CNM Varney's Review Book Part F

Question 1

What is the minimum age for which the New Ballard Scale is accurate?

Answer 1

20 weeks

Question 2

What is the margin of error for the NBS?

Answer 2

2 weeks

Question 3

How do you do the popliteal angle test for neuromuscular maturity?

Answer 3

with infant supine and pelvis flat on examining suface, leg is flexed on thigh at knee and thigh is fully flexed using one hand; the leg is then extended at the knee while keeping the thigh flexed

Question 4

what is an anthropomorphic measurement of the newborn?

Answer 4

birthweight

Question 5

teh presence of how many minor malformations is suggestive of a major underlying malformation in the nenwborn?

Answer 5

3

Question 6

what is the most commonly used criteria for the evaluation of the neurological status of the newborn?

Answer 6

Moro reflex

startle reflex. usually disappears by 3-4 months

Question 7

persistence of the entire Moro reflex beyond what age following a term birth is considered abnormal?

Answer 7

4 months

Question 8

What is the relationship of vernix to GA?

Answer 8

it decreases with GA

Question 9

which of the following findings upon inspection of the skin of the newborn is not an indicator of prematurity?
Absence of vernix
Abundance of lanugo
Visible veins across abdomen
Mottling

Answer 9

Mottling

Question 10

When does the anterior fontanelle close?

Answer 10

approx 12-18 months

Question 11

what are normal findings on examination of a newborn’s eyes?

Answer 11

red eye reflex
doll’s eye response
blink response

Question 12

what is the normal range for head circumference for the average full-term newborn?

Answer 12

32-38 cm

Question 13

a positive result on the Ortolani or Barlow maneuvers signals to what neonatal abnormality?

Answer 13

congenital hip dysplasia

Question 14

Upon examining a newborn shortly after birth:
Arms fully flexed at elbows while legs are extended
You can flex wrist completely against forearm without effort
There is almost no lanugo present, the body is mostly bald
Creases are present over 2/3 of the anterior portion of the sole of the foot
There is some cracking of the skin and a few veins are visible
The ear pinna are well formed and firm, ther is instant recoil
What GA does this indicate?

Answer 14

40 wks

Question 15

What mechanism is responsible for transient tachypnea of the newborn?

Answer 15

inadequate absorption of liquid from the lungs after birth

Question 16

what is the most common sign of neurological compromise in the newborn period?

Answer 16

seizure activity

Question 17

a newborn is born with eviscerated abdominal organs that are covered by a membranous sac. What is this called?

Answer 17

omphalocele

Question 18

gastroschisis

Answer 18

looks similar to omphalocele, but instead of sticking out abdominal wall, it sticks out belly button and is NOT covered by membrane

Question 19

in addition to a STAT call to peds, what is the midwifery mgmt of a diaphragmatic hernia dx at birth?

Answer 19

immediate endotracheal intubation and artificial ventilation

Question 20

Newborn develops severe resp distress immediately after birth with decreased breath sounds in L lung field, heart sounds predominantly on the righ side of chest, and concave abdominal contour. What is suspected dx?

Answer 20

diaphragmatic hernia

Question 21

Midwifery mgmt of esophageal atresia includes positioning of the newborn in which position?

Answer 21

prone

Question 22

Newonatal absitnence syndrome is associated with which drug exposure of the fetus in utero?

Answer 22

heroin

Question 23

neonatal abstinence syndrome

Answer 23

symptoms depend on drug involved. Can begin 1-3 days after birth, or may take 5-10 days to appear. May include:
blotchy skin diarrhea
excessive crying or high-pitched crying
excessive sucking fever
hyperactive reflexes increased muscle tone
irritability poor feeding
rapid breathing seizures
sleep problems slow weight gain
stuffy nose, sneezing sweating
trembling vomiting

Question 24

the infant of a diabetic mother is at increased risk for:

Answer 24

early jaundice
tremors
polycythemia

Question 25

prognosis for newborn suffering for Erb-Duchenne paralysis

Answer 25

majority of these cases of paralysis disappear in 3-6 months

Question 26

Breech delivery in which traction was applied to neck could result in ...?

Answer 26

brachial plexus injury

Question 27

What is the mgmt step to take when you suspect that a newborn has a congenital viral or bacterial infection?

Answer 27

order that the cord blood be saved for testing or culture

Question 28

What should be the top priority in the midwife's mgmt plan for the care of a newborn who appears to have an early-onset bacterial infection?

Answer 28

coordinating/ensuring adequate respiratory support efforts

Question 29

what is the most common type of sz activity in the newborn?

Answer 29

subtle

Question 30

``` A newborn under your care: weight: 5 lb 12 oz head circ: 28 cm loose skin around shoulders and back dry, peeling skin that is meconium stained prominent eyes what is your suspicion? ```

Answer 30

IUGR (is what the book says, but I think it's | postmaturity syndrome)

Question 31

10 days old, lethargic, not feeding well. skin has slight grayish color, HR 178 bpm, respirations 70 bpm. What do you suspect?

Answer 31

congenital heart dz

Question 32

Waht is the rate of complications from circumcision of the male newborn?

Answer 32

1%

Question 33

Waht is the best method for cleaning the penis of the newborn while a circumcision is healing?

Answer 33

using lukewarm water only

Question 34

At what age do formula-fed infants need to start receiving iron supplementation?

Answer 34

6 months | or is that for bf infants only?

Question 35

what mineral other than iron needs to be supplemented in bf infant?

Answer 35

flouride | per 2002 varney's

Question 36

for a normal term newborn what is the caloric requirement for formula?

Answer 36

20 cal/oz | 24 if preemie

Question 37

approx how much breastmilk/formula shoud a term infant receive at each feeding during the first two weeks of life?

Answer 37

30-60 ml

Question 38

Over the course of the first year of life, how big should baby be in relation to birthweight?

Answer 38

weight should quadruple in first year

Question 39

What is a reason for physiologic rather than pathologic jaundice?

Answer 39

decreased life span of red blood cells

Question 40

What vaccine for infants and children should not be given prior to 12 months of age?

Answer 40

MMR

Question 41

in what waking behavioral state of the newborn as defined by brazelton does the newborn learn best?

Answer 41

alert

Question 42

6 wk infant. rash in diaper area with erythematous confluent lesions, marked skin-fold involvement, and satellite lesions on abdomen, thighs, and lower back. Infant appears to be in pain as a result. What condition do you suspect?

Answer 42

monilial diaper rash

Question 43

what is the best tx for monilial diaper rash?

Answer 43

topcal nystatin or miconozole

Question 44

pityriasis rosea

Answer 44

common skin problem seen ages 10-35 yr problem if pregnant woman gets it starts with herald patch, rarely spreads to face