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Maternity paediatrics nursing (Viterbo university)

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Total Questions : 72

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Question 1:

The nurse case manager is conducting a home visit for a family with an 11-month-old infant. When reviewing the infant's dietary intake, which food choice by the family requires further education by the nurse?

A. Noodles with cheese sauce B. Yogurt with honey C. cooked broccoli D. Cut-up cherry tomatoes

Answer and Explanation

Choice A:

Cheese sauce may be high in fat and sodium, but noodles with cheese sauce are generally safe for an 11-month-old infant to consume in moderation. The primary concern for infants' diet is ensuring that foods are safe to swallow and do not pose a choking hazard, which noodles do not.

Choice B:

Honey is not recommended for children under one year old due to the risk of botulism, a serious illness caused by a toxin produced by the bacterium Clostridium botulinum. Infants have underdeveloped immune systems that cannot fight off the toxin, making honey a potentially dangerous food choice for them.

Choice C:

Cooked broccoli is generally a safe and nutritious food for an 11-month-old infant. It's a good source of vitamins, minerals, and fibre. However, it should be soft enough for the infant to chew and swallow without risk of choking.

Choice D:

Cut-up cherry tomatoes are appropriate for an 11-month-old infant as long as they are cut into small, manageable pieces to prevent choking. Cherry tomatoes provide essential nutrients like vitamins A and C and can be a healthy addition to an infant's diet.

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Question 2:

The nurse is caring for an 11-year-old child during a well visit. Which vaccine will the nurse prepare to administer?

A. Human Papillomavirus B. Pneumococcal C. Measles D. Rubella

Answer and Explanation

Choice A:

The Human Papillomavirus (HPV) vaccine is typically recommended for preteens at age 11 or 12 to protect against HPV infections that can lead to certain types of cancer later in life. This vaccine is given as a series of shots, and starting the series at 11 years old is ideal for maximizing its effectiveness before any potential exposure to the virus.

Choice B:

The Pneumococcal vaccine is generally recommended for infants, young children, and older adults, particularly those with certain health conditions. It protects against pneumococcal disease, including infections in the lungs, blood, and brain. While it is crucial for vulnerable populations, it is not typically administered to healthy 11-year-old children.

Choice C:

The Measles vaccine is part of the MMR (Measles, Mumps, Rubella) vaccine, which is usually administered in two doses—the first dose at 12-15 months of age and the second dose at 4-6 years of age. By the time a child reaches 11 years old, they would have already received both doses of the MMR vaccine, assuming they followed the standard vaccination schedule.

Choice D:

The Rubella vaccine is also included in the MMR vaccine, which is given in two doses during early childhood. Since the second dose is typically administered by the age of 6, an 11-year-old child would not require another dose of the Rubella vaccine if they followed the standard vaccination schedule.

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Question 3:

The clinic nurse is performing phone triage on pregnant patients. Which patient will the nurse refer to the hospital for immediate evaluation?

A. The patient who is 11 weeks pregnant and nauseous, tired, and sleepy most of the day. B. The patient who is 30 weeks pregnant complained of "blurred vision and seeing spots." C. The patient who is 40 weeks pregnant and has to urinate every 2 hours. D. The patient who is 37 weeks pregnant and has 4 to 5 contractions in an hour.

Answer and Explanation

Choice A:

While nausea, tiredness, and sleepiness are common during the first trimester of pregnancy, they are typically not signs of an immediate emergency. This patient does not exhibit any alarming symptoms that would require immediate hospital referral.

Choice B:

Blurred vision and seeing spots during pregnancy can be symptoms of preeclampsia, a potentially dangerous condition characterized by high blood pressure. Preeclampsia can pose serious health risks to both the mother and the baby and requires immediate medical attention.

Choice C:

Frequent urination is a common symptom in the later stages of pregnancy due to the pressure the growing baby exerts on the bladder. This symptom alone does not indicate an immediate need for hospital evaluation.

Choice D:

Having 4 to 5 contractions in an hour at 37 weeks of pregnancy can be a sign of early labor. However, unless the contractions are persistent and intensifying, this may not necessitate an immediate hospital referral. The nurse would likely advise the patient to monitor the contractions and come in if they continue or become stronger.

