ST.

LOUIS REVIEW CENTER NURSING REVIEW Pedia ANSWER KEYS

1. A baby girl was born at 9:15 A.M. At 9:20A.M. her heart rate was 132 beats per minute, she was crying vigorously, moving all e tremities, an! only her han!s an! "eet were still slightly blue. #he nurse shoul! enter her Apgar score as: a. $ b. % c. 9 !. 10

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51. B. This response points out really and allows the client to elaborate 52. A. This opens up an area of communication to get at what really is troubling the mother about feeding the baby 53. C. Rooming in pro ides time for the mother and infant to be together! the mother can become ac"uainted with the infant more "uic#ly 5$. A. %urses with positi e attitudes toward abortion should counsel women who are thin#ing of undergoing the procedure! they should #now what ser ices are a ailable and the arious methods that are used to induce abortion 55. B. Because mothering is not an inborn instinct& almost all mothers& including multiparas& report some ambi alence and an'iety about their ability to be good mothers B. (amily)centered childbearing should adapt needs to the cultural system whene er possible C. *% an emergency surgical situation when in asi e are necessary& it is important to ha e a consent signed as well as a history to the client+s #nown allergies A. This response pro ides the client with a comfort measure while gi ing her an opportunity to erbali,e her fears about ha ing an abnormal labor B. Both the father and the mother need additional support during the transitional stage of labor D. -others need to e'plore their infants isually and tactilely to assure themsel es that the infants are normal in all respects C. Allowing the mother time to inspect the child permits iewing& touching& and holding& promoting bonding C. Bonding between parent and baby is most successful when interaction is possible right after birth! if the child is ill& contact its limited C. C. 1arenting is not an inborn instinct but rather a learned beha ior based on the past e'periences or current instruction C. (amily)centered maternity care focuses on the whole family! including the relati es in the care will be most therapeutic for the client A. 4eparin is used because its molecular si,e is too large to pass the placental barrier B. -aternal hypotension is a common complication of this anesthesia for labor and nausea is one of the first clues that this has occurred. 5le ating the e'tremities restores blood to the central circulation B. 6'ytocin is a small polypeptide hormone normally synthesi,ed in the hypothalamus and secreted from the neurohypophysis during parturition or suc#ling the synthetic form promotes powerful uterine 2 smooth muscle3 contractions and thus is used to induce labor C. Respiratory depression occurs with the use of meperidine 7 8emerol9 and produces significant depression of the infant at birth if circulating le els are high 8. -eperidine 7 8emerol9 is classified as a narcotic analgesic drug and is effecti e for the relief of pain

15. C. Terbutaline sulfate 7 Brethine9 is a betamimetic drug acts on the smooth muscles of the uterus to reduce contractility& which in turn inhibits dilation and contractions

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1.. 8. The *:8 may cause irritability of the myometrium& inducing contraction of the uterus and e'pulsion of the de ice

the true conBugate uses the upper ridge of the symphysis pubis anteriorly but cannot be measured on a li ing woman 33. 8. 1rogesterone acts to reduce contractility of the uterine musculature and to maintain the decidual bed

1/. 8. ;perm are damaged by copper *:8s& while progesterone *:8s interfere with endometrial maturation

31. 10. B. *t is the surge of <4 secretion in midcycle that is responsible for o ulation

C. The blood olume increases by appro'imately 53C during pregnancy. 1ea# blood olume occurs between 33 to 3$ wee#s of gestation

12. C. The o um is capable of being fertili,ed for only 2$ to 3. hours following o ulation! after this time it tra els a ariable distance between the fallopian tube and uterus& disintegrates& and is phagocyti,ed by leu#ocytes 23. B. As o ulation approaches& there may be a drop in the basal temperature because of an increased production of estrogen! when o ulation occurs there will be a rise in the basal temperature because of an increased production of progesterone 21. 8. This commonly occurs when clients first start on oral contracepti e! it is midcycle bleeding and if it persists& pill dosage is changed

32. 8. A purplish color results form the increased ascularity and blood essel engorgement of the agina

33. B. There is a 33C to 53C increase in maternal plasma olume at the end of the first trimester& leading to a decrease in the concentration of hemoglobin and erythrocytes 3$. 8. A normal cardiopulmonary symptom in pregnancy caused by increased entricular rate and ele ated diaphragm

35. A. -enstruation during pregnancy is interrupted secretion of the o arian hormones ceases. This response answers the client+s "uestion in understandable terms. 22. C. There are monophasic& biphasic and triphasic oral contracepti es! regardless of which is prescribed the regimen should be followed e'actly. *nterruption permits release of luteini,ing hormone& resulting in o ulation and possible pregnancy 23. C. This is necessary to protect the incisional area because sutures may slip with pulling or stretching 2$. A. =hen placental formation is complete around the twelfth wee# of pregnancy& it produces progesterone and estrogen 25. B. The umbilical ein carries blood high in o'ygen form the placenta and empties it into the fetal ena ca a by way of the ductus enosus 2.. 8. %agale+s rule is an indirect& nonin asi e method for estimating the date of birth> 58B ?<-1 @/ days A months @ 1year 2/. A. :sing %agele+s rule& subtract 3 months add 1 year and / days to the first day of the last menstrual period

3.. B. This test determines the number and condition of sperm aspirated from the cer i' within two hours after coitus 3/. 8. This test enables the e'aminer to isuali,e the uterus and fallopian tubes and the pel ic organs for reproduction 30. B. The amnion encloses the embryo and the shoc#) protecti e amniotic fluid in which the embryo floats 32. C. 1rogesterone stimulates differentiation of the endometrium into a secretory type of tissue

20. 8. *ncreasing the client+s #nowledge of physical and psychologic changes resulting from pregnancy is done during the first trimester 22. B. The diagonal conBugate is an estimation of the true conBugate with the lower edge of the symphysis pubis used as its anterior point and the sacral promontory posteriorly!

$3. 8. This is the result of a reduced chromosome number& form $. to 23 readying the se' cells for fertili,ation

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$1. C. (ollicle stimulating hormone is secreted form the anterior pituitary gland

$2. B. *% the first / to 1$ the de eloping o um is #nown as a blastocyst! it is called embryo until the eight wee#! the de eloping cells are then called a fetus until birth

$3. B. To allow for the larger inta#e of air the normal adaptation is to increase the si,e of the thoracic ca ity

$$. C. By this time the fetus and placenta ha e gown& e'panding the si,e of the uterus e'pands into the abdominal ca ity

$5. B. The word originates form the -iddle 5nglish word "uic#& which means ali e

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