WHNP Boards Exam With Rationale
Questions & Answers / well Graded A+ .
Nutrition requirements in pregnancy
Calories
Protein
Calcium
Iron
Folate - CORRECT ANSWERS-cals - Increase by 300 (2,000-2,500)/day
protein - 30 g
calcium - 1200 mg
iron - 30 mg elemental
folate - 800-1000 mcg
Weight gain during pregnancy
Underweight (<18.5)
Normal (18.5-24.9)
Overweight (25.0-29.9)
Obese (>30) - CORRECT ANSWERS-underweight 28-40 lbs
normal 25-35 lbs
overweight 15-25 lbs
obese 11-20 lbs
Fe deficiency in pregnancy
RBC Morphology
Transferrin/TIBC
Ferritin
amniocentesis - CORRECT ANSWERS-*15-18 weeks*
Genetic and biochemical diagnosis, determine fetal lung maturity, assessment for fetal
disease
Risks fetal loss (0.5-1%), amnionitis (0.1%), ROM, infection, abruption, possible fetal
injury
FKCs
When to start?
How to do? - CORRECT ANSWERS-start at 28-32 weeks
count daily for 1 hour
10 movements/hour yay!
count for another hour, if still <10/2 hours call provider
,BPP scoring interventions - CORRECT ANSWERS-<4 deliver
6 - depends, repeat in 24 hours
>8 - reassuring
AFI levels - CORRECT ANSWERS->24cm poly
10-24 normal
5.1 - 9.9 low normal
<5 oligo
Serum Fe - CORRECT ANSWERS-Hypochromic, MCV <80
Transferrin Increased
Ferritin decreased
Serum Fe decreased
Hemolytic anemia in pregnancy
RBC morphology
transferrin/TIBC
Ferritin - CORRECT ANSWERS-Reticulocyte increased
transferrin decreased
ferritin increased
Chronic disease anemia in pregnancy
RBC morphology
transferrin/TIBC
Ferritin - CORRECT ANSWERS-Microcytic, hypochromic
Normal or decreased transferring/TIBC
Normal or increased ferritin
G6PD deficiency - CORRECT ANSWERS-Increased hemolysis causes hemolytic
anemia
Drugs associated: sulfa drugs, nitrofurantoin, antipyretics
SCT/Disease is associated with - CORRECT ANSWERS-increased risk for UTIs
How long to treat UTI in pregnancy - CORRECT ANSWERS-7 days!
+ 1 hour glucose result - CORRECT ANSWERS-greater than 140!
3 hour gtt thresholds - CORRECT ANSWERS-fasting 95
1 hour 180
2 hours 155
3 hours 140
RFs for ectopic pregnancy - CORRECT ANSWERS-previous ectopic
h/o tubal surgery, PID, DES exposure or infertility
,past or current IUD use
low-dose progestin or emergency contraception
assisted reproduction
uterine or tubal anatomic abnormalities
50% have no identifiable risk factor
uterine involution - CORRECT ANSWERS-below symphysis by day 10 PP
complete involution by 6 weeks PP
What is EBP? - CORRECT ANSWERS-The delivery of individualized healthcare on the
basis of an awareness of the impact and strength of related scientific evidence
When can you treat a minor without parental consent? - CORRECT ANSWERS-
pregnant and consents to treatment related to pregnancy, other than abortion
consent to diagnosis and treatment of STDS that must be reported to Texas Dept of
health
consent to examination or treatment for chemical addiction, dependency, or any other
condition related to chemical use
consent for counseling for suicide prevention, chemical addiction or dependency, pr for
sexual, physical or emotional abuse
***Parental consent is not required for minors to receive information about family
planning. Texas laws require minors to get parental permission to receive contraception.
When parental consent is required the parent must sign both the general consent for
treatment and method specific consent for for a prescription method of contraception.
Under federal law, minors may give consent and receive confidential family planning
services if the funding source is Medicaid or Title Family Planning Program
MVP S&S - CORRECT ANSWERS-CO usually uncompromised - usually goes
unnoticed by patient
TYPICALLY BENIGN
tugging chest pain, dyspnea if severe regurge, can have tachycardia or palpitations
Cardiac exam in MVP - CORRECT ANSWERS-presence of a Grade I-III/IV mid to late
systolic crescendo murmur with honking quality during peak pressure, which is the
middle of systole
Normal PMI
Best indicator for asthma flare - CORRECT ANSWERS-FEV
Necessary for diagnosis of HTN - CORRECT ANSWERS->2 abnormal readings on >2
occasions
highest to lowest level of research - CORRECT ANSWERS-meta analysis
systemic reviews
, RCTs
Cohort studies
case-controlled studies
case series, case reports
editorial, expert opinion
Definition of primary prevention - CORRECT ANSWERS-preventing the health problem,
the most cost-effective from of healthcare
examples of primary prevention - CORRECT ANSWERS-immunizations, counseling,
helmet, seat belt, condom
Definition of secondary prevention - CORRECT ANSWERS-Detecting disease in early
asymptomatic, or preclinical state
examples of secondary prevention - CORRECT ANSWERS-screening tests - BP,
mammo, colonoscopy, pap smear, skin survey
definition of tertiary prevention - CORRECT ANSWERS-minimizing negative disease
induced outcomes; a failure of primary prevention
examples of tertiary prevention - CORRECT ANSWERS-adjusting therapy to avoid
further target damage
congenital rubella - CORRECT ANSWERS-extremely teratogenic can lead to
developmental disability, blindness, hearing loss
Should immunization be deferred in presence of minor illness - CORRECT ANSWERS-
no, immunization should be deferred only in the presence of a moderate to severe
illness with or without fever
What should be available if administering vaccines - CORRECT ANSWERS-telephone
to call 911 and epipen
When are babies fully vaccinated against pertussis - CORRECT ANSWERS-6 months
contraindicatons to live vaccines - CORRECT ANSWERS-pregnancy, immune
suppression (HIV)
Examples of live vaccines - CORRECT ANSWERS-MMR, varicella, zoster, intranasal
influenza
expected side effects of all vaccines - CORRECT ANSWERS-discomfort, erythema at
immunization site
