Health and Illness 1 Flashcards
1
Q
What is the probability that a child will inherit an autosomal dominant disorder if one parent has one copy of the gene and the other has none?
A
Each child has a 50% chance of having the allele for the disorder.
2
Q
What are appropriate nursing interventions for patients with stress and/or anxiety problems?
A
Emotion-focused and problem-focused coping, relaxation breathing, biofeedback, meditation, imagery, massage, music, prayer.
3
Q
What does GTPAL stand for in obstetric history?
A
Gravida, Term, Preterm, Abortions, Live births.
4
Q
What does REEDA stand for in perineal assessment?
A
Redness, Edema, Ecchymosis, Drainage, Approximation.
5
Q
What do newborn metabolic screens test for in New Mexico?
A
Over 40 genetically transmitted diseases, including newborn metabolic disorders.
6
Q
What will the nurse assess in a patient with hypothermia?
A
Shivering, altered mental status, pale or blue skin, cyanosis, dysrhythmias, hypotension, hypoventilation, low perfusion.
Severity: Mild 93–95°F, Moderate 86–93°F, Severe <86°F
7
Q
What causes physiologic anemia during pregnancy?
A
Dilution of red blood cells due to a 45% increase in maternal blood volume.
8
Q
What are risk factors for postpartum hemorrhage?
A
Overdistended uterus, multiparity, advanced maternal age, fast or prolonged labor, instrumented delivery, C-section, placenta issues, infection, clotting disorders, anesthesia, previous PPH.
9
Q
Define heterozygous and homozygous traits.
A
Heterozygous = two different alleles; dominant trait is expressed. Homozygous = identical alleles; that trait is expressed.
10
Q
Define myopia, hyperopia, and presbyopia.
A
Myopia = nearsighted; Hyperopia = farsighted; Presbyopia = loss of lens flexibility with age.
11
Q
What will the nurse assess in a patient with hyperthermia?
A
Thirst, cramps, sweating, altered mental status, fatigue, tachycardia, hypotension, hot dry skin (heatstroke), tachypnea.
Heat exhaustion: 99.6–105.8°F, Heatstroke: >105.8°F
12
Q
What indicates true labor?
A
Progressive cervical changes—effacement and dilation.
13
Q
What are the four methods of heat loss in newborns?
A
Evaporation, conduction, convection, radiation.
14
Q
What are key nursing interventions for patients with STIs?
A
Safe sex, complete treatment, abstain 7 days, treat partners, contact partners from past 60 days, hygiene, follow-up.
15
Q
How is visual acuity tested?
A
Snellen chart (20 feet away) and Jaeger card (14 inches for near vision).
16
Q
What are four major assessment findings in PTSD?
A
Flashbacks, avoidance, hypervigilance, mood alterations like depression and disinterest.
17
Q
Define contraction duration, frequency, and interval.
A
Duration: start to end of contraction; Frequency: start of one to next; Interval: end of one to start of next.
18
Q
What testing confirms cystic fibrosis?
A
Newborn screen for CFTR gene; sweat chloride test >60 mEq/L.
19
Q
What initiates respiration in newborns?
A
Chemical (↓O₂, ↑CO₂), mechanical (thoracic pressure), thermal (temp drop), sensory (tactile stimulation).
20
Q
What will the nurse assess in a patient with stress or anxiety?
A
Fight/flight, depression, fatigue, nausea, hypertension, tachycardia, irritability, GI discomfort, poor focus.
21
Q
What are nursing interventions for hypothermia?
A
Remove wet clothes, apply dry/warm coverings, warm IV fluids, warm lavage, ECMO if needed.
22
Q
What are nursing interventions for hyperthermia?
A
Cool IV fluids, cooling environment, remove clothes, ice packs, cool lavage.
23
Q
What are nursing interventions for decelerations during labor?
A
Reposition, oxygen, IV bolus.
VEAL CHOP: Variable = Cord, Early = Head, Accels = OK, Late = Placenta.
24
Q
What will the nurse assess in a patient with STIs?
A
Risk factors (e.g., drugs, multiple partners), symptoms (e.g., drainage, pain, ulcers, fatigue, lymphadenopathy).
25
What are treatments for retinal detachment?
Laser, cryopexy, scleral buckling, pneumatic retinopexy (gas bubble), silicone bubble.
26
Define acrocyanosis.
Blue hands/feet.
27
Define CDM (Mongolian spot).
Blue-gray birthmark.
28
Define erythema toxicum.
Newborn rash.
29
Define nevus simplex.
Pink 'stork bite.'
30
Define nevus flammeus.
Dark red to purple mark.
31
Define nevus vasculosus.
Strawberry hemangioma.
32
Define café au lait.
Light brown patches.
33
What are the temperature ranges for mild, moderate, and severe hypothermia?
Mild: 93–95°F (33.9–35°C)
Moderate: 86–93°F (30–33.8°C)
Severe: <86°F (<30°C)
34
What are common signs and symptoms of mild hypothermia?
Shivering
Cold, pale skin
Tachypnea
Tachycardia
Slight confusion or impaired judgment
35
What are signs of moderate to severe hypothermia?
Muscle rigidity
Bradycardia
Hypotension
Dysrhythmias
Slow, shallow respirations
Decreased level of consciousness
Cyanosis
Dilated pupils (late)
36
What are priority nursing interventions for a patient with hypothermia?
