1.

May arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. She also tells the nurse that a home pregnancy test was positive but she began to have mild cramps and is now having moderate vaginal bleeding. During the physical examination of the client, the nurse notes that May has a dilated cervix. he nurse determines that May is experiencing which type of abortion!

a. "nevitable b. "ncomplete c. hreatened d. Septic

#. $urse %eese is reviewing the record of a pregnant client for her first prenatal visit. &hich of the following data, if noted on the client's record, would alert the nurse that the client is at risk for a spontaneous abortion!

a. (ge )* years b. +istory of syphilis c. +istory of genital herpes d. +istory of diabetes mellitus

). $urse +a,el is preparing to care for a client who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. $urse +a,el develops a plan of care for the client and determines that which of the following nursing actions is the priority!

a. Monitoring weight b. (ssessing for edema

c. Monitoring apical pulse d. Monitoring temperature

-. $urse .liver is teaching a diabetic pregnant client about nutrition and insulin needs during pregnancy. he nurse determines that the client understands dietary and insulin needs if the client states that the second half of pregnancy re/uire0

a. Decreased caloric intake b. "ncreased caloric intake c. Decreased "nsulin d. "ncrease "nsulin

1. $urse Michelle is assessing a #- year old client with a diagnosis of hydatidiform mole. She is aware that one of the following is unassociated with this condition!

a. 2xcessive fetal activity. b. 3arger than normal uterus for gestational age. c. 4aginal bleeding d. 2levated levels of human chorionic gonadotropin.

*. ( pregnant client is receiving magnesium sulfate for severe pregnancy induced hypertension 56"+7. he clinical findings that would warrant use of the antidote , calcium gluconate is0

a. 8rinary output 99 cc in # hours. b. (bsent patellar reflexes. c. %apid respiratory rate above -9:min. d. %apid rise in blood pressure.

;. During vaginal examination of <anah who is in labor, the presenting part is at station plus two. $urse, correctly interprets it as0

a. 6resenting part is # cm above the plane of the ischial spines. b. =iparietal diameter is at the level of the ischial spines. c. 6resenting part in # cm below the plane of the ischial spines. d. =iparietal diameter is # cm above the ischial spines.

>. ( pregnant client is receiving oxytocin 56itocin7 for induction of labor. ( condition that warrant the nurse in?charge to discontinue ".4. infusion of 6itocin is0

a. @ontractions every 1 A minutes lasting ;9?>9 seconds. b. Maternal temperature 191.# c. 2arly decelerations in the fetal heart rate. d. Betal heart rate baseline 1-9?1*9 bpm.

9. @alcium gluconate is being administered to a client with pregnancy induced hypertension 56"+7. ( nursing action that must be initiated as the plan of care throughout inCection of the drug is0

a. 4entilator assistance b. @46 readings c. 2DE tracings d. @ontinuous @6%

19. ( trial for vaginal delivery after an earlier caesareans, would likely to be given to a gravida, who had0

a. Birst low transverse cesarean was for active herpes type # infectionsF vaginal culture at )9 weeks pregnancy was positive. b. Birst and second caesareans were for cephalopelvic disproportion. c. Birst caesarean through a classic incision as a result of severe fetal distress. d. Birst low transverse caesarean was for breech position. Betus in this pregnancy is in a vertex presentation.

11.$urse %yan is aware that the best initial approach when trying to take a crying toddler's temperature is0

a. alk to the mother first and then to the toddler. b. =ring extra help so it can be done /uickly. c. 2ncourage the mother to hold the child. d. "gnore the crying and screaming.

1#.=aby ina a ) month old infant Cust had a cleft lip and palate repair. &hat should the nurse do to prevent trauma to operative site!

a. (void touching the suture line, even when cleaning. b. 6lace the baby in prone position. c. Eive the baby a pacifier. d. 6lace the infant's arms in soft elbow restraints.

1). &hich action should nurse Marian include in the care plan for a # month old with heart failure!

a. Beed the infant when he cries. b. (llow the infant to rest before feeding. c. =athe the infant and administer medications before feeding. d. &eigh and bathe the infant before feeding.

1-.$urse +a,el is teaching a mother who plans to discontinue breast feeding after 1 months. he nurse should advise her to include which foods in her infant's diet!

a. Skim milk and baby food. b. &hole milk and baby food. c. "ron?rich formula only. d. "ron?rich formula and baby food.

11.Mommy 3inda is playing with her infant, who is sitting securely alone on the floor of the clinic. he mother hides a toy behind her back and the infant looks for it. he nurse is aware that estimated age of the infant would be0

a. * months b. - months c. > months d. 19 months

1*.&hich of the following is the most prominent feature of public health nursing!

a. "t involves providing home care to sick people who are not confined in the hospital. b. Services are provided free of charge to people within the catchments area. c. he public health nurse functions as part of a team providing a public health nursing services. d. 6ublic health nursing focuses on preventive, not curative, services.

1;.&hen the nurse determines whether resources were maximi,ed in implementing 3igtas igdas, she is evaluating

a. 2ffectiveness b. 2fficiency

c. (de/uacy d. (ppropriateness

1>.4angie is a new =.S.$. graduate. She wants to become a 6ublic +ealth $urse. &here should she apply!

a. Department of +ealth b. 6rovincial +ealth .ffice c. %egional +ealth .ffice d. %ural +ealth 8nit

19. ony is aware the @hairman of the Municipal +ealth =oard is0

a. Mayor b. Municipal +ealth .fficer c. 6ublic +ealth $urse d. (ny /ualified physician

#9.Myra is the public health nurse in a municipality with a total population of about #9,999. here are ) rural health midwives among the %+8 personnel. +ow many more midwife items will the %+8 need!

a. 1 b. #

c. ) d. he %+8 does not need any more midwife item.

#1.(ccording to Breeman and +einrich, community health nursing is a developmental service. &hich of the following best illustrates this statement!

a. he community health nurse continuously develops himself personally and professionally. b. +ealth education and community organi,ing are necessary in providing community health services. c. @ommunity health nursing is intended primarily for health promotion and prevention and treatment of disease. d. he goal of community health nursing is to provide nursing services to people in their own places of residence.

##.$urse ina is aware that the disease declared through 6residential 6roclamation $o. - as a target for eradication in the 6hilippines is!

a. 6oliomyelitis b. Measles c. %abies d. $eonatal tetanus

#).May knows that the step in community organi,ing that involves training of potential leaders in the community is0

a. "ntegration b. @ommunity organi,ation c. @ommunity study d. @ore group formation

#-.=eth a public health nurse takes an active role in community participation. &hat is the primary goal of community organi,ing!

a. o educate the people regarding community health problems b. o mobili,e the people to resolve community health problems c. o maximi,e the community's resources in dealing with health problems. d. o maximi,e the community's resources in dealing with health problems.

