King Saud University College of Nursing Final Examination 2nd semester 1428/1429H.

************************ Course Title: Course number: Department : Date: Time allowed: Course Instructor:

Normal Child bearing family NUR 530 Maternal and Child Health Nursing 28 /4 /1429H. Three (3) Hours Prof. Dr. Salma Moawed

Students Name: ____________________________________ Students No.: _____________________________________ Final Grade:_______________________________

I. Mrs. Nofe, a 22 years old, primigravida, attending prenatal clinic, she missed 2 menstrual periods she relates that the first day of her last menstrual period was February 22, 2008. Answer the following questions:

1. Mrs. Nofe estimated date of conferment would be 2. Discuss with Mrs. Nofe all lab. Investigation that must be done during first visit. 3. Mrs. Nofe is concerned because she has read that nutrition during pregnancy is important for proper growth and development 4. The major disadvantage of a non-stress test relates to its high rate of false-negative results. 5. A lower than normal alpha-fetoprotein level in the maternal serum has been associated with Downs syndrome. II.Give reason(s) for the following statement:
1.

As a nurse you must monitoring for the women with cardiac disease, intake of potassium ------------------------------------------------------------------------------------------------------------------------------------------------------------.

2. You must give penicillin for the same women during pregnancy & at the first stage of labor ------------------------------------------------------------------------------------------------------------------------------------------------------------------.
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3.

After aminocentesis, pregnant women must stay in clinic for some house --------------------------------------------------------------------------------------------------------------------------------------.

4.

Exercise very important for diabetic women ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------.

5. Nurse must instruct women not to take calcium with iron -----------------------------------------------------------------------------------------------------------------------------------------------------------.

6.

No problem if there is some post partum bleeding for a pregnant women have cardiac disease -----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.

7. Women with D.M must has petalizae between 36w-40 week why the nurse always instruct women with sickle cell anemia to avoid situations such as cold, dehydration hypoxia& infection -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------.

III.

Choose the best answer:-

1. A client with pregnancy-induced hypertension is being treated on an ambulatory basis & bed rest for three days is prescribed. The nurse encourage the client to stay in the bed & assume the :
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a. Supine position. b. Sid-lying position. c. Semi-Fowlers position. d. Slight trendelenburg position.

2. A Non-stress test is scheduled for a client with pregnancy-induced

hypertension .During the non-stress test the nurse should be aware that if non-periodic accelerations of the fetal heart rate occur with fetal movement it most likely indicates: a. Fetal well-being b. Head compression c. Uteroplacental insufficiency d. Umbilical cord compression

3. When providing health teaching for a client with pregnancy-induced hypertension, a thertension, a therapeutic instruction that the nurse should give the client is : a. Eat a sodium-free diet b. Walk at least a mile a day c. Limit fluid intake to 1000 ml a day d. Rest frequently in the side-lying position

4. When doing a physical assessment on a client with worsening preeclampsia, the nurse should expect to find: a. Vaginal spotting b. Proteinuria of 3+ c. Difficulty in breathing
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d. Blood pressure of 130/80 5. Before administering IV magnesium sulfate therapy to a client with pregnancy-induced hypertension, the nurse should assess the clients: a. Urinary glucose, acetone, & specific gravity. b. Temperature, blood pressure, & respiration. c. Urinary output, respiration, & patellar reflexes d. Level of consciousness, funduscopic appearance

6. A client who is hospitalized with pregnancy-induced hypertension is

encouraged to lie in the left lateral recumbent position because it maximizes:

a. Urinary & kidney perfusion & relieves compression of the major

vessels. b. Intra-abdominal pressure on the iliac viens & increase blood in the pelvic area. c. Aortic compression, decrease uterine arterial pressure, & increase uterine blood flow.
d. Hemoconcentration, reduces blood volume & cardiac output, &

increase placental perfusion

7. A client with pregnancy-induced hypertension is suspected of having impending eclampsia. A characteristic symptom of eclampsia for which the nurse should assess is : a. Anasarca
b. Convulsions

c. Excessive weight gain d. Increased blood pressure.

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8. While a client is receiving magnesium sulfate for severe pregnancyinduced hypertension, a primary nursing intervention would be : a. Limiting her fluid intake to 100ml/24 hours. b. Preparing for the possibility of a precipitate delivery. c. Restricting visitors & keeping the room darkened & quiet. d. Obtaining magnesium gluconate for use as an antagonist if necessary.

9. A client is in the hospital undergoing therapy for severe pregnancy

induced hypertension. If eclampsia should occur, the nurses first action should be to: a. Assess fetal heart tones b. Maintain an open airway c. Protect the client from injury
d. Increase the infusion of magnesium sulfate immediately.

IV.

Answer the following question:a. Home care for P.I.H (6 point)

b. 6 important equipment necessary in eclamptic room.

c. Differentiate between hypo & hyperglycemia

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