ABCs and provide oxygen
Move to warm environment
Remove wet clothing
Apply dry blankets or warm packs to core
Passive warming: blankets, warm room
Active external warming: forced air, warm water immersion
Active internal warming (severe): warm IV fluids, warm lavage, heated oxygen, ECMO if needed
37
What are the temperature ranges for heat exhaustion and heatstroke?
Heat exhaustion: 99.6–105.8°F (37.5–41°C)
Heatstroke: >105.8°F (>41°C) – this is a medical emergency
38
What are assessment findings in heat exhaustion?
Heavy sweating
Fatigue
Weakness
Nausea/vomiting
Headache
Tachycardia
Orthostatic hypotension
Mild confusion
Muscle cramps
39
What are signs and symptoms of heatstroke?
Hot, dry skin (no sweating)
Altered mental status or unconsciousness
Seizures
Hypotension
Tachycardia
Tachypnea
Core temp >105.8°F
40
What are priority nursing interventions for a patient with hyperthermia or heatstroke?
ABCs, administer oxygen
Move to cool environment
Remove excess clothing
Apply cooling methods: fans, wet sheets, ice packs to groin/axilla
IV fluids for rehydration
Cool lavage or ice gastric/rectal tubes in severe cases
Monitor for dysrhythmias, seizure activity
41
How does the skin differ in heat exhaustion vs. heatstroke?
Heat exhaustion: moist, clammy skin
Heatstroke: hot, dry skin (no sweating)
42
What is the difference between genotype and phenotype?
Genotype: The genetic makeup (alleles) of an individual
Phenotype: The observable traits (appearance, function)
43
What does 'heterozygous' mean in genetic inheritance?
Having two different alleles for one gene (one dominant, one recessive). The dominant trait is typically expressed.
44
What does 'homozygous' mean in genetics?
Having identical alleles for a gene (either both dominant or both recessive).
45
What is an autosomal dominant inheritance pattern?
Only one copy of a dominant allele is needed to express the trait.
Affected parent has 50% chance of passing it to each child.
Both sexes equally affected.
46
What is an autosomal recessive inheritance pattern?
Two copies of the recessive gene (one from each parent) are needed to express the trait.
Carriers are heterozygous and typically unaffected.
25% chance affected, 50% carrier, 25% unaffected if both parents are carriers.
47
What is an X-linked recessive disorder?
The defective gene is carried on the X chromosome.
Males are more frequently affected (only one X).
Female carriers can pass it to 50% of sons (affected) and 50% of daughters (carriers).
48
What is mitochondrial inheritance?
Inherited only from the mother.
Affects both sons and daughters, but only females pass it on.
Mitochondrial DNA mutations affect high-energy organs (e.g., brain, muscles).
49
What does the acronym GTPAL refer to?
Gravidity, Term births, Preterm births, Abortions, Living children
50
What does a GTPAL of 3-2-0-1-2 indicate?
She has been pregnant 3 times, had 2 full-term births, no preterm births, 1 abortion, and 2 living children
51
What is the most likely cause of fatigue and nausea during the first trimester?
Hormonal changes
52
For a woman with a GTPAL of 2-1-0-1-1, what does the '2' signify?
She has been pregnant 2 times
53
If a woman's GTPAL is 4-2-1-0-3, what does the '1' represent?
1 preterm birth
54
What does a GTPAL of 1-0-0-1-0 indicate?
She has been pregnant once, had no births, had 1 abortion, and no living children
55
During the first prenatal visit, what should the nurse specifically ask about?
The woman's feelings and concerns about the pregnancy, The woman's diet and nutritional intake, The woman's alcohol and tobacco use
56
What should the nurse anticipate for a woman with a GTPAL of 5-3-1-1-4 who is pregnant again?
An increased risk for preterm birth
57
When is newborn screening typically performed?
24-28 hours after birth
58
If screening results are abnormal, what is the next step?
Further confirmatory testing is necessary
59
How many blood samples are required for all newborn screening tests together?
One blood sample
60
What is the principal cause of hyperthermia?
Exposure to hot environments, excessive exercise or physical activity, and dysfunction of the hypothalamic heat regulation mechanisms.
## Footnote
Answer: d) All of the above
61
At what core body temperature do seizures typically begin?
107°F (41.7°C).
## Footnote
Answer: b) 107°F (41.7°C)
62
Which form of hyperthermia involves a dysfunctional hypothalamic heat regulator?
Neuroleptic malignant syndrome.
## Footnote
Answer: d) Neuroleptic malignant syndrome
63
What triggers malignant hyperthermia?
Exposure to certain anesthetic gases.
## Footnote
Answer: a) Certain anesthetic gases
64
What are early signs of malignant hyperthermia?
Muscle rigidity, tachycardia, and rapid rise in body temperature.
## Footnote
Answer: a) Muscle rigidity, c) Tachycardia, d) Rapid rise in body temperature
65
What is the antidote for malignant hyperthermia?
Dantrolene.
## Footnote
Answer: a) Dantrolene
66
What are false labor contractions?
They are irregular and unpredictable, Do not increase in intensity or duration, and subside with activity
## Footnote
Answer: d) Both B and C
67
What are true labor contractions?