#1. ertiary prevention is needed in which stage of the natural history of disease!

a. 6re?pathogenesis b. 6athogenesis c. 6rodromal d. erminal

#*. he nurse is caring for a primigravid client in the labor and delivery area. &hich condition would place the client at risk for disseminated intravascular coagulation 5D"@7!

a. "ntrauterine fetal death. b. 6lacenta accreta. c. Dysfunctional labor. d. 6remature rupture of the membranes.

#;.( fullterm client is in labor. $urse =etty is aware that the fetal heart rate would be0

a. >9 to 199 beats:minute b. 199 to 1#9 beats:minute c. 1#9 to 1*9 beats:minute d. 1*9 to 1>9 beats:minute

#>. he skin in the diaper area of a ; month old infant is excoriated and red. $urse +a,el should instruct the mother to0

a. @hange the diaper more often. b. (pply talc powder with diaper changes. c. &ash the area vigorously with each diaper change. d. Decrease the infant's fluid intake to decrease saturating diapers.

#9.$urse @arla knows that the common cardiac anomalies in children with Down Syndrome 5tri?somy #17 is0

a. (trial septal defect b. 6ulmonic stenosis c. 4entricular septal defect d. 2ndocardial cushion defect

)9.Malou was diagnosed with severe preeclampsia is now receiving ".4. magnesium sulfate. he adverse effects associated with magnesium sulfate is0

a. (nemia b. Decreased urine output c. +yperreflexia d. "ncreased respiratory rate

)1.( #) year old client is having her menstrual period every # weeks that last for 1 week. his type of menstrual pattern is bets defined by0

a. Menorrhagia b. Metrorrhagia c. Dyspareunia d. (menorrhea

)#.<annah is admitted to the labor and delivery unit. he critical laboratory

result for this client would be0

a. .xygen saturation b. "ron binding capacity c. =lood typing d. Serum @alcium

)).$urse Eina is aware that the most common condition found during the second?trimester of pregnancy is0

a. Metabolic alkalosis b. %espiratory acidosis c. Mastitis d. 6hysiologic anemia

)-.$urse 3ynette is working in the triage area of an emergency department. She sees that several pediatric clients arrive simultaneously. he client who needs to be treated first is0

a. ( crying 1 year old child with a laceration on his scalp. b. ( - year old child with a barking coughs and flushed appearance. c. ( ) year old child with Down syndrome who is pale and asleep in his mother's arms. d. ( # year old infant with stridorous breath sounds, sitting up in his mother's arms and drooling.

)1.Maureen in her third trimester arrives at the emergency room with painless vaginal bleeding. &hich of the following conditions is suspected!

a. 6lacenta previa b. (bruptio placentae c. 6remature labor d. Sexually transmitted disease

)*.( young child named %ichard is suspected of having pinworms. he community nurse collects a stool specimen to confirm the diagnosis. he nurse should schedule the collection of this specimen for0

a. <ust before bedtime b. (fter the child has been bathe c. (ny time during the day d. 2arly in the morning

);."n doing a child's admission assessment, $urse =etty should be alert to note which signs or symptoms of chronic lead poisoning!

a. "rritability and sei,ures b. Dehydration and diarrhea c. =radycardia and hypotension

d. 6etechiae and hematuria

)>. o evaluate a woman's understanding about the use of diaphragm for family planning, $urse rish asks her to explain how she will use the appliance. &hich response indicates a need for further health teaching!

a. G" should check the diaphragm carefully for holes every time " use itH b. G" may need a different si,e of diaphragm if " gain or lose weight more than #9 poundsH c. G he diaphragm must be left in place for atleast * hours after intercourseH d. G" really need to use the diaphragm and Celly most during the middle of my menstrual cycleH.

)9.+ypoxia is a common complication of laryngotracheobronchitis. $urse .liver should fre/uently assess a child with laryngotracheobronchitis for0

a. Drooling b. Muffled voice c. %estlessness d. 3ow?grade fever

-9.+ow should $urse Michelle guide a child who is blind to walk to the playroom!

a. &ithout touching the child, talk continuously as the child walks down the hall.

b. &alk one step ahead, with the child's hand on the nurse's elbow. c. &alk slightly behind, gently guiding the child forward. d. &alk next to the child, holding the child's hand.

-1.&hen assessing a newborn diagnosed with ductus arteriosus, $urse .livia should expect that the child most likely would have an0

a. 3oud, machinery?like murmur. b. =luish color to the lips. c. Decreased =6 reading in the upper extremities d. "ncreased =6 reading in the upper extremities.

-#. he reason nurse May keeps the neonate in a neutral thermal environment is that when a newborn becomes too cool, the neonate re/uires0

a. 3ess oxygen, and the newborn's metabolic rate increases. b. More oxygen, and the newborn's metabolic rate decreases. c. More oxygen, and the newborn's metabolic rate increases. d. 3ess oxygen, and the newborn's metabolic rate decreases.

-).=efore adding potassium to an infant's ".4. line, $urse %on must be sure to assess whether this infant has0

a. Stable blood pressure

b. 6atant fontanelles c. Moro's reflex d. 4oided

--.$urse @arla should know that the most common causative factor of dermatitis in infants and younger children is0

a. =aby oil b. =aby lotion c. 3aundry detergent d. 6owder with cornstarch

-1.During tube feeding, how far above an infant's stomach should the nurse hold the syringe with formula!

a. * inches b. 1# inches c. 1> inches d. #- inches

-*. "n a mothers' class, $urse 3hynnete discussed childhood diseases such as chicken pox. &hich of the following statements about chicken pox is correct!

a. he older one gets, the more susceptible he becomes to the complications

of chicken pox. b. ( single attack of chicken pox will prevent future episodes, including conditions such as shingles. c. o prevent an outbreak in the community, /uarantine may be imposed by health authorities. d. @hicken pox vaccine is best given when there is an impending outbreak in the community.

-;.=arangay 6inoy had an outbreak of Eerman measles. o prevent congenital rubella, what is the =2S advice that you can give to women in the first trimester of pregnancy in the barangay 6inoy!

a. (dvice them on the signs of Eerman measles. b. (void crowded places, such as markets and movie houses. c. @onsult at the health center where rubella vaccine may be given. d. @onsult a physician who may give them rubella immunoglobulin.

