Maternal and Paediatric Health Flashcards
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
B. 11-16 kgs
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
D. Reassure her that most women experience some mixed feelings in early pregnancy, even when their pregnancies are planned
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
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
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
C. Iron supplementation is recommended for women whose diets are lacking in iron
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
B. 16 weeks gestation
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
C. Threatened abortion
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
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.
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. The placenta
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
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.
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?
“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.
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. 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.
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
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
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”
D. “The HPV vaccine can help prevent cervical cancer”
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
D. Rubella
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
B. Eye infections
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. 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.
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”
B. “Syphilis can be transferred from you to your baby through the placenta”
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
B. Frothy and malodorous
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
D. Oedema, proteinuria and hypertension
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
D. On the first pregnancy of the Rh negative mother, the fetus will not be affected
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
C. No foetal movements and foetal parts
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
D. Hypoglycaemia
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
C. Heart rate, breathing, muscle tone, colour and reflex irritability
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
C. 24
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
D. 2 and 3
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
D. Reduction of serum bilirubin levels
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
C. Normal as most babies lose weight in the first few days of life
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. Blood clotting
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. Procedure to determine if the fallopian tubes are open or blocked
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
B. An excessive menstruation
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”
B. “There is an increased risk of ectopic pregnancy or infertility”
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”
D. “If my husband sits in the hot tub every night, his sperm count will decrease”
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
B. Semen enters the bladder instead of emerging through the penis
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
C. There is scarring of the tube