Original DHA nursing questions on maternal & child health, with explanations.
Short answer: 10 original multiple-choice practice questions on maternal & child health for nurses preparing for the DHA licensing exam, each with the correct answer and a full explanation. This is a Meddex topic, not a DHA heading. They are original and are not real exam items.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
What maternal & child covers
Antenatal, labour, postnatal, neonatal and paediatric care.
Keep the mother, the baby and the child apart in your head, and read the age before the dose. Many answers turn on a normal range for age, so learn those ranges before you drill cases.
Where it fits in the exam
DHA lists four coverage headings for Registered Nurse and publishes no weights. Maternal & Child Health is one of ten Meddex domains, so it is a Meddex grouping and not a DHA heading. Its questions can appear under more than one DHA heading.
DHA does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Maternal & Child HealthEasy
A woman at 12 weeks of pregnancy asks which snack is safest. Which choice should the nurse recommend?
AOption A: Chilled pâté on toast
BOption B: Hard cheese such as cheddar, with fruit
COption C: A glass of unpasteurised goat's milk
DOption D: Brie or camembert with crackers and grapes
Show answer for question 1
Correct answer: B. Hard cheese such as cheddar, with fruit
Listeria monocytogenes can survive in the fridge and can cause miscarriage, stillbirth or severe newborn infection. Pregnant women are advised to avoid mould-ripened soft cheeses such as brie and camembert (unless cooked until steaming hot), all types of chilled pâté, and unpasteurised milk and dairy products. Hard cheeses such as cheddar are safe.
Why A is wrong. Chilled pâté of any type can contain listeria and is avoided.
Why C is wrong. Unpasteurised milk can carry listeria and other harmful bacteria.
Why D is wrong. Mould-ripened soft cheeses are a recognised source of listeria unless cooked until steaming hot.
Topic: Pregnancy: food safety and listeriosis. Reference: NHS. Foods to avoid in pregnancy; NICE NG201. Antenatal care
Question 2
Maternal & Child HealthMedium
A nurse is teaching a mother who will bottle-feed her newborn with powdered infant formula. Which instruction about preparing a feed is correct?
AOption A: Use water already cooled to body temperature, to avoid scalding the baby's mouth
BOption B: Make a full day's feeds in the morning and keep them at room temperature
COption C: Add the powder to freshly boiled water that has cooled for no more than 30 minutes, so that it is hot enough to kill bacteria in the powder
DOption D: Add the powder to cold water and warm the bottle, so that nutrients are not destroyed by heat
Show answer for question 2
Correct answer: C. Add the powder to freshly boiled water that has cooled for no more than 30 minutes, so that it is hot enough to kill bacteria in the powder
Powdered infant formula is not sterile and can contain bacteria such as Cronobacter. Safe preparation uses water that has been boiled and left for no more than 30 minutes (so that it is still at least 70 degrees C), added to the bottle first, followed by the powder. The feed is then cooled quickly and used soon, or stored in the fridge for a limited time. Cool water, room-temperature storage and warming a cold mixture do not kill bacteria.
Why A is wrong. Water at body temperature does not kill bacteria in the powder, and the feed is cooled after mixing.
Why B is wrong. Feeds kept at room temperature for hours allow bacteria to multiply rapidly.
Why D is wrong. Cold water does not kill bacteria, and warming afterwards allows them to multiply.
Topic: Newborn feeding: safe preparation of powdered formula. Reference: WHO and FAO. Safe preparation, storage and handling of powdered infant formula: guidelines, 2007; NHS. How to make up infant formula
Question 3
Maternal & Child HealthMedium
A 7-year-old boy has a moderate asthma exacerbation. He speaks in short sentences, respiratory rate is 28 per minute and oxygen saturation is 95% on room air. The nurse gives salbutamol through a pressurised metered-dose inhaler and spacer. Which technique is correct?
AOption A: Use the inhaler without the spacer, firing one puff as he breathes in and holding his breath for 30 seconds
BOption B: Give two puffs, then wait at least 30 minutes before considering any more
COption C: Fire ten puffs into the spacer together and ask him to breathe from it for a minute
DOption D: Give one puff at a time and have him take about five tidal breaths from the spacer after each
Show answer for question 3
Correct answer: D. Give one puff at a time and have him take about five tidal breaths from the spacer after each
For children, salbutamol from a pressurised metered-dose inhaler is given through a spacer, one puff at a time, with each puff inhaled separately over about five tidal breaths. Puffs are repeated according to response, as often as every 60 seconds up to a maximum of 10 puffs, and the child is reassessed. Several puffs fired together lose drug on the spacer walls. Severe attacks with saturation below 92% need oxygen and nebulised bronchodilators instead.