->.Myrna a public health nurse knows that to determine possible sources of sexually transmitted infections, the =2S method that may be undertaken is0

a. @ontact tracing b. @ommunity survey c. Mass screening tests d. "nterview of suspects

-9.( ))?year old female client came for consultation at the health center with the chief complaint of fever for a week. (ccompanying symptoms were muscle pains and body malaise. ( week after the start of fever, the client noted yellowish discoloration of his sclera. +istory showed that he waded in flood waters about # weeks before the onset of symptoms. =ased on her history, which disease condition will you suspect!

a. +epatitis ( b. +epatitis = c. etanus d. 3eptospirosis

19.Mickey a )?year old client was brought to the health center with the chief complaint of severe diarrhea and the passage of Grice waterH stools. he client is most probably suffering from which condition!

a. Eiardiasis b. @holera c. (mebiasis d. Dysentery

11. he most prevalent form of meningitis among children aged # months to ) years is caused by which microorganism!

a. +emophilus influen,ae b. Morbillivirus c. Steptococcus pneumoniae

d. $eisseria meningitidis

1#. he student nurse is aware that the pathognomonic sign of measles is Doplik's spot and you may see Doplik's spot by inspecting the0

a. $asal mucosa b. =uccal mucosa c. Skin on the abdomen d. Skin on neck

1).(ngel was diagnosed as having Dengue fever. Iou will say that there is slow capillary refill when the color of the nailbed that you pressed does not return within how many seconds!

a. ) seconds b. * seconds c. 9 seconds d. 19 seconds

1-."n "ntegrated Management of @hildhood "llness, the nurse is aware that the severe conditions generally re/uire urgent referral to a hospital. &hich of the following severe conditions D.2S $. always re/uire urgent referral to a hospital!

a. Mastoiditis

b. Severe dehydration c. Severe pneumonia d. Severe febrile disease

11.Myrna a public health nurse will conduct outreach immuni,ation in a barangay Masay with a population of about 1199. he estimated number of infants in the barangay would be0

a. -1 infants b. 19 infants c. 11 infants d. *1 infants

1*. he community nurse is aware that the biological used in 2xpanded 6rogram on "mmuni,ation 526"7 should $. be stored in the free,er!

a. D6 b. .ral polio vaccine c. Measles vaccine d. MM%

1;."t is the most effective way of controlling schistosomiasis in an endemic area!

a. 8se of molluscicides b. =uilding of foot bridges c. 6roper use of sanitary toilets d. 8se of protective footwear, such as rubber boots

1>.Several clients is newly admitted and diagnosed with leprosy. &hich of the following clients should be classified as a case of multibacillary leprosy!

a. ) skin lesions, negative slit skin smear b. ) skin lesions, positive slit skin smear c. 1 skin lesions, negative slit skin smear d. 1 skin lesions, positive slit skin smear

19.$urses are aware that diagnosis of leprosy is highly dependent on recognition of symptoms. &hich of the following is an early sign of leprosy!

a. Macular lesions b. "nability to close eyelids c. hickened painful nerves d. Sinking of the nosebridge

*9.Marie brought her 19 month old infant for consultation because of fever, started - days prior to consultation. "n determining malaria risk, what will you

do!

a. 6erform a tourni/uet test. b. (sk where the family resides. c. Eet a specimen for blood smear. d. (sk if the fever is present everyday.

*1.Susie brought her - years old daughter to the %+8 because of cough and colds. Bollowing the "M@" assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital!

a. "nability to drink b. +igh grade fever c. Signs of severe dehydration d. @ough for more than )9 days

*#.<immy a #?year old child revealed Gbaggy pantsH. (s a nurse, using the "M@" guidelines, how will you manage <immy!

a. %efer the child urgently to a hospital for confinement. b. @oordinate with the social worker to enroll the child in a feeding program. c. Make a teaching plan for the mother, focusing on menu planning for her child. d. (ssess and treat the child for health problems like infections and intestinal parasitism.

*).Eina is using .resol in the management of diarrhea of her )?year old child. She asked you what to do if her child vomits. (s a nurse you will tell her to0

a. =ring the child to the nearest hospital for further assessment. b. =ring the child to the health center for intravenous fluid therapy. c. =ring the child to the health center for assessment by the physician. d. 3et the child rest for 19 minutes then continue giving .resol more slowly.

*-.$ikki a 1?month old infant was brought by his mother to the health center because of diarrhea for - to 1 times a day. +er skin goes back slowly after a skin pinch and her eyes are sunken. 8sing the "M@" guidelines, you will classify this infant in which category!

a. $o signs of dehydration b. Some dehydration c. Severe dehydration d. he data is insufficient.

*1.@hris a -?month old infant was brought by her mother to the health center because of cough. +is respiratory rate is -#:minute. 8sing the "ntegrated Management of @hild "llness 5"M@"7 guidelines of assessment, his breathing is considered as0

a. Bast b. Slow c. $ormal

d. "nsignificant

**.Maylene had Cust received her -th dose of tetanus toxoid. She is aware that her baby will have protection against tetanus for

a. 1 year b. ) years c. 1 years d. 3ifetime

*;.$urse %on is aware that unused =@E should be discarded after how many hours of reconstitution!

a. # hours b. - hours c. > hours d. (t the end of the day

*>. he nurse explains to a breastfeeding mother that breast milk is sufficient for all of the baby's nutrient needs only up to0

a. 1 months b. * months c. 1 year

d. # years

*9.$urse %on is aware that the gestational age of a conceptus that is considered viable 5able to live outside the womb7 is0

a. > weeks b. 1# weeks c. #- weeks d. )# weeks

;9.&hen teaching parents of a neonate the proper position for the neonate's sleep, the nurse 6atricia stresses the importance of placing the neonate on his back to reduce the risk of which of the following!

a. (spiration b. Sudden infant death syndrome 5S"DS7 c. Suffocation d. Eastroesophageal reflux 5E2%7

;1.&hich finding might be seen in baby <ames a neonate suspected of having an infection!

a. Blushed cheeks b. "ncreased temperature

c. Decreased temperature d. "ncreased activity level

;#.=aby <enny who is small?for?gestation is at increased risk during the transitional period for which complication!

a. (nemia probably due to chronic fetal hyposia b. +yperthermia due to decreased glycogen stores c. +yperglycemia due to decreased glycogen stores d. 6olycythemia probably due to chronic fetal hypoxia

;).MarCorie has Cust given birth at -# weeks' gestation. &hen the nurse assessing the neonate, which physical finding is expected!

a. ( sleepy, lethargic baby b. 3anugo covering the body c. Des/uamation of the epidermis d. 4ernix caseosa covering the body

;-.(fter reviewing the Myrna's maternal history of magnesium sulfate during labor, which condition would nurse %ichard anticipate as a potential problem in the neonate!

a. +ypoglycemia

b. <itteriness c. %espiratory depression d. achycardia

;1.&hich symptom would indicate the =aby (lexandra was adapting appropriately to extra?uterine life without difficulty!

a. $asal flaring b. 3ight audible grunting c. %espiratory rate -9 to *9 breaths:minute d. %espiratory rate *9 to >9 breaths:minute

;*. &hen teaching umbilical cord care for <ennifer a new mother, the nurse <enny would include which information!

a. (pply peroxide to the cord with each diaper change b. @over the cord with petroleum Celly after bathing c. Deep the cord dry and open to air d. &ash the cord with soap and water each day during a tub bath.

