Maternal and Paediatric Health Flashcards

1
Q

Which of the following represents a recommended weight gain during pregnancy?
A. 6-11 kgs
B. 11-16 kgs
C. 13-18 kgs
D. 18-20 kgs

A

B. 11-16 kgs

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2
Q

Larry and Mary Smith had planned their first pregnancy for some time, but when it was confirmed, Mary felt conflicting emotions. She comes to the clinic for her first prenatal (antenatal) visit at ten weeks gestation. Mary shares her mixed feelings about the pregnancy with the midwife. The midwife’s best response would be to:
A. Encourage her to consider abortion counselling
B. Encourage her to seek support from Larry
C. Reassure her that when she feels the baby move, her mixed feelings will disappear completely
D. Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned

A

D. Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned

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3
Q

Mary’s last menstrual period was 11 April. Her EDD (expected date of delivery) would be:
A. 4 January
B. 18 January
C. 25 January
D. 4 February

A

B. 18 January

Negele’s Rule - this is used for estimating the expected date of delivery (EDD) based on LMP (last menstrual period).

Last menstrual period - 3 months + 7 days + 1 year = expected date of delivery

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4
Q

Which of the following statements can be used as a guideline for planning diets during pregnancy?
A. An increase of 300 calories per day beginning in the first trimester
B. A ten percent increase in protein above daily requirements
C. Iron supplementation is recommended for women whose diets are lacking in iron
D. The requirement for folic acid is increased by 50 percent

A

C. Iron supplementation is recommended for women whose diets are lacking in iron

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5
Q

During a subsequent visit, Mary states she has begun to feel foetal movement. Foetal movement is usually felt by the pregnant woman when the foetus is approximately
A. 12 weeks gestation
B. 16 weeks gestation
C. 22 weeks gestation
D. 26 weeks gestation

A

B. 16 weeks gestation

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6
Q

During Tui’s sixth week of pregnancy, she experienced a small episode of vaginal bleeding. You should suspect?
A. Placenta previa
B. Urinary tract infection
C. Threatened abortion
D. Abruption placenta

A

C. Threatened abortion

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7
Q

Four purposes of chromosomal studies, amniocentesis is most commonly performed:
A. Anytime in early pregnancy
B. Usually not until after the 12th week
C. Usually not until after the 20th week
D. Anytime during pregnancy

A

B. Usually not until after the 12th week

Amniocentesis is a medical procedure used primarily in the prenatal diagnosis of genetic conditions. It has other uses such as in the assessment of infection and foetal lung maturity.

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8
Q

Tina, a midwife, tells an antenatal class that progesterone is considered the hormone most responsible for maintaining pregnancy. Where is the primary source of progesterone found throughout most of the pregnancy?
A. The placenta
B. The corpus luteum
C. The ovary
D. The pituitary gland

A

A. The placenta

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9
Q

A preterm infant born at 32-weeks gestation and diagnosed with hyperbilirubinemia has a total serum bilirubin (TSB) level of 17 mg/dL on day 2 after birth. The next day, the TSB level is 25 mg/dL despite phototherapy treatment and frequent breastfeeding. Which intervention should the nurse anticipate next?
A. Transcutaneous bilirubin level
B. Continuous infusion of heparin
C. Exchange blood transfusion
D. Autologous transfusion of whole blood

A

C. Exchange blood transfusion

If phototherapy is ineffective and the condition is worsening, the objective is to remove damaged cells and excess bilirubin and replace it with normal blood.

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10
Q

The nurse is obtaining a history from a 22-year old female client before administering the influenza vaccine. Which client statement should the nurse recognize as a contraindication to this vaccine and report to the healthcare provider?

A

“I took a pregnancy test last week and it was positive.”

Live vaccines, such as influenza, are not recommended during pregnancy, as the weakened pathogens could potentially cross the placenta and affect the fetus.

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11
Q

A 6-month-old with croup presents to the emergency department with nasal flaring, intercostal retractions, and agitation. Which complication is priority for the nurse to monitor?
A. Hypoxia
B. Pleural effusion
C. Poor feeding
D. Dehydration

A

A. Hypoxia

The nurse’s priority is to monitor the client for hypoxia. Hypoxia occurs when there is inadequate tissue oxygenation. Hypoxia can cause respiratory arrest resulting from inadequate oxygenation of the lungs.

