MNN Questions

FOR QUESTIONS 65-66: Ms. A. is a 23-year-old gravida 2, para 1 (G2, P1) woman whose last menstrual period was 24 weeks ago. She had one prenatal visit. She now complains of increasing urinary frequency for 5 days and of burning on urination for 2 days. For the last 24 hours, she has had a constant aching pain in her back and right side, along with chills and fever. Her temperature is 38.9 C (102 F), her pulse is 110 bpm, and her blood pressure is 110/70 mm Hg. There is marked costovertebral angle tenderness on the right. Her uterus measures 23 cm, the fetal heart rate is 146 bpm, and her cervix is long and closed. Based on urine laboratory values, she is diagnosed as having acute pyelonephritis. Select three physiological changes that occur during pregnancy that predispose women to UTI. a. changes in urine composition b. Dilation of the upper third of ureters c. Decreased frequency of urination d. Compression of ureters by enlarging uterus e. Increased intakes of liquids (1) a, b, c (2) b, c, e (3) a, b, d (4) b, c, d

(3) a, b, d

TRUE or FALSE: Acidosis and hypothermia may lead to decreased pulmonary blood flow, which perpetuates decreased production of surfactant and may cause RDS.

TRUE

FOR QUESTIONS 57-58 Mrs. S., a health care worker in a daycare setting, is a 27-year-old multigravida whose last menstrual period was 11 weeks ago. Her 3-year-old daughter experienced a fever and rash 5 days earlier. Two days later, the pediatrician established a diagnosis of rubella. On examination, Mrs. S, is found to be healthy, and her uterus is 10 to 11 weeks in size. She does not remember having had rubella. Her friend told her to be tested for TORCH. She wants to know what it is. What does TORCH stand for?

Toxoplasmosis, other (Hepatitis B), Rubella, Cytomegalovirus, Herpes Simplex

In what sequence (1 to 5) should the activities occur for initial resuscitation of an infant? __a. Position infant's head __b. Suction mouth __c. Dry infant __d. Place infant under preheated radiant warmer __e. Suction nose

a)2, b)3, c)5, d)1, e)4

FOR QUESTIONS 67-68: Ms. V. is a 24-year-old schoolteacher who is approximately 14 weeks' pregnant with her first baby. She is concerned about many of the diseases that she may be exposed to and asks many questions. How is the chickenpox transmitted? a. Aerosolized droplets b. Blood and mucus c. Skin-to-skin contact

a. Aerosolized droplets

In actuality, the nurse finds the infant has a fractured clavicle, which is confirmed by x-ray. What may have led the nurse to this conclusion? a. Asymmetric startle reflex b. Extreme jitterness c. History of forceps delivery

a. Asymmetric startle reflex

Which statement is false about breast milk? a. Breast milk contains 30 kcal/ounce b. Breast milk is economical c. Breast milk provides protection against diarrhea d. Breast milk provides protection against otitis media

a. Breast milk contains 30 kcal/ounce

Which recommendation for maternal self-assessment at home is correct? a. Check weight and blood pressure daily. b. Call the office when contractions are 2 minutes apart. c. Call the office for proteinuria of 1 +. d. Assess fetal activity level before eating a meal

a. Check weight and blood pressure daily.

A term infant develops severe respiratory distress immediately after birth. On physical examination, the chest is hyperexpanded, and the point of maximal impulse (PMI) is shifted to the right. What is the most likely cause for this infant's respiratory distress? a. Diaphragmatic hernia b. Right pneumothorax c. Transposition of the great arteries

a. Diaphragmatic hernia

Determine whether the following statements are true or false. a. Because Ms. G. does not appear to have symptoms, you need not worry about gonorrhea or chlamydia. b. Untreated gonorrhea may cause premature rupture of the membranes. c. Gonorrhea has been on the decline for the last 5 years because of better hygiene. d. An allergic reaction to soap or medications can mimic STI symptoms

a. False b. True c. False d. True

All of the following factors indicate that Baby M. is at greater risk for hyperbilirubinemia except: a. Gestational age of 40 6/7 weeks b. Mother taking aspirin for her headaches c. Respirations having to be stimulated and oxygen adminstered

