: Agranulocytosis and aplastic anemia are two of Dilantin's side effects, so the client
will need frequent CBCs.
4. ANSWER: C
RATIO: Protecting the airway should be the first priority during a generalized tonic-clonic
seizure. The next step should be to administer lorazepam, which will help manage the seizure
quickly. Although oxygen may be beneficial during the postictal period, apnea is the cause of
hypoxia in tonic-clonic seizures. Checking the degree of consciousness during the seizure is
inappropriate since generalized tonic-clonic seizures are linked with a loss of consciousness.
5. ANSWER: B
RATIO: Diazepam can be administered every 10 to 15 minutes as needed to treat status
epilepticus, up to a maximum dose of 30 mg. If necessary, the nurse can repeat the regimen
in 2 to 4 hours, but the total dose in 24 hours should not exceed 100 mg.
6. ANSWER: D
RATIO: Patients with seizure disorders should seek medical advice before taking over-the-
counter drugs. The other three statements are useful teaching points for patients and their
families who are dealing with seizure disorders.
7. ANSWER: D
RATIO: Absence seizures, also known as petit mal seizures, are marked by a momentary
loss of consciousness, rapid eye blinking, mouth smacking, and slight myoclonus of the upper
limbs. Option A is wrong because it relates to a myoclonic seizure. Option B is erroneous
since it refers to tonic-clonic seizures, formerly known as grand mal seizures. Option C is
wrong because it pertains to atonic seizures.
8. ANSWER: A
RATIO: The priority care for a patient with tonic-clonic seizure is to maintain a patent airway,
therefore, the nurse must elevate the head of the bed for the patient to breath properly.
9. ANSWER: D
RATIO: Maintaining airway patency, assuring the safety, administering drugs, and offering
emotional support are all part of nursing care for a kid who is having a seizure. Nothing should
be put into the child's mouth, and they should not be moved, because the seizure has already
started. Safety would take precedence over all other considerations.
10. ANSWER: B
RATIO: Providing privacy, loosening restrictive clothing, removing the pillow and raising side
rails in the bed, and placing the client on one side with the head flexed forward, if possible, to
allow the tongue to fall forward and facilitate drainage are all nursing actions that should be

lOMoARcPSD|35074610
taken during a seizure. The limbs are never restrained because the strong muscle
contractions could cause the client harm.

lOMoARcPSD|35074610

SAS #37
1. ANSWER: E
RATIO: Myopia, often known as nearsightedness, is a condition in which vision is clear up
close but hazy in the distance. Hyperopia, often known as farsightedness, is characterized by
a good vision in the distance but hazy vision up close. Presbyopia is the inability to focus
closely due to age. Astigmatism is a condition in which the cornea causes issues with focus.
2. ANSWER: B
RATIO: Both myopia (nearsightedness) and hyperopia (farsightedness) are refractive
conditions in which light is focused in relation to the eye.
3. ANSWER: B
RATIO: Astigmatism is an uneven curvature of the cornea that can be congenital or acquired.
As a result, light rays arriving at the retina are not all refracted in the same way, resulting in
unequal vision quality.
4. ANSWER: B
RATIO: The patient is tested for visual acuity in one eye at a time, then in both at the same
time while standing or sitting comfortably. Testing is done first with the left eye covered, then
with the right eye covered. After that, both eyes are tested simultaneously. The client stands
20ft away from the chart as the chart is used to measure visual acuity with or without corrective
lenses.
5. ANSWER: D
RATIO: An individual is considered legally blind if their vision is 20/200 or less with either
corrective lenses (glasses or contact lenses), or if their visual acuity is less than 20 degrees
in the better eye.
6. ASNWER: D
RATIO: Having 20/20 vision means the client can see from 20 feet what a normal person can
see from 20 feet. With 20/60 visual acuity, a client can only read at 20 feet what a normal-
sighted person can read at 60 feet.
7. ANSWER: B
RATIO: The numerator pertains to the client's vision during a comparison between normal
and client visions.
8. ANSWER: A
RATIO: Strabismus causes a child's head to be tilted in order to see. Strabismus is unequally
aligned eyes (cross-eyes) caused by unbalanced muscle control. If non-surgical therapies do
not work, the patient may develop regular headaches and squint to see. If nonsurgical
interventions do not work, the patient may need surgery to straighten the weak muscles.
9. ANSWER: D
RATIO: If the result of the Snellen chart test is 20/200 vision, the patient is termed legally
blind. This indicates that the patient can read at a distance of 20 feet what a normal-vision
individual can read at a distance of 200 feet. Legal blindness is defined as corrected vision of
20/200 or less in the better eye, or visual acuity of less than 20 degrees of the visual field.
10. ANSWER: C