;;.$urse <ohn is performing an assessment on a neonate. &hich of the following findings is considered common in the healthy neonate!

a. Simian crease

b. @onCunctival hemorrhage c. @ystic hygroma d. =ulging fontanelle

;>.Dr. 2steves decides to artificially rupture the membranes of a mother who is on labor. Bollowing this procedure, the nurse +a,el checks the fetal heart tones for which the following reasons!

a. o determine fetal well?being. b. o assess for prolapsed cord c. o assess fetal position d. o prepare for an imminent delivery.

;9.&hich of the following would be least likely to indicate anticipated bonding behaviors by new parents!

a. he parents' willingness to touch and hold the new born. b. he parent's expression of interest about the si,e of the new born. c. he parents' indication that they want to see the newborn. d. he parents' interactions with each other.

>9.Bollowing a precipitous delivery, examination of the clientJs vagina reveals

a fourth?degree laceration. &hich of the following would be contraindicated

when caring for this client! a. (pplying cold to limit edema during the first 1# to #- hours. b. "nstructing the client to use two or more peripads to cushion the area. c. "nstructing the client on the use of sit, baths if ordered. d. "nstructing the client about the importance of perineal 5kegel7 exercises.

>1. ( pregnant woman accompanied by her husband, seeks admission to the labor and delivery area. She states that sheJs in labor and says she attended the facility clinic for prenatal care. &hich /uestion should the nurse .liver ask her first!

a. GDo you have any chronic illnesses!H b. GDo you have any allergies!H c. G&hat is your expected due date!H d. G&ho will be with you during labor!H

>#.( neonate begins to gag and turns a dusky color. &hat should the nurse do first!

a. @alm the neonate. b. $otify the physician. c. 6rovide oxygen via face mask as ordered d. (spirate the neonate's nose and mouth with a bulb syringe.

>). &hen a client states that her Kwater broke,K which of the following actions would be inappropriate for the nurse to do!

a. .bserving the pooling of straw?colored fluid. b. @hecking vaginal discharge with nitra,ine paper. c. @onducting a bedside ultrasound for an amniotic fluid index. d. .bserving for flakes of vernix in the vaginal discharge.

>-. ( baby girl is born > weeks premature. (t birth, she has no spontaneous respirations but is successfully resuscitated. &ithin several hours she develops respiratory grunting, cyanosis, tachypnea, nasal flaring, and retractions. SheJs diagnosed with respiratory distress syndrome, intubated, and placed on a ventilator. &hich nursing action should be included in the babyJs plan of care to prevent retinopathy of prematurity!

a. @over his eyes while receiving oxygen. b. Deep her body temperature low. c. Monitor partial pressure of oxygen 56ao#7 levels. d. +umidify the oxygen.

>1. &hich of the following is normal newborn calorie intake!

a. 119 to 1)9 calories per kg. b. )9 to -9 calories per lb of body weight. c. (t least # ml per feeding

d. 99 to 199 calories per kg

>*. $urse <ohn is knowledgeable that usually individual twins will grow appropriately and at the same rate as singletons until how many weeks!

a. 1* to 1> weeks b. 1> to ## weeks c. )9 to )# weeks d. )> to -9 weeks

>;. &hich of the following classifications applies to mono,ygotic twins for whom the cleavage of the fertili,ed ovum occurs more than 1) days after fertili,ation!

a. conCoined twins b. diamniotic dichorionic twins c. diamniotic monochorionic twin d. monoamniotic monochorionic twins

>>. yra experienced painless vaginal bleeding has Cust been diagnosed as having a placenta previa. &hich of the following procedures is usually performed to diagnose placenta previa!

a. (mniocentesis b. Digital or speculum examination

c. 2xternal fetal monitoring d. 8ltrasound

>9. $urse (rnold knows that the following changes in respiratory functioning during pregnancy is considered normal0

a. "ncreased tidal volume b. "ncreased expiratory volume c. Decreased inspiratory capacity d. Decreased oxygen consumption

99. 2mily has gestational diabetes and it is usually managed by which of the following therapy!

a. Diet b. 3ong?acting insulin c. .ral hypoglycemic d. .ral hypoglycemic drug and insulin

91. Magnesium sulfate is given to <emma with preeclampsia to prevent which of the following condition!

a. +emorrhage b. +ypertension

c. +ypomagnesemia d. Sei,ure

9#. @ammile with sickle cell anemia has an increased risk for having a sickle cell crisis during pregnancy. (ggressive management of a sickle cell crisis includes which of the following measures!

a. (ntihypertensive agents b. Diuretic agents c. ".4. fluids d. (cetaminophen 5 ylenol7 for pain

9). &hich of the following drugs is the antidote for magnesium toxicity!

a. @alcium gluconate 5Dalcinate7 b. +ydrala,ine 5(presoline7 c. $aloxone 5$arcan7 d. %ho 5D7 immune globulin 5%hoE(M7

9-. Marlyn is screened for tuberculosis during her first prenatal visit. (n intradermal inCection of purified protein derivative 566D7 of the tuberculin bacilli is given. She is considered to have a positive test for which of the following results!

a. (n indurated wheal under 19 mm in diameter appears in * to 1# hours.

b. (n indurated wheal over 19 mm in diameter appears in -> to ;# hours. c. ( flat circumcised area under 19 mm in diameter appears in * to 1# hours. d. ( flat circumcised area over 19 mm in diameter appears in -> to ;# hours.

91. Dianne, #- year?old is #; weeks' pregnant arrives at her physician's office with complaints of fever, nausea, vomiting, malaise, unilateral flank pain, and costovertebral angle tenderness. &hich of the following diagnoses is most likely!

a. (symptomatic bacteriuria b. =acterial vaginosis c. 6yelonephritis d. 8rinary tract infection 58 "7

9*. %h isoimmuni,ation in a pregnant client develops during which of the following conditions!

a. %h?positive maternal blood crosses into fetal blood, stimulating fetal antibodies. b. %h?positive fetal blood crosses into maternal blood, stimulating maternal antibodies. c. %h?negative fetal blood crosses into maternal blood, stimulating maternal antibodies. d. %h?negative maternal blood crosses into fetal blood, stimulating fetal antibodies.

9;. o promote comfort during labor, the nurse <ohn advises a client to assume certain positions and avoid others. &hich position may cause maternal hypotension and fetal hypoxia!

a. 3ateral position b. S/uatting position c. Supine position d. Standing position

9>. @eleste who used heroin during her pregnancy delivers a neonate. &hen assessing the neonate, the nurse 3hynnette expects to find0

a. 3ethargy # days after birth. b. "rritability and poor sucking. c. ( flattened nose, small eyes, and thin lips. d. @ongenital defects such as limb anomalies.

99. he uterus returns to the pelvic cavity in which of the following time frames!

a. ;th to 9th day postpartum. b. # weeks postpartum. c. 2nd of *th week postpartum. d. &hen the lochia changes to alba.