a. Gestational age of 40 6/7 weeks

FOR QUESTIONS 63-64: Ms. G. is a 17-year-old single primigravida (G1) who is seen for her first prenatal visit at 20 weeks' gestation. Her history is unremarkable with the exception of treatment for gonorrhea 1 year previously. Examination of the skin, head, ears, nose, and throat yields normal results. Ms. G. is afebrile, her pulse is 88 bpm, and her blood pressure is 118/72 mm Hg. The size of her uterus corresponds with gestational age by dates. There is a small amount of yellow discharge at the cervix. The vulva appears red and inflamed. What is the causative agent of gonorrhea? a. Gram-negative diplococcus b. Gram-positive diplococcus c. Protozoa d. Spirochete

a. Gram-negative diplococcus

Mr. K. has some potential indicators of an abuser, which include all of the following except: a. His older age b. His unstable employment c. His constant presence during her clinic visit d. He is under financial stress with the pregnancy after losing his job

a. His older age

Prior to discharge, the newborn should have all of the following screening tests except: a. Hypoglycemia screening b. Newborn hearing screening c. Critical congenital heart disease (CCHD) screening d. Newborn blood screening (NBS)

a. Hypoglycemia screening

Why is hyperbilirubinemia of special concern in preterm infants? a. Immature liver function b. Poor vascular system c. Immature endocrine function

a. Immature liver function

FOR QUESTIONS 32-33: Baby L. was born to a 21-year-old gravida 1, para 1(G1, P1) Vietnamese mother. He was born vaginally after a difficult delivery due to shoulder dystocia. At admission, his weight was 4400g (9 pounds, 11.5 ounces). Physical and neurologic examination placed him at 40 weeks of gestation. His physical examination revealed an unequal Moro reflex with decreased movement of the left arm and crepitus at the left neck area. Bluish marking was also noted across the lower back. What is the correct gestational classification for Baby L.? a. LGA with risk for hypoglycemia b. AGA with risk for hypothermia c. SGA with risk for hypoglycemia

a. LGA with risk for hypoglycemia

What is the priority nursing intervention immediately after a convulsion? a. Lower head of the bed, and turn her head to the side. b. Administer oxygen at 10 L/min. c. Cover her with a blanket. d. Pad the side rails.

a. Lower head of the bed, and turn her head to the side.

During a routine prenatal at 28 weeks' visit, Ms. M.'s blood pressure was 146/94 mm Hg, which at her last prenatal visit had been 130/80 mm Hg. Her urine dipstick reveals 1 + protein. She has dependent edema and denies headache, blurred vision, or epigastric pain. Ms. M. is admitted to the hospital for a thorough assessment of maternal-fetal status. All of her labs are within normal limits (WNL). Her plan of care includes expectant management at home to allow time for the fetus to mature. Her signs and symptoms are associated with which type of hypertensive disorder? a. Preeclampsia b. Preeclampsia with severe features c. HELLP syndrome d. Gestational Hypertension

a. Preeclampsia

What might the nurse expect to find in the mother's history? a. Premature labor treated with tocolytics b. Gestational diabetes c. Exposure to rubella in the first trimester

a. Premature labor treated with tocolytics

A sign of magnesium toxicity is: a. Slurred speech b. More than 20 respirations per minute c. increased DTRs d. Hypertension

a. Slurred speech

At 34 weeks' gestation, Mrs. K. calls the labor and delivery unit one evening complaining of contractions that are becoming progressively stringer and occurring more closely together. She is advised to come in to the unit to be checked. When she arrives at the unit, monitoring is started. She is kept overnight for observation and discharged the next morning. Women experiencing IPV during pregnancy might present to labor and delivery in a similar manner because: a. They need a safe place for the night. b. They don't how labor contractions feel. c. They may be confused about when to expect labor might begin. d. They may experience dehydration.

a. They need a safe place for the night.

