1. Why is it important for your social and professional life to know yourself, know your own character, and know the positive and negative effects of genetic and environmental factors on you? (10 p.)

2. What is holistic philosophy?What factors are the starting point of this philosophy?(10 p.)

3. What are the differences between traditional care and holistic care model? (10 p.)

4. Mr Jo is 52 years old; He was admitted to the hospital with abdominal pain, constipation and weight loss. As a result of the diagnostic examinations, a tumor was found in the descending colon. However, no complete information was given to the patient and his family. Doctors decided to operate and to open a stoma in surgery. They did not evaluate the patient socially and environmentally. The patient signed the consent form (But he didn’t understand exactly why he signed it) and operated. However, it was not stated in the consent form that a stoma would be opened. (10 p.)

       a) This is the traditional care approach.   (   ) Yes       (   )   No

       b) Apply the "Holistic approach model" that should be for this patient?

5. a) How should your behavior be when you enter a meeting environment?

     b) How should your behavior be when you enter a patient's room?

     c)What are the behavioral differences that should exist between these two environments? (10 p.)

6. What is creativity? Explain the difference with innovation. ( 5 p.)

7. What should the nurse do to have a flexible brain and be creative for the patient? (10 p.)

8. How would you explain the artistic and therapeutic use of body language? (10p.)

9. “If a person can feel pain, he is alive. If he can feel someone else's pain, it is human. " TOLSTOY.    What does Tolstoy want to tell in this sentence? Comment in terms of patient / nurse communication (10 p.)

Define the following:

Sign and Symptoms of AIDS
Diagnostic Test (confirmatory) of AIDS
Nursing Management of AIDS

Discuss strategies to provide care to patients who are from different cultures and may have diffcultural beliefs. What might Advanced practice nurse do if the patient refuses a high -quality, evidence based treatment meant to cure the illnrss because of culural beliefs? How can the APN respect cultural beliefs while still providing quality care? In what ways can the nurse do more than simply "do no harm"?

4. Mr Jo is 52 years old; He was admitted to the hospital with abdominal pain, constipation and weight loss. As a result of the diagnostic examinations, a tumor was found in the descending colon. However, no complete information was given to the patient and his family. Doctors decided to operate and to open a stoma in surgery. They did not evaluate the patient socially and environmentally. The patient signed the consent form (But he didn’t understand exactly why he signed it) and operated. However, it was not stated in the consent form that a stoma would be opened. (10 p.)

       a) This is the traditional care approach.   (   ) Yes       (   )   No

       b) Apply the "Holistic approach model" that should be for this patient?

5. a) How should your behavior be when you enter a meeting environment?

     b) How should your behavior be when you enter a patient's room?

     c)What are the behavioral differences that should exist between these two environments? (10 p.)

6. What is creativity? Explain the difference with innovation. ( 5 p.)

7. What should the nurse do to have a flexible brain and be creative for the patient? (10 p.)

8. How would you explain the artistic and therapeutic use of body language? (10p.)

9. “If a person can feel pain, he is alive. If he can feel someone else's pain, it is human. " TOLSTOY.    What does Tolstoy want to tell in this sentence? Comment in terms of patient / nurse communication

write a 250 to a 350 words about the MRI machine explaining the uses and how it work

CRITICAL THINKING:

1) Patricia knows that if her 3-year-old, Emma, comes down with the flu this winter, it’s likely that the entire household will get sick. Last year, Emma got sick and sneezed and wiped her nose on whatever was near her, including her baby brother, and wanted to be held when she felt feverish. What’s the reason for the spread of the flu in Patricia’s house?

2) Why is it necessary for an allied health professional to be extremely careful when handling and transporting microbiologic specimens?

Discuss Community acquired pneumonia, etiology, drug of choice to be prescribed and why, parameters for monitoring success of the medication therapy. If patient has history of hypertension, what would be the choice for a second line therapy.

Identify 1 Leading Health Indicator from Healthy people 2020 that is relevant to the disease process(MEASLES) and describe the relevance.