199. Maureen, a primigravida client, age #9, has Cust completed a difficult, forceps?assisted delivery of twins. +er labor was unusually long and re/uired oxytocin 56itocin7 augmentation. he nurse whoJs caring for her should stay alert for0

a. 8terine inversion b. 8terine atony c. 8terine involution d. 8terine discomfort

1. (nswer0 5(7 "nevitable %ationale0 (n inevitable abortion is termination of pregnancy that cannot be prevented. Moderate to severe bleeding with mild cramping and cervical dilation would be noted in this type of abortion.

#. (nswer0 5=7 +istory of syphilis %ationale0 Maternal infections such as syphilis, toxoplasmosis, and rubella are causes of spontaneous abortion.

). (nswer0 5@7 Monitoring apical pulse %ationale0 $ursing care for the client with a possible ectopic pregnancy is focused on preventing or identifying hypovolemic shock and controlling pain. (n elevated pulse rate is an indicator of shock.

-. (nswer0 5=7 "ncreased caloric intake

%ationale0 Elucose crosses the placenta, but insulin does not. +igh fetal demands for glucose, combined with the insulin resistance caused by hormonal changes in the last half of pregnancy can result in elevation of maternal blood glucose levels. his increases the mother's demand for insulin and is referred to as the diabetogenic effect of pregnancy.

1. (nswer0 5(7 2xcessive fetal activity. %ationale0 he most common signs and symptoms of hydatidiform mole includes elevated levels of human chorionic gonadotropin, vaginal bleeding, larger than normal uterus for gestational age, failure to detect fetal heart activity even with sensitive instruments, excessive nausea and vomiting, and early development of pregnancy?induced hypertension. Betal activity would not be noted.

*. (nswer0 5=7 (bsent patellar reflexes %ationale0 (bsence of patellar reflexes is an indicator of hypermagnesemia, which re/uires administration of calcium gluconate.

;. (nswer0 5@7 6resenting part in # cm below the plane of the ischial spines. %ationale0 Betus at station plus two indicates that the presenting part is # cm below the plane of the ischial spines.

>. (nswer0 5(7 @ontractions every 1 A minutes lasting ;9?>9 seconds. %ationale0 @ontractions every 1 A minutes lasting ;9?>9 seconds, is indicative of hyperstimulation of the uterus, which could result in inCury to the mother and the fetus if 6itocin is not discontinued.

9. (nswer0 5@7 2DE tracings %ationale0 ( potential side effect of calcium gluconate administration is cardiac arrest. @ontinuous monitoring of cardiac activity 52DE7 throught administration of calcium gluconate is an essential part of care.

19. (nswer0 5D7 Birst low transverse caesarean was for breech position. Betus in this pregnancy is in a vertex presentation. %ationale0 his type of client has no obstetrical indication for a caesarean section as she did with her first caesarean delivery.

11. (nswer0 5(7 alk to the mother first and then to the toddler. %ationale0 &hen dealing with a crying toddler, the best approach is to talk to the mother and ignore the toddler first. his approach helps the toddler get used to the nurse before she attempts any procedures. "t also gives the toddler an opportunity to see that the mother trusts the nurse.

1#. (nswer0 5D7 6lace the infant's arms in soft elbow restraints. %ationale0 Soft restraints from the upper arm to the wrist prevent the infant from touching her lip but allow him to hold a favorite item such as a blanket. =ecause they could damage the operative site, such as obCects as pacifiers, suction catheters, and small spoons shouldn't be placed in a baby's mouth after cleft repair. ( baby in a prone position may rub her face on the sheets and traumati,e the operative site. he suture line should be cleaned gently to prevent infection, which could interfere with healing and damage the cosmetic appearance of the repair.

1). (nswer0 5=7 (llow the infant to rest before feeding. %ationale0 =ecause feeding re/uires so much energy, an infant with heart failure should rest before feeding.

1-. (nswer0 5@7 "ron?rich formula only. %ationale0 he infants at age 1 months should receive iron?rich formula and that they shouldn't receive solid food, even baby food until age * months.

11. (nswer0 5D7 19 months %ationale0 ( 19 month old infant can sit alone and understands obCect permanence, so he would look for the hidden toy. (t age - to * months,

infants can't sit securely alone. (t age > months, infants can sit securely alone but cannot understand the permanence of obCects.

1*. (nswer0 5D7 6ublic health nursing focuses on preventive, not curative, services. %ationale0 he catchments area in 6+$ consists of a residential community, many of whom are well individuals who have greater need for preventive rather than curative services.

1;. (nswer0 5=7 2fficiency %ationale0 2fficiency is determining whether the goals were attained at the least possible cost.

1>. (nswer0 5D7 %ural +ealth 8nit %ationale0 %.(. ;1*9 devolved basic health services to local government units 53E8's 7. he public health nurse is an employee of the 3E8.

19. (nswer0 5(7 Mayor %ationale0 he local executive serves as the chairman of the Municipal +ealth =oard.

#9. (nswer0 5(7 1 %ationale0 2ach rural health midwife is given a population assignment of about 1,999.

#1. (nswer0 5=7 +ealth education and community organi,ing are necessary in providing community health services. %ationale0 he community health nurse develops the health capability of people through health education and community organi,ing activities.

##. (nswer0 5=7 Measles %ationale0 6residential 6roclamation $o. - is on the 3igtas igdas 6rogram.

#). (nswer0 5D7 @ore group formation %ationale0 "n core group formation, the nurse is able to transfer the technology of community organi,ing to the potential or informal community leaders through a training program.

#-. (nswer0 5D7 o maximi,e the community's resources in dealing with health problems. %ationale0 @ommunity organi,ing is a developmental service, with the goal of developing the people's self?reliance in dealing with community health problems. (, = and @ are obCectives of contributory obCectives to this goal.

#1. (nswer0 5D7 erminal %ationale0 ertiary prevention involves rehabilitation, prevention of permanent disability and disability limitation appropriate for convalescents, the disabled, complicated cases and the terminally ill 5those in the terminal stage of a disease7.

#*. (nswer0 5(7 "ntrauterine fetal death. %ationale0 "ntrauterine fetal death, abruptio placentae, septic shock, and amniotic fluid embolism may trigger normal clotting mechanismsF if clotting factors are depleted, D"@ may occur. 6lacenta accreta, dysfunctional labor, and premature rupture of the membranes arenJt associated with D"@.

#;. (nswer0 5@7 1#9 to 1*9 beats:minute %ationale0 ( rate of 1#9 to 1*9 beats:minute in the fetal heart appropriate for filling the heart with blood and pumping it out to the system.

#>. (nswer0 5(7 @hange the diaper more often. %ationale0 Decreasing the amount of time the skin comes contact with wet soiled diapers will help heal the irritation.