Why A is wrong. Without a spacer a child cannot coordinate the puff and breath, so most of the dose lands in the mouth and throat.
Why B is wrong. Waiting 30 minutes after two puffs is too slow, because the dose is titrated at short intervals according to response.
Why C is wrong. Multiple actuations fired together lose drug to the spacer walls, so less reaches the lungs.
Topic: Paediatric asthma: spacer technique. Reference: British Thoracic Society/SIGN British Guideline on the Management of Asthma (SIGN 158); Global Initiative for Asthma: Global Strategy for Asthma Management and Prevention
Question 4
Maternal & Child HealthEasy
A 3-week-old boy is brought to the clinic because he has been feeding poorly. The nurse needs to measure his temperature. Which method is recommended for an infant of this age?
AOption A: Chemical strip thermometer on the forehead
BOption B: Infrared tympanic thermometer in the ear
COption C: Digital thermometer in the rectum as the routine method
DOption D: Electronic thermometer in the axilla
Show answer for question 4
Correct answer: D. Electronic thermometer in the axilla
NICE advises that in infants under 4 weeks old, temperature is measured with an electronic thermometer in the axilla. From 4 weeks to 5 years, an axillary electronic or chemical dot thermometer or an infrared tympanic thermometer can be used. Forehead strips are unreliable, and oral and rectal routes are not used routinely.
Why A is wrong. Forehead chemical thermometers are unreliable and should not be used.
Why B is wrong. Infrared tympanic thermometers are recommended only from 4 weeks of age.
Why C is wrong. Routine rectal measurement is not recommended because of discomfort and risk of injury.
Topic: Infant temperature measurement. Reference: NICE NG143: Fever in Under 5s: Assessment and Initial Management
Question 5
Maternal & Child HealthMedium
A term baby is 90 minutes old. The nurse counts a respiratory rate of 76 per minute, with grunting, nasal flaring and mild subcostal recession. Temperature is 36.8 C. What is the most appropriate action?
AOption A: Check oxygen saturation and call the neonatal team for urgent review
BOption B: Place the baby prone to ease the work of breathing and reassess later
COption C: Give a formula feed to settle the baby and review after one hour
DOption D: Return the baby to skin-to-skin contact and recheck at the next feed
Show answer for question 5
Correct answer: A. Check oxygen saturation and call the neonatal team for urgent review
A normal newborn breathes about 40 to 60 times per minute. A rate above 60 with grunting, flaring and recession signals respiratory distress, which can be due to transient tachypnoea, infection or other serious causes, so saturation is measured and the neonatal team called without delay.
Why B is wrong. Prone positioning is unsafe for unobserved newborns and does not treat the cause.
Why C is wrong. Feeding a distressed, tachypnoeic baby risks aspiration and delays treatment.
Why D is wrong. Waiting for the next feed delays assessment of a baby who is in distress.
Topic: Newborn assessment: respiratory distress. Reference: WHO Pocket Book of Hospital Care for Children, 2nd edition (2013); NICE NG195: Neonatal Infection: Antibiotics for Prevention and Treatment
Question 6
Maternal & Child HealthMedium
A nurse is about to take a blood sample from a frightened 4-year-old boy. Which approach to preparing him is most developmentally appropriate?
AOption A: Explain the reasons for the test and how blood is analysed in detail the night before
BOption B: Show the steps on a doll with real equipment, in simple honest words
COption C: Tell him it will not hurt at all so that he stays calm and still
DOption D: Hold him firmly without explanation so that it is over quickly
Show answer for question 6
Correct answer: B. Show the steps on a doll with real equipment, in simple honest words
Preschool children think concretely and are helped by play, simple honest language and being allowed to handle equipment. Preparation is given shortly before the event because a long delay increases anxiety, and a trusted adult should stay with the child.
Why A is wrong. Detailed abstract explanations are beyond his level, and a long interval increases anxiety.
Why C is wrong. A false promise damages trust and makes later procedures harder.
Why D is wrong. Restraint without preparation increases fear and distress, and it should be used only as a last resort.
Topic: Play and developmentally appropriate communication. Reference: Hockenberry MJ, Wilson D. Wong's Essentials of Pediatric Nursing
Question 7
Maternal & Child HealthMedium
On day 4 after a vaginal birth, a woman has temperature 38.6 C, lower abdominal pain, a tender uterus larger than expected for this stage and foul-smelling lochia. Which complication does the nurse suspect?
AOption A: Early mastitis
BOption B: A urinary tract infection
COption C: Postpartum endometritis
DOption D: Normal lochia serosa
Show answer for question 7
Correct answer: C. Postpartum endometritis
Lochia normally changes from red to pink-brown to yellow-white over several weeks and has a stale, not offensive, odour. Fever with uterine tenderness and offensive lochia indicates uterine infection, which needs prompt medical review, cultures and antibiotics because it can progress to sepsis.
