OB/Peds Final Exam

What indicates true labor verses false labor (Braxton Hicks)? Contractions go away after adequate hydration Cervical change Regular contractions Painful contractions

Cervical change

What does IUGR stand for? Intrauterine growing reduced Intrauterine growth reinforcement Intrauterine growth restriction Intrauterine growth reduction

Intrauterine growth restriction

What is probably the single most important influence on growth at all stages of development? Nutrition Culture Heredity Environment

Nutrition

This is the term for the first menstruation.

menarche

Using Nagele's rule, calculate the estimated date of confinement for a woman who reports the first day of her last menstrual cycle is 09/02/18. 05/09/19 06/16/19 06/09/18 05/28/19

06/09/18

By what age do the head and chest circumferences generally become equal? 6 to 9 months 1 to 2 years 2.5 to 3 years 1 month

1-2 years

The nurse should expect the anterior fontanel to close at age: 6 to 8 months 12 to 18 months 2 months 2 to 4 months

12- 18 months

The earliest age at which a satisfactory radial pulse can be taken in children is: 1 year 2 years 3 years 6 years

2

An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? 21 18 14 16

21

What is the recommended weight gain for a woman with a BMI of 26? 5-10 lbs 1-2 lbs 25-35 lbs No weight gain

25-35

This is the trimester when the most fetal energy stores are produced:

3rd trimester

With the National Center for Health Statistics (NCHS) criteria, which body mass index (BMI)-for-age percentile indicates a risk for being overweight? 95th percentile 10th percentile 9th percentile 85th percentile

85th percentile

What is Chadwick's sign? Another word for stretch marks Sebaceous sweat gland found on the nipple A violet-bluish color of the vaginal mucosa related to increased vascularity White or slightly grey vaginal discharge

A violet-bluish color of the vaginal mucosa related to increased vascularity

Select the ways you, as a nurse, can be culturally competent when caring for an obstetrical patient and her family. A) Educate yourself B) Realize that if a patient identifies with one culture, that means that all of the cultural practices will be the same for every patient of the same culture. C) Make sure policies/procedures in your facility are culturally competent. D) Be respectful of the patient and their beliefs.

A, C, D

The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to: Discontinue morphine until the child is fully awake Discontinue the IV infusion Stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply Administer naloxone (Narcan).

Administer naloxone (Narcan).

Dehydration while pregnant can cause: Cramping Preterm labor Contractions All of the above

All of the above

When the nurse interviews an adolescent, it is especially important to: Emphasize that confidentiality will always be maintained. Focus the discussion on the peer group. Use the same type of language as the adolescent Allow an opportunity to express feelings.

Allow an opportunity to express feelings.

What is a presumptive sign of pregnancy? hegar Sign Amenorrhea Hearing fetal heart tones Visualizing the fetus

Amenorrhea

In which cultural group is good health considered to be a balance between yin and yang? Australian aborigines African-Americans Native Americans Asians

Asians

Frequent developmental assessments are important for which reason? Infants need stimulation specific to the stage of development. Critical periods of development occur during childhood Stable developmental periods during infancy provide an opportunity to identify any delays or deficits. Child development is unpredictable and needs monitoring

Critical periods of development occur during childhood

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? FACES pain rating tool FLACC tool Oucher scale Numeric scale

FLACC tool

What nutrient is important for a pregnant woman to take to prevent neural tube defects?

Folic Acid

A woman comes in for her first prenatal appointment. She states that this is her fifth pregnancy. She has in the past had one elective abortion, one miscarriage and has three living children at home. When you question her about her living children, she states that her oldest was born on his due date but her twin girls were born at 32 weeks gestation. Using this information what is the GTPAL that you will document? G4 T2 P1 A2 L3 G5 T2 P0 A1 L3 G4 T1 P1 A2 L3 G5 T1 P1 A2 L3

G5 T1 P1 A2 L3

When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is: Infection or inflammation close to the site Some form of cancer. Infection or inflammation distal to the site Local scalp infection common in children

Infection or inflammation close to the site

The nurse must assess 10-month-old infant. The infant is sitting on the father's lap and appears to be afraid of the nurse and of what may happen next. Which initial action by the nurse would be most appropriate? Initiate a game of peek-a-boo Ask the father to place the infant on the examination table. Talk softly to the infant while taking him from his father Undress the infant while he is still sitting on his father's lap

Initiate a game of peek-a-boo

The Vietnamese mother of a child being seen in the clinic avoids eye contact with the nurse. Considering cultural differences, the best explanation for this is that the parent: Is embarrassed to seek health care Is showing respect for nurse. Feels responsible for her child's illness. Feels inferior to nurse.