What is the incubation period for measles? a. 5 to 9 days b. 10 to 14 days c. 15 to 20 days

b. 10 to 14 days

FOR QUESTIONS 4-6: A 39-week-gestation, 3270-g (7-pound, 2-ounce) infant was born to a 17-year-old Latina, gravida 1, para 1 (G1, P1). Labor and birth events were unremarkable. The infant's body was pink with blue extremities, heart rate (HR) was 120, cough with suctioning, flexed muscle tone, and strong cry at 1 minute of life. What is the initial Apgar score? a. 10 b. 9 c. 7 d. 6

b. 9

FOR QUESTIONS 11-12: A 2300-g (5-pound, 1.5-ounce) infant girl is born to a 25-year-old gravida 1, now para 1 (G1, P1) woman by spontaneous vaginal delivery. The infant's length is 44cm (17.5 inches), and her head circumference is 30.5 cm (12 inches). No abnormalities are noted on physical examination. Maternal history and a gestational age assessment reveal the neonate to be at approximately 38 weeks gestation and that she is SGA. What might you expect to find in the mother's history? a. Weight gain of 15.9 kg (35 pounds) b. A history of smoking one pack of cigarettes per day c. Documented class A diabetes

b. A history of smoking one pack of cigarettes per day

FOR QUESTIONS 34-35: Baby R. is a 6-hour-old female born to a 28-year-old mother with a history of preeclampsia. Baby R. was born 5 weeks premature and has a birthweight of 1450 g (3 pounds, 3 ounces). On admission tp the newborn nursery, the infant's respiratory rate was 74, and she was noted to have mild intercostal and substernal retractions with adequate air entry on auscultation. Auscultation of her heart revealed a harsh murmur that was best heard in the area of the left upper sternal border. Baby R.'s history and presentation are most indicative of: a. Coarctation of the aorta b. Atrial septal defect c. Patent ductus arteriosus (PDA)

b. Atrial septal defect

FOR QUESTIONS 13-14: A 4100-g (9-pound, 1.5-ounce) boy is born after a difficult forceps delivery. The prenatal history reveals an uncomplicated pregnancy of 40 weeks gestation. The infant's length is 53.3 cm (21 inches), and his head circumference is 37 cm (14.6 inches). Gestational age assessment reveals the infant to be LGA. On physical examination, what might you expect to find with this infant? a. Clubfoot b. Brachial plexus injury c. Diminished Babinski reflex

b. Brachial plexus injury

You are preparing to care for several recently born infants. Which infant is at greatest risk for TTN? a. Spontaneous vaginal delivery; 40 weeks' gestation b. Cesarean birth; 41 weeks' gestation c. Vaginal delivery with maternal anesthesia; 38 weeks gestation

b. Cesarean birth; 41 weeks' gestation

Standard umbilical cord care for the mother at home is: a. Clean cord with alcohol three times a day b. Clean cord with warm water and air dry c. Apply petroleum jelly-covered gauze every 4 hours d. Apply triple dye after the bath

b. Clean cord with warm water and air dry

Which prenatal factor is most likely to predispose the neonate to develop respiratory distress? a. Maternal diabetes b. Gestation of 34 weeks c. Fetal scalp pH of 7.20

b. Gestation of 34 weeks

FOR QUESTIONS 53-56: Ms. T. is a 35-year-old, gravida 1, para 0 (G1P0) woman with chronic hypertension and superimposed preeclampsia at 30 weeks' gestation who is admitted to labor and delivery. Her baseline blood pressure had been 130/90mm Hg, and today it is 160/105 mm Hg. She has 3+ pitting edema and 2+ protein in her urine. She complains of a severe frontal headache. During the admission process, Ms. T. has a grand mal seizure. Usual signs of an impending seizure include all of the following except: a. Persistent headaches b. Hypertonic uterus c. Blurred vision d. Severe right upper quadrant pain

b. Hypertonic uterus

When should resuscitation be started in the delivery room? a. After the 1-minute Apgar score is obtained b. Immediately, if respirations are absent or ineffective c. Immediately, if HR is less than 80 bpm d. After 90 seconds of attempted tactile stimulation