DISEASE- MEASLES

Lorraine Terrance, an 83-year-old widow who has lived alone since her husband died 6 months ago, is in the early stages of Alzheimer’s disease. She has a history of cardiovascular disease and hypertension and has been admitted to the local hospital for observation after complaints of chest pain. At present, she is very anxious and agitated. The admitting nurse received a telephone call from Mrs. Terrence’s daughter, who lives out of town. The daughter states that her mother has experienced anxiety and depression for many years and her symptoms have worsened since her father died. The daughter does not know what medications her mother currently takes, and she is concerned that her mother lives alone and wants her to move to a nursing home. The provider orders the following medications: Alprazolam (Xanax) for anxiety, Citalopram (celexa) for depression, and Zolpidem (Ambien) for sleep.

Mrs. Terrence’s two sons come to visit her in the hospital. They complain to the nurse that their mother seems oversedated. In denial about her mental status, the sons request that their mother’s medication be discontinued, but the nurses are concerned that if she is agitated, she may pull out her IV lines and Foley catheter as well as possibility strike out at staff.

1. How does the nurse handle this situation while respecting the family’s concerns, based on his or her knowledge and skills of patient-centered care?

Mrs. Terrence receives alprazolam 0.25 mg PO at 2:00 PM. Later, when the nurse brings in her supper tray, the patient seems relaxed. The supper tray contains raost beef, salad, chocolate pie, and hot tea. Visitors arrive at 5:00 PM and remark to the nurse that Mrs. Terrence is agitated and wringing her hands. She says that she is afraid to verbalize her anxiety to the nursing staff. The nurse prepares to give Mrs. Terrence another dose of medication.

1. What does the nurse prepare and why?

2. What foods on the supper tray contribute to the patient’s safety?

3. What patient teaching is necessary?

CLINICAL SCENARIO:

Mr A.G. is a 76-year -old widower being seen in your outpatient clinic for a medication refill for his Parkinson’s disease. He is a retired railroad engineer who derives great pleasures from collecting railroad memorabilia and taking walks with his dog around the vicinity of his neighborhood. Mr. A.G. was diagnosed with moderate (Stage III) Parkinson’s Disease 2 years ago. He does not smoke tobacco nor drink alcohol. His PMH includes a femur fx at age 22, a cholecystectomy at age 47, and a transurethral resection of the prostate (TURP) at age 72.

Activity

1. List six things that you would assess to determine whether Mr. A.G.’s care can be managed in his home and explain. How might Mr. A.G. PMH affects his symptoms?

What are the most important organizations that work on global health issues? What functions do these organizations play? Why is it important that different actors cooperate to address global health concerns?

What are some of the future challenges that demand continued or strengthened collaboration in global public health?

St. Paul University Dumaguete

College of Nursing

NCM 107 – Intrapartum

Name : __________________________________Year Level & Section______________

1. Which of the following best defines the intrapartum period?

A. Time from complete cervical dilatation through delivery of the newborn.

B. Period from the onset of contractions through complete cervical dilation.

C. Period from the onset of contractions to the first 1 to 4 hours after delivery.

D. Time from the 28th week of gestation through 28 days after birth of the newborn.

2. Very Preterm birth are babies born alive at :

A. less than 28 weeks

B. 28 to 32 weeks

C. 32 to 37 weeks

D. 38 weeks

3. Pressure on the cervix stimulates nerve plexus causing release of oxytocin by maternal posterior pituitary gland. This is known as:

A. McRobert’s Maneuver

B. Crede’s prophylaxis

C. Ferguson’s Reflex

D. None of the above

4. Which of the following is true of the theory of labor:

A. An increase in progesterone allows estrogen to stimulate the contractile response of the uterus.

B. A decrease in progesterone allows estrogen to stimulate the contractile response of the uterus.

C. A decrease in estrogen allows progesterone to stimulate the contractile response of the uterus.

D. An increase in estrogen allows progesterone to stimulate the contractile response of the uterus.

5. Which of the following statement is true of the possible causes of the onset of labor. Select all that apply:

A. Uterine muscles stretch cause the release of prostaglandin.

B. Prostaglandin and oxytocin works together to activate contractions.

C. Placental aging triggers initiation of contractions.

D. Rising fetal cortisol levels increases progesterone formation and initiates contraction.

6. The true signs of labor includes the following except:

A. Rupture of membrane

B. Uterine contractions

C. Show

D. Lightening

7. The woman will experience an irregular contractions and is termed as _______ which will become stronger, longer and more frequent when labor is neat at hand,

A. True labor

B. Braxton Hick’s contractions

C. Chadwick’s

D. Goodell’s sign

8. Early morning, the woman experienced a leaking bag of water. Which of the following statement of the woman that is incorrect and need health teaching? Select all that apply.