They occur at regular intervals, increase in intensity over time, and arent relieved by ambulation.
68
What is a sign that labor may be true?
Contractions that continue despite hydration, vaginal spotting or bloody show, and rupture of membranes.
## Footnote
Answer: d) All of the above
69
What happens to the cervix during true labor?
The cervix gradually effaces and dilates.
## Footnote
Answer: b) Gradually effaces and dilates
70
What indicates true labor as opposed to false labor?
If contractions are regular, increase in intensity and frequency, and are not relieved by ambulation or hydration.
71
A patient has a family history of breast cancer. What is the most appropriate recommendation? a) Routine mammograms starting at age 40 b) Genetic counseling and BRCA testing c) Lifestyle modifications and regular screenings d) a and c
d) a and c
72
A pregnant patient is concerned about the risk of passing on a genetic disorder to her child. What is the best way for the nurse to explain the risk? a) Use a Punnett square to explain inheritance patterns b) Refer to a genetic counselor c) Discuss the specific disorder and carrier status d) All of the above
d) All of the above
73
A patient has a family history of type 2 diabetes. Which lifestyle modifications should the nurse recommend? (Select all that apply) a) Regular exercise b) Balanced diet c) Weight management d) Smoking cessation
a, b, c, d
74
A patient is interested in genetic testing for a neurodegenerative disorder. What should the nurse advise? a) Consider the emotional impact b) Testing may guide treatment c) Referral to genetic counseling is appropriate d) All of the above
d) All of the above
75
A patient has a family history of colon cancer. Which of the following is true regarding genetic testing? a) It is only done if the patient has symptoms b) Early screening can prevent cancer progression c) Genetic testing can identify high-risk individuals d) b and c
d) b and c
76
A patient is considering genetic testing for a cardiac condition. Which statement about confidentiality is correct? a) Results can be shared with insurance providers b) Employers may request genetic information c) Testing is not protected under privacy laws d) Results are protected under the Genetic Information Nondiscrimination Act (GINA)
d) Results are protected under the Genetic Information Nondiscrimination Act (GINA)
77
A patient has a family history of cystic fibrosis, an autosomal recessive disorder. Which statement about risk is correct? a) Each child has a 50% chance of having the disease b) Each child has a 25% risk if both parents are carriers c) Only males are affected d) If one parent is a carrier, all children will be carriers
b) Each child has a 25% risk if both parents are carriers
78
A patient is interested in genetic testing for a rare metabolic disorder. Which potential benefit should the nurse explain? a) Early diagnosis may improve outcomes b) It can help with family planning c) It may allow for early treatment d) All of the above
d) All of the above
79
A patient has a family history of Huntington's disease, an autosomal dominant disorder. How should the nurse explain the risk to offspring? a) Only daughters are affected b) Each child has a 50% risk of inheriting the disorder c) The disorder skips generations d) All children will be affected
b) Each child has a 50% risk of inheriting the disorder
80
A patient is considering genetic testing for a behavioral disorder. Which statement is correct? a) Behavioral disorders are never inherited b) Results may lead to more effective drug treatments c) Testing is not useful in psychiatry d) Genetic testing is only used for physical conditions
b) Results may lead to more effective drug treatments
81
A patient presents with increased heart rate, muscle tension, and dilated pupils. These are likely signs of: a) Depression b) PTSD c) Exhaustion d) Acute stress response
d) Acute stress response
82
Which of the following techniques can be an effective way for a nurse to manage patient stress? a) Mindfulness meditation b) Ignoring minor complaints c) Deep breathing d) Both a and c
d) Both a and c
83
A nurse is assessing a patient's coping mechanisms. Which question is most appropriate? a) "Why are you feeling so stressed?" b) "What strategies have helped you cope with stress in the past?" c) "Have you tried relaxing?" d) "Do you want to speak to a counselor?"
b) "What strategies have helped you cope with stress in the past?"
84
A patient with newly diagnosed diabetes is exhibiting signs of stress. An appropriate nursing intervention would be: a) Telling the patient to focus on diet changes b) Suggesting stress management techniques c) Ignoring the stress until follow-up d) Discussing insulin administration only
b) Suggesting stress management techniques
85
When assessing a patient for anxiety, which physical finding may be present? a) Bradycardia b) Cold extremities c) Diaphoresis d) Rash
c) Diaphoresis
86
A patient tells the nurse, "I can't relax, my mind keeps racing." An appropriate response would be: a) "You need to calm down." b) "Would you like to talk about it?" c) "Let’s try some breathing exercises together." d) Both b and c
d) Both b and c
87
When assessing a patient for stress, which subjective data would be important to gather? a) Sleep pattern b) Appetite changes c) Mood d) All of the above
d) All of the above
88
A patient is struggling with anxiety related to an upcoming surgery. An appropriate nursing intervention would be: a) Tell them it’s normal and walk away b) Offer pain medication c) Discuss relaxation strategies d) Reschedule the surgery
c) Discuss relaxation strategies
89
Which manifestation indicates a patient may be experiencing effects of chronic stress? a) Fatigue b) Irritability c) Gastrointestinal issues d) All of the above
d) All of the above
90
A nurse recognizes a patient is overwhelmed by stress related to a new diagnosis. The best initial approach is to: a) Provide pamphlets b) Allow the patient to express their feelings and concerns c) Leave them to process it d) Call social work without asking
b) Allow the patient to express their feelings and concerns
91
When assessing a family's ability to cope with a patient's illness, which question is most helpful? a) "Are you handling this okay?" b) "What aspects of the illness are most stressful for you?" c) "Do you need help?" d) "Who is your support system?"
b) "What aspects of the illness are most stressful for you?"