#9. (nswer0 5D7 2ndocardial cushion defect %ationale0 2ndocardial cushion defects are seen most in children with Down syndrome, asplenia, or polysplenia.

)9. (nswer0 5=7 Decreased urine output %ationale0 Decreased urine output may occur in clients receiving ".4. magnesium and should be monitored closely to keep urine output at greater than )9 ml:hour, because magnesium is excreted through the kidneys and can easily accumulate to toxic levels.

)1. (nswer0 5(7 Menorrhagia %ationale0 Menorrhagia is an excessive menstrual period.

)#. (nswer0 5@7 =lood typing %ationale0 =lood type would be a critical value to have because the risk of blood loss is always a potential complication during the labor and delivery process. (pproximately -9L of a woman's cardiac output is delivered to the uterus, therefore, blood loss can occur /uite rapidly in the event of uncontrolled bleeding.

)). (nswer0 5D7 6hysiologic anemia %ationale0 +emoglobin values and hematocrit decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.

)-. (nswer0 5D7 ( # year old infant with stridorous breath sounds, sitting up in

his mother's arms and drooling. %ationale0 he infant with the airway emergency should be treated first, because of the risk of epiglottitis.

)1. (nswer0 5(7 6lacenta previa %ationale0 6lacenta previa with painless vaginal bleeding.

)*. (nswer0 5D7 2arly in the morning %ationale0 =ased on the nurse's knowledge of microbiology, the specimen should be collected early in the morning. he rationale for this timing is that, because the female worm lays eggs at night around the perineal area, the first bowel movement of the day will yield the best results. he specific type of stool specimen used in the diagnosis of pinworms is called the tape test.

);. (nswer0 5(7 "rritability and sei,ures %ationale0 3ead poisoning primarily affects the @$S, causing increased intracranial pressure. his condition results in irritability and changes in level of consciousness, as well as sei,ure disorders, hyperactivity, and learning disabilities.

)>. (nswer0 5D7 G" really need to use the diaphragm and Celly most during the middle of my menstrual cycleH. %ationale0 he woman must understand that, although the GfertileH period is approximately mid?cycle, hormonal variations do occur and can result in early or late ovulation. o be effective, the diaphragm should be inserted before every intercourse.

)9. (nswer0 5@7 %estlessness %ationale0 "n a child, restlessness is the earliest sign of hypoxia. 3ate signs of hypoxia in a child are associated with a change in color, such as pallor or

cyanosis.

-9. (nswer0 5=7 &alk one step ahead, with the child's hand on the nurse's elbow. %ationale0 his procedure is generally recommended to follow in guiding a person who is blind.

-1. (nswer0 5(7 3oud, machinery?like murmur. %ationale0 ( loud, machinery?like murmur is a characteristic finding associated with patent ductus arteriosus.

-#. (nswer0 5@7 More oxygen, and the newborn's metabolic rate increases. %ationale0 &hen cold, the infant re/uires more oxygen and there is an increase in metabolic rate. $on?shievering thermogenesis is a complex process that increases the metabolic rate and rate of oxygen consumption, therefore, the newborn increase heat production.

-). (nswer0 5D7 4oided %ationale0 =efore administering potassium ".4. to any client, the nurse must first check that the client's kidneys are functioning and that the client is voiding. "f the client is not voiding, the nurse should withhold the potassium and notify the physician.

--. (nswer0 5c7 3aundry detergent %ationale0 2c,ema or dermatitis is an allergic skin reaction caused by an offending allergen. he topical allergen that is the most common causative factor is laundry detergent.

-1. (nswer0 5(7 * inches %ationale0 his distance allows for easy flow of the formula by gravity, but the flow will be slow enough not to overload the stomach too rapidly.

-*. (nswer0 5(7 he older one gets, the more susceptible he becomes to the complications of chicken pox. %ationale0 @hicken pox is usually more severe in adults than in children. @omplications, such as pneumonia, are higher in incidence in adults.

-;. (nswer0 5D7 @onsult a physician who may give them rubella immunoglobulin. %ationale0 %ubella vaccine is made up of attenuated Eerman measles viruses. his is contraindicated in pregnancy. "mmune globulin, a specific prophylactic against Eerman measles, may be given to pregnant women.

->. (nswer0 5(7 @ontact tracing %ationale0 @ontact tracing is the most practical and reliable method of finding possible sources of person?to?person transmitted infections, such as sexually transmitted diseases.

-9. (nswer0 5D7 3eptospirosis %ationale0 3eptospirosis is transmitted through contact with the skin or mucous membrane with water or moist soil contaminated with urine of infected animals, like rats.

19. (nswer0 5=7 @holera %ationale0 6assage of profuse watery stools is the maCor symptom of cholera. =oth amebic and bacillary dysentery are characteri,ed by the presence of blood and:or mucus in the stools. Eiardiasis is characteri,ed by fat malabsorption and, therefore, steatorrhea.

11. (nswer0 5(7 +emophilus influen,ae %ationale0 +emophilus meningitis is unusual over the age of 1 years. "n developing countries, the peak incidence is in children less than * months of

age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and $eisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

1#. (nswer0 5=7 =uccal mucosa %ationale0 Doplik's spot may be seen on the mucosa of the mouth or the throat.

1). (nswer0 5(7 ) seconds %ationale0 (de/uate blood supply to the area allows the return of the color of the nailbed within ) seconds.

1-. (nswer0 5=7 Severe dehydration %ationale0 he order of priority in the management of severe dehydration is as follows0 intravenous fluid therapy, referral to a facility where "4 fluids can be initiated within )9 minutes, .resol or nasogastric tube. &hen the foregoing measures are not possible or effective, then urgent referral to the hospital is done.

11. (nswer0 5(7 -1 infants %ationale0 o estimate the number of infants, multiply total population by )L.

1*. (nswer0 5(7 D6 %ationale0 D6 is sensitive to free,ing. he appropriate storage temperature of D6 is # to >M @ only. .64 and measles vaccine are highly sensitive to heat and re/uire free,ing. MM% is not an immuni,ation in the 2xpanded 6rogram on "mmuni,ation.

1;. (nswer0 5@7 6roper use of sanitary toilets %ationale0 he ova of the parasite get out of the human body together with

feces. @utting the cycle at this stage is the most effective way of preventing the spread of the disease to susceptible hosts.

1>. (nswer0 5D7 1 skin lesions, positive slit skin smear %ationale0 ( multibacillary leprosy case is one who has a positive slit skin smear and at least 1 skin lesions.

19. (nswer0 5@7 hickened painful nerves %ationale0 he lesion of leprosy is not macular. "t is characteri,ed by a change in skin color 5either reddish or whitish7 and loss of sensation, sweating and hair growth over the lesion. "nability to close the eyelids 5lagophthalmos7 and sinking of the nosebridge are late symptoms.

