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• Maternal and Child Health Nurse Test Part 2
• Maternal and Child Health Nurse Test Part 1
• Dehydration: Types, Causes and Treatment
• Behavior Modification
• Thalassemias

Maternal and Child Health Nurse Test Part 2 Posted: 14 Nov 2010 11:08 PM PST December 2010 Nursing Board Exam Review Questions on Maternal and Child Health Nursing. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. If you want a simulated Nursing Board Exam, get a copy of our Nursing Board Exam Reviewer v1.0 and v2 now. 1. The primitive gonadal tissue that develops into the male reproductive organ: a. Mesonephric Duct b. Paramesonepric Duct c. Mullerian Duct d. B and C 2. Growth of long bones is stimulated in females due to hormonal secretions, however, mature height is only limited. What is the best explanation for this? a. Initiation of fat deposition during the puberty period in females inhibits growth b. Progesterone increases bone growth but is mostly utilized for endometrial proliferation before ovulation c. Estrogen causes closure of epiphysis d. Decrease follicle stimulating hormone is noted during the later stage of adolescence 3. Sexual development is discussed in a nursing forum. Which of the following is not true about sexual development? a. Genetic sex is determined at conception. b. The external genitalia start to differentiate when the genetic sex is determined. c. Presence of only a small part of Y chromosome directs the primitive cells to become testes d. Although ovary is secreted by the female ovary, it is not required to initiate development of female reproductive structures 4. In an anatomy class, the clinical instructor asked a student nurse about the definition of "vulva." The student nurse answered correctly if she answered that vulva is composed of: a. Vagina, uterus, and cervix b. Clitoris, vestibule and fourchette c. Labia majora, fallopian tubes and ovaries d. Cervix, mammary glands and ovaries 5. A pregnant woman is admitted. Based on the last menstrual period given she is 38 week's AOG. During vaginal examination the doctor tells the patient that she is on station -1. This is best interpreted as: a. One cm below the ischial spine b. At the level of the ischial spine c. One inch above the ischial spine d. One cm above the ischial spine 6. Shanna is a 2 year old child. She weighs 30 lbs. What is her birthweight? a. 6 lbs b. 6.5 lbs c. 7 lbs d. 7.5 lbs 7. Shanna's mother asked what is the MAIN reason why hospitals and clinics weigh children every check-up. The nurse's best answer is: a. To keep track of the child's social progress b. To be used in calculating drug dosages c. For baseline data purposes d. To assess developmental delay in a child 8. An 8-month old infant is under what stage of development according to Erik Erikson? a. Trust vs. Mistrust b. Anal c. Oral d. Initiave vs. Guilt 9. Right after delivery Baby Girl Fe has been suctioned to promote a clear and patent airway. What is the correct technique in suctioning a newborn? a. Starting with the nose then the mouth follows b. Positioning the infant in a prone position to drain secretions c. Suctioning the mouth first followed by the nose d. Wrapping the infant carefully 10. Wrapping newborns and drying them after bathing is a technique to: a. Prevent cold stress b. Prevent hypoglycemia c. Promote shivering thermogenesis d. Metabolize brown fats 11. A pregnant client visited the health care agency. During assessment, the nurse learned that her last day of her last menstrual period (LMP) is January 24, 2010. She added that the duration her last menstruation is 4 days. Using Nagele's Rule calculate for the exact date of delivery. a. February 29, 2011 b. October 31, 2011 c. October 31, 2010 d. October 27, 2010 12. The nurse was performing leopold's maneuver. In executing the techniques of the maneuver, which is least likely done by the nurse? a. Instruct the patient to drink plenty of fluid before the procedure. b. Warm the nurse's hand before initiating the palpation. c. Allowing the client to void first before the procedure. d. Close the curtains and provide privacy. 