Maternal and Child Health Nursing Review Questions Part 1

A- There is no such thing as conjugated hemoglobin B- If conjugated bilirubin decreases no jaundice will be observed C- There is no such thing as conjugated hemoglobin D- Jaundice in newborns is caused by elevated unconjugated bilirubin (fat soluble). To be excreted out of the body, the bilirubin has to be converted to a water soluble form, a process known as bilirubin conjugation. Therefore, an increase of the fat-soluble bilirubin (unconjugated) results to jaundice.

A- Clay-colored stool is seen in children with bile duct obstruction. B- Bright green stool results from increased bile flow and peristalsis. Bile mixing with the light-yellow stool will result to this color of the feces. Stools of infants in phototherapy are frequent, loose and green. C- Currant and jelly-like stools are seen with intussusceptions D- Ribbon like stool is observed in Hirschprung’s disease (aganglionic megacolon)

Phenylalanine levels increase due to the absence of the liver enzyme. The end product of phenylalanine metabolism is phenylpyruvic acid (a keto acid). The by-product spills into the urine that gives it a strong “mousy” or “musty” odor that often spreads through the entire body of the infant or child. This is the reason why the disorder is called phenylketonuria (meaning there is phenylpruvic or keto acid in the urine). Letters A,B and C are therefore incorrect.

the keyword is “young infants”. Infants feed only milk. Older infants can be given cereals and chopped meat is given later.

Mode of transmission of Fifth disease (erythema infectiosum) is through droplet (respiratory secretions transmitted by cough and sneeze). Therefore droplet precautions should be implemented.

A- Rete testis is the passageway from the testes to the epidydimis B- Tunica Albuginea is a fibrous capsule that covers the testes. C- Septum – separates the lobules inside the testes D- Leydig’s cells – responsible for sperm formation.

D - (Antigout) A- For Hypoparathyroidism B- For diabetes Insipidus C- A chemotherapeutic agent

A- Glucose is a sugar in the blood. B- Amylase is an enzyme present in saliva that breaks down starch into sugar. C- Gliadin is a protein known for its role that helps in the formation of gluten. It is a glycoprotein present in wheat and cereals. D- Mucin is the form of protein that is secreted by the mucus gland.

A- The corrected foot may return to its deformed state if the parents or primary caregiver fails to apply the methods to further correct the position (e.g. passive foot exercises and Denis Brown splint). B- This is not included in the complication in the treatment of talipes deformity C- This is not included in the complication in the treatment of talipes deformity D- Vertical talus results from a forceful manipulation causing bone breakage. This then will give rise to a flat foot.

Slight abdominal cramping and vaginal bleeding are noted on threatened abortion. In the inevitable form these two are present plus the occurrence of cervical dilatation. Headache is not listed as signs and symptoms in abortion, but can be found in hypertensive disorders of pregnancy.

A- Amenorrhea – absence of menstrual flow B- Menorrhagia -excessive menstrual bleeding C- Metrorrhagia – bleeding between periods of less than 2 weeks D- Hypermenorrhea – abnormally long menstruation

A- Placenta pancreta B- Placenta accreta

PKU is an inherited disorder that is characterized by the absence of P.Hydroxylase. Phenylalanine hydroxylase is used to convert pheneylalanine to tyrosine which is the precursor of thyroxine, Melanin and some neurotransmitters. Without tyrosine normal metabolic and physical functions may be altered.

A- Factor VIII – antihemophilic factor (functions in the intrinsic passageway of blood coagulation). Deficiency, a sex-linked recessive trait called classic hemophilia. B- Factor IV – calcium C- Factor XI – plasma thromboplastin antecedent. Deficiency - Hemophilia C. D- Factor IX – plasma thromboplastin component (Christmas Factor). It functions in the extrinsic passageway of blood coagulation. Deficiency - Hemophilia B.

A- Skene’s gland helps in vaginal lubrication during coitus and is found at the sides of the urethral meatus. B- Bartholin’s gland is found at the lateral sides of vaginal orifice C- C and D are just the same, which is a part of male reproductive organ.

The keyword of the question is “apart from,” therefore we will be looking for incorrect statements. Letters A, B, C correctly describes the incidence rate and pattern of the disorder. There is a 10% chance of a subsequent child being affected not 50%, if the parents already have a child with a clubfoot, therefore, Letter D is the only incorrect response that meets the criteria of the question.

A- T. Pallidum is the causative agent for Syphilis B- Coxsackivirus is the causative agent for Hand-foot-mouth disease C- Rhabdovirus cause Rabies D- Parvovirus B19 is the causative agent for erythema infectiosum.

Febrile seizures are caused by elevated body temperature (high fever). A- Phenobarbital is not recommended because it takes 2-3 days for this drug to take effect. Diazepam is given instead, but this is not the main treatment. B- This procedure/technique is done during the episode of seizure. C- The keyword is MAIN TREATMENT therefore; the way to eliminate the seizure is to combat its cause which is the fever. This is done by giving antipyretics such as Acetaminophen. D- Antibiotics are not administered in febrile seizure.

the other choices are incorrect.

A- Aspirin can cause bleeding tendencies (platelet aggregation inhibitor) but it is not the main reason why IN GENERAL it is not advised to be used as treatment for fever. B- Aspirin has the same antipyretic properties that are found in acetaminophen. C- In general, children usually refuse to drink all kinds of medicine. D- Aspirin has been associated with the occurrence of Reye’s syndrome, thus letter D is the best option.

Calcaneus (dorsiflex) + Valgus (eversion). (Letter A) equinus (plantarflexion) + varus (inversion). (Letter B) equinus (plantarflexion) + Valgus (eversion). (Letter D) Calcaneus (dorsiflex) + varus (inversion)

A- Melanin is used for skin pigmentation. B- Thyroxine is used for cellular metabolism. C- Gluten is the protein that children with Celiac disease cannot tolerate. D- Serotonin – use for regulating mood

The safest modality is a planned cesarean section and hysterectomy (surgical removal of the uterus) therefore; the best answer is B. Conservative treatment is done only if the woman wants to maintain her fertility under the condition that no active bleeding is present. This treatment saves the uterus but poses higher risk of complications and low successful rate. Techniques for this treatment are as follows: • The placenta is left in the uterus and the cord is ligated. • Closure of the uterus is performed. • Methotrexate (an antineoplastic agent) is usually given to the woman to destroy the still attached placenta.

A- Stimulates the anterior pituitary gland (APG) to release LH. B- Released by the APG to stimulate the ovaries to secrete estrogen. C- Released by the APG to stimulate the ovaries to secrete progesterone. D- Stimulates the anterior pituitary gland (APG) to release FSH.

A- At 5 weeks primitive gonadal tissue forms. B- By twelve weeks the sexual differentiation internally and externally is completed for both sexes. C- By 8 weeks, internal sexual organs start to develop. D- Prenatal period ends until the 9th calendar or 10th month.