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Question 4:

A nurse is reviewing the chart of a patient on the postpartum unit. The chart indicates the patient is a G6, T3, P1, A2, L4. What is the nurse's interpretation of this patient's obstetric history? Select All That Apply

A. Three births at 37 to 42 weeks gestation. B. One birth between 20 weeks and 36 weeks 6 days gestation. C. One pregnancy loss before 20 weeks gestation. D. Three elective abortions. E. Four children currently living.

Answer and Explanation

Choice A:

The designation T3 indicates that the patient has had three full-term births, defined as births that occurred between 37 and 42 weeks of gestation. This is part of the standard obstetric history notation.

Choice B:

The notation P1 means the patient has had one preterm birth, which is defined as a birth that occurred between 20 weeks and 36 weeks 6 days of gestation. This is an important part of understanding the patient's pregnancy history.

Choice C:

A2 denotes that the patient has had two pregnancy losses before 20 weeks of gestation, which can include miscarriages or stillbirths. This is crucial for assessing the patient's reproductive health history.

Choice D:

There is no indication from the notation G6, T3, P1, A2, L4 that the patient has had three elective abortions. Elective abortions would be noted differently in the patient's chart if they were part of the obstetric history.

Choice E:

The notation L4 indicates that the patient currently has four living children. This is an important part of the patient's obstetric history as it gives insight into their childbearing outcomes.

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Question 5:

The nurse is consulting with a 16-year-old diagnosed with chlamydia who is reluctant to treat this disease pharmacologically. The nurse will monitor for which complication in this patient?

A. Human papillomavirus B. Pelvic inflammatory disease C. Cardiac arrhythmias D. Extreme weight loss

Answer and Explanation

Choice A:

Human papillomavirus (HPV) is a separate infection that is not a direct complication of untreated chlamydia. While both are sexually transmitted infections, they have different causative agents and manifestations.

Choice B:

Pelvic inflammatory disease (PID) is a serious complication that can arise from untreated chlamydia. PID can lead to severe reproductive health issues, including chronic pelvic pain, ectopic pregnancy, and infertility. Monitoring and treating chlamydia is crucial to prevent the development of PID.

Choice C:

Cardiac arrhythmias are not a known complication of chlamydia. This condition pertains to abnormal heart rhythms, which are unrelated to the infection caused by chlamydia.

Choice D:

Extreme weight loss is not directly associated with chlamydia infection. While untreated chlamydia can have significant health impacts, extreme weight loss is not a typical complication of this disease.

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Question 6:

The nurse is caring for a primigravida at 36-weeks gestation admitted with suspected partial placental abruption. What actions will the nurse implement? Select all that apply.

A. Place the patient in a supine position. B. Encourage oral intake. C. Administer IV fluids as indicated. D. Evaluate fatal heart rate monitoring. E. Monitor maternal pain.

Answer and Explanation

Choice A:

Placing the patient in a supine position is not recommended in cases of suspected partial placental abruption. The supine position can compress the inferior vena cava, reducing blood flow to the placenta and potentially worsening the condition. Instead, a lateral position is generally preferred to enhance blood flow.

Choice B:

Encouraging oral intake is not a priority action in this scenario. In cases of suspected placental abruption, the patient may need to undergo emergency medical procedures, and maintaining an empty stomach is often advised to prevent aspiration if anaesthesia is required.

Choice C:

Administering IV fluids is crucial in managing suspected partial placental abruption. This intervention helps maintain maternal blood pressure and ensures adequate blood flow to the placenta, which is essential for fatal well-being. IV fluids can also be vital in managing any potential blood loss.

Choice D:

Evaluating fatal heart rate monitoring is essential to assess the foetus’s well-being. Continuous monitoring allows the healthcare team to detect any signs of fatal distress, which can guide further medical interventions and decision-making processes.

Choice E:

Monitoring maternal pain is a critical component of managing suspected partial placental abruption. Pain assessment helps determine the severity of the abruption and the effectiveness of pain management strategies. It also provides valuable information about the patient's condition and the need for additional interventions.

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Question 7:

A school nurse is talking with a 13-year-old non-binary student at their annual health screening visit. Which statement by the adolescent will the nurse prioritize?

A. I haven't had a growth spurt yet, and all my friends are taller than me. B. My parents treat me like a baby sometimes. C. None of the kids at this school like me, and I don't like them either. D. There's a big project due by the end of the month, and I'm really stressed about it.

