Systems of care 1 exam 2

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Systems of care 1 exam 2
2012-10-23 10:47:48

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  1. 1.A pregnant patient understand pre-conceptual
    self-care measures when she states: 
    • I know I need to take vitamins, get plenty of sleep at night, exercise,
    • eat well and not smoke or drink
  2. 2.While discussing anticipatory guidance for car
    safety, the nurse would teach the parents of a 17-pound infant that the car
    seat should be:
    • Put them in an infant seat so they are in the middle
    • of the back seat, facing the back of the car and strap the seat belt
  3. 3.The nurse knows that the study of growth and
    development is an exploration of which of the following?
    • Physical developments and the increasing level and
    • progression of function and skill of the growing child
  4. 4.A patient appears in the clinic for her first
    prenatal visit at 26 weeks of pregnancy.  She states, “I didn’t see any
    point in coming sooner since I felt fine.”  The nurse uses which of the
    following statements to explain why prenatal care in the first trimester is
    • The first trimester is the most crucial time of
    • development-  458,000 babies will be born to women who did not receive
    • adequate prenatal care. Prenatal vitamins. nutrition, and adequate exercise are
    • all important.
  5. 5.For the safety of infants and small children, smoke
    detectors should be present in the home and hot water heaters should be set at:
    • -below
    • 120 F
  6. 6.During her prenatal visit a pregnant patient
    complains of nausea with vomiting.  These symptoms in pregnancy are caused
    by increased levels of:
    HCG : human chorionic gonadotropin
  7. 7.Occupational exposure to infectious material by the
    health care worker is defined by the Occupational Safety and Health
    Administration (OSHA) as skin, eye, mucous membrane, or parenteral contact
    • blood or other potentially infectious material (semen, vaginal secretions, cerebrospinal fluid,
    • synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic
    • fluid, saliva in dental procedures, any body fluid that is visibly contaminated
    • with blood, and all body fluids in situations where it is difficult or
    • impossible to differentiate between body fluids; (2) Any unfixed tissue or
    • organ (other than intact skin) from a human (living or dead); and (3)
    • HIV-containing cell or tissue cultures, organ cultures, and HIV- or
    • HBV-containing culture medium or other solutions; and blood, organs, or other
    • tissues from experimental animals infected with HIV or HBV.)
  8. 8.A child or adolescent is considered obese if they
    have a body mass index (BMI) of:
    • >95% (has to mean BMI percent not BMI)
    • BMI greater than 30
  9. 9.A patient who is in the second trimester of her
    pregnancy tells the RN that her sister developed a darkened line in the midline
    of her abdomen from the symphysis pubis to the umbilicus when she was pregnant.
     The patient asks what other skin changes she might expect to see during
    her pregnancy.  The RN should tell the patient that she might notice:
    • Integumentary system changes: Striae Gravidarium
    • (Stretch Marks). Cholasma - splashes of darkened skin that may appear on the
    • forehead, nose, and cheeks in a mask-like configuration on some pregnant women
    • — more often in dark-skinned women, Linea Negra- a dark vertical line that
    • appears on the abdomen during about three quarters of all pregnancies.[  (I think this is what she  is talking
    • about in the question), Palmar Erythema- is reddening of the palms at the thenar and hypothenar eminences. Pruitus- itching , Gum hypertrophy- increase size of
    • gums. Increased perspiration and Increased hair and nail growth, acne
  10. 10.Obesity in children has been directly correlated to
    all of the following conditions except: The answer is not these:
    • Cultural,
    • Low SES (fresh food more expensive), Single parent or both parents working
    • households, No or limited PE in school, Safety issues, Increased
    • TV/Computer/Gaming time, Increased consumption processed and fast foods (“Super
    • Size It!”), high calorie beverages, Psychologic – security, comfort, stress
    • relief, boredom, depression
  11. 11.The embryonic phase is the 8-week period during
    which the fertilized ovum develops into an organism with most of the features
    of the human
    . True
  12. 12.A pregnant woman tells the RN, “I smoke a pack of
    cigarettes every day.  Will smoking hurt my baby?” The RN’s best reply
    would be:
    • YES, Smoking
    • is detrimental to pregnancy because nicotine is a VASOCONSTRICTOR, babies
    • aren’t getting the nutrients they need
    • There is a good chance that it would because
    • there are studies that have shown that there is an increased risk of ear
    • infections, SIDS, asthma, miscarriage and a low birth weight
  13. 13.All of the following are considered
    contra-indications for receiving administration of live virus vaccines except: 
    Women who are breast feeding
  14. 14.A primigravida should feel quickening (or the first
    perception of fetal movement)  at about
    18-20 weeks 
  15. 15.For the health care worker is involved in an
    accidental puncture wound with a hypodermic needle.  If medically
    indicated, , post exposure prophylaxis should begin within which time frame?