b. Immediately, if respirations are absent or ineffective

FOR QUESTIONS 17-20: A 32-year-old gravida 3, now para 3 (G3, P3) woman delivered a 3250-g (7-pound, 3-ounce) girl through meconium-stained fluid at 42 weeks gestation. The infant's initial presentation is that she is limp, cyanotic, has minimal respirations, and has a heart rate less than 100 bpm. She was intubated and suctioned by the neonatal team. Although she was suctioned through the endotracheal tube (ETT), no meconium was seen below the cords. With oxygen and stimulation, her Apgar scores at 1 and 5 minutes were 7 and 9, respectively. What is the most serious consequence that might result from this delivery? a. Patent ductus arteriosus (PDA) b. Meconium aspiration c. Hyaline membrane disease

b. Meconium aspiration

A 30-year-old gravida 1, para 1 (G1, P1) mother who is attempting to nurse a 1-day-old infant is concerned that the infant is too sleepy to breastfeed. The most developmentally appropriate nursing intervention is to: a. Keep the infant warm with blankets b. Place the infant skin-to-skin (STS) with the mother c. Let the infant sleep; try nursing at a later time d. Feed every 2 hours regardless of behavioral feeding cues

b. Place the infant skin-to-skin (STS) with the mother

Chorioamnionitis is associated with premature rupture of membranes and what other factor? a. Cerclage use b. Prolonged rupture of membranes c. Inadequate hydration

b. Prolonged rupture of membranes

FOR QUESTIONS 36-37: Mrs. K. is 24 years old, married and 28 weeks pregnant. She lives with her husband who is 28 years old and is the father of her unborn infant. Mr. K. was laid off from his technology job 4 months ago and has been unable to find steady employment. Mrs. K. works as an administrative assistant at a local community college. She has come for her prenatal visit with her husband. Mr. K says he wants to stay with her throughout the visit. Mrs. K. is late in seeking prenatal care. Why is this one of the indicators of potential IPV? a. She may have been unable to take time off from work without losing income. b. She may have been trying to conceal signs of IPV before this visit. c. She did not want her family to know she was pregnant. d. Her husband did not want her to come for care.

b. She may have been trying to conceal signs of IPV before this visit.

FOR QUESTIONS 40-41: Mrs. K. returned to the clinic 2 weeks later for a scheduled ultrasound examination. Mr. K. was unable to be with her. He insisted that she should reschedule the appointment, but she did not because she was anxious to find out the sex of the infant. Exposure of her abdomen revealed several bruises, which were all in various states of healing. She tried to explain the presence of the bruises as merely the result of her clumsiness. With further questioning, she broke down in tears and admitted that Mr. K. slapped her, pulled her by her hair, kicked her, and hit her in the stomach. He was extremely mad that she did not reschedule the appointment. She said that she had sure learned her lesson and would never do that again. She also said he is all over it now and has been wonderfully sweet to her. He promised to never do that again. Mr. K.'s actions are examples of all of the phases of: a. The circle of abuse b. The cycle of violence c. The abuser-abuse-victim syndrome d. The abuse, cover-up, make-up theory

b. The cycle of violence

Two weeks later, Ms. M. is admitted to labor and delivery. Her blood pressure is 168/96 mm Hg, and she states that she has a severe headache, blurred vision, and epigastric pain. Her lab results reveal elevated liver enzymes. Her signs and symptoms are associated with which type of hypertensive disorder? a. preeclampsia b. preeclampsia with severe features c. Chronic hypertension d. Gestational hypertension

b. preeclampsia with severe features

In RDS, blood may not be well oxygenated because of all the following except: a. A patent ductus arteriosus (PDA) b. Decreased pulmonary resistance c. Atelectasis of the alveoli

c. Atelectasis of the alveoli

What physiologic factor contributes to greater skin integrity in preterm infants? a. Immature immunologic system b. Malfunctioning of regulatory organs, such as the kidneys and respiratory tract c. Decreased cohesion between the dermis and epidermis

c. Decreased cohesion between the dermis and epidermis

The historical and physical findings for Baby L. might suggest: a. Torticollis b. Fractured clavicle c. Duchenne-Erb's palsy