13. During the first maneuver the nurse feels a round, soft portion at the fundus. This is best interpretation of this is: a. The head is at the fundus b. The abdomen is at the fundus c. The buttocks is at the fundus d. The shoulder is at the fundus 14. What is the purpose of doing the fourth maneuver? a. To know the fetal part at the fundus b. To assess the degree of flexion or attitude c. To have an idea what the fetal presenting part is d. To know if engagement occurred or not 15. Seven weeks after the conception the growing structure inside a uterus is now called: a. Zygote b. Embryo c. Fetus d. Neonate 16. A 7-month old child has been diagnosed with meningitis. The nurse has obtained a medical history of the condition. Of the following choices, which is not a risk factor of meningitis? a. Otitis Media b. Splenectomy c. Genetics d. Myelomenigocele 17. The mother of a child diagnosed with meningitis asked the nurse about the signs and symtoms of the disease. The nurse correctly responded when she said that in most children with meningitis the first noticeable sign of the illness is: a. Seizure or shock b. Irritability due to headache c. Nuchal rigidity d. Bulging fontanels 18. The causative factor of meningitis has been determined. H. Influenzae has caused the infection. If this is the causative agent, what would you expect in a child to manifest that is exclusively seen in the meningitis caused by H. Influenzae? a. Papular petechial skin rash b. Papilledema c. Septic arthritis d. Photophobia 19. During assessment the nurse flexed the patient's neck which also caused an involuntary and bilateral flexion of the hip, knee and ankle. The patient is positive for what sign? a. Opisthothonus b. Kernig's sign c. Brudzinski's sign d. Increase intracranial pressure 20. Some children with meningitis cannot follow a light through full visual fields. If this occurred, cranial nerve paralysis is also suspected. Typically, what cranial nerve damage causes this? a. First and second cranial nerves b. Third and sixth cranial nerves c. First and fourth cranial nerves d. Second and sixth cranial nerves 21. The blood culture and CSF analysis indicates H.Influenzae as the causative agent. What is the drug of choice for meningitis caused by this organism? a. Ampicillin b. Cefotaxime c. Ceftriaxone d. Mannitol 22. If a child is suspected with meningitis what is the top priority intervention to execute? a. Assess for signs of meningeal irritation b. Position the client in a fowler's position to decrease ICP c. Observe and place the child in respiratory precautions d. Promoting safety 23. In CSF analysis, done through lumbar puncture, if a child has meningitis which of the following values would you expect to drop? a. WBC b. Glucose c. Protein d. Platelet 24. If the organism that caused meningitis is E. Coli and Group B Streptococcus, what antibiotic would you expect the physician to prescribe in the patient? a. Ampicillin b. Cefotaxime c. Dexamethasone d. Mannitol 25. To assess and examine for abscess in children with meningitis what diagnostic procedures can be done? a. MRI b. CT scan c. Ultrasound study d. All of the above Related posts: Maternal and Child Health Nurse Test Part 1 Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 1 Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 2

Maternal and Child Health Nurse Test Part 1 Posted: 14 Nov 2010 11:03 PM PST December 2010 Nursing Board Exam Review Questions on Maternal and Child Health Nursing. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. If you want a simulated Nursing Board Exam, get a copy of our Nursing Board Exam Reviewer v1.0 and v2 now. Please go to Maternal and Child Health Nurse Test Part 1 to view the quiz Related posts: Maternal and Child Health Nurse Test Part 2 Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 1 Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 2

Dehydration: Types, Causes and Treatment Posted: 14 Nov 2010 06:57 PM PST Dehydration is defined as an excessive loss of body fluid. Dehydration occurs when more fluids are lost than taken in and the body doesn’t have enough water and other fluids to carry out its normal functions. Three main types of dehydration based on type of fluid loss: Hypotonic or hyponatremic – primarily a loss of electrolytes, particularly sodium Hypertonic or hypernatremic – primarily a loss of water Isotonic or isonatremic – equal loss of water and electrolytes Three types of dehydration based on severity: Mild – when the body has lost about 2% of it’s total fluid Moderate – when the total fluid loss reaches 5% Severe – when the body reaches 10% fluid loss, considered a emergency In humans, the most commonly seen type of dehydration is isotonic (isonatraemic) dehydration, which equ ates with hypovolemia, but the distinction of isotonic from hypotonic or hypertonic dehydration