Chapter 4: Care of the Emerging Family
DONNA C. MAHEADY
JILL E. WINLAND-BROWN
Questions
4-1 Talya is 2 years old and presents with signs and symptoms of acute otitis media. Mom
reports that Talya experienced a rash after the administration of penicillin in the past. If
a “wait and see” approach is not indicated, which of the following antibiotics should be
prescribed?
A. Augmentin
B. Amoxicillin
C. Omnicef
D. Trimox
4-2 Kim states that she has heard many old wives’ tales of harmful things during
pregnancy. Which of the following is in fact harmful late in pregnancy?
A. Intercourse
B. Swimming
C. Douching
D. Dental visits
4-3 The drug of choice for the pregnant woman with diabetes is
A. insulin.
B. glyburide (DiaBeta, Glynase, Micronase).
C. glipizide (Glucotrol).
D. metformin (Glucophage).
4-4 Pediatric patients may now be prescribed OxyContin for pain. Patients must be already
responding to and tolerating a minimum opioid dose equal to at least 20 mg of oxycodone
per day before they can be prescribed an equivalent dose of OxyContin. In order to be
prescribed OxyContin, pediatric patients must be
A. 5 to 16 years old.
B. 11 to 16 years old.
C. 8 to 16 years old.
D. over 16 years old.
4-5 In a “guidance to industry” document, the U.S. Food and Drug Administration
(FDA) endorsed the use of flow restrictors for over-the-counter (OTC) pediatric oral
liquid drug products containing acetaminophen. This will result in
1
, A. stiff fines to manufacturers who do not provide flow restrictors.
B. a strong signal being sent to manufacturers that flow restrictors are considered an important
safety feature to help reduce accidental overdoses.
C. uniform standards for manufacturing of flow restrictors.
D. FDA supervision of development and production of flow restrictors.
4-6 After 28 weeks’ gestation, all women should perform fetal movement counts
(FMCs). Which of the following statements is true regarding FMCs?
A. Counts should be done as the woman is going about her work.
B. Ten movements should be obtained in 1 hour.
C. Ten movements should be obtained in 2 hours.
D. If decreased activity is perceived, a nonstress test (NST) should be performed at the next
obstetric visit.
4-7 Pregnancy following the rapid weight loss and weight stabilization phase of bariatric
surgery appears to be safe. Which nutritional deficiency is the most common problem
related to pregnancy following bariatric surgery?
A. Vitamin A
B. Iron
C. Vitamin K
D. Vitamin C
4-8 Care of the infant experiencing neonatal abstinence syndrome due to maternal
substance abuse should include which of the following?
A. Placing stuffed animals and mobiles in the crib to provide visual stimulation
B. Positioning the infant’s crib in a quiet corner of the nursery
C. Avoiding the use of pacifiers
D. Spending extra time holding and rocking the baby
4-9 Mrs. Marcello calls you in a panic because her 8-year-old daughter has head lice.
Which of the following medications is not recommended as a first-line therapy?
A. Lindane shampoo
B. Permethrin (Nix)
C. Piperonyl butoxide/pyrethrins (Rid)
D. Malathion (Ovide)
4-10 Sally and June report the news of their upcoming international adoption. The clinician
should discuss the baby’s need for follow-up examination within how long after arrival in
the United States?
A. 2 weeks
B. 4 to 6 weeks
C. 6 to 8 weeks
2
, D. 72 hours
4-11 During Kim’s first prenatal visit, she denies having had rubella or the rubella
vaccine. Based on this information, which of the following is the most appropriate action?
A. Administer the rubella vaccine.
B. Take a blood sample to assess the rubella titer.
C. Tell the client to avoid infection with rubella during her pregnancy because it will result
in a preterm birth.
D. Tell the client that because rubella has little effect on the fetus, she should not worry
about exposure to the disease.
4-12 An example of an X-linked recessive condition or trait is
A. muscular dystrophy.
B. hemophilia.
C. sickle cell anemia.
D. cystic fibrosis.
4-13 Which of the following antibiotics is the best choice for acute pyelonephritis when
it occurs during the seventh month of pregnancy?