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12
Q

Judy visits her lead maternity carer (LMC) and she orders various blood tests. One of the tests is a VDRL test. Judy asks what this test is for. Your best reply would be:
A. Chlamydia
B. Venereal disease
C. Gonorrhoea
D. Syphillis

A

D. Syphillis

The VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, which your body may produce if you have been infected with the bacteria that cause syphilis

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13
Q

A patient asks the healthcare provider about the benefits of receiving th human papillomavirus (HPV) vaccine. Which statement is the most appropriate response by the healthcare provider?
A. “You will need to have a booster vaccination each year”
B. “You will no longer need to get a routine cervical exam”
C. “The HPV vaccine will protect you from all types of the virus”
D. “The HPV vaccine can help prevent cervical cancer”

A

D. “The HPV vaccine can help prevent cervical cancer”

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14
Q

In which of the following conditions can the causative agent pass through the placenta and affect the foetus in utero?
A. Candidiasis
B. Gonorrhoea
C. Moniliasis
D. Rubella

A

D. Rubella

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15
Q

Ali was treated for chlamydia during her pregnancy. If untreated, what is one of the effects it could have on the neonate?
A. Skin rashes
B. Eye infections
C. Brain damage
D. Urinary tract infections

A

B. Eye infections

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16
Q

The neonate nurse is caring for a new born diagnosed with a gonococcal infection. Which of the following will the nurse expect to observe?
A. Purulent conjunctivitis
B. Hard and fixed lymph nodes
C. Generalised maculopapular rash
D. Changes in skin pigmentation

A

A. Purulent conjunctivitis

A woman with untreated gonorrhoea can pass the bacteria to her baby during childbirth. Symptoms usually include red eyes, thick pus in the eyes, and swelling of the eyelids.

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17
Q

During her first prenatal visit, a woman asks why she is being screened for syphilis. Which of the following is the best response by the healthcare provider?
A. “If you have the infection, the safest time to treat you is during the first trimester”
B. “Syphilis can be transferred from you to your baby through the placenta”
C. “We must report all cases of syphilis to the health department”
D. “If you test positive you may need to be admitted to the hospital for care”

A

B. “Syphilis can be transferred from you to your baby through the placenta”

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18
Q

The healthcare provider is assessing a female patient diagnosed with trichomoniasis. Which of the following characteristics would the healthcare provider use to describe the vaginal discharge of this patient?
A. White and curd-like
B. Frothy and malodorous
C. Clear and watery
D. Scant and blood-tinged

A

B. Frothy and malodorous

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19
Q

At 35 weeks pregnant, Ali is diagnosed with Hypertension of Pregnancy (HOP). The signs and symptoms of HOP include:
A. Oedema and hypertension
B. Vomiting and headache
C. Proteinuria and hypertension
D. Oedema, proteinuria and hypertension

A

D. Oedema, proteinuria and hypertension

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20
Q

Which of the following is most correct in Rh incompatibility?
A. Every pregnancy of an Rh negative mother with result in erythroblastosis
B. RhoGam is given only during the first pregnancy to prevent incompatibility
C. The condition can occur if the mother is Rh positive and the fetus is Rh negative
D. On the first pregnancy of the Rh negative mother, the fetus will not be affected

A

D. On the first pregnancy of the Rh negative mother, the fetus will not be affected

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21
Q

Which of the following symptoms occurs with hydatidiform mole?
A. Fetal cardiac motion after 6 weeks gestation
B. Negative pregnancy test result
C. No foetal movements and foetal parts
D. No signs of bleeding

A

C. No foetal movements and foetal parts

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22
Q

Kiri, a diabetic client is on the post natal ward after having a caesarean birth last evening for fetal distress. After the delivery from the diabetic mother, the baby is usually monitored closely because the baby often develops:
A. Hyperglycaemia
B. Anaemia
C. Rhesus problems
D. Hypoglycaemia

A

D. Hypoglycaemia

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23
Q

Reading through the babies notes, you see that baby Zac had an Apgar score of 9 at one minute and 10 at five minutes. Which five characteristics are evaluated using this system?
A. The Babinski, Moro, stepping, swimming and grasping reflexes
B. Length, weight, suckling, breathing reflexes and disease symptoms
C. Heart rate, breathing, muscle tone, colour and reflex irritability
D. Reaction to cuddling, startling, irritability, vocal and visual response

A

C. Heart rate, breathing, muscle tone, colour and reflex irritability

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24
Q

A term new born should pass the first meconium stool no later than how many hours after birth?
A. 6
B. 12
C. 24
D. 36