lOMoARcPSD|35074610
RATIO: Using a patch or special corrective lens over the stronger eye helps strengthen the
muscles of the weaker eye. Surgery may be necessary for effective eye movement if
nonsurgical measures do not yield the desired results.
SAS #38
1. ANSWER: D
RATIO: The only correct glaucoma statement is Option D. When glaucoma causes vision
loss, it is NOT reversible; however, eye drops can prevent further progression. Glaucoma is
caused by an INCREASED intraocular pressure (rather than a decreased intraocular
pressure), and there is no cure.
2. ANSWER: B
RATIO: Tonometry is considered the standard method for measuring intraocular pressure and
is most frequently used by ophthalmologists in the clinical setting.
3. ANSWER: C
RATIO: Angle-closure glaucoma is a sudden and severe condition. The patient will NOT be
asymptomatic, as is the case with open-angle glaucoma, and will experience sudden vision
changes.
4. ANSWER: D
RATIO: Eye drops are inserted into the lower sac of the eye (conjunctiva) rather than directly
onto the cornea. Nurses should observe the patient's use of the drops and re-educate them if
they aren't using them correctly.
5. ANSWER: B
RATIO: The nurse will apply eye drops first, followed by the ointment.
6. ANSWER: B
RATIO: Carbonic anhydrase inhibitors should not be used by patients who are allergic to
sulfonamides (hence Acetazolamide).
7. ANSWER: B
RATIO: Cataracts usually cause painless, gradual vision loss, despite the fact that both eyes
may develop at different rates.
8. ANSWER: A
RATIO: The primary reason for performing iridectomy after cataract extraction is to prevent
secondary glaucoma. An iridectomy, also known as a surgical iridectomy or corectomy, is the
surgical removal of part of the iris. These procedures are most frequently performed in the
treatment of closed-angle glaucoma and iris melanoma.
9. ANSWER: B
RATIO: Cataracts usually cause painless, gradual vision loss, despite the fact that both eyes
may develop at different rates.
10. ANSWER: A
RATIO: The primary problem in cataracts is blurring of vision. Older children may report
blurred vision because of cataract formation.

lOMoARcPSD|35074610
SAS #39
1. ANSWER: B
RATIO: Frequently asking for the question to be repeated indicates a hearing loss. Options
A, C, and D do not specifically indicate hearing loss.
2. ANSWER: D
RATIO: A first episode of otitis media (OM) occurring within the first three months of life raises
the risk of recurrent OM. Three episodes in the last three months or four episodes in the last
year are considered recurrent OM.
3. ANSWER: A
RATIO: The visible portion of the ear is known as the auricle or pinna. It projects from the side
of the head, and the short external auditory canal, the inner end of which is closed by the
tympanic membrane, also known as the eardrum.
4. ANSWER: C
RATIO: The inner ear also called the labyrinth of the ear, is part of the ear that contains organs
of the senses of hearing and equilibrium.
5. ANSWER: C
RATIO: An audiometer assesses a person's ability to hear sounds of varying frequency to
provide a precise quantitative measure of hearing.
6. ANSWER: C
RATIO: Even if the child begins to feel better, parents should always be encouraged to
complete the entire course of therapy; shorter courses may be sufficient in children 6 years of
age and older. Amoxicillin is the treatment of choice for AOM and is a first-line drug, thus a
myringotomy would not be considered this early. Acetaminophen (Tylenol) and ibuprofen are
only alternated for pain control in select situations.
7. ANSWER: B
RATIO: The cochlea contains the nerves for hearing. It is a hollow, spiral-shaped bone found
in the inner ear that plays an important role in hearing and participates in the auditory
transduction process.
8. ANSWER: C
RATIO: The stapes or stirrup is a bone in the middle ear of humans and other animals which
is involved in the conduction of sound vibrations to the inner ear. This bone is connected to
the oval window by its annular ligament, which allows the footplate to transmit sound energy
through the oval window into the inner ear.
9. ANSWER: B
RATIO: When a client complains of tinnitus, a subjective symptom such as ringing in the ears
can be felt only by the client.
10. ANSWER: C
RATIO: The middle ear cavity is home to the three auditory ossicles, the malleus, incus, and
stapes, all of which serve to transmit vibrations towards the inner ear and, together with the
tympanic membrane and oval window, form an amplifying system.