Is showing respect for nurse.

This part of the female anatomy fuses to the prepuce and frenulum and is made up of connective tissue and smooth muscle. It does not have hair follicles. It is found externally and only visible when the labia majora is separated. Mons pubis Perineum Vagina Labia minora

Labia minora

How would a 3-4 year old child adapt to their mother's pregnancy? May have difficulty accepting evidence of parent's sexuality Unaware of process Like to hear their own birth story May notice changes in mother's appearance

Like to hear their own birth story

What should you tell a couple about incorporating a new baby into their family? You're a natural, you'll know what to do when the time comes. The baby will fit right in, no need to worry! Babies are small and quiet, you'll barely even notice it's here. Married/committed relationships may need restructuring to fit a baby.

Married/committed relationships may need restructuring to fit a baby.

The pediatric nurse understands that nonpharmacologic strategies for pain management: May reduce pain perception Usually take too long to implement. Make pharmacologic strategies unnecessary. Trick children into believing they do not have pain.

May reduce pain perception

Which age group is most concerned with body integrity? Adolescent Toddler Preschooler School-age child

School-age child

An appropriate tool to assess pain in a 3-year-old child is the (Select all that apply): A) Visual Analog Scale (VAS) B) Poker Chip Tool C) Oucher tool D) FACES pain rating scale E) Adolescent and pediatric pain tool

b c d

The nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for (Select all that apply)? A) Diarrhea B) Pruritus C) Hypertension D) Respiratory depression E) Sweating

b d e

If a woman takes a prenatal vitamin she doesn't need to worry about consuming the proper nutrients true or false?

false

True or False A woman has a lower chance of developing pelvic inflammatory disease (PID) during her menstrual cycle.

false

True or False If a woman follows a lacto-vegan diet she will not have a nutritionally adequate diet for pregnancy and lactation.

false

True or False: Certified Nurse Midwives (CNM) can independently preform cesarean sections.

false

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? Codeine Meperidine Morphine Methadone

morphine

Health beliefs vary among the cultural groups living in the United States. The belief that health is "a state of harmony with nature and the universe" is common in which culture? Japanese African-American Hispanic American Native American

native americans

Where is the best place to observe for the presence of petechiae in dark-skinned individuals? Face Arms Buttocks Oral mucosa

oral mucosa

This is an infection where a chancre appears 5-90 days after infection and looks like a non-tender, shallow, indurated ulcer. Gonorrhea Herpes Simplex Virus Primary syphilis Secondary syphilis

Primary syphilis

The appropriate placement of a tongue blade for assessment of the mouth and throat is the: The side of the tongue Against the soft palate. Incorrect Response The center back area of the tongue On the lower jaw.

The side of the tongue

What is the practice of consuming non-food substances such as dirt, clay, or laundry starch? Hypocalcemia Iron Deficiency Anemia Hyponatremia Pica

pica

The nurse is testing an infant's visual acuity. By what age should the infant be able to fix on and follow a target? 6 months 3 to 4 months 1 month 1 to 2 months

3 to 4 months

By what age does birth length usually double? 4 years 6 years 2 years 1 year

4

A 13-year-old girl asks the nurse how much taller she will become. She has been growing about 2 inches per year but grew 4 inches this past year. Menarche recently occurred. The nurse should base her response on knowing that: Approximately 95% of mature height is achieved when menarche occurs. The pubertal growth spurt lasts about 1 year Growth cannot be predicted. Mature height is achieved when menarche occurs.

Approximately 95% of mature height is achieved when menarche occurs.

The nurse is having difficulty communicating with a hospitalized 6-year-old child. What technique may be most helpful? Suggest that the parent read fairy tales to the child. Ask the parent whether the child is always uncommunicative. Suggest that the child keep a diary Ask the child to draw a picture.

Ask the child to draw a picture.

