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NURS 5432 UNIVERSITY OF TEXAS ARLINGTON FAMILY I MIDTERM EXAM
CURRENTLY TESTING RATIONALE WITH COMPLETE SOLUTIONS
What age should you begin annual mammograms according to the American Cancer Society? Age 45- 54 How does Tamoxifen and Raloxifene help with breast cancer prevention? Tamoxifen is a SERM and is an estrogen. Tamoxifen works by blocking estrogen from binding to receptors on breast cancer cells, which prevents them from receiving the hormone they need to grow and multiply How does Anastrozole work to prevent breast cancer? Anastrozole helps prevent breast cancer by decreasing the amount of estrogen the body makes How does heparin impact a pregnant mother? Cause osteoporosis How do prostaglandins impact a pregnant mother? Stimulate uterine contractions
How can pain relievers impact the fetus in pregnant women? Can depress neonatal respirations When is the most critical time during pregnancy to avoid medications due to risk of teratogenesis? A. Conception through Week 2 B. Embryonic Period (Week 3-8) C. Fetal Period (Week 9 - Delivery) B. Embryonic Period (Week 3-8) FluMist is safe for pregnancy women to use during pregnancy as Influenza vaccines is one of the recommended vaccinations to protect mother and baby, True or False? FluMist is a live attenuated vaccine and although the influenza vaccine is recommended, FluMist is contraindicated Tdap is given at every pregnancy between 27-36 weeks gestation to help the baby gain protection against which is the following? A. Pertussis B. COVID- 19 C. Hand-foot-and-mouth disease D. Influenza A. Pertussis
What is Goodell's sign? softening of the cervix What is Chadwick's sign? bluish discoloration of cervix due to increased vascularity What is Hegar's sign? Softening moves from the cervix to the uterus. During what Trimester does "quickening" occur? Between 16-20 weeks How long (what weeks) is the Second Trimester? 13 - 27 weeks During which trimester is it important to make sure to get maximum hydration? (Double fluid intake) Third Trimester
How long is the Third Trimester? 27 - 40 weeks Braxton Hicks contractions can often times be alleviated by: A. Eating B. NSAIDS C. Folic acid supplements D. Hydration D. Hydration At 16 weeks pregnant, the fundus is typically located about halfway between the pubic bone and the belly button, True or False True Where is the fundus palpable at 20 weeks gestation? Umbilicus (17-23 cm) - grows approximately 1 cm per week thereafter What weeks is quad testing conducted? 16 - 20 weeks
- Have mother drink a liquid with 50 grams of glucose
- Measure plasma glucose 1 hour later What glucose level warrants a positive test (OGTT)? 130 - 140 mg/dL or greater is considered positive and warrants further testing Explain the Two-Step testing method for pregnancy glucose testing? Administer a 100gram glucose load Measure plasma glucose at:
- Fasting
- 1 hour
- 2 hours
- 3 hours Two-Step testing method for pregnancy glucose testing What is considered abnormal for Fasting level ≥ 95 mg/dL Two-Step testing method for pregnancy glucose testing What is considered abnormal at 1 hour
≥ 180 mg/dL Two-Step testing method for pregnancy glucose testing What is considered abnormal at 2 hour ≥ 155 mg/dL Two-Step testing method for pregnancy glucose testing What is considered abnormal at 3 hour ≥ 140 mg/dL At what week is RhoGAM for unsenitized mothers tested? 28 weeks Between what weeks of pregnancy would you test for Group B Strep (GBS) with culture? 35 - 37 weeks How to establish due date through Naegele's rule? First day of Last Menstrual Period (LMP) Add 7 days
C. Naproxen D. Acetaminophen D. Acetaminophen What hormone is responsible for the general relaxation of smooth muscle and reduced GI motility during pregnancy? Progesterone Which of the following constipation medications are contraindicated in pregnancy? A. Castor oil B. Psyllium (Metamucil) C. Docusate Sodium D. Docusate Calcium E. Senokot A. Castor Oil Which of the following medications can be used for Reflux in pregnancy? A. Sodium Bicarbonate antacids B. Calcium Carbonate C. Maalox (Alum Hydroxide/Mag Hydroxide/ Simethicone) D. Magnesium Trisillcate
E. Ranitidine F. Famotidine G. Lansoprazole B. Calcium Carbonate (TUMS) C. Maalox E. Ranitidine (H2 blockers) F. Famotidine (H2 blockers) G. Lansoprazole (Proton Pump inhibitors) Which of the following medications are safe (1st line) for nausea and vomiting during pregnancy? A. Ginger Capsules B. Dicyclomine (Bentyl) C. Ginger Tea D. Ondansetron (Zofran) E. Doxylamine and Pyridoxine (Diclegis) A. Ginger Capsules C. Ginger Tea E. Doxylamine and Pyridoxine (Diclegis) Dicyclomine may cause and increase risk of colorectal cancer in infants. And Ondansetron may increase the risk of cardiac malformations and major congenital malformations in the fetus
What is the dose of Cephalexin for Pregnant women with a UTI? A. Cephalexin 20-50mg QID for 5-7 days B. Cephalexin 200-500mg QID for 5-7 days C. Cephalexin 50-80mg QID for 5-7 days D. Cephalexin 500-800mg QID for 5-7 days B. Cephalexin 200-500mg QID for 5-7 days What is the dose of Fosfomycin for pregnant women with a UTI? 3 grams orally in a single dose Would you use Fosfomycin if you suspect kidney infection (pyelonephritis)? (Yes or No) No Ectopic pregnancy will present with abnormal uterine bleeding that's bright red and heavy, True or False? False Bleeding will present like Spotting with dark brown and tarry blood Where will the patient have pain during ectopic pregnancy? (3 locations)
- Unilateral lower quadrant abdominal pain
- Lower back pain
- Sudden shoulder pain What diagnostics would you run do confirm a Ectopic Pregnancy? (2)
- Serum Quantitative HCG
- Transvaginal Ultrasound (Absence of a intrauterine pregnancy) What would you find in the Ultrasound of an Ectopic Pregnancy?