92
A patient shares they have been experiencing nightmares and difficulty sleeping. The nurse should: a) Refer to psychiatry b) Screen for trauma c) Both a and b d) Suggest sleeping pills
c) Both a and b
93
Which finding indicates a patient may be struggling with anxiety? a) Insomnia b) Difficulty concentrating c) Irritability d) All of the above
d) All of the above
94
An appropriate intervention for a highly anxious patient would be: a) Tell them to stay busy b) Provide a calm, quiet environment c) Use therapeutic communication d) Both b and c
d) Both b and c
95
A patient is having difficulty concentrating after a traumatic event. The nurse should: a) Allow the patient time to process the event b) Push them to talk c) Assign them group therapy d) Discharge them for safety
a) Allow the patient time to process the event
96
Signs that a nurse may be experiencing burnout include: a) Emotional exhaustion b) Decreased job performance c) Depersonalization of patients d) All of the above
d) All of the above
97
When assessing stress levels in a new mother, which question is most appropriate? a) "Are you tired a lot?" b) "How are you coping with this major life change?" c) "Is the baby healthy?" d) "Do you want help?"
b) "How are you coping with this major life change?"
98
A patient reports difficulty making decisions at work due to stress. The nurse should: a) Offer stress education b) Reassure them c) Refer to counseling d) Both a and c
d) Both a and c
99
An appropriate way to manage student stress would be: a) Drinking coffee b) Practicing mindfulness techniques c) Avoiding friends d) Overstudying
b) Practicing mindfulness techniques
100
When gathering information on a patient’s anxiety, which open-ended question is best? a) "Are you anxious?" b) "What's causing you to feel anxious?" c) "Do you want medication?" d) "Should I call the provider?"
b) "What's causing you to feel anxious?"
101
Which prenatal screening test is offered to detect chromosomal abnormalities? a) Nuchal translucency ultrasound b) Cell-free DNA c) Quad screen d) All of the above
d) All of the above
102
What percentage of weight gain is recommended in pregnancy for normal BMI? a) 15-25 lbs b) 25-35 lbs c) 35-45 lbs d) 10-15 lbs
b) 25-35 lbs
103
Which activity is contraindicated in pregnancy? a) Walking b) Hot tub use c) Prenatal yoga d) Swimming
b) Hot tub use
104
Anemia in pregnancy is defined as a hemoglobin less than: a) 14 g/dL b) 13 g/dL c) 11 g/dL d) 12 g/dL
d) 12 g/dL
105
Which condition requires urgent evaluation in pregnancy? a) Mild swelling b) Nasal congestion c) Vaginal bleeding d) Leg cramps
c) Vaginal bleeding
106
Which complication of pregnancy is characterized by high blood pressure, protein in the urine, and edema? a) Gestational diabetes b) Preeclampsia c) Placenta previa d) Hyperemesis gravidarum
b) Preeclampsia
107
A pregnant woman with severe nausea and vomiting to the point of dehydration and weight loss is likely suffering from: a) Morning sickness b) GERD c) Hyperemesis gravidarum d) Food poisoning
c) Hyperemesis gravidarum
108
Placental abruption refers to: (Select all that apply) a) Premature separation of the placenta b) Vaginal bleeding c) Abdominal pain d) Fetal distress
a, b, c, d
109
Which complication increases the risk of postpartum hemorrhage? a) Gestational diabetes b) Urinary tract infection c) Placenta previa d) Morning sickness
c) Placenta previa
110
A pregnant woman with gestational diabetes may require: a) Immediate delivery b) Insulin therapy c) Dietary modification d) B and C
d) B and C
111
Preterm premature rupture of membranes (PPROM) refers to: a) Rupture of membranes before 37 weeks b) Rupture of membranes during active labor c) Artificial rupture during labor d) Rupture at term
a) Rupture of membranes before 37 weeks
112
Pregnant women with which condition may require cervical cerclage? a) Placenta previa b) Ectopic pregnancy c) Incompetent cervix d) Uterine fibroids
c) Incompetent cervix
113
A fetus with intrauterine growth restriction may exhibit: (Select all that apply) a) Low birth weight b) Poor muscle tone c) Wrinkled skin d) Excessive amniotic fluid
a, b, c
114
Rh isoimmunization can occur when: a) The mother is Rh positive and the fetus is Rh negative b) The mother is Rh negative and the fetus is Rh positive c) Both mother and fetus are Rh positive d) Both mother and fetus are Rh negative
b) The mother is Rh negative and the fetus is Rh positive
115
Which placental abnormality increases the risk of postpartum hemorrhage and surgical delivery? a) Placenta accreta b) Placenta previa c) Placenta increta d) A and C