Why A is wrong. Mastitis causes breast pain and redness, not uterine tenderness or offensive lochia.
Why B is wrong. Urinary infection usually causes dysuria and suprapubic pain, and it does not change lochia.
Why D is wrong. Normal lochia does not cause fever or a foul smell.
Topic: Postnatal complications: lochia and infection. Reference: WHO Recommendations on Maternal and Newborn Care for a Positive Postnatal Experience; NICE Postnatal Care Guideline
Question 8
Maternal & Child HealthEasy
A 3-year-old with two days of watery diarrhoea and vomiting is alert and has dry lips, but is drinking eagerly and passing urine. The nurse assesses mild dehydration. Which is the best fluid choice?
AOption A: Undiluted fruit juice from a bottle
BOption B: A fizzy drink diluted with water
COption C: Nothing by mouth for six hours, then clear water
DOption D: Oral rehydration solution in frequent small sips
Show answer for question 8
Correct answer: D. Oral rehydration solution in frequent small sips
Oral rehydration solution has the right balance of glucose and sodium to promote absorption and is first-line for mild to moderate dehydration. It is given in small, frequent amounts by cup, spoon or syringe, and normal feeding continues.
Why A is wrong. Undiluted juice has high sugar and low sodium, and it can worsen diarrhoea.
Why B is wrong. Fizzy drinks are not balanced for rehydration and add sugar without enough sodium.
Why C is wrong. Fasting from fluids worsens dehydration, and early rehydration is needed.
Topic: Dehydration in children: oral rehydration. Reference: NICE CG84: Diarrhoea and Vomiting Caused by Gastroenteritis in Under 5s: Diagnosis and Management; WHO Pocket Book of Hospital Care for Children, 2nd edition (2013)
Question 9
Maternal & Child HealthMedium
Late decelerations on the cardiotocograph during labour suggest uteroplacental insufficiency. What is the FIRST nursing action?
AOption A: Turn her to a lateral position, stop oxytocin and inform the obstetrician
BOption B: Keep her supine to maintain a good CTG trace and observe for 30 minutes
COption C: Increase the oxytocin rate to speed delivery before the fetus deteriorates
DOption D: Encourage active pushing to deliver the baby quickly
Show answer for question 9
Correct answer: A. Turn her to a lateral position, stop oxytocin and inform the obstetrician
Intrauterine resuscitation: change position (left or right lateral), stop oxytocin, correct hypotension and hydration, consider oxygen if maternal hypoxia is present, and notify the obstetrician.
Why B is wrong. Supine position compresses the vena cava, reduces placental perfusion, and observing for 30 minutes delays action.
Why C is wrong. More oxytocin increases contraction frequency and worsens uteroplacental hypoxia.
Why D is wrong. Pushing before full dilatation and in a compromised fetus is unsafe and may worsen hypoxia.
Topic: Late decelerations. Reference: ACOG intrapartum monitoring
Question 10
Maternal & Child HealthMedium
A mother tells the nurse that her 13-month-old, born at term, cannot yet sit without support and has not tried to crawl. He babbles and smiles, and examination is otherwise normal. What is the most appropriate response?
AOption A: Suggest that he is a late developer and begin physiotherapy exercises without further assessment
BOption B: Reassure her that the range of normal is wide and review at 24 months
COption C: Advise a baby walker to build his leg strength and review in 3 months
DOption D: Refer him for developmental assessment, as most babies sit unsupported by about 9 months
Show answer for question 10
Correct answer: D. Refer him for developmental assessment, as most babies sit unsupported by about 9 months
In the WHO motor development study of healthy children, the 1st to 99th percentile window for sitting without support ran from 3.8 to 9.2 months. A child of 13 months who cannot sit is well outside this range and needs a developmental assessment to look for causes such as hypotonia, neuromuscular disease or global delay. Walkers do not help development and carry a risk of injury.
Why A is wrong. Starting treatment without finding the cause may miss a treatable condition.
Why B is wrong. Normal variation is wide, but 13 months without sitting is outside it, and waiting until 24 months delays assessment.
Why C is wrong. Baby walkers do not promote walking and cause injuries, so they are not advised.
Topic: Child development: delayed sitting. Reference: WHO Multicentre Growth Reference Study Group. WHO motor development study: windows of achievement for six gross motor development milestones. Acta Paediatr Suppl 2006;450:86-95
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Frequently asked questions
DHA does not publish how many questions come from each topic. It lists four coverage headings for Registered Nurse with no weights. Meddex groups its questions into ten domains of its own.
No. They are original practice questions written by Meddex for exam preparation. DHA does not publish sample questions, and its Assessment Manual says sharing assessment questions is not allowed, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.