c. Duchenne-Erb's palsy

FOR QUESTIONS 49-51: Precautions are taken to prevent seizures, and she is given a 4-g loading dose of magnesium sulfate, which is followed by a 2-g/hr maintenance dose. Orders are written for a Foley catheter, blood pressure checks every 15 minutes during loading dose and then every 30 minutes with oxygen saturation, hourly respiratory rate, pulse, level of consciousness (LOC), deep tendon reflexes (DTRs), intake and output (I&O), and continuous fetal monitoring. Laboratory work includes a complete blood count (CBC), liver enzymes, and renal function studies. A common side effect of magnesium sulfate is: a. Drowsiness b. Decreased uteroplacental blood flow c. Feeling warm and flushed d. Sympathetic nervous system stimulation

c. Feeling warm and flushed

As Ms. Z.'s nurse, you should know that a transverse lie: a. Is an isolated condition b. Has an increased incidence of abruption placentae c. Has an increased incidence of placentae previa d. Will be rotated by her primary care provider to a normal presentation

c. Has an increased incidence of placentae previa

Ms. M. is a healthy 28-year-old gravida 3, para 2 (G3P2) woman. She had preeclampsia with both of her previous pregnancies. At 12 weeks' gestation, her obstetrician placed Ms. M. on 81 mg of aspirin daily. What is the indication for low dose aspirin therapy? a. Advanced maternal age b. Prevention of preterm birth c. History of preeclampsia in more than one pregnancy d. Prevention of heart disease

c. History of preeclampsia in more than one pregnancy

The newborn infant of a mother who was on magnesium sulfate may exhibit all of the following except: a. Lethargy b. Respiratory depression c. Hypertonia d. Poor suck

c. Hypertonia

To what should the nurse be alert when caring for this infant? a. Possible skull fracture b. Positive drug screen c. Hypothermia

c. Hypothermia

FOR QUESTIONS 28-29: Baby M. was delivered after a 16-hour induced labor. Mental membranes were artificially ruptured, fluid was clear, and an oxytocin (Pitcoin) infusion was initiated. The mother was afebrile throughout the labor. The second stage of labor was 2 hours, 45 minutes. Review of the mother's prenatal and labor history yielded the following information: Blood type is A+; Venereal Disease Research Laboratory (VDRL) is nonreactive; Alpha-fetoprotein is normal; Average blood pressure is 116 to 124/76 to 82; Total weight gain was 12.25 kg (27 pounds); Medications are prenatal vitamins, iron, and aspirin for stress headaches; Gestational age is 40 6/7 weeks; Nonstress test is reactive Baby M. had the umbilical cord wrapped twice around her neck and required stimulation to initiate breathing and administration of oxygen by face mask. Apgar scores were 7 at 1 minute and 8 at 5 minutes. From this information, which factor places Baby M. at increased risk for hyperbilirubinemia? a. Ruptured membranes for 16 hours b. Postmaturity c. Labor induced with Pitocin

c. Labor induced with Pitocin

What would the nurse expect to see on examination of this infant? a. Abundant lanugo b. Absence of sole creases c. Leathery, cracked, and wrinkled skin

c. Leathery, cracked, and wrinkled skin

Which is not a risk factor for developing preeclampsia? a. Age extremes b. First pregnancy c. Low body mass index (BMI) d. Periodontal disease

c. Low body mass index (BMI)

What problem may the LGA infant experience? a. PDA b. Facial nerve damage c. Poor suck, swallow, and breathing coordination

c. Poor suck, swallow, and breathing coordination

FOR QUESTIONS 30-31: On her second day of life, Baby M. required phototherapy treatment. Her mother was being discharged from the hospital and came to the nursery to breastfeed her infant before leaving. Baby M.'s mother was crying and did not want to go home without her infant. Baby M.'s father was trying to comfort his wife. While Baby M. is under the phototherapy lights, it is important to: a. Keep the infant under the lights at all times so that there will be maximal effectiveness in the shortest period. b. Discontinue Baby M.'s breastfeeding because the fluid content of breast milk is deficient for a neonate undergoing phototherapy. c. Prevent hypothermia, hyperthermia, or both in Baby M.

c. Prevent hypothermia, hyperthermia, or both in Baby M.