A

C. 24

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25
Q

Baby Karyn has developed physiological jaundice on day two, which is the most likely due to:
1. ABO incompatibility
2. Immaturity of the neonatal liver
3. Breakdown of foetal red blood cells
4. Insufficient fluid intake in the first 24 hours
A. 1 and 2
B. 3 and 4
C. 2 and 4
D. 2 and 3

A

D. 2 and 3

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26
Q

Karyn is placed in a biliwrap as part of phototherapy. What is the rationale for this?
A. Prevention of hypothermia
B. Promotion of neutral thermal environment
C. Promotion of rest and to reduce movement
D. Reduction of serum bilirubin levels

A

D. Reduction of serum bilirubin levels

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27
Q

Judy is concerned that her baby has lost weight during the first few days of life. Baby Karyn weighed 3400 grams at birth and on day three weighed 3220 grams. You could best explain this to Judy by telling her the weight loss is:
A. A direct result of early poor milk supply
B. Abnormal and probably caused by neonatal infection
C. Normal as most babies lose weight in the first few days of life
D. A good indication to increase the feeding time at the breast

A

C. Normal as most babies lose weight in the first few days of life

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28
Q

A single dose of Vitamin K was administered to Karyn after birth to promote:
A. Blood clotting
B. Coagulation of bilirubin
C. Foramen ovule closure
D. Digestion of complex proteins

A

A. Blood clotting

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29
Q

Which of the following best describes the purpose of hysterosalpingograms?
A. Procedure to determine if the fallopian tubes are open or blocked
B. Procedure to introduce hormones into the fallopian tubes
C. Procedure to measure the amount of mucus in the fallopian tubes
D. Procedure to move the fertilised ovum from the fallopian tube to uterus

A

A. Procedure to determine if the fallopian tubes are open or blocked

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30
Q

Greta has suffered from menorrhagia in the past. Menorrhagia is:
A. Infrequent menstruation
B. An excessive menstruation
C. Bleeding between periods
D. Cessation of menstruation

A

B. An excessive menstruation

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31
Q

A female adolescent, who has pelvic inflammatory disease (PID), inquires about the effects of the disease on her ability to bear children. Which is the pediatric nurses’ best response?
A. “The occurrence of spontaneous abortion during pregnancy increases with PID”
B. “There is an increased risk of ectopic pregnancy or infertility”
C. “There is an increased risk of placenta previa”
D. “There should be no problems with your ability to conceive”

A

B. “There is an increased risk of ectopic pregnancy or infertility”

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32
Q

The nurse is teaching a class in the community on common myths regarding fertility and infertility. Which statement made by a class participant indicates teaching has been successful?
A. “If my husband works out everyday, he won’t be able to make a baby”
B. “If we have intercourse standing up, we won’t be able to conceive”
C. “If we have intercourse on the even days after ovulation, we will conceive a girl”
D. “If my husband sits in the hot tub every night, his sperm count will decrease”

A

D. “If my husband sits in the hot tub every night, his sperm count will decrease”

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33
Q

A cause for male infertility is known as dry orgasm or retrograde ejaculation which occurs when:
A. Testosterone level decreases
B. Semen enters the bladder instead of emerging through the penis
C. The semen’s passage to the urethra is blocked
D. Sperm continuously dies while stored in epididymitis

A

B. Semen enters the bladder instead of emerging through the penis

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34
Q

How an chlamydia or gonorrhea infections result in infertility or an ectopic pregnancy?
A. They cause abnormal hormonal stimulation in the tube
B. The sperm motility is reduced in the tube
C. There is scarring of the tube
D. The matured oval is enlarged and blocked in the tube

A

C. There is scarring of the tube

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35
Q

Leila asks you when she should stop having cervical smears. It is recommended until she is:
A. 70 years old
B. At menopause
C. Not sexually active
D. 65 years old

A

A. 70 years old

36
Q

Leila has a family history of breast cancer and asks about breast screening. Breast screening is provided free of charge to New Zealand women from the age of:
A. 45-69 years
B. 45-70 years
C. 40-50 years
D. 40-60 years

A

A. 45-69 years

37
Q

Why should another form of contraception be used for about one month following vasectomy?
A. This is a temporary contraception method
B. Sperm could still be present distal to the area of ligation
C. To stop the production of sperm
D. The secretion of seminal fluid increases the changes of fertilisation