From weeks 18-32 the fundal height is: Height measured in centimeters is the same as gestational age Height measured in inches is the same as gestational age Height measured in millimeters is the same as gestational age Not accurate, every fetus grows differently

Height measured in centimeters is the same as gestational age

Which statement is true about the basal metabolic rate (BMR) in children? It increases with the age of child It is reduced by fever. It decreases as proportion of surface area to body mass increases It is slightly higher in boys than in girls at all ages.

It is slightly higher in boys than in girls at all ages.

How does the onset of the pubertal growth spurt compare in girls and boys? It occurs earlier in boys In both boys and girls it depends on their growth in infancy It occurs earlier in girls It is about the same in both boys and girls

It occurs earlier in girls

The nurse has a 2-year-old boy sit in "tailor" position during palpation for the testes. The rationale for this position is that: The child does not yet have a need for privacy Undescended testes can be palpated. This tests the child for an inguinal hernia It prevents cremasteric reflex

It prevents cremasteric reflex

The nurse caring for the child in pain understands that distraction: Can give total pain relief to the child. Is the best method for pain relief Must be developmentally appropriate to refocus attention. Is effective when the child is in severe pain

Must be developmentally appropriate to refocus attention.

During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is: Normal if the condition is unilateral or asymmetric Abnormal unless it occurs in conjunction with knock-knee. Normal because the lower back and leg muscles are not yet well developed Abnormal and requires further investigation

Normal because the lower back and leg muscles are not yet well developed

Physiologic measurements (vital signs) in children's pain assessment are: The best indicator of pain in children of all ages Of most value when children also report having pain Essential to determine whether a child is telling the truth about pain. Of limited value as sole indicator of pain

Of limited value as sole indicator of pain

Your pregnant patient tells you that she's so excited to be pregnant because now she can "eat whatever I want". What do you tell her about overindulging during pregnancy? Go ahead, you will lose the weight quickly after delivery Overindulging can lead to obesity which can lead to chronic illnesses Overindulging is fine during pregnancy but after delivery you need to watch what you eat Breastfeeding burns a lot of calories so if you plan on breastfeeding indulging during pregnancy is ok

Overindulging can lead to obesity which can lead to chronic illnesses

The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. The most appropriate action is to: Refer for immediate medical evaluation Ask the parent when the child's neck was injured. Continue the assessment to determine the cause of neck pain Record "head lag" on the assessment record and continue the assessment of the child.

Refer for immediate medical evaluation `

During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action? efer the child for further evaluation if the anterior fontanel is still open Recheck head control at the next visit Teach the parents appropriate exercises Refer the child for further evaluation.

Refer the child for further evaluation.

The most frequently used test for measuring visual acuity is the: Denver Eye Screening test Allen picture card test Snellen letter chart Ishihara vision test

Snellen letter chart

Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication? The child is lying rigidly in bed and not moving. The child becomes quiet when held and cuddled. The child has just returned from the recovery room. The child's current vital signs are consistent with vital signs over the past 4 hours.

The child is lying rigidly in bed and not moving.

A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, Popsicles, and juices are left. What would best explain this? The parent is trying to restore normal balance through appropriate "hot" remedies The parent is trying to feed child only what child likes most. Hispanics believe that an innate energy called chi is strengthened by eating soup. Hispanics believe that the "evil eye" enters when a person gets cold.

The parent is trying to restore normal balance through appropriate "hot" remedies

An appropriate approach to performing a physical assessment on a toddler is to: Perform traumatic procedures first. Demonstrate use of equipment. Use minimal physical contact initially. Always proceed in a head-to-toe direction.

Use minimal physical contact initially.

What type of breath sound is normally heard over the entire surface of the lungs, except for the upper intrascapular area and the area beneath the manubrium? Bronchial Vesicular Bronchovesicular Adventitious

Vesicular

A nurse is planning to use an interpreter during a health history interview of a non-English speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter (Select all that apply)? A) Arrange for the family to speak with the same interpreter, if possible. B) Elicit one answer at a time. C) Introduce the interpreter to the family. D) Interrupt the interpreter if the response from the family is lengthy.

a b c

Where in the health history should the nurse describe all details related to the chief complaint? Past history Review of systems Chief complaint Present illness

present illness

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting a migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain? Acute Subacute Recurrent Chronic

recurrent

True or False: Delaying pregnancy until later in life can be a cause of infertility.

true