may be important when treating people who become dehydrated. Causes: intense diarrhea vomiting fever increased urination excessive sweating burns inadequate intake of water during hot weather or exercise People at Risk: infants and children older adults people with chronic illness endurance athletes people living in high altitudes Symptoms: Mild to moderate dehydration is likely to cause: Dry, sticky mouth Sleepiness or tiredness — children are likely to be less active than usual Thirst Decreased urine output — fewer than six wet diapers a day for infants and eight hours or more without urination for older children and teens Few or no tears when crying Muscle weakness Headache Dizziness or lightheadedness Severe dehydration, a medical emergency, can cause: Extreme thirst Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults Very dry mouth, skin and mucous membranes Lack of sweating Little or no urination — any urine that is produced will be dark yellow or amber Sunken eyes Shriveled and dry skin that lacks elasticity and doesn’t “bounce back” when pinched into a fold In infants, sunken fontanels — the soft spots on the top of a baby’s head Low blood pressure Rapid heartbeat Fever In the most serious cases, delirium or unconsciousness Diagnostic tests: blood tests urinalysis Treatment: The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on your age, the severity of your dehydration and its cause. Oral rehydration solution (ORS) Fluid replacement through intravenous therapy Treating the cause of dehydration Nursing Considerations: Assess vital signs, noting peripheral pulses. Monitor blood pressure and invasive hemodynamic parameters. Strictly monitor intake and output. Observe the physical properties of the urine. Correctly infuse the right amount of IVF. Encourage small, frequent feedings. Provide frequent, oral care. Administer medications as prescribe. Photo credits: www.droitfondamental.eu Related posts: Acute Gastroenteritis (Stomach flu) Fluids and Electrolytes Fluid and Electrolyte Therapy

Behavior Modification Posted: 14 Nov 2010 06:06 PM PST Behavior Modification Definition Behavior modification is a method of strengthening desired behavior or response through a positive or negative reinforcement of adaptive behavior or the reduction of a maladaptive behavior through extinction, punishment or therapy. For example you are an employee. You worked extra hours just to finish your tasks, arrives at work on time and sometimes you skip lunch just to complete the assigned job. A hard worker – that's what you are! Now after a month of hard work your paycheck is delayed. Weeks and months passed and still the salary is not released. Would you perform the same effort towards your job now that you are still unpaid? You might still go to work with a change behavior or stop working. For working people, receiving a regular and on-time paycheck is a positive reinforcer that motivates the employees to do their job well. If this motivating factor is lacking, expect a less efficient job performance from the employees. Behaviorists believed that a behavior can be change through a system of rewards and punishments. Positive and Negative Reinforcement A positive reinforcement is provided by giving a person attention and positive feedback. For example, a child has successfully made it through the night without wetting the bed. The mother acknowledges the child's behavior in front of the family during breakfast period. A negative reinforcement on the other hand is done by removing a stimulus after a behavior occurred to prevent it from occurring again. For example, a student becomes anxious when he is seated at the back during classes. He or she may ask the professor to be seated in front to prevent such anxiety. Indication Obsessive-compulsive behavior (OCD) Attention deficit hyperactivity disorder (ADHD) Phobias Enuresis (bed-wetting) Generalized anxiety disorder Separation anxiety disorder Behavior Modification Techniques ABC approach A – Antecedents Antecedents are the events that occur before a particular behavior is demonstrated. "What comes directly before the behavior?" B – Behaviors The behavior developed as a result of the presence of antecedent. "What does the behavior look like?" C – Consequences These are the events that occur after the behavior. "What comes directly after the behavior?" After the ABC's are assessed, the data gathered is analyzed and identified as inappropriate and appropriate behavior. Inappropriate behaviors