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NSG6020 Final/Baby/Women/Prego – Qs And As
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NSG6020 Final/Baby/Women/Prego – Qs And As
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NSG6020 Final/Baby/Women/Prego – Qs And AsDuring 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? Correct Ans - 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? Correct Ans - 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? Correct Ans -
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? Correct
Ans - 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? Correct Ans -
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?
Correct Ans - 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? Correct Ans -
Small and light for his age (<5%)
A mother brings her 4-year-old daughter to your office because of fever
and decreased
eating and drinking. When you ask the little girl what is wrong, she says
her mouth and throat
hurt. On examination her temperature is 101 degrees. Her ears and nose
examinations are
unremarkable. Her mouth has ulcerations on the buccal mucosa and the
tongue. She also has
cervical lymphadenopathy. Her cardiac and pulmonary examinations are
normal. She is up to
date on her childhood vaccinations.
What mouth abnormality does she most likely have? Correct Ans -
herpetic stomatitis
A mother brings her 15-month-old daughter to your office for evaluation of
a rash and fever.
She says the rash started one day and the fever developed the next day. Her
daughter has had all
of her vaccinations up to 10 months. The mother sheepishly admits that
she hasn't had time to
bring her daughter in since her 10-month check-up. On examination you
see a mildly
sick-appearing toddler with a 102-degree temperature. Looking at her skin
you see at least 100 of
a variety of papules, vesicles, and ulcers in different stages of development.
What illness prevented by proper vaccination does this toddler have?
Correct Ans - varicella (chickenpox)
An adolescent male comes to your clinic with a note from his mother
stating it is okay for
him to be seen today without her presence. He has come in for his annual
sports physical
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