A

B. Sperm could still be present distal to the area of ligation

38
Q

A young female client visits a clinic for guidance on using barrier method of contraception. Which method would be most appropriate method to recommend to the client?
A. Diaphragm
B. Copper IUD
C. Depo Provera
D. Emergency pills

A

A. Diaphragm

39
Q

A nurse is instructing a patient on birth control methods. The patent asks about the cervical mucus method. When should the nurse tell the patient she is fertile in relation to her mucus?
A. Cervical mucus is not a reliable indicator
B. When it is thick
C. When it is clear, slippery and stretches
D. When it does not stretch

A

C. When it is clear, slippery and stretches

40
Q

A woman who chooses to take the emergency contraceptive pill (Levonorgestrel) must do so within how many hours of unprotected sexual intercourse?
A. 24 hours after sexual intercourse
B. 72 hours after sexual intercourse
C. 14 hours after sexual intercourse
D. Two weeks after sexual intercourse

A

B. 72 hours after sexual intercourse

41
Q

Julie’s last menstrual period (LMP) was January 19th 2019. Using Naegales rule her expected date of delivery (EDD) is:

A

October 27th

42
Q

A positive sign of pregnancy is:
A. A positive pregnancy test
B. Ballottement
C. Increase in abdominal size
D. Hearing foetal heart

A

D. Hearing foetal heart

43
Q

Judy’s friend Mia has been admitted to the maternity ward in labour. A probable sign of labour is:
A. Bleeding
B. Pain
C. Cervical dilation
D. Braxton-Hicks contractions

A

D. Braxton-Hicks contractions

44
Q

Which of the following signs should be reported promptly during the antenatal period?
A. Nasal stuffiness
B. Leaking amniotic fluid
C. Breast tenderness
D. Constipation

A

B. Leaking amniotic fluid

45
Q

At each clinic, the midwife checks the foetal heart. The normal foetal heart rate ranges from:
A. 140-180 beats per minute
B. 80-120 beats per minute
C. 120-160 beats per minute
D. 70-100 beats per minute

A

C. 120-160 beats per minute

46
Q

Ali has had her baby four hours ago and is now on the postnatal ward where you are helping to take care of her. While checking Ali’s fundus on day one post partum, you observe that the level of the fundus is at the umbilicus and displaced to the right. You evaluate that Ali probably has:
A. A full bladder
B. Overstretched uterine ligaments
C. A slow rate of involution
D. Retained placental products

A

A. A full bladder

47
Q

Judy is keen to breast feed baby. What does breast milk provide in addition to nourishment for the infant?
A. Maternal antibodies
B. Endorphins that soothe the infant
C. Stimulus for red blood cell production
D. Hormones that stimulate growth

A

A. Maternal antibodies

48
Q

Involution is the process by which:
A. The uterus progressively reduces in size
B. Milk is expressed from the breasts
C. The pelvic floor regains its muscle tone
D. The bladder returns to normal

A

A. The uterus progressively reduces in size

49
Q

The hormone responsible for the let-down reflex when breastfeeding is:
A. Oxytocin
B. Prolactin
C. Progesterone
D. Oestrogen

A

A. Oxytocin

50
Q

Kiri is now day four post partum and due to go home later today. She is concerned because her milk looks watery and blue in appearance. You explain this is:
A. A sign of immature breast milk
B. An indication to wean the baby
C. A normal variation in breast milk colour
D. A sign that the breast milk is of poor quality

A

C. A normal variation in breast milk colour

51
Q

Karyn’s umbilical cord was inspected at birth. Judy asks the nurse what the cord consists of? the nurse response that the umbilical cord was normal, which of the following is a normal umbilical cord structure?
A. Two veins and one artery
B. Two arteries and one vein
C. One artery and one vein
D. Wharton’s jelly, one artery and one vein

A

B. Two arteries and one vein

52
Q

Which of the following does the Guthrie test NOT screen for?
A. Cystic fibrosis
B. Icterus neonatorum
C. Phenylketonuria
D. Hypothyroidism

A

B. Icterus neonatorum

A blood sample is taken from your baby’s heel at or as soon as possible after 24 hours of age (the ‘heel prick’ or ‘Guthrie’ test). If a disorder is found, early treatment can prevent permanent damage or death.