d) A and C
116
During the first stage of labor, the cervix: a) Effaces b) Dilates c) Both A and B d) None of the above
c) Both A and B
117
The latent phase of the first stage typically lasts: a) 6-8 hours b) 30 minutes c) Several hours d) A and C
d) A and C
118
Signs that a woman is in active labor include: (Select all that apply) a) Contractions 3-5 minutes apart b) Cervical dilation of 4+ cm c) Bloody show d) Nausea
a, b, c
119
Which factor increases the likelihood of a precipitous (rapid) labor? a) Primigravida b) Obesity c) Multiparity d) Sedation
c) Multiparity
120
During the second stage, the mother should: a) Bear down with contractions b) Lie flat on her back c) Be encouraged to push d) A and C only
d) A and C only
121
Routine episiotomy is no longer recommended because: a) Increases risk of tearing b) Slows healing c) Increases pain d) All of the above
d) All of the above
122
If shoulder dystocia occurs, the first maneuver attempted is usually: a) McRoberts maneuver b) Fundal pressure c) C-section d) Suprapubic pressure
a) McRoberts maneuver
123
The placenta should deliver within: a) 10 minutes b) 30 minutes c) 1 hour d) Immediately after birth
b) 30 minutes
124
Pitocin is given after delivery to: a) Induce labor b) Manage hypertension c) Control postpartum bleeding d) Relieve pain
c) Control postpartum bleeding
125
Signs of placental separation include: (Select all that apply) a) Lengthening of the umbilical cord b) Gush of blood from vagina c) Uterine fundus rises d) Fever
a, b, c
126
Reasons for prolonged third stage include: a) Uterine atony b) Retained placenta c) Full bladder d) All of the above
d) All of the above
127
The earliest sign of uterine rupture is: a) Severe abdominal pain b) Abnormal fetal heart tracing c) Maternal hypotension d) Loss of contractions
b) Abnormal fetal heart tracing
128
Complications that can occur in the fourth stage include: a) Hemorrhage b) Hypotension c) Uterine inversion d) All of the above
d) All of the above
129
Initial nursing assessments in the fourth stage focus on: a) Fundus and lochia b) Vital signs c) Bladder status d) All of the above
d) All of the above
130
Risk factors for postpartum hemorrhage include: (Select all that apply) a) Prolonged labor b) Multiple gestation c) Chorioamnionitis d) Operative vaginal delivery
a, b, c, d
131
A complication caused by premature rupture of membranes is: a) Macrosomia b) Shoulder dystocia c) Umbilical cord prolapse d) Preeclampsia
c) Umbilical cord prolapse
132
Chorioamnionitis may result from: a) Prolonged rupture of membranes b) Multiple vaginal exams c) Internal fetal monitoring d) All of the above
d) All of the above
133
Signs of obstructed labor include: (Select all that apply) a) Protracted descent b) Arrested dilation c) Bandl's ring d) Rapid delivery
a, b, c (protracted decent is just slower decent than normal and Bandl’s ring is in the picture)
134
Uterine rupture is most likely with: a) Previous low transverse cesarean incision b) Multiple vaginal deliveries c) First-time pregnancy d) Breech presentation
a) Previous low transverse cesarean incision (actually regular c section is higher risk. Scar tissue is less elastic and more likely to rip)
135
Placental abruption may present with: a) Vaginal bleeding b) Uterine tenderness c) Fetal distress d) All of the above
d) All of the above
136
An inability to adequately push may result from: a) Epidural anesthesia b) Exhaustion c) Malposition d) All of the above
d) All of the above
137
Intrauterine fetal demise is a complication of: a) Preeclampsia b) Placental abruption c) Severe infection d) All of the above
d) All of the above
138
Postpartum hemorrhage may be caused by: (Select all that apply) a) Uterine atony b) Retained placenta c) Trauma to birth canal d) Coagulopathy
a, b, c, d
139
Shoulder dystocia increases the risk of: a) Brachial plexus injury b) Clavicle fracture c) Hypoxia d) All of the above
d) All of the above
140
Precipitous labor may be associated with: a) Uterine rupture b) Trauma to the birth canal c) Fetal distress d) All of the above
d) All of the above
141
Intrapartum fever may indicate: a) Chorioamnionitis b) Epidural reaction c) Blood loss d) Dehydration
a) Chorioamnionitis
142
Failure to descend is a type of: a) Protraction disorder b) Precipitous labor c) Arrest disorder d) Obstructed labor
a) Protraction disorder (Protraction disorders in labor refer to situations where cervical dilation or fetal descent is slower than expected, but not completely stopped, during the first or second stage of labor. This means labor is progressing, but at a slower rate than normal.)