Baby M.'s mother is crying, expressed fear about her infant's health, and does not want to leave. Which intervention would be the least effective? a. Encourage the mother to come in to feed her infant as often as possible b. Emphasize the temporary nature of hyperbilirubinemia, and explain the monitoring of Baby M.'s bilirubin levels c. Remind the mother that newborns require demanding care, which is very fatiguing to a new mother, and that she should take this added opportunity to rest and recover

c. Remind the mother that newborns require demanding care, which is very fatiguing to a new mother, and that she should take this added opportunity to rest and recover

FOR QUESTIONS 59-62: Ms. D. is a 21-year-old primigravida (G1) who had her last menstrual period 12 weeks ago. She is in for her initial prenatal visit. Her uterus is approximately 12 weeks in size, and her blood pressure is 110/72 mm Hg. During your discussion with Ms. D., she expresses some concern over the possibility of being exposed to AIDS. She states that she has had only one sexual partner and they have been in a monogamous relationship for 2 years. When questioned, her concern stems from the fact that a colleague at work recently tested positive for HIV. As part of your assessment, what other information do you need to know? a. Does she live with other people? b. Has she eaten at her colleague's home? c. Sexual history of her partner

c. Sexual history of her partner

The FHR tracing after a convulsion may demonstrate all of the following except: a. Late decelerations b. Minimal Variability c. Tachycardia d. Bradycardia

c. Tachycardia

A 42-week postterm neonate was born with greenish discoloration of the nails and skin and greenish secretions in the nasal passages. Why might the infant be transferred to a level 3 nursery? a. To determine the reason for the postmaturity b. To observe more closely for skin color c. To manage severe respiratory problems that develop

c. To manage severe respiratory problems that develop

FOR QUESTIONS 69-70: Ms. R. is a 16-year-old single primigravida (G1) who is admitted at 36 weeks' gestation with a temperature of 39.4 C (103 F), uterine tenderness, chills, and blood pressure of 102/72 mm Hg. Fetal heart rate is 180 bpm. Fetal monitoring tracing shows minimal variability but no decelerations. Catheterized urinalysis is unremarkable. CBC shows hemoglobin values of 10.5 g/ dL, hematocrit of 36%, and WBC count 22,000/mm^3 with 85% PMNs, 10% bands, and 5% lymphocytes. All of the following are diagnostic for chorioamnionitis except: a. Culture of cervix b. Amniotic fluid smear c. Vaginal smear

c. Vaginal smear

A newborn infant should have the first bath: a. Immediately b. Just prior to discharge c. After the vitamin K injection d. After temperature stabilization

d. After temperature stabilization

FOR QUESTIONS 38-39: Mr. K. leaves the room briefly to go to the bathroom. When asked about her relationship with Mr. K., Mrs. K. says that it is good most of the time. She says it is usually over some dumb thing that she has done or said, so she deserves it. She said she thinks that's she just needs to try harder not to do and say those things anymore. Her response is typical of abused women because they frequently: a. Cannot admit to others that abuse is taking place b. Take the blame for invoking the abuse c. Are trying hard to be a better partner or wife to the abuser d. All of the above

d. All of the above

The abuser typically tries to minimize the acute abuse episode. This was evident when Mrs. K. said that: a. He is all over it now. b. He brought her flowers and told her how much he loved her. c. He promised he would never do that again. d. All of the above

d. All of the above

The most developmentally appropriate intervention to ensure that this infant is in a neutral thermal environment (NTE) in the delivery room is to: a. Place in an incubator b. Place in a radiant warmer c. Place in an open crib, double wrapped with a hat d. Dry thoroughly, place prone STS on mother's bare chest, and cover with a warm blanket

d. Dry thoroughly, place prone STS on mother's bare chest, and cover with a warm blanket

Which physiological alteration occurs during preeclampsia? a. Increased serum albumin and plasma colloid osmotic pressure b. Decreased peripheral vascular resistance c. Reduced plasma volume and increased hematocrit d. Increased hematocrit

d. Increased hematocrit

What is not an appropriate nursing activity during a seizure? a. Remain with the woman, and call for help. b. Note time of onset and duration of seizure. c. Lower the head of the bed, and turn her head to the side. d. Insert a tongue blade

d. Insert a tongue blade

What is not an indicator for immediate delivery? a. Signs of fetal distress or deterioration b. thrombocytopenia or elevated liver enzymes with epigastric pain and tenderness c. HELLP syndrome d. Urine output of 40 mL/hr