*9. (nswer0 5=7 (sk where the family resides. %ationale0 =ecause malaria is endemic, the first /uestion to determine malaria risk is where the client's family resides. "f the area of residence is not a known endemic area, ask if the child had traveled within the past * months, where she was brought and whether she stayed overnight in that area.

*1. (nswer0 5(7 "nability to drink %ationale0 ( sick child aged # months to 1 years must be referred urgently to a hospital if he:she has one or more of the following signs0 not able to feed or drink, vomits everything, convulsions, abnormally sleepy or difficult to awaken.

*#. (nswer0 5(7 %efer the child urgently to a hospital for confinement. %ationale0 G=aggy pantsH is a sign of severe marasmus. he best management is urgent referral to a hospital.

*). (nswer0 5D7 3et the child rest for 19 minutes then continue giving .resol more slowly.

%ationale0 "f the child vomits persistently, that is, he vomits everything that he takes in, he has to be referred urgently to a hospital. .therwise, vomiting is managed by letting the child rest for 19 minutes and then continuing with .resol administration. each the mother to give .resol more slowly.

*-. (nswer0 5=7 Some dehydration %ationale0 8sing the assessment guidelines of "M@", a child 5# months to 1 years old7 with diarrhea is classified as having S.M2 D2+ID%( ".$ if he shows # or more of the following signs0 restless or irritable, sunken eyes, the skin goes back slow after a skin pinch.

*1. (nswer0 5@7 $ormal %ationale0 "n "M@", a respiratory rate of 19:minute or more is fast breathing for an infant aged # to 1# months.

**. (nswer0 5(7 1 year %ationale0 he baby will have passive natural immunity by placental transfer of antibodies. he mother will have active artificial immunity lasting for about 19 years. 1 doses will give the mother lifetime protection.

*;. (nswer0 5=7 - hours %ationale0 &hile the unused portion of other biologicals in 26" may be given until the end of the day, only =@E is discarded - hours after reconstitution. his is why =@E immuni,ation is scheduled only in the morning.

*>. (nswer0 5=7 * months %ationale0 (fter * months, the baby's nutrient needs, especially the baby's iron re/uirement, can no longer be provided by mother's milk alone.

*9. (nswer0 5@7 #- weeks %ationale0 (t approximately #) to #- weeks' gestation, the lungs are developed enough to sometimes maintain extrauterine life. he lungs are the most immature system during the gestation period. Medical care for premature labor begins much earlier 5aggressively at #1 weeks' gestation7

;9. (nswer0 5=7 Sudden infant death syndrome 5S"DS7 %ationale0 Supine positioning is recommended to reduce the risk of S"DS in infancy. he risk of aspiration is slightly increased with the supine position. Suffocation would be less likely with an infant supine than prone and the position for E2% re/uires the head of the bed to be elevated.

;1. (nswer0 5@7 Decreased temperature %ationale0 emperature instability, especially when it results in a low temperature in the neonate, may be a sign of infection. he neonate's color often changes with an infection process but generally becomes ashen or mottled. he neonate with an infection will usually show a decrease in activity level or lethargy.

;#. (nswer0 5D7 6olycythemia probably due to chronic fetal hypoxia %ationale0 he small?for?gestation neonate is at risk for developing polycythemia during the transitional period in an attempt to decrease hypoxia. he neonates are also at increased risk for developing hypoglycemia and hypothermia due to decreased glycogen stores.

;). (nswer0 5@7 Des/uamation of the epidermis %ationale0 6ostdate fetuses lose the vernix caseosa, and the epidermis may become des/uamated. hese neonates are usually very alert. 3anugo is missing in the postdate neonate.

;-. (nswer0 5@7 %espiratory depression %ationale0 Magnesium sulfate crosses the placenta and adverse neonatal effects are respiratory depression, hypotonia, and bradycardia. he serum blood sugar isn't affected by magnesium sulfate. he neonate would be floppy, not Cittery.

;1. (nswer0 5@7 %espiratory rate -9 to *9 breaths:minute %ationale0 ( respiratory rate -9 to *9 breaths:minute is normal for a neonate during the transitional period. $asal flaring, respiratory rate more than *9 breaths:minute, and audible grunting are signs of respiratory distress.

;*. (nswer0 5@7 Deep the cord dry and open to air %ationale0 Deeping the cord dry and open to air helps reduce infection and hastens drying. "nfants aren't given tub bath but are sponged off until the cord falls off. 6etroleum Celly prevents the cord from drying and encourages infection. 6eroxide could be painful and isn't recommended.

;;. (nswer0 5=7 @onCunctival hemorrhage %ationale0 @onCunctival hemorrhages are commonly seen in neonates secondary to the cranial pressure applied during the birth process. =ulging fontanelles are a sign of intracranial pressure. Simian creases are present in -9L of the neonates with trisomy #1. @ystic hygroma is a neck mass that can affect the airway.

;>. (nswer0 5=7 o assess for prolapsed cord %ationale0 (fter a client has an amniotomy, the nurse should assure that the cord isnJt prolapsed and that the baby tolerated the procedure well. he most effective way to do this is to check the fetal heart rate. Betal well?being is assessed via a nonstress test. Betal position is determined by vaginal examination. (rtificial rupture of membranes doesnJt indicate an imminent delivery.

;9. (nswer0 5D7 he parents' interactions with each other.

%ationale0 6arental interaction will provide the nurse with a good assessment of the stability of the familyJs home life but it has no indication for parental bonding. &illingness to touch and hold the newborn, expressing interest about the newbornJs si,e, and indicating a desire to see the newborn are behaviors indicating parental bonding.

>9. (nswer0 5=7 "nstructing the client to use two or more peripads to cushion the area %ationale0 8sing two or more peripads would do little to reduce the pain or promote perineal healing. @old applications, sit, baths, and Degel exercises are important measures when the client has a fourth?degree laceration.

>1. (nswer0 5@7 G&hat is your expected due date!H %ationale0 &hen obtaining the history of a client who may be in labor, the nurseJs highest priority is to determine her current status, particularly her due date, gravidity, and parity. Eravidity and parity affect the duration of labor and the potential for labor complications. 3ater, the nurse should ask about chronic illnesses, allergies, and support persons.

>#. (nswer0 5D7 (spirate the neonate's nose and mouth with a bulb syringe. %ationale0 he nurseJs first action should be to clear the neonateJs airway with a bulb syringe. (fter the airway is clear and the neonateJs color improves, the nurse should comfort and calm the neonate. "f the problem recurs or the neonateJs color doesnJt improve readily, the nurse should notify the physician. (dministering oxygen when the airway isnJt clear would be ineffective.

>). (nswer0 5@7 @onducting a bedside ultrasound for an amniotic fluid index. %ationale0 "t isnJt within a nurseJs scope of practice to perform and interpret a bedside ultrasound under these conditions and without speciali,ed training. .bserving for pooling of straw?colored fluid, checking vaginal discharge with nitra,ine paper, and observing for flakes of vernix are appropriate assessments for determining whether a client has ruptured

membranes.