lOMoARcPSD|35074610

SAS #40
1. ANSWER: B
RATIO: Diagnoses and treatment of ASD at an early age increase the chances of the patient
becoming a fully functioning adult. ASD that is undiagnosed or untreated can lead to
depression and other conditions that can worsen the quality of life. ASD is not curable and an
early diagnosis and treatment does not prevent other mental conditions from developing but
allows for the treatment of depression and anxiety that may develop as a result. ASD-affiliated
adults cannot enroll in an assistive living facility with this form.
2. ANSWER: C
RATIO: Despite their high IQs, children with autism cannot understand the finer nuances of
language, and thus cannot comprehend well beyond the complexity of their age. Therefore,
this is not a clinical manifestation that supports the diagnosis. In addition to displaying
repetitive behaviors and exhibiting self-destructive behavior, ASD manifests clinically as a
failure to respond appropriately to social cues.
3. ANSWER: A
RATIO: Children with ASD often become aware of its essential characteristics (social deficits,
language impairment, and repetitive behaviors) around the age of three, not five. Playing
imaginatively or reading nonverbal behavior is impossible for a child with ASD.
4. ANSWER: B
RATIO: Again, children with ASD often become aware of its essential characteristics (social
deficits, language impairment, and repetitive behaviors) around the age of three, not five.
Playing imaginatively or reading nonverbal behavior is impossible for a child with ASD.
5. ANSWER: A
RATIO: One of the associated causes of autism spectrum disorder is thought to be genetic
factors. Autistic people have defects in their genes and gene expression in areas of cell-cycle
expression. The other responses are not thought to be the source of ASD.
6. ANSWER: D
RATIO: Therapy aims to advocate for parental support and coping groups, to implement
focused techniques and behavior management, and to reduce maladaptive behaviors in a
child with ASD and their family. Even if the goal of treatment is to modify behavior,
electroconvulsive therapy cannot be used to treat children with ASD.
7. ANSWER: A
RATIO: Depression is more likely to develop in elderly patients with ASD. ASD does not cause
schizophrenia. There is no evidence that ASD patients are more likely than the general
population to develop gout or diabetes.
8. ANSWER: A
RATIO: Autism spectrum disorder (ASD) risk factors include advanced maternal age (greater
than 40), paternal age (greater than 50), male gender, and having parents with an age gap of
more than ten years.
9. ANSWER: C