53
Q

Pica is defined as:
A. Intolerance to milk products
B. Iron-deficiency anaemia
C. Ingestion of non food substances
D. Episodes of anorexia and vomiting

A

C. Ingestion of non food substances

54
Q

What lifestyle changes may reduce a woman’s risk of breast cancer?
A. Staying trim and exercising regularly
B. Drinking a glass of wine, preferably red, each day
C. Regular mammography screening
D. There is little you can do to lower your chances of developing breast cancer

A

A. Staying trim and exercising regularly

55
Q

The first sign of pregnancy is usually:
A. Thinning hair and excessive tiredness
B. Immediate weight gain
C. Amenorrhoea
D. Nausea and vomiting

A

C. Amenorrhoea

The absence of monthly menstrual periods.

56
Q

If untreated, gonorrhoea can result in what health problems for men?
A. Epididymitis
B. Benign polyps
C. Testicular cancer
D. Both A and B

A

A. Epididymitis

Inflammation of the tube at the back of the testicle that stores and carries sperm.

57
Q

Chelsea is a two year old who has been admitted to the children’s ward pre-operatively for a bilateral myringotomy an insertion of ventilation tubes due to chronic otitis media. You are the admitting student nurse and your Registered Nurse Mentor (RNM) asks you to complete the pre-operative checklist.

What is the rationale for ensuring Chelsea’s weight is accurately recorded in her medical documentation and patient identification label?
A. To ensure all paperwork is ticked off prior to sending her to the operating theatre
B. To ensure that the prescriber’s are calculating drug dosages correctly related to her weight
C. To indicate whether Chelsea has had food and/or fluids prior to surgery
D. To ensure that you are able to work out Chelsea’s weight percentile prior to surgery

A

B. To ensure that the prescriber’s are calculating drug dosages correctly related to her weight

58
Q

Chelsea’s father asks you to explain why she has continual ‘ear infections’. You explain:
A. All the children have ear infections, it is very common
B. When children attend childcare, they can pick up infections easily
C. The eustachian tubes in toddlers are shorter, wider and straighter which may contribute to the recurrent infections
D. It is probably because she is being fed with a bottle when she goes to bed

A

C. The eustachian tubes in toddlers are shorter, wider and straighter which may contribute to the recurrent infections

59
Q

Chelsea returns from the operating theatre and is sleepy but rousable. You complete a full set of vital signs and calculate the PEWS score as 0. As the student nurse your role is to:
A. Inform the Paediatric consultant
B. Inform the nurse in charge
C. Inform the medical officer and increase observations to half hourly
D. Report directly to your RNM to discuss what is the most appropriate clinical decision

A

D. Report directly to your RNM to discuss what is the most appropriate clinical decision

60
Q

When your RNM asks you to communicate with Chelsea, you understand that when a child has potential hearing deficit it is important to:
A. Establish eye contact with the parent so that they know you are caring
B. Establish eye contact with the child and speak without using exaggerated mouth movements
C. Talk in long sentences so that you can reduce the amount of time spent with interventions
D. Sit at face level with the child on the bed when talking to ensure you have their full attention

A

B. Establish eye contact with the child and speak without using exaggerated mouth movements

61
Q

Chelsea’s father comes to the nurse’s station and says he thinks Chelsea has some pain in her left ear, after completing a pain assessment and discussing this with your RNM, you decide to give paracetamol. Why is Paracetamol an appropriate medication to give to Chelsea?
A. It is commonly used analgesic agent used in paediatric patients, with few significant side effects
B. Incorrect: It is commonly used for mild to moderate pain relief and can be combined with opioid agents
C. Hepatotoxicity can result if prolonged prescribed doses are higher than 15mg/kg/dose
D. All of the above

A

D. All of the above

62
Q

When assessing Chelsea post-operatively for fever, which method for taking her temperature would be the most appropriate?
A. Using an axillary temperature probe due to her having aural surgery which may affect the reading or cause discomfort
B. Using a tympanic temperature probe
C. Using an oral temperature probe and asking Chelsea to be still while it reads
D. Asking Chelsea’s father to feel her forehead and see if it feel’s ‘normal’ for her

A

A. Using an axillary temperature probe due to her having aural surgery which may affect the reading or cause discomfort

63
Q

Your RNM has asked you to redress the wound on Manaia’s leg. While you are assessing the dressing, you notice that her left leg feels warmer than the right leg and Manaia tells you that the pain relief you gave her earlier is not working. This could be:
A. Potential post-operative complication of deep vein thrombosis or compartment syndrome
B. Complication of bleeding from the wound site
C. Complication of the wound dressing being too tight over the wound
D. Normal process in the post-operative period