    • - As soon
    • as possible/ under an hour
  16. 16.All vaccines that are administered intramuscularly
    in infants and young children are given in the: 
  17. Insert needle at a 90° angle into the anterolateral thigh muscle for
    • infants, Insert needle at a 90° angle into thickest portion of deltoid muscle —
    • above the level of the axilla and below the acromion for young children
    • vastus lateralis ( the
    • thigh muscle)
  18. 17.Fatigue and breast tenderness are which of the
    following signs of pregnancy?
    • Presumptive signs
    • of pregnancy
  19. 18.All of the following vaccines could be administered
    at the 11-12y/o well child check except:
    SHOULD RECEIVE: Tdap, HPV, MCV, Influenza 
  20. 19.In an interview with a pregnant patient, the nurse
    discussed three risk factors that have been cited as having a possible effect
    on prenatal development.  Which of the following group accurately reflects
    the factors?
    • There are a ton of risk factors in the book so here
    • they are:)
    • Genetic Factors: may interfere with normal fetal development & result
    • in abnormalities
    • Demographic Characteristics: Geographic Location, Socioeconomic Status,
    • Educational attainment, marital status, maternal age, racial & ethnic
    • origins, occupational hazards
    • Behavioral Characteristics: Substance abuse, failure to seek prenatal care,
    • nutritional status, dental hygiene, psychosocial stressors, abuse &
    • violence
    • (Box 9-3 on pg 192 in the
    • maternity book gives more specific examples of risk factors)
  21. 20.During pregnancy the plasma volume increases to a
    greater extent than the number of red blood cells.  This change results
  22. Hemodilutional anemia (Physiologic anemia of pregnancy). Decrease in Hgb and
    Hct, Hct decrese to 34% (WNL 36-52%)
  23. 21.The Vaccines for Children program is a federally
    funded vaccine program that covers the cost of vaccination for:
    • The Vaccines For Children (VFC) program is a federally
    • funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because
    • of inability to pay. medicaid, uninsured, native american or native
    • alaskan or children under insured.
  24. 22.A patient complains during her first few months of
    pregnancy, “It seems like I have to go to the bathroom every five minutes.”
     She denies burning on urination.  The nurse should explain this is
    • Her uterus is pressing on her bladder as the baby
    • grows
    • The fetus (ie-uterus) is competing for space
    • with the bladder, and it is increasing the pressure on your bladder. This makes
    • you have frequency which is a common issue among pregnant women, and should go
    • away after delivery.
  25. 23.Occupational health takes place within the work
    setting.  Which statement best describes the over-arching goal of
    occupational health? 
    • To prevent diseases, injuries, and deaths that are due to working
    • conditions.  
  26. 24.Which client would be able to receive the Flu Mist
    nasal vaccine instead of the seasonal influenza injection?
    • Women that are breastfeeding
    • -Contra-indicated for those with active
    • asthma, immunocompromised, pregnancy, previous reaction, allergic to thimerosal
  27. 25.A nurse teaching a pregnant patient about the
    importance of iron in her diet, tells her to avoid consuming which of the
    following foods at the same time as her iron supplement because it decreases
    iron absorption.
    • Calcium,
    • antacids, calcium supplements, caffeinated beverages like tea and coffee, eggs,
    • milk or other dairy products like cheese and yogurt etc, soy proteins, cereals,
    • whole grain breads including dietary fiber, medicines which contain
    • bicarbonates, carbonates and phosphates.