A. “Sexual intercourse should be avoided.”

B. “I can still walk in the house and do household chores.”

C. “I will go to the hospital by tomorrow.”

D. None of the above.

9. Which of the following factors affecting labor is associated with the passageway?

A. Size of the head and its ability to mold to the maternal pelvis.

B. The presentation of the fetus in relation to the maternal pelvis,

C. The structure of the maternal pelvis.

D. The frequency, duration and strength of uterine contractions.

10. A typical female pelvis with rounded inlet:

A. Android

B. Anthropoid

C. Gynecoid

D. Platypelloid

11. The part of the fetus body which has the widest diameter:

A. Abdomen

B. Legs

C. Head

D. All of the above

12. Immediately, before expulsion, which of the following cardinal movement occur?

A. Descent

B. Flexion

C. Extension

D. External rotation

13. This refers to the relationship between the long axis of the fetal body and the long axis of the woman’s body.

A. Fetal attitude

B. Fetal lie

C. Longitudinal lie

D. Transverse lie

14. The hips are flexed but the knees are extended to rest on the chest. The buttocks alone present to the cervix. This statement describes:

A. Complete breech

B. Frank breech

C. Single footling breech

D. Double footling breech

15. During pelvic examination, a diamond shaped of the fontanelle has been palpated. The fontanelle palpated is the:

A. Anterior fontanelle

B. Posterior fontanelle

C. Anteroposterior fontanelle

D. Occiput fontanelle

16. The triangular shaped fontanelle usually closes when the infant is:

A. 2 months of age

B. 6 months of age

C. 12 months of age

D. 1 year and 6 months

17. When describing fetal position, the first letter of the series denotes which of the following?

A. Presenting part of the fetus

B. Side of the maternal pelvis

C. Size of the maternal pelvis

D. Type of fetal delivery

18. The labor and delivery nurse performs Leopold’s maneuvers. A soft round mass is

felt in the fundal region. A flat object is noted on the left and small objects are

noted on the right of the uterus. A hard round mass is noted above the symphysis.

Which of the following positions is consistent with these findings?

A. Left occipital anterior (LOA)

B. Left sacral posterior (LSP)

C. Right mentum anterior (RMA)

D. Right sacral posterior (RSP)

19. The fetus assumes this position during labor: the spinal column is bowed forward, the head is flexed forward that the chin touches the sternum, the arms are flexed and folded on the chest, the thigh are flexed onto the abdomen and the calves are pressed against the posterior aspect of the thigh. This indicates that:

A. The fetus has good flexion.

B. The fetus has moderate flexion.

C. The fetus is in partial extension.

D. The fetus is in complete extension.

20. While performing Leopold’s maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse?5

A. The fetal position is transverse.

B. The fetal presentation is vertex.

C. The fetal lie is vertical.

D. The fetal attitude is flexed.

21. The nurse is assessing the fetal station during a vaginal examination. Which of the

following structures should the nurse palpate?

A. Sacral promontory

B. Ischial spines

C. Cervix

D. Symphysis pubis

22. When performing Leopold’s maneuvers, the nurse notes that the fetus is in the left occiput anterior position. Where should the nurse place a fetoscope best to hear the fetal heart beat?

A. Left upper quadrant.

B. Right upper quadrant.

C. Left lower quadrant.

D. Right lower quadrant.

23. A woman has just arrived at the labor and delivery suite. In order to report the

client’s status to her primary health care practitioner, which of the following assessments should the nurse perform? Select all that apply.

A. Fetal heart rate.

B. Contraction pattern.

C. Contraction stress test.

D. Vital signs.

E. Biophysical profile.

24. A nurse is teaching a class of pregnant couples the most therapeutic breathing technique for the latent phase of labor. Which of the following techniques did the nurse teach?

