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NR 509 FINAL TEST CHAPTER #18 QUESTIONS AND ANSWERS
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NR 509 FINAL TEST CHAPTER #18 QUESTIONS AND ANSWERS
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NR 509 FINAL TEST CHAPTER #18QUESTIONS AND ANSWERS
During the delivery of a male infant, you are there to assess the Apgar score. He was
born through an intact pelvis and had no complications during labor or delivery. At 1
minute he is pink all over and grimaces. He is flexing his arms and legs occasionally. He
is breathing well and his heart rate is 110. At 5 minutes he is still pink all over but now is
crying vigorously, with active movement. His respiratory effort is good and his heart rate
is 130.
What is his Apgar score?
A) 8 at 1 minute, 10 at 5 minutes
B) 7 at 1 minute, 9 at 5 minutes
C) 9 at 1 minute, 10 at 5 minutes
D) 8 at 1 minute, 9 at 5 minutes - Answer-A) 8 at 1 minute, 10 at 5 minutes
A 24-year-old mother who is a smoker and cocaine addict gave birth at 39 weeks to a
2,000-gram female infant who is in the neonatal intensive care unit. Using the
Intrauterine Growth Curve chart, you determine whether the infant's weight is
appropriate for her gestational age.
In which category does the infant best fit?
A) Large for gestational age
B) Normal for gestational age
C) Small for gestational age - Answer-C) Small for gestational age
A mother brings her 16-month-old son in for an evaluation. She is afraid he is not
meeting his developmental milestones and wants to know if he should be sent to
therapy. He was the product of an uneventful pregnancy and a spontaneous vaginal
delivery. His Apgar scores were 7 and 9. Until reaching a year old the mother believes
he was hitting his milestones appropriately. You decide to administer the Denver
Developmental Screening Test. You find that he is using a spoon to eat with and can
take off his own shoes and shirt. He can build a tower of two cubes and dump raisins.
His vocabulary consists of at least 10 words. He can stand alone and stoop and
recover, but he is unable to walk without holding onto someone's hand.
What type of developmental delay does he have?
A) Personal/social
B) Fine motor
C) Language
D) Gross motor - Answer-D) Gross motor
A foster mother brings a 4-year-old child to see you for an evaluation. She has had
custody of the girl for 2 weeks. She knows that the child was born in your state and that
her maternal grandmother had custody for 6 months. She received good medical care
, during that time, but after her biologic mother obtained custody the child was abused
and has had no further medical care. She says the child has had many behavioral
problems and seems to be very behind on her developmental tasks. When you examine
the child you notice short palpebral fissures, a wide nasal philtrum, and thin lips. Her
cardiac, pulmonary, musculoskeletal, and abdominal examinations are normal. Her
Denver Developmental Screening Test shows most of her milestones have occurred
only through the 24th month.
What form of congenital retardation is she most likely to have?
A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome - Answer-A) Fetal alcohol syndrome
A young Hispanic mother brings in her 2-month-old son. She is upset because her
neighbors have threatened to call the Child Protective Agency because they think his
birthmark is a bruise. Her son was the product of an uneventful pregnancy and
spontaneous vaginal delivery. On examination you see a large, smooth-bordered bluish
mark on his buttock and lower back. Otherwise his examination is unremarkable.
What form of birthmark is this likely to be?
A) Café-au-lait spot
B) Salmon patch
C) Mongolian spot - Answer-C) Mongolian spot
A 32-year-old white female presents to labor and delivery fully effaced and delivers a
5.8-lb (2,500-gram) infant female with Apgar scores of 6 and 8. The mother has had no
prenatal care and in the nursery you perform the newborn examination. With the Ballard
scoring system, the neuromuscular examination score is 15. Looking at physical
maturity, you see superficial peeling and few veins on the skin. The lanugo hair has bald
areas and the plantar surface of the foot has creases on two thirds of it. The areola is
stippled with a 2-mm bud. The pinna is well curved, is firm, and has instant recoil. The
labia majora and minora are equally prominent.
Add the score of the neuromuscular components to your score of physical maturity to
determine weeks of gestation. How many weeks of gestation has this child had?
A) 34 weeks
B) 36 weeks
C) 40 weeks - Answer-B) 36 weeks
A mother brings in her 3-year-old son for a well-child check-up. She is concerned that
he seems different in size from all of the other preschool boys. He was the product of an
uneventful pregnancy and vaginal delivery. He has hit all of his developmental
milestones on time. On examination he is 26 lbs (11.8 kg) and is 35 inches (89 cm) tall.
Otherwise his examination is unremarkable. You give the correct education for his age
and then discuss his size.
For his age, what are his growth chart percentiles?
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