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RATIO: Of all of the following options, option C in not part of the Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for autism spectrum
disorder (ASD).
10. ANSWER: B
RATIO: Mental Health is a state of well-being in which the individual is able to make a
contribution to society, realize their potential, cope with life, and work productively.
SAS #41
1. ANSWER: A
RATIO: The manic client is hyperactive and may engage in harmful activities. To ensure
safety, a quiet environment should be maintained, as well as consistent and firm limits.
2. ANSWER: D
RATIO: Excess energy from the client can be channeled through non-competitive physical
activities such as cleaning. This is also a method of releasing tension.
3. ANSWER: A
RATIO: It is necessary to take a consistent firm approach. This is a therapeutic method of
dealing with attempts to exploit others' weaknesses or to cause conflict among staff members.
4. ANSWER: A
RATIO: A direct approach during the client's verbalization of anger can deescalate the
situation. A confrontational approach can be threatening and exacerbate the client's anxiety.
If less restrictive interventions fail, restraints and isolation may be required.
5. ANSWER: A
RATIO: Assist the client in identifying the stressor or true object of hostility in a non-violent
aggressive behavior. This assists in bringing to light unresolved issues, allowing them to be
addressed.
6. ANSWER: D
RATIO: The appropriate method for managing destructive conduct is to initially attempt to
quiet understanding verbally. When verbal and psychopharmacologic mediations are not
sufficient to deal with the forcefulness, confinement or restrictions might be relevant.
7. ANSWER: B
RATIO: The most experienced nurse should be assigned to the client who is unstable and
aggressive. An angry patient may intimidate a shy, inexperienced, soft-spoken nurse.
8. ANSWER: A
RATIO: A direct approach during the client's verbalization of anger can deescalate the
situation. A confrontational approach can be threatening and exacerbate the client's anxiety.
If less restrictive interventions fail, restraints and isolation may be required.
9. ANSWER: D
RATIO: This documentation demonstrates that the customer has been put on limitations after
the most un-prohibitive measures bombed in containing the customer's vicious conduct.
10. ANSWER: C
RATIO: Personality disorders are distinguished by firm attributes and qualities that are deep-
rooted. Life-long behavioral patterns characterize this disorder. Clients with this disorder are
unlikely to seek treatment unless something has turned out badly in their life so, they may not
recuperate from therapeutic intervention. Prescriptions are, for the most part, not suggested
for behavioral conditions.

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SAS #42
1. ANSWER: C
RATIO: The manifestations of the client indicate that he or she has severe anxiety. Mild
anxiety is characterized by slight muscle tension, fidgeting, alertness, the ability to
concentrate, and problem-solving abilities. Moderate anxiety is characterized by moderate
muscle tension, increased vital signs, periodic slow pacing, rapid speech, and difficulty
concentrating. Panic anxiety is distinguished by immobility, incoherence, a sense of being
overwhelmed, and disorganization.
2. ANSWER: B
RATIO: Anxiety is caused by a threat that is perceived subjectively. An objective threat causes
fear. When a client is depressed, he or she internalizes hostility. Mania is caused by masked
depression.
3. ANSWER: A
RATIO: The client's perceptual field has become narrower. Long explanations will not be
tolerated by the client. The client will be unable to identify the source of his or her anxiety, as
well as have difficulty concentrating and focusing.
4. ANSWER: B
RATIO: Valium is the medication that will likely be ordered for the client because this
medication is an Antianxiety. Prozac is an Antidepressant. Risperdal is an Antipsychotic.
Lithium is an Antimanic.
5. ANSWER: B
RATIO: G.I. is caused by anti-anxiety medications. As a result, it should be taken after meals.
Option A: This is only applicable to antidepressant MAOI. Taking tyramine-rich foods can lead
to hypertension. Option C: Valium is addictive. In that case, the medication should be
gradually tapered off to avoid convulsions. Option D: If the previous dose of Valium was not
taken, the dose should not be doubled. It has the potential to amplify the CNS depressant
effects.
6. ANSWER: C
RATIO: Using short sentences, staying with the client, reducing stimuli, remaining calm, and
medicating as needed are all appropriate nursing interventions for an anxiety attack.
7. ANSWER: B
RATIO: The presence of a nurse may provide support and a sense of control to the client.
8. ANSWER: D
RATIO: The major symptom that distinguishes post-traumatic stress disorder from other
anxiety disorders is experiencing the actual trauma in dreams or flashbacks.
9. ANSWER: C
RATIO: Perceiving circumstances that produce nervousness permits the client to plan to
adapt to tension or keep away from specific stimuli.
10. ANSWER: B
RATIO: Life-saving information is obtained first in an emergency. In order to treat this
potentially life-threatening situation, the name and amount of medication ingested are critical.