>-. (nswer0 5@7 Monitor partial pressure of oxygen 56ao#7 levels. %ationale0 Monitoring 6a.# levels and reducing the oxygen concentration to keep 6a.# within normal limits reduces the risk of retinopathy of prematurity in a premature infant receiving oxygen. @overing the infantJs eyes and humidifying the oxygen donJt reduce the risk of retinopathy of prematurity. =ecause cooling increases the risk of acidosis, the infant should be kept warm so that his respiratory distress isnJt aggravated.

>1. (nswer0 5(7 119 to 1)9 calories per kg. %ationale0 @alories per kg is the accepted way of determined appropriate nutritional intake for a newborn. he recommended calorie re/uirement is 119 to 1)9 calories per kg of newborn body weight. his level will maintain a consistent blood glucose level and provide enough calories for continued growth and development.

>*. (nswer0 5@7 )9 to )# weeks %ationale0 "ndividual twins usually grow at the same rate as singletons until )9 to )# weeks' gestation, then twins don't' gain weight as rapidly as singletons of the same gestational age. he placenta can no longer keep pace with the nutritional re/uirements of both fetuses after )# weeks, so there's some growth retardation in twins if they remain in utero at )> to -9 weeks.

>;. (nswer0 5(7 conCoined twins %ationale0 he type of placenta that develops in mono,ygotic twins depends on the time at which cleavage of the ovum occurs. @leavage in conCoined twins occurs more than 1) days after fertili,ation. @leavage that occurs less than ) day after fertili,ation results in diamniotic dicchorionic twins. @leavage that occurs between days ) and > results in diamniotic monochorionic twins. @leavage that occurs between days > to 1) result in monoamniotic monochorionic twins.

>>. (nswer0 5D7 8ltrasound %ationale0 .nce the mother and the fetus are stabili,ed, ultrasound evaluation of the placenta should be done to determine the cause of the bleeding. (mniocentesis is contraindicated in placenta previa. ( digital or speculum examination shouldn't be done as this may lead to severe bleeding or hemorrhage. 2xternal fetal monitoring won't detect a placenta previa, although it will detect fetal distress, which may result from blood loss or placenta separation.

>9. (nswer0 5(7 "ncreased tidal volume %ationale0 ( pregnant client breathes deeper, which increases the tidal volume of gas moved in and out of the respiratory tract with each breath. he expiratory volume and residual volume decrease as the pregnancy progresses. he inspiratory capacity increases during pregnancy. he increased oxygen consumption in the pregnant client is 11L to #9L greater than in the nonpregnant state.

99. (nswer0 5(7 Diet %ationale0 @lients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. .ral hypoglycemic drugs are contraindicated in pregnancy. 3ong?acting insulin usually isn't needed for blood glucose control in the client with gestational diabetes.

91. (nswer0 5D7 Sei,ure %ationale0 he anticonvulsant mechanism of magnesium is believes to depress sei,ure foci in the brain and peripheral neuromuscular blockade. +ypomagnesemia isn't a complication of preeclampsia. (ntihypertensive drug other than magnesium are preferred for sustained hypertension. Magnesium doesn't help prevent hemorrhage in preeclamptic clients.

9#. (nswer0 5@7 ".4. fluids %ationale0 ( sickle cell crisis during pregnancy is usually managed by exchange transfusion oxygen, and 3.4. Bluids. he client usually needs a

stronger analgesic than acetaminophen to control the pain of a crisis. (ntihypertensive drugs usually aren't necessary. Diuretic wouldn't be used unless fluid overload resulted.

9). (nswer0 5(7 @alcium gluconate 5Dalcinate7 %ationale0 @alcium gluconate is the antidote for magnesium toxicity. en milliliters of 19L calcium gluconate is given 3.4. push over ) to 1 minutes. +ydrala,ine is given for sustained elevated blood pressure in preeclamptic clients. %ho 5D7 immune globulin is given to women with %h?negative blood to prevent antibody formation from %+?positive conceptions. $aloxone is used to correct narcotic toxicity.

9-. (nswer0 5=7 (n indurated wheal over 19 mm in diameter appears in -> to ;# hours. %ationale0 ( positive 66D result would be an indurated wheal over 19 mm in diameter that appears in -> to ;# hours. he area must be a raised wheal, not a flat circumcised area to be considered positive.

91. (nswer0 5@7 6yelonephritis %ational0 he symptoms indicate acute pyelonephritis, a serious condition in a pregnant client. 8 " symptoms include dysuria, urgency, fre/uency, and suprapubic tenderness. (symptomatic bacteriuria doesn't cause symptoms. =acterial vaginosis causes milky white vaginal discharge but no systemic symptoms.

9*. (nswer0 5=7 %h?positive fetal blood crosses into maternal blood, stimulating maternal antibodies. %ationale0 %h isoimmuni,ation occurs when %h?positive fetal blood cells cross into the maternal circulation and stimulate maternal antibody production. "n subse/uent pregnancies with %h?positive fetuses, maternal antibodies may cross back into the fetal circulation and destroy the fetal blood cells.

9;. (nswer0 5@7 Supine position %ationale0 he supine position causes compression of the clientJs aorta and inferior vena cava by the fetus. his, in turn, inhibits maternal circulation, leading to maternal hypotension and, ultimately, fetal hypoxia. he other positions promote comfort and aid labor progress. Bor instance, the lateral, or side?lying, position improves maternal and fetal circulation, enhances comfort, increases maternal relaxation, reduces muscle tension, and eliminates pressure points. he s/uatting position promotes comfort by taking advantage of gravity. he standing position also takes advantage of gravity and aligns the fetus with the pelvic angle.

9>. (nswer0 5=7 "rritability and poor sucking. %ationale0 $eonates of heroin?addicted mothers are physically dependent on the drug and experience withdrawal when the drug is no longer supplied. Signs of heroin withdrawal include irritability, poor sucking, and restlessness. 3ethargy isnJt associated with neonatal heroin addiction. ( flattened nose, small eyes, and thin lips are seen in infants with fetal alcohol syndrome. +eroin use during pregnancy hasnJt been linked to specific congenital anomalies.

99. (nswer0 5(7 ;th to 9th day postpartum %ationale0 he normal involutional process returns the uterus to the pelvic cavity in ; to 9 days. ( significant involutional complication is the failure of the uterus to return to the pelvic cavity within the prescribed time period. his is known as subinvolution.

199. (nswer0 5=7 8terine atony %ationale0 Multiple fetuses, extended labor stimulation with oxytocin, and traumatic delivery commonly are associated with uterine atony, which may lead to postpartum hemorrhage. 8terine inversion may precede or follow delivery and commonly results from apparent excessive traction on the umbilical cord and attempts to deliver the placenta manually. 8terine involution and some uterine discomfort are normal after delivery.