are observed, targeted and stopped while the appropriate ones are identified, developed, strengthened and maintained. Some Behavioral Theories and Theorists Theorists such as Ivan Pavlov and Burrhus Frederick Skinner focused on observable behaviors and factors that bring about behavioral changes. Classical Conditioning by Ivan Petrovich Pavlov Ivan Pavlov is a Russian psychologist, physiologist and physician widely known for providing the best example of classical conditioning through experimentation on dogs. Classical conditioning principle states that a behavior can be modified or changed through conditioning of the external stimuli or conditions. Operant conditioning by Burrhus Frederick Skinner B.F. Skinner is an American psychologist who developed the operant conditioning. Operant conditioning states that people learn their behaviors from their past experiences particularly those which as constantly reinforced. Related posts: Lamaze Childbirth Method What is Anxiety? Paraphilias

Thalassemias Posted: 14 Nov 2010 06:06 PM PST Thalassemias Definition Thalassemia is a group of inherited disorders which is associated with hemoglobin defects. The disorder results in excessive destruction of red blood cells leading to anemia. Types of Thalassemia There are two main types of Thalassemia based on the chain of hemoglobin it affects. These are the following: Beta Thalassemia or Cooley's anemia – defect in the beta-chain of hemoglobin is present. Alpha Thalassemia – defect in the alpha-chain of hemoglobin is present. Forms of Thalassemia Both the alpha and beta thalassemia include the following forms: Minor - threatening disease characterized by severe anemia, hemolysis and ineffective erythropoiesis Major - a mild form of anemia. The affected individual has only one defective gene and is asymptomatic. Incidence Aplha thalassemias occur frequently among Southeast Asians, Middle East Asians, Chinese and Africans. Beta Thalassemias occur frequently to those of Mediterranean origin and lesser to Chinese, other Asians and African Americans. Review of Related Anatomy and Physiology Red blood cells or erythrocytes carry oxygen to the different parts of the body. Different from other cells, RBC's do not contain a nucleus (anucleated). These small cells are circular and flattened with depressed centers on both sides resembling to that of a doughnut when viewed under a microscope. Their size and shape provides a large surface area for carrying oxygen in relation to their volume. The normal RBC count is 4-6 million/mm3. RBC's has the life span of 120 days. Hemoglobin is a form of protein that contains iron which is responsible for transporting oxygen that is carried in blood. Adult hemoglobin contains a beta chain (HBB) while a fetus' hemoglobin has a gamma chain. Hemoglobin is comprised of four protein (amino acid) components. It has two beta-globin and two alpha-globin. The subunit beta-globin is located inside the RBCs. These amino acids carry an iron-bearing molecule called heme. Heme molecules, which are only found in mature RBC's, enables the erythrocytes to pick oxygen from the lungs and transport it throughout the body. Once oxygen attaches to hemoglobin it gives the blood its bright red pigment. The more hemoglobin molecules the RBC contain, a higher amount of oxygen will they be able to carry. If the hemoglobin is defective, the erythrocyte will also malfunction. A red blood cell is just a vessel; the one that performs the oxygen transportation is the hemoglobin. Normal hemoglobin is 13-18 grams/100 ml of blood in males and 12-16 grams in females. Pathophysiology Risk Factors Family history Asian, Chinese, Mediterranean or African American ethnicity Causes Thalassemia is an inherited disorder that follows an autosomal recessive pattern. Thalassemias are inherited disorders of hemoglobin synthesis that result from a change in globin chain production. Beta-globin normally joins to alpha-globin component of hemoglobin. When beta-protein is lacking, alpha-globin accumulates and causes destructive membrane effects and vice versa. This leads to destruction of red blood cells. Not only that it causes membrane damage and cell destruction but it also suppresses the mitosis in stem cells, thus RBC production falls. The result of impaired hemoglobin synthesis is a microcytic, hypochromic anemia. Related posts: Classifications of Anemia Sickle Cell Anemia – Case Study Nursing Care Plan – Anemia

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