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SAS #43
1. ANSWER: B
RATIO: Since the client appears to be dehydrated, fluid volume deficit takes precedence over
altered nutrition. Options A and D are two psychosocial needs of a client suffering from
anorexia nervosa, but they are not the most important.
2. ANSWER: C
RATIO: Starvation is used by clients with anorexia nervosa in order to cope with anxiety.
Adaptive coping involves discussing feelings with the nurse.
3. ANSWER: B
RATIO: The best way to measure the client's progress is by weight gain. 1-2 pounds should
be gained each week by the client.
4. ANSWER: A
RATIO: In Bulimia, large amounts of food are consumed over a short period of time, as a
result of binge eating.
5. ANSWER: A
RATIO: The client will feel more in control of her life if she learns problem-solving skills. Thus,
option A is the correct answer.
6. ANSWER: B
RATIO: The client is frequently self-conscious about her eating habits. Feelings should be at
the forefront of any discussion.
7. ANSWER: C
RATIO: The goal of inpatient treatment for an anorexic is usually to establish a refeeding plan
that addresses the effects of self-induced starvation. Behavioral therapy involves using
rewards and reinforcements to establish weight restoration through refeeding.
8. ANSWER: A
RATIO: One of the most pressing concerns for the family of an anorexic client is control.
Acceptance of the client's ability to make independent decisions by the family is critical to
successful family intervention.
9. ANSWER: C
RATIO: Enmeshment occurs when family members become overly involved in each other,
and expectations exist as to how all family members should think and act. Enmeshment
affects development in children who act constantly to please their parents. The control of
eating behavior is often the only area where a child with anorexia nervosa exerts any control.
The remaining options are inapplicable to the described situation.
10. ANSWER: B
RATIO: This disorder necessitates the establishment of a consistent eating plan as well as
the monitoring of the client's weight.

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SAS #44
1. ANSWER: A
RATIO: The most common symptom of Tourette syndrome are tics — multiple motor tics and
at least one vocal tic. Tics can range from eye blinking and grimacing to head jerking and
foot-stomping. Throat clearing, clicking sounds, repeated sniffing, yelping, or shouting are all
examples of vocal tics.
2. ANSWER: C
RATIO: All of the following options are common types of tics.
3. ANSWER: A
RATIO: Tourette Syndrome is characterized by tics – repetitive, involuntary behaviors,
vocalizations and movements such as eye blinking, grimacing, and shrugging or jerky muscle
movements. Self-harm, such as punching oneself repeatedly, as well as coprolalia and
echolalia, are examples of tics. Tourette syndrome patients frequently experience behavioral
issues such as hyperactivity, impulsivity, attention deficits, and repetitive behaviors.
4. ANSWER: D
RATIO: Among all the following options, option D is UNTRUE regarding Tourette’s syndrome.
Tourette’s syndrome responds to medications that alter the effects of dopamine, such as
haloperidol (Haldol), pimozide (Orap), or risperidone (Risperdal).
5. ANSWER: D
RATIO: All of the said options are treatments for Tourette’s syndrome. Some of the
medications proven to be most effective in treating tics are neuroleptics, such as haloperidol
and pimozide. In CBIT, children and teens are taught to recognize the urge to tic. Because tic
symptoms often are mild and do not cause impairment, some people with TS require no
treatment.
6. ANSWER: D
RATIO: All of the following statements are true regarding Tourette’s Syndrome.
7. ANSWER: B
RATIO: The method reflects the assessment of knowledge and learning needs of participants.
It is important for nurse educators to evaluate the student's understanding as well as the
amount of information the student will need to know to be able to educate students effectively.
8. ANSWER: C
RATIO: The child's animistic thinking is characteristic of preoperational thought. According to
Piaget, children in this stage do not yet understand concrete logic, cannot mentally manipulate
information, and are unable to take the point of view of other people, which he termed
egocentrism.
9. ANSWER: D
RATIO: The diagnosis could be a Tourette disorder. Tourette Syndrome (TS) is a condition of
the nervous system. It causes people to have “tics” which are sudden twitches, movements,
or sounds that they repeat. People who have tics cannot stop their bodies from doing these
things. And based on what the child has exhibited, he has this type of disorder.
10. ANSWER: A
RATIO: Culture can influence how people describe and feel about their symptoms. It can
affect whether someone chooses to recognize and talk about only physical symptoms, only
emotional symptoms, or both.