d. Urine output of 40 mL/hr

A history of ________ places a pregnant woman at an increased risk for UTI. a. childhood UTIs b. Chronic disease and hypertension c. Prior UTIs d. a, c e. a, b, c

d. a, c

Mrs. K.'s pregnancy is high risk because of the late prenatal care. If she is physically abused, what added risks occurs? a. Fetus might have a genetic disorder b. Gestational diabetes c. Polyhydramnios d. fetus might be physically injured

d. fetus might be physically injured

For what other TORCH disease might she be at risk? a. AIDS b. CMV c. Toxoplasmosis d. Rubeola

b. CMV

If the test result were positive, what test would confirm HIV infection? a. ELISA b. Western blot c. T-cell count

b. Western blot

HIV has been found in all of the following except: a. Saliva b. Tears c. Sweat d. Semen

c. Sweat

If it is established that Ms. D.'s partner had previous partners, what would you recommend for general screening? a. ELISA b. Western blot c. T-cell count

a. ELISA

FOR QUESTIONS 23-27: Ms. J., a gravida 2, para 1 (G2, P1) woman, delivered an infant boy vaginally at 35 weeks gestation. The infant weighed 2500-g (5 pounds, 8 ounces); the fetal heart rate appeared fine during labor, although an L/S ratio was reported at 1.8:1. Ms. J. has gestational diabetes. What is a characteristic of a neonate with RDS? a. Has a deficiency of pulmonary surfactant b. Is postmature c. Has sternal excursions

a. Has a deficiency of pulmonary surfactant

FOR QUESTIONS 71-74: Ms. Z., a 24-year-old, gravida 5, para 1 (G5, P1) woman, has been admitted to a regional level-I hospital at 27 weeks' gestation complaining of painless vaginal bleeding. Vital signs are stable, hematocrit is 31.5%, and an ultrasound scan reveals a complete placenta previa. She is given IV magnesium sulfate and oral terbutaline for mild uterine contractions, and she is transferred to a level-III (tertiary) regional hospital. After 7 days hospitalization, no further bleeding is noted and Ms. Z. is discharged to home on bed rest. She lives within 15 minutes of the hospital. Upon readmission for bleeding at 30 weeks, about 200 mL of vaginal blood is noted. Ms. Z. is started on a graduated-dose regimen of magnesium sulfate, 5 g the first hour, 4 g the second hour, 3 g the next hour, and then a maintenance dose. At this time, an ultrasound scan reveals a complete previa, grade II placenta, and transverse fetal lie. On the fifth day of admission, uterine contractions and increased amounts of bleeding begin. Her hematocrit is 24.7%, hemoglobin value is 8.5 g/ dL, vital signs are stable, and a nonstress test (NST) is reactive. On day 10, she experiences spontaneous rupture of the membranes (SROM) with clear amniotic fluid, increasing uterine contractions, persistent bloody drainage; ultrasonography shows an oblique line. A cesarean section is performed, and the placenta previa is noted to have abrupted free of the internal os. The combined blood loss before and during surgery is estimated at 2000 mL. In the recovery room, lochia rubra is light to moderate, the fundus is firm at the umbilicus, and oxygen saturation (SaO2) is 98% to 99%. Ms. Z. receives a continuous infusion of lactated Ringer solution with 20 units of oxytocin, morphine sulfate for pain, an additional 2 units of packed red blood cells (PRBCs), and prophylactic ampicillin. The initial hospital admission exam of Ms. Z. should omit examination of: a. Blood pressure b. Digital vaginal exam c. Vaginal bleeding d. Fetal hear tones

b. Digital vaginal exam

FOR QUESTIONS 15-16: An 18-year-old G1, P1 woman delivered a 2000-g (4-pound, 6.5-ounce) boy by cesarean section. The infant is assessed to be AGA of 34 weeks. No abnormalities are noted on physical examination. This infant is at risk for what condition? a. Hyperglycemia b. Premature closure of the ductus arteriosus c. Respiratory distress syndrome (RDS)

c. Respiratory distress syndrome (RDS)

What is the most frequent mechanism of heat loss in the newborn infant? a. Convection b. Conduction c. Radiation d. Evaporation

d. Evaporation