143
A complication of vacuum-assisted delivery is: a) Uterine rupture b) Fetal scalp injury c) Shoulder dystocia d) Cord prolapse
b) Fetal scalp injury
144
Which condition requires immediate cesarean delivery? a) Transverse lie b) Complete breech c) Footling breech d) Face presentation
c) Footling breech
145
Prolonged, late decelerations in fetal heart rate may indicate: a) Head compression b) Uteroplacental insufficiency c) Fetal hypoxia d) B and C only
d) B and C only
146
What is the ideal fetal position for labor and delivery? a) Vertex (head first) b) Breech c) Transverse d) Occiput posterior
a) Vertex (head first)
147
What does an occiput posterior position mean? a) The baby is facing: the mother’s back b) The baby is facing: the mother’s front c) The baby's head is down, back facing front d) The baby is sideways
The baby is facing: the mother’s front
148
What does deflexion of the fetal head increase the risk of? a) Rapid delivery b) Breech presentation c) Prolonged labor d) Preterm labor
c) Prolonged labor
149
What does the station of the fetal head refer to? a) Cervical effacement b) Descent of the head c) Position in relation to spine d) Fetal orientation
b) Descent of the head
150
In a complete breech presentation, what are the fetal parts? a) Hips flexed b) Knees extended c) Feet close to buttocks d) All of the above
d) All of the above
151
What does a compound presentation involve? a) The arm or hand presenting first b) Feet presenting c) Breech presentation d) Head presenting without extremities
a) The arm or hand presenting first
152
For which presentations may external cephalic version be attempted? a) Breech b) Transverse lie c) Face presentation d) A and B only
d) A and B only
153
What risks are increased by persistent occiput posterior position? a) Preterm birth b) Prolonged labor c) Instrumental delivery d) B and C only
d) B and C only
154
What type of breech is a footling breech? a) Complete breech b) Frank breech c) Incomplete breech d) Transverse breech
c) Incomplete breech
155
What procedures may help rotate a persistent occiput posterior? a) Position changes b) Manual rotation c) Forceps-assisted rotation d) All of the above
d) All of the above
156
What may prolonged occiput posterior position result in? a) Back labor b) Prolonged second stage c) Increased perineal trauma d) All of the above
d) All of the above
157
What is a transverse lie presentation? a) Fetus lies sideways b) Shoulder or back presents c) Vaginal delivery usually not possible d) All of the above
d) All of the above
158
What may initial management for a face presentation include? a) Monitoring labor progress b) Allowing labor to continue if chin is anterior c) Both a and b d) Emergency C-section
c) Both a and b
159
What does brow presentation refer to? a) Buttocks presenting b) Chin presenting first c) The anterior fontanel presenting first d) Head fully flexed
c) The anterior fontanel presenting first
160
In a frank breech, what are the fetal parts? a) Hips flexed, knees extended b) Hips and knees flexed c) Feet first d) Arms presenting
a) Hips flexed, knees extended
161
The APGAR score assesses: a) Appearance b) Pulse c) Grimace d) All of the above
d) All of the above
162
Grunting respirations in a newborn may indicate: a) Respiratory distress b) Sepsis c) Meconium aspiration d) Any of the above
d) Any of the above
163
Causes of respiratory distress in the newborn include: (Select all that apply) a) Preterm birth b) Meconium aspiration c) Congenital anomalies d) Infection
a, b, c, d
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A newborn with respiratory distress syndrome is treated with: a) Oxygen b) Surfactant c) CPAP or mechanical ventilation d) All of the above
d) All of the above
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Signs that an infant is ready to breastfeed include: (Select all that apply) a) Rooting reflex b) Hand to mouth movements c) Lip smacking d) Crying loudly
a, b, c
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Proper positioning for breastfeeding includes: a) Laying the baby on their back b) Baby’s nose level with nipple c) Baby’s body facing mother d) B and C only
d) B and C only
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Techniques to relieve engorgement include: (Select all that apply) a) Frequent nursing b) Warm compress before feeding c) Cold compress after feeding d) All of the above
d) All of the above
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Signs that a breastfed newborn is getting enough milk include: a) 6–8 wet diapers/day b) Audible swallowing c) Steady weight gain d) All of the above
d) All of the above
169
Contraindications to breastfeeding include: (Select all that apply) a) Maternal HIV b) Maternal flu c) Some medications d) Cold sores on face
a, c
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The newborn hip screening exam checks for: a) Developmental hip dysplasia b) Spinal curvature c) Femoral length d) Leg circumference
a) Developmental hip dysplasia (ortolani and Barlow maneuvers)
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Components of the newborn neurological exam include: (Select all that apply) a) Reflexes b) Muscle tone c) Posture d) All of the above
d) All of the above
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Common causes of jaundice in newborns include: (Select all that apply) a) Immature liver b) Hemolysis c) Bruising from delivery d) All of the above
d) All of the above
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The newborn metabolic screening is done: a) At 1 week b) Within 24–48 hours c) After discharge d) At 2 weeks
b) Within 24–48 hours
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Newborn hearing screening is recommended: a) At 6 months b) During first pediatric visit c) Only if risk factors d) Before hospital discharge
d) Before hospital discharge