A. Alternately panting and blowing.

B. Rapid, deep breathing.

C. Grunting and pushing with contractions.

D. Slow chest breathing

25. The nurse auscultates a fetal heart rate of 150 on a client in early labor. Which of the following actions by the nurse is appropriate?

A. Inform the mother that the rate is normal.

B. Reassess in 5 minutes to verify the results.

C. Immediately report the rate to the health care practitioner.

D. Place the client on her left side and apply oxygen by face mask.

26. The nurse documents in a laboring woman’s chart that the fetal heart is being “assessed via intermittent auscultation.” To be consistent with this statement, the nurse, using a Doppler electrode, should assess the fetal heart at which of the following times?

A. After every contraction.

B. For 10 minutes every half hour.

C. Periodically during the peak of contractions.

D. For 1 minute immediately after contractions

27. While evaluating the fetal heart monitor tracing on a client in labor, the nurse notes that there are fetal heart decelerations present. Which of the following assessments must the nurse make at this time?

A. The relationship between the decelerations and the labor contractions.

B. The maternal blood pressure.

C. The gestational age of the fetus.

D. The placement of the fetal heart electrode in relation to the fetal position.

28. An obstetrician is performing an amniotomy on a gravid woman in transition. Which of the following assessments must the nurse make immediately following the procedure?

A. Maternal blood pressure.

B. Maternal pulse.

C. Fetal heart rate.

D. Fetal fibronectin level.

29. The fundal height of the woman is 30 cm and the fetus is engaged. What is the estimated fetal weight?

A. 2790 grams

B. 2945 grams

C. 3000 grams

D. 3100 grams

30. A patient is in transition phase. How frequently should you check or assess the perineum?

A. Every 5 minutes

B. Every 15 minutes

C. Every 30 minutes

D. Every 60 minutes

11. The part of the fetus body which has the widest diameter:
A. Abdomen
B. Legs
C. Head
D. All of the above

12. Immediately, before expulsion, which of the following cardinal movement occur?
A. Descent
B. Flexion
C. Extension
D. External rotation

13. This refers to the relationship between the long axis of the fetal body and the long axis of the woman’s body.
A. Fetal attitude
B. Fetal lie
C. Longitudinal lie
D. Transverse lie

14. The hips are flexed but the knees are extended to rest on the chest. The buttocks alone present to the cervix. This statement describes:
A. Complete breech
B. Frank breech
C. Single footling breech
D. Double footling breech

15. During pelvic examination, a diamond shaped of the fontanelle has been palpated. The fontanelle palpated is the:
A. Anterior fontanelle
B. Posterior fontanelle
C. Anteroposterior fontanelle
D. Occiput fontanelle

16. The triangular shaped fontanelle usually closes when the infant is:
A. 2 months of age
B. 6 months of age
C. 12 months of age
D. 1 year and 6 months

17. When describing fetal position, the first letter of the series denotes which of the following?
A. Presenting part of the fetus
B. Side of the maternal pelvis
C. Size of the maternal pelvis
D. Type of fetal delivery

18. The labor and delivery nurse performs Leopold’s maneuvers. A soft round mass is
felt in the fundal region. A flat object is noted on the left and small objects are
noted on the right of the uterus. A hard round mass is noted above the symphysis.
Which of the following positions is consistent with these findings?
A. Left occipital anterior (LOA)
B. Left sacral posterior (LSP)
C. Right mentum anterior (RMA)
D. Right sacral posterior (RSP)

19. The fetus assumes this position during labor: the spinal column is bowed forward, the head is flexed forward that the chin touches the sternum, the arms are flexed and folded on the chest, the thigh are flexed onto the abdomen and the calves are pressed against the posterior aspect of the thigh. This indicates that:
A. The fetus has good flexion.
B. The fetus has moderate flexion.
C. The fetus is in partial extension.
D. The fetus is in complete extension.

20. While performing Leopold’s maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse?5
A. The fetal position is transverse.
B. The fetal presentation is vertex.
C. The fetal lie is vertical.
D. The fetal attitude is flexed.