Answer and Explanation

Choice A:

Concerns about physical development, such as not having had a growth spurt yet, are common among adolescents. While this statement indicates some distress, it is generally considered a normal part of adolescent development and may not require immediate intervention.

Choice B:

Feeling infantilized by parents is also a common issue among teenagers. This can be addressed through communication and support, but it is not typically an urgent matter.

Choice C:

Statements about social isolation and feeling disliked by peers can be indicative of significant emotional distress or even depression. This statement warrants immediate attention to assess the adolescent's mental health and provide necessary support or intervention.

Choice D:

Stress related to academic pressures, such as a big project, is common among students. While it is important to address stress management, it does not typically indicate an immediate risk to the student's well-being.

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Question 8:

A pregnant person telephones the prenatal clinic and reports that their "water just broke." How will the nurse respond?

A. Come in as soon as you feel the urge to push. B. Call us back when you start having contractions. C. Come to the Labor and delivery unit for an evaluation. D. Drink three to four glasses of water and lie down.

Answer and Explanation

Choice A:

Waiting until the urge to push before going to the hospital is not advisable. If the water has broken, it indicates that Labor may be starting, and the pregnant person should be evaluated to ensure the safety of both the parent and the baby.

Choice B:

Waiting for contractions to start before calling back is not recommended. If the water has broken, there is a risk of infection and other complications, so immediate evaluation is necessary.

Choice C:

Coming to the Labor and delivery unit for an evaluation is the correct response. When the water breaks, it is important to assess the mother and baby to determine the next steps and ensure that both are healthy and safe.

Choice D:

Drinking water and lying down is not an appropriate response to the water breaking. While staying hydrated is important during pregnancy, the priority should be to seek immediate medical evaluation.

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Question 9:

The nurse is assessing a 5-month-old patient on their readiness for solid foods. Which observation will indicate the family should postpone solid foods?

A. Holding head upright and sitting unsupported. B. Pushing food out with their tongue. C. Grasping small objects and not letting go. D. The infant is between 4 and 6 months old.

Answer and Explanation

Choice A:

Holding their head upright and sitting unsupported are signs that an infant may be ready for solid foods. These motor skills indicate that the baby has enough control to handle swallowing food safely.

Choice B:

Pushing food out with their tongue is known as the tongue-thrust reflex, and it is a sign that the infant may not be ready for solid foods yet. This reflex prevents choking and generally diminishes between 4 and 6 months of age.

Choice C:

Grasping small objects and not letting go demonstrates that the baby has developed fine motor skills, which are also important for starting solid foods. However, this alone does not determine readiness.

Choice D:

Being between 4 and 6 months old is an appropriate age range for introducing solid foods, as long as other readiness signs are also present. Age alone is not the sole indicator of readiness for solid foods.

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Question 10:

The nurse is assessing newborn patients who are at risk for feeding difficulties. Which patient is at the highest risk?

A. An infant 6 hours old, 41 weeks and 5 days gestation. B. An infant 18 hours old, 36 weeks and 6 days gestation. C. An infant 34 hours old, 37 weeks and 3 days gestation. D. An infant 27 hours old, 38 weeks and 0 days gestation.

Answer and Explanation

Choice A:

A newborn at 41 weeks and 5 days gestation is past full term and, while being older in gestational age, does not typically present increased risk for feeding difficulties as compared to preterm infants. At 6 hours old, this infant would still be adapting, but no additional risk is posed by the gestational age.

Choice B:

An infant born at 36 weeks and 6 days gestation is considered late preterm. Late preterm infants often have immature suck and swallow reflexes and may experience difficulties with feeding, coordinating breathing with feeding, and maintaining body temperature. These issues place them at a higher risk for feeding difficulties compared to full-term infants.

Choice C:

A newborn at 37 weeks and 3 days gestation is considered early term and generally faces fewer risks compared to preterm infants. At 34 hours old, feeding patterns are still being established, but there are no significant additional risks related to their gestational age.

Choice D:

An infant born at 38 weeks gestation is considered full term. At 27 hours old, the baby would still be in the early stages of adapting to feeding, but being full term generally implies a lower risk for feeding difficulties compared to preterm infants.

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Maternity paediatrics nursing (Viterbo university)

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