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2024 NR 509 FINAL EXAM WITH CORRECT ANSWERS
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2024 NR 509 FINAL EXAM WITH CORRECT ANSWERS
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2024 NR 509 FINAL EXAM WITHCORRECT ANSWERS
Delayed puberty in males - CORRECT-ANSWERSno testicular growth has
occurred by age 14 or no skeletal growth spurt has occurred by age 18
constitutional- most common. familial trait. normal hormones
primary/secondary hypogonadism (less common) or congenital GnRH
deficiency
Premature adrenarche - CORRECT-ANSWERSmay be associated with PCOS,
insulin resistance, metabolic syndrome, obesity, may cause early onset
puberty
delayed puberty in females - CORRECT-ANSWERSno breast/pubic growth by
age 12 caused by inadequate gonadotropin secretion in the anterior pituitary
d/t defective hypothalmic GnRH- caused by anorexia,
Below 3rd percentile- turner syndrome or chronic disease
sudden cardia death during sports - CORRECT-ANSWERSdizziness
palpitations
prior syncope
family history
cardiac murmurs
wheezing
previous history of concussion
focused neuro exam
immunizations and pregnancy - CORRECT-ANSWERS1) Tdap at 27-36wks
gestation for every pregnancy
2) inactivated influenza- give in flu season
3) safe to give during pregnancy- pneumococcal, meningoccal, hepatitis A
and B
4) Not safe- MMR, polio, varicella
Lab work for pregnant women - CORRECT-ANSWERSmust have rubella titer
Rh(D) and antibody typing at 1st prenatal visit, 28 weeks and delivery- give
anti-d to all Rh-negative women at 28 weeks and 3 days after delivery
,blood type, antibody, CBC, hematocrit, platelet, rubella titer, syphilis, hep B
antigen, HIV test, STI test for gonorrhea, chlamydia, UA with culture
oral glucose test at 24-28 weeks and rectovaginal swab for group B strep at
35-37 weeks
test glucose in 1st trimester if obese
Naegele's Rule - CORRECT-ANSWERSadd 7 days to LMP, subtract 3 months,
add 1 year
Leopold maneuver sequence - CORRECT-ANSWERS1st maneuver- upper fetal
pole- fetal buttocks firm and irregular
2nd maneuver- sides of abdomen- 32 weeks back is smooth, firm surface, as
long as your hand
fetal arms/legs feel like irregular bumps
3rd maneuver- lower fetal pole and descent into pelvis head feels firm and
globular (vertex or cephalic with head presenting part)
4th maneuver- flexion of fetal head
extended if cephalic prominence juts out along fetal back
flexed if cephalic prominence juts out along anterior side
Peripartum cardiomyopathy - CORRECT-ANSWERSOccurs during the last
trimester of pregnancy or the first 6 months after delivery
s/s include dyspnea, increased RR, cough, rale, resp distress.
These s/s may also be caused by infection, PE, asthma
Childhood immunizations - CORRECT-ANSWERSBirth- Hep B, Flu
1-2 mos- DTap, Hep B(2), HIB, Polio, Pneumococcal, Rotavirus
3-4 mos- DTap (2), HIB (2), Polio (2), Pneumo (2), Rotavirus (2)
5-6 mos- Dtap (3), HIB (3), polio (3), pneumo (3), Rotavirus (3), Flu
7-11 mos- flu
12-23 mos- Varicella, DTap (4), HIB (4), MMR (1), Polio (3), Pnuemo (4), Hep
A, Hep B (3), Flu
2-3 years- Flu
4-6 years- DTap (5), Polio (4), MMR (2), Varicella (2), Flu
7-10 years- Flu, HPV
11-12 years- Mening, HPV (2), Tdap (1)
13-18 years- Mening (2), Serogroup B Mening (2)
, Apgar scale - CORRECT-ANSWERSa standard measurement system that looks
for a variety of indications of good health in newborns. Score at 1 min and
again at 5 min
3 pt scale (0,1,2) score ranges 0-10
HR: absent- <100- >100
Resp: Absent- slow- good
Color: Blue/pale- Pink body/blue arms- pink
Muscle tone: Flaccid- Some flexion- Active
Reflexes: None- Grimaces- Vigorous Cry
Gestational Age Assessment - CORRECT-ANSWERSPerformed within 2 to 12
hr of birth
Newborn Measurements and New Ballard Scale
Gestational age estimation and baseline to assess growth and development.
*Neonatal morbidity and mortality are related to gestational age and birth
weight.
Large gestational age - CORRECT-ANSWERSabove 90th percentile
risk for hypoglycemia- s/s include jitteriness, irritability, cyanosis
small gestational age - CORRECT-ANSWERS<10th percentile
babies who weigh substantially less than is normal for whatever their
gestational age
May be caused by fetal, placental, maternal factors, maternal smoking
Preterm appropriate gestational age at risk for - CORRECT-
ANSWERSrespiratory distress, apnea, patent ductus arteriosis (PDA) with left
to right shunt and infection
Preterm small gestation age at risk for - CORRECT-ANSWERSasphyxia,
hypoglycemia, hypocalcemia
tremors after 4 days old suggest - CORRECT-ANSWERSCNS disease,
asphyxia, drug withdrawal, central or peripheral neurologic defect, or birth
injuries
s/s include asymmetric movements of arms or legs
failure to thrive - CORRECT-ANSWERS1) growth <5th percentile
2) drop >2 quartiles in 6 months
3) weight for length <5th percentile
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