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Signs that indicate breastfeeding difficulties include: (Select all that apply) a) Poor latch b) Inadequate weight gain c) Persistent crying after feeding d) All of the above
d) All of the above
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Risk factors for respiratory distress syndrome include: (Select all that apply) a) Preterm birth b) Diabetic mother c) Cesarean delivery d) Breech presentation
a, b, c
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Treatment for transient tachypnea of the newborn includes: a) IV antibiotics b) Intubation c) Supplemental oxygen d) A and C only
d) A and C only
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Delayed initiation of crying after birth may indicate: a) Good APGAR b) Respiratory distress c) Perinatal asphyxia d) B and C
d) B and C
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Meconium staining of amniotic fluid increases risk of: a) Meconium aspiration syndrome b) Respiratory distress c) Jaundice d) A and B only
d) A and B only
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Supplemental feedings for breastfed infants may be recommended for: (Select all that apply) a) Hypoglycemia b) Excessive weight loss c) Poor latch d) All of the above
d) All of the above
181
What does external fetal monitoring use? a) Ultrasound transducers b) Fetal scalp clip c) Amnioinfusion d) Palpation
a) Ultrasound transducers
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What is internal fetal monitoring done with? a) Doppler b) A fetal scalp electrode c) External probe d) Oxygen sensor
b) A fetal scalp electrode
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What are the advantages of internal fetal monitoring? (Select all that apply) a) More accurate FHR readings b) Less interference from maternal movements c) Ability to monitor after rupture of membranes d) Noninvasive
a, b, c
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What are the contraindications for internal fetal monitoring? (Select all that apply) a) Active genital herpes b) Undiagnosed vaginal bleeding c) HIV positive mother d) All of the above
d) All of the above
185
What are the components of FHR assessment? (Select all that apply) a) Baseline rate b) Variability c) Accelerations d) Decelerations
a, b, c, d
186
What may a non-reassuring fetal heart tracing show? a) Absent variability b) Late decelerations c) Bradycardia d) All of the above
d) All of the above
187
What is external fetal monitoring preferred for? a) Invasive monitoring b) Accurate variability c) Monitoring during cesarean d) None of the above
d) None of the above
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What are the reasons for internal fetal monitoring? (Select all that apply) a) Difficulty tracking FHR externally b) Maternal obesity c) Need for precise data d) All of the above
d) All of the above
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What interventions may be taken for repetitive late decelerations? a) Repositioning b) Oxygen administration c) IV fluid bolus d) All of the above
d) All of the above
190
What are the potential complications of internal fetal monitoring? (Select all that apply) a) Infection b) Fetal scalp trauma c) Dislodgment d) All of the above
d) All of the above
191
A newborn's ability to regulate temperature is influenced by: a) Gestational age b) Environment c) Amount of brown fat d) All of the above
d) All of the above
192
Nonshivering thermogenesis in newborns involves: a) Muscle contractions b) Increased metabolic activity of brown fat c) Shivering d) High-protein diet
b) Increased metabolic activity of brown fat
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The most accurate way to assess a newborn's temperature is: a) Axillary b) Rectal c) Oral d) Skin sensor
b) Rectal
194
Signs of hypothermia in a newborn include: (Select all that apply) a) Lethargy b) Poor feeding c) Respiratory distress d) Hypoglycemia
a, b, c, d
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Risk factors for hypothermia in newborns are: (Select all that apply) a) Prematurity b) Overheating c) Low birth weight d) Both A and C
d) Both A and C
196
To prevent heat loss in preterm infants, which measures are recommended? (Select all that apply) a) Radiant warmers b) Plastic wraps c) Humidified incubators d) All of the above
d) All of the above
197
A normal axillary temperature range for a newborn is: a) 35.5–36.0°C b) 36.5–37.5°C c) 37.5–38.5°C d) 34.5–35.5°C
b) 36.5–37.5°C
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Which finding suggests cold stress in a newborn? a) Mottled skin b) Hypoglycemia c) Acidosis d) All of the above
d) All of the above
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An effective way to promote nonshivering thermogenesis is: a) Warm formula b) Skin-to-skin contact c) Incubator lighting d) Bathing
b) Skin-to-skin contact
200
Metabolic adaptations in the newborn period include: (Select all that apply) a) Glycogen storage b) Ketone production for fuel c) Insulin resistance d) Brown fat metabolism
b, d
201
Transient newborn hypoglycemia may be caused by: (Select all that apply) a) Preterm birth b) Diabetic mother c) Inadequate feeding d) All of the above
d) All of the above
202
A normal blood glucose range for a term newborn is: a) 30–50 mg/dL b) 45–80 mg/dL c) 60–100 mg/dL d) 80–120 mg/dL
b) 45–80 mg/dL
203
Interventions for neonatal hypoglycemia include: (Select all that apply) a) Early feeding b) IV dextrose c) Phototherapy d) Both A and B
d) Both A and B
204
Consequences of untreated neonatal hypoglycemia can include: a) Seizures b) Brain injury c) Developmental delay d) All of the above
d) All of the above
205
Temperature instability in newborns may contribute to: a) Hypoglycemia b) Respiratory distress c) Poor feeding d) All of the above
d) All of the above
206
A common cause of conductive hearing loss is: a) Damage to cochlea b) Outer or middle ear pathology c) Ototoxic medications d) Age-related degeneration