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SAS #45
1. ANSWER: D
RATIO: The nurse should note that this client's behavior is "Agitated and pacing. Exhibiting
grandiosity. Mood labile." The client is acting aggressively as well as showing signs of
irritation. Grandiosity is defined as an overestimation of one's own power, importance,
knowledge, or identity.
2. ANSWER: D
RATIO: The client's symptoms should be interpreted by the nurse as indicating lithium
carbonate toxicity. Toxic symptoms include ataxia, blurred vision, severe diarrhea, nausea
and vomiting, and tinnitus. Monthly monitoring is crucial during maintenance therapy in order
to ensure proper dosage.
3. ANSWER: B
RATIO: The nurse should identify that the client's priority nursing diagnosis is altered nutrition:
less than body requirements R/T hyperactivity AEB weight loss. The nurse should prioritize
interventions to ensure proper nutrition and health because of the client's rapid weight loss.
4. ANSWER: B
RATIO: Even though lithium is a prototype drug for the treatment of bipolar disorders,
anticonvulsants such as valproic acid have also shown efficacy in mood stabilization.
5. ANSWER: C
RATIO: The nurse should explain to the client that weight gain is a common side effect of
lithium carbonate. If the client does not wish to continue taking the medication, the nurse
should educate the client on the importance of medication adherence and discuss concerns
with the prescribing physician.
6. ANSWER: B
RATIO: The nursing student is correct in stating that bipolar disorder is more common in
higher socioeconomic groups. In the etiology of bipolar disorder, theories take into account
both hereditary and environmental factors.
7. ANSWER: D
RATIO: The statement in option D provides accurate information as well as a ray of hope to
the family of a schizophrenic client.
8. ANSWER: A
RATIO: A client with paranoid schizophrenia has distorted perceptions and believes that
people, institutions, and aspects of his environment are conspiring against him. A realistic
interpretation of daily events is the desired outcome for someone suffering from delusional
perceptions.
9. ANSWER: D
RATIO: A client with these symptoms would have poor impulse control and thus be prone to
acting-out behavior that could be dangerous to himself or others. All of the remaining nursing
diagnoses may apply to the manic client; however, the priority diagnosis would be a risk of
violence.
10. ANSWER: B
RATIO: The parents are feeling responsible, and this inappropriate self-blame can be reduced
by providing them with information about the biological basis of schizophrenia.

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SAS #46
1. ANSWER: A
RATIO: Encopresis is defined as a loss of feces that occurs at least once a month in places
that are not culturally appropriate for that purpose. It is classified as primary if the child was
never fully toilet trained and secondary if the problem developed after effective training.
2. ANSWER: C
RATIO: The majority of cases of encopresis are caused by chronic constipation. Constipation
causes the child's stool to be hard, dry, and painful to pass. As a result, the child avoids using
the restroom, exacerbating the problem. The longer the stool remains in the colon, the more
difficult it becomes for the child to push the stool out.
3. ANSWER: C
RATIO: The best way to prevent encopresis is to avoid constipation with a high-fiber diet, as
well drinking plenty of water and getting plenty of exercises. Since constipation is caused by
dehydration in the colon, you must drink plenty of water. When your body is properly hydrated,
less water is withdrawn from the colon, and this will keep your stool soft and easy to pass.
4. ANSWER: E
RATIO: All of the following statements are managements for encopresis, therefore, none of
them are excluded.
5. ANSWER: B
RATIO: Enuresis is defined as repeated involuntary or intentional urination during the day or
at night after a child has attained or should have attained control over bladder function and no
organic cause for the problem can be identified. Therefore, the statement is false because
enuresis does not only happen at night; it can also happen during the day.
6. ANSWER: D
RATIO: Enuresis is defined as intermittent urinary incontinence while sleeping and is
considered to be present in children as early as five years old.
7. ANSWER: D
RATIO: Punishing children for bedwetting will not solve the problem; instead, it can actually
make the problem worse, leading to more frequent bedwetting, more depression, and a poorer
quality of life for the child.
8. ANSWER: B
RATIO: Bedwetting is slightly more common in boys than in girls; however, it affects children
of all genders.
9. ANSWER: C
RATIO: The medical term for not being able to control your pee is enuresis. Enuresis is
defined as repeated involuntary or intentional urination during the day or at night.
10. ANSWER: A
RATIO: A possible cause of enuresis is Urinary Tract Infection (UTI). Other medical conditions
that can trigger secondary enuresis include diabetes, urinary tract abnormalities (problems
with the structure of a person's urinary tract), and constipation.

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