A

A. Potential post-operative complication of deep vein thrombosis or compartment syndrome

64
Q

When looking at the menu for lunch, you check the ingredients. Which grain can Manaia have that will not affect her coeliac disease?
A. Oats
B. Barley
C. Wheat
D. Rice

A

D. Rice

65
Q

Which of the following symptoms are associated with coeliac disease? Choose three answers.
A. Rapid weight gain
B. Abdominal distention, pain and flatulence.
C. Chronic constipation
D. Diarrhoea

A

B. Abdominal distention, pain and flatulence.
C. Chronic constipation
D. Diarrhoea

66
Q

Manaia’s mother is concerned that the medication you are giving her daughter may have gluten in it which she is not allowed due to her coeliac disease. Your understanding of this condition is:
A. Stools are often unformed and are a liquid consistency
B. Is diagnosed through endoscopy only after gluten has been removed from the diet
C. It is an autoimmune disease also known as gluten enteropathy
D. Is a malabsorption syndrome due to the body’s ability to absorb wheat

A

C. It is an autoimmune disease also known as gluten enteropathy

67
Q

Manaia is being discharged this afternoon, her wound clips need removal in approximately 12 days. As part of your discharge education, you advise:
A. Limit mobility to increase the chance of better wound healing
B. Monitor the wound daily for increased signs of pain, swelling, heat, odour or ooze that may indicate infection
C. Remove the wound dressing in one week to check how the wound is healing
D. Bath the wound daily in a normal saline solution

A

B. Monitor the wound daily for increased signs of pain, swelling, heat, odour or ooze that may indicate infection

68
Q

Manaia has been prescribed paracetamol and tramadol as part of her discharge medications. As adjuvant medications you know that:
A. Taking paracetamol regularly and tramadol when required can work well together to provide good pain control
B. Tramadol being a synthetic opioid should not be prescribed for children
C. Strong pain relievers can become addictive if used regularly when not required
D. Taking paracetamol regularly should reduce the requirement for taking tramadol

A

A. Taking paracetamol regularly and tramadol when required can work well together to provide good pain control

69
Q

What is multimodal analgesia?
A. The use of the same analgesic via different administering routes
B. The use of several different types of analgesic agents together for pain management
C. The use of analgesia multiple times during your shift
D. The use of analgesics and non-pharmacological interventions for pain management

A

B. The use of several different types of analgesic agents together for pain management

70
Q

Ben is a 14 year old boy with type 1 diabetes, he is admitted to the emergency department, he is flushed and drowsy and his skin is dry. His father states that Ben has been feeling progressively worse since the morning. What is Ben most likely experiencing?
A. Ketoacidosis
B. Somogyi phenomenon
C. Hypoglycaemia
D. Dawn syndrome

A

A. Ketoacidosis

71
Q

Ben has some of the symptoms of a cold. What signs and symptoms alert his parent to the likelihood of ketoacidosis?
A. Ear pain
B. Chest congestion
C. Fruity smelling breath, nausea
D. Hyperactivity

A

C. Fruity smelling breath, nausea

72
Q

Ketoacidosis is a life threatening condition resulting from the combination of dangerously high levels of ketones and blood glucose. This makes the blood too acidic, which can change the functioning of internal organs such as the liver and kidneys. Early signs and symptoms of ketoacidosis include:
A. Hypotension, altered level of consciousness and coma.
B. Polyuria, polydipsia and polyphagia.
C. Weight loss, abdominal pain and fruity smelling breath.
D. Polyuria, dehydration and shock.

A

B. Polyuria, polydipsia and polyphagia.

73
Q

What occurs as a result of inadequate secretion of insulin?
A. Serum glucose levels are markedly decreased
B. Protein synthesis is increased
C. More rapid conversion and storage of carbohydrates to glucose occurs
D. Increased fat breakdown leads to ketonemia

A

D. Increased fat breakdown leads to ketonemia

74
Q

You are talking to Ben about using the side of his finger for blood testing, he asks you why this is important. Your response is:
A. It is less likely to become infected
B. It is easier to puncture
C. It has fewer capillaries
D. It has fewer nerve endings