  28. 26.A patient’s first child had spina bifida (a neural
    tube defect).  Pre-conceptually and during her next pregnancy the
    physician will recommend increased supplementation of:
    • All women capable of becoming pregnant should consume folic acid ( b9) (400 micrograms) daily. Also, the nurse should
    • instruct the patient to eat folate rich foods (e.g. green leafy vegetables,
    • oranges, dried beans) and suggest she take a vitamin supplement that contains
    • folic acid.
  29. 27.You are working in an adolescent health center when
    a 15-year-old-girl shares with you that she thinks she is pregnant and is
    worried that she may now have a sexually transmitted infection (STI).  Her
    pregnancy test is negative.  What is your next priority of care?
    • -screening for STI’s and then treating if she has oneteach/
    • counsel about safe sex practices
  30. 28.Which statement by a pregnant client at 16
    weeks gestation indicates a potential nutritional problem and should be further
    • second trimester nutrition concern: inadequate weight
    • gain associated w/ LBW
  31. 29.Which of the following describes the
    bluish-purplish discoloration of the cervix/vaginal mucosa and is considered a
    probable sign of pregnancy?
    • Chadwick’ sign:
    • bluish/purplish discoloration of the cervix
  32. 30.Which of the following lab values for a pregnant
    woman would need reporting to a physician and follow-up management: 
    • ABO blood type and Rh screen, if mother is Rh negative
    • give RhoGam to keep mom from killing baby, Blood sugar, HIV possiblity
    • Iron, folate, B12 and blood sugar,
    •                (High
    • BP, possoble pre-eclampsia?)
  33. 31.An occupational nurse is working to do provide a
    program that focuses on health promotion. Which of the following is an example
    of a health promotion activity?
    • Increasing a person’s level of wellness, growth and
    • development topics, fertility control, hygiene, nutrition, exercise, stress
    • management, lifestyle modification, resources within the community. (This was a
    • quiz question. I think the answer was meditation
    • classes)
  34. 32.Persistent blurred vision, edema of the hands and
    face, and a headache not disappearing with Tylenol and rest are all symptoms
    associated with:
  35. 33.Which symptoms should a pregnant patient report
    immediately to their healthcare provider?
    • Lack of fetal movement for the past hour? bleeding,
    • pain
  36. 34.Which of the following is true concerning Fetal
    Movement Counts:
  37. -
    • begins at 33-35 weeks
    • - should have 10 fetal
    • movements in less than two hours
    • - fetal movement is a sign
    • of fetal well being
    • - fetal movements DO NOT
    • slow down the closer you are to delivery
  38. 35.Folic acid is an important dietary component for
    the fetus.  Which combination provides the highest quantity? 
    • * Folic acid supplementation (0.4mg/day) 400
    • micrograms per day
    • * Foods high in folic acid
    • include fresh green leafy
    • vegetables, whole grains, meats especially liver, dairy products, and peanuts
  39. 36.When completing a facility assessment, the
    occupational health nurse will take several aspects into account.  What is
    the first stage of the assessment? 
    • Assess for safety issues (slippery floors, trip hazards, loud noise,
    • awkward positions, abnormal forces, repetitive motions, etc.)
  40. 37. The RN has just been stuck with a syringe while
    dropping it into a sharps container that was too full in a client's room. Which
    of the following steps should be taken first for a puncture?
    • (1)Report to the Charge Nurse & go to
    • occupational health department (probably in ER)
    • -milk finger on your
    • way, you have 1hr to get prophylactic treatment for it to be 99% effective,
    • wash hands with soap and water (if in mucous membrane flush for 5 to 10 minutes)
    • (2)Complete
    • injury/accident report
    • (3) Seek appropriate
    • evaluation (possibly blood tests)
  41. 38.A client diagnosed with an infectious disease asks
    the nurse how the infection “got inside” her body. Which responses would be
    appropriate for the nurse to make? 
    • Depends on the type of infection, but explain to them the different
    • modes of transmission

    • Various ways... airborne, contact, droplet (coughs
    • or sneezes), bloodborne (sharing needles), secretions.. compromised skin/ open
    • wound, immunodepression, etc.
    • “ There are many routes this infection can be
    • transferred” or something along these lines..