b) Outer or middle ear pathology
207
Sensorineural hearing loss may result from: a) Earwax buildup b) Noise exposure c) Aging d) Both b) and c
d) Both b) and c
208
The semicircular canals are involved in: a) Hearing perception b) Balance and equilibrium c) Fluid drainage d) Pain response
b) Balance and equilibrium
209
Benign paroxysmal positional vertigo (BPPV) is caused by: a) Ear infection b) Displaced otoconia crystals c) Eustachian tube dysfunction d) Head trauma
b) Displaced otoconia crystals
210
Which cranial nerve is responsible for hearing? a) VII (Facial) b) VIII (Vestibulocochlear) c) IX (Glossopharyngeal) d) X (Vagus)
b) VIII (Vestibulocochlear)
211
Otosclerosis commonly results in: a) Conductive hearing loss b) Sensorineural hearing loss c) Mixed hearing loss d) Tinnitus only
a) Conductive hearing loss
212
An acoustic neuroma can cause: a) Ear discharge b) Hearing loss c) Tinnitus d) Both b) and c
d) Both b) and c
213
In presbycusis (age-related hearing loss): a) High frequencies are affected first b) Conductive loss is most common c) Sudden hearing loss occurs d) Hearing improves with age
a) High frequencies are affected first
214
Manifestations of acute otitis media may include: (Select all that apply) a) Otalgia b) Fever c) Hearing loss d) All of the above
a, b, c
215
Which of the following would be included in a complete obstetric history? a) Course of previous pregnancies b) Method of previous deliveries c) Health and weight of infants at birth d) Postpartum course after previous births
a, b, c, d
216
Which of the following is NOT a common change experienced by pregnant women? a) Severe headaches b) Nausea c) Fatigue d) Breast tenderness
a) Severe headaches
217
Which statement about the obstetric history is TRUE? a) It documents information about each previous pregnancy and birth b) It only includes complications during labor c) It focuses solely on postpartum health d) It replaces the need for a medical history
a) It documents information about each previous pregnancy and birth
218
What should the nurse recognize if a pregnant woman at 32 weeks gestation reports leakage of fluid? a) A potential sign of preterm premature rupture of membranes b) Normal increase in vaginal discharge c) Sign of urinary incontinence d) Possible labor pain
a) A potential sign of preterm premature rupture of membranes
219
During the first prenatal visit, what should the nurse specifically ask about? a) The woman's feelings and concerns about the pregnancy b) The woman's diet and nutritional intake c) The woman's alcohol and tobacco use d) All of the above
d) All of the above
220
Screening for which of these hemoglobin disorders is routinely performed? a) Sickle cell anemia b) Thalassemia c) Both a and b d) Neither a nor b
c) Both a and b
221
What other conditions may be screened for? (Select all that apply) a) Congenital adrenal hyperplasia b) Maple syrup urine disease c) Cystic fibrosis
a, b, c
222
What are the signs of mild hypothermia? (Select all that apply) a) Shivering b) Cool skin with delayed capillary refill c) Apathy or mild confusion
a, b, c
223
What is the hallmark sign of frostbite? a) Tingling sensation in extremities b) Persistent redness of skin c) Blanching of affected area d) Swelling and warmth
c) Blanching of affected area
224
Which areas are most prone to frostbite? (Select all that apply) a) Fingertips b) Earlobes c) Tip of nose
a, b, c
225
The process of fertilization occurs in which part of the female reproductive system? a) Uterus b) Fallopian tube c) Cervix d) Ovary
b) Fallopian tube
226
Which phase of the menstrual cycle is the fertile window? a) Menstrual phase b) Luteal phase c) Ovulatory phase d) Follicular phase
c) Ovulatory phase
227
Approximately how many days after ovulation is the fertile window? a) 1–2 days b) 3–5 days c) 6–7 days d) 8–10 days
b) 3–5 days
228
Which hormone surge triggers ovulation? a) Estrogen b) Luteinizing hormone (LH) c) Progesterone d) Follicle-stimulating hormone (FSH)
b) Luteinizing hormone (LH)
229
What is the lifespan of a sperm cell? a) 12–24 hours b) 1–3 days c) 4–5 days d) 7 days
b) 1–3 days
230
Factors that can impair fertility include: (Select all that apply) a) Smoking b) Excessive alcohol use c) Obesity d) Certain medications
a, b, c, d
231
The "morning after pill" works by: a) Delaying ovulation b) Preventing implantation c) Both a and b d) Causing abortion
c) Both a and b
232
Which imaging technique can evaluate fallopian tube patency? a) Pelvic ultrasound b) Hysterosalpingogram c) Laparoscopy d) Transvaginal sonography
b) Hysterosalpingogram
233
In vitro fertilization involves: a) Fertilization of the egg outside the body b) Implantation of the fertilized egg into the uterus c) Both a and b d) Hormonal suppression of ovulation
c) Both a and b
234
What is the most fertile period for conception? a) One week after the menstrual period b) A few days before menstruation c) Midway between periods d) The last day of menstruation
c) Midway between periods
235
During which trimester does the fetus begin kicking and making purposeful movements? a) First trimester b) Second trimester c) Third trimester d) At birth
b) Second trimester
236
What lab test is used to screen for gestational diabetes? a) Glucose tolerance test b) Hemoglobin A1C c) Fasting insulin test d) Urine dipstick
a) Glucose tolerance test
237
Which of the following increases a woman's risk of pregnancy-induced hypertension? a) Obesity b) Multiple gestation c) First pregnancy d) All of the above
d) All of the above
238
Signs of preterm labor include: (Select all that apply) a) Menstrual-like cramps b) Low, dull backache c) Spotting or light bleeding d) Regular uterine contractions
a, b, d
239
At what week of pregnancy can electronic fetal monitoring begin? a) 12 weeks b) 20 weeks c) 28 weeks d) 36 weeks
b) 20 weeks
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