A

D. It has fewer nerve endings

75
Q

When discussing how to administer insulin, what do you instruct Ben to do?
A. Inject the needle into the subcutaneous level of the skin
B. Select an injection site that was recently used
C. Give the injection deep into the muscle
D. Make sure the injection sites are six inches apart

A

A. Inject the needle into the subcutaneous level of the skin

76
Q

Ben tells you that he often east foods that he knows he shouldn’t eat when he is out with his friends because he is tired of being different from everybody else. A strategy to manage this situation is:
A. Ben is developing his sense of identity with his friends and fitting in; in his part of the developmental stage and this should be acknowledged
B. Consult with a dietitian and document a list of recommended foods that Ben should follow
C. Tell his father the types of foods Ben is eating when with friends
D. Write a referral to the diabetes nurse specialist to deal with theses issues

A

A. Ben is developing his sense of identity with his friends and fitting in; in his part of the developmental stage and this should be acknowledged

77
Q

The respiratory system in children differs from adults in several different ways. Select the most correct answer.
A. Oxygen consumption is low in children in proportion to body size; metabolic rate is lower than adults
B. Accessory muscles of respiration are not as strong in children, particularly infants
C. Airway diameter is larger in children, which reduces the potential for obstruction
D. Respiratory rates area lower than or equal to adults

A

B. Accessory muscles of respiration are not as strong in children, particularly infants

78
Q

Levi is a 5-year-old boy and diagnosed with cerebral palsy (CP) as an infant, when it was noted that he had spasticity which affects his muscle. While in hospital, Levi is trying to communicate with you about what he has been doing on the ward. How would you communicate with Levi?
A. Take you time and sit and listen
B. Ring the speech language therapist
C. Get his family to interpret for him
D. Talk to his mum, ensure his posture enhances his communication, and use a device such as a tablet or white board

A

D. Talk to his mum, ensure his posture enhances his communication, and use a device such as a tablet or white board

79
Q

Levi’s mum asks you to explain why he had a seizure last time when he had a ‘really high temperature’. Your response regarding febrile seizures is:
A. They occur when the body temperature exceeds 38.3 C
B. They usually lead to the development of epilepsy
C. They can be prevented by an anticonvulsant medication
D. They occur when the temperature rises too quickly

A

D. They occur when the temperature rises too quickly

80
Q

Corey is an 8 year old and has had increasing trouble with abdominal pain over the past 12 months. As the student nurse working with the RNM, you are responsible for providing care for Corey who has been admitted for assessment and treatment.

When assessing his gastrointestinal system, he complains of the following:

Pain while having a bowel movement
Dry and difficult stools to pass
Abdominal pain
Bowel movement twice a week
Traces of liquid stools in his underwear
You suspect the following diagnosis:
A. Constipation
B. Rectal prolapse
C. Coeliac disease
D. Anal fissures

A

A. Constipation

81
Q

Because Corey has small dry stools, you would recommend which foods to include in his diet?
A. Pretzels
B. Yoghurt
C. Cooked vegetables
D. Whole-grain cereal

A

D. Whole-grain cereal

82
Q

The treatment pathway for moderate croup is:
A. 6-8 puffs of Salbutamol via a spacer and discharge home
B. Dexamethasone 0.6mg/kg or 2-3 days of prednisolone and discharge home
C. 10 day course of oral Augmentin and discharge home
D. Admission, monitoring and symptoms management

A

B. Dexamethasone 0.6mg/kg or 2-3 days of prednisolone and discharge home

83
Q

Rose’s mother informs you that Rose’s Brother Sam has recently been diagnosed with asthma. Your understanding of asthma is:
A. It is a condition that requires patients to use an inhaler every day
B. Asthma is a respiratory condition that children usually grow out of by the time they are 16 years old
C. It is a chronic inflammation condition where inhaled drugs are the mainstay for all ages
D. It is a condition which increases work of breathing and is exacerbated by cold air

A

C. It is a chronic inflammation condition where inhaled drugs are the mainstay for all ages

84
Q

What are characteristic features of asthma:
A. Wheeze and cough
B. Dyspnoea
C. Chest tightness
D. All of the above

A

D. All of the above

85
Q

Which of the following statements are common fallacies (are not true) about pain in babies, children or adolescents?
A. Neonates and young children do not feel pain.
B. Nurses commonly underestimate pain levels in children.
C. Opioids can be safely used in children and adolescents, including low weight babies.
D. If children or young people report pain this must be treated.

A

A. Neonates and young children do not feel pain.