- Absence of an intrauterine pregnancy
- Adnexal Mass or free fluid in the pelvis Ashley has been diagnosed with an unruptured Ectopic Pregnancy. What is the first line medication that she can take to have a therapeutic abortion? Methotrexate (Single, Two or fixed multi-dose) Patient with ectopic pregnancy should be administered RhoGAM if they are Rh (Negative/Positive)? Negative Which of the following are giving for an induced abortion?
Pregnancy induced hypertension (PIH) is a blood pressure of > 140/90 mmHg or a rise in systolic BP by > 30mmHg from baseline with Proteinuria, True or False? FALSE, PIH does not included Proteinuria although you should complete a 24 hr urine collection to check for Proteinuria What's the difference between PIH and Preeclampsia? PIH is just hypertension with pregnancy Preeclampsia is PIH with Proteinuria and generalized edema Eclampsia included a BP of > 160/100, Proteinuria, severe edema, and tonic-clinic seizure activity, True or False? True Why is Magnesium sulfate given to patient with Eclampsia? Prevents and controls seizure activity What class of medication can be given if Magnesium Sulfate fails to control seizures in a patient with Eclampsia? Benzodiazepines (diazepam)
What does HELLP syndrome stand for? Hemolysis, Elevated Liver enzymes, Low Platelets A pregnant patient comes in with with painless vaginal bleeding after intercourse. She is in her 3rd trimester. Upon physical exam there is no uterine tenderness. What are some diagnostic tests you should consider (3)?
- Ultrasound: to view the placenta and the baby
- Electronic Fetal Montoring: evaluate fetal HR
- CBC: monitor if the bleeding is excessive Preterm labor is defined as the presence of uterine contractions between __ to __ weeks gestation that result in cervical dilation or effacement ≥ 3cm 20 to 37 weeks Why is a Fetal Fibronectin Test conducted in patient suspected of preterm labor? FFN is a protein that's acts at the "glue" between amniotic membranes and the uterus. If the fFN levels are Positive, it can suggest the patient is in preterm labor. Why would you conduct a Biophsyical Profile (BPP) if a patient is suspected of preterm labor? BBP helps to assess the fetal wellbeing and determine gestational age.
D. 300-500 kca/day D. 300-500 kca/day How many calories should a breast feeding mother consume in total? (Range) 1900 - 2500 kcal/day Nicotine level in breast milk are 3 times higher that in maternal blood levels, True or False? True Infant Elimination of nicotine is prolonged, taking about 3-4 times longer than adults, True or False? True For mothers, unable to quit advise smoking away from the infant and waiting at least 30 minutes after smoking before breast-feeding to reduce nicotine exposure, True or False? False The mother must wait at least two hours after smoking before continuing to breast-feed Which of the following supplements may be necessary for Vegans who choose to breastfeed I order to avoid malnourishment? SATA A. Iron
B. Calcium C. DHA D. Vitamin B E. Vitamin C C. DHA: vegans may need to supplement with DHA because it's difficult to get enough from food sources alone. DHA is an omega-3 fatty acid that is important for brain health and development. D. Vitamin B A mother come into the office with her infant, she complains that he baby has white patches on her tongue and mouth that cannot be wiped off. She said that her nipples have been itchy and red. What medication would you consider giving to the infant? Nystatin Suspension What is the key feature of the eyes of a newborn with Trisomy 21? Inner epicanthal folds Slanted upwards eyes What is the key feature of the Ears of a newborn with Trisomy 21? Low set ears What is the key features of the hands of a newborn with Trisomy 21?