A. Nitrofurantoin (Furadantin)
B. Trimethoprim and sulfamethoxazole (Bactrim, Septra)
C. Ampicillin (Principen, Polycillin)
D. Tetracycline (Panmycin, Achromycin V)
4-14 Marta asks you how pregnancy will affect her rheumatoid arthritis. You respond,
A. “There is a one-third rule: One-third get better, one-third remain the same, and one-
third get worse.”
B. “Pregnancy will have no effect on your rheumatoid arthritis.”
C. “Seventy-five percent of women experience remission of the disease during pregnancy.”
D. “It is advised that you don’t get pregnant with this condition.”
4-15 When counseling a pregnant woman about the use of drugs, alcohol, and
teratogenic agents, you share that the brain configuration of a fetus is roughly complete
at
A. 4 weeks’ gestation.
B. 12 weeks’ gestation.
C. 20 weeks’ gestation.
D. 24 weeks’ gestation.
4-16 According to the International Association of Diabetes and Pregnancy Study Group,
screening for gestational diabetes mellitus (GDM) should be done on which of the
following women?
A. All pregnant women at 24 to 28 weeks
3
, B. Women aged 40 or older
C. All women with threatened miscarriage
D. Women who report hypoglycemic symptoms
4-17 What is the presumptive symptom of pregnancy that involves tingling or frank pain of
the breasts?
A. Montgomery’s tubercles
B. Colostrum secretion
C. Melasma
D. Mastodynia
4-18 Ginny, who is planning on getting pregnant, is taking phenytoin (Dilantin). She asks
you if she should switch to another medication. What do you tell her?
A. While there is positive evidence of human fetal risk, the benefits may outweigh risks in
certain situations.
B. Animal studies have not demonstrated a fetal risk, but there are no human studies in
pregnant women; or animal studies have shown an adverse effect that was not confirmed
in human studies.
C. Studies or experience have shown fetal risk that clearly outweighs any possible benefits.
D. Controlled studies in women failed to demonstrate a risk to the fetus in the first
trimester, and fetal harm appears remote.
4-19 The American Academy of Pediatrics policy on medical marijuana use in children
A. recognizes that some exceptions should be made for compassionate use in children
with debilitating or life-limiting diseases.
B. discourages use in children and teenagers under any circumstances.
C. recommends stricter penalties for marijuana-related offenses.
D. supports legalization for medical use of marijuana.
4-20 Mrs. Sullivan shares concerns about her 5-year-old son’s frequent bedwetting. She
asks you about medication she has read about on the Internet. The clinician knows that
desmopressin acetate (DDAVP) can be used for primary nocturnal enuresis in children
older than
A. 6 years.
B. 5 years.
C. 4 years.
D. 3 years.
4-21 Who answers the questions included in the Ages and Stages ASQ-3 questionnaire®?
A. School nurse
B. Health-care provider
C. Parent or caregiver
4
DONNA C. MAHEADY
JILL E. WINLAND-BROWN
Questions
4-1 Talya is 2 years old and presents with signs and symptoms of acute otitis media. Mom
reports that Talya experienced a rash after the administration of penicillin in the past. If
a “wait and see” approach is not indicated, which of the following antibiotics should be
prescribed?
A. Augmentin
B. Amoxicillin
C. Omnicef
D. Trimox
4-2 Kim states that she has heard many old wives’ tales of harmful things during
pregnancy. Which of the following is in fact harmful late in pregnancy?
A. Intercourse
B. Swimming
C. Douching
D. Dental visits
4-3 The drug of choice for the pregnant woman with diabetes is
A. insulin.
B. glyburide (DiaBeta, Glynase, Micronase).
C. glipizide (Glucotrol).
D. metformin (Glucophage).
4-4 Pediatric patients may now be prescribed OxyContin for pain. Patients must be already
responding to and tolerating a minimum opioid dose equal to at least 20 mg of oxycodone
per day before they can be prescribed an equivalent dose of OxyContin. In order to be
prescribed OxyContin, pediatric patients must be
A. 5 to 16 years old.
B. 11 to 16 years old.
C. 8 to 16 years old.
D. over 16 years old.
4-5 In a “guidance to industry” document, the U.S. Food and Drug Administration
(FDA) endorsed the use of flow restrictors for over-the-counter (OTC) pediatric oral
liquid drug products containing acetaminophen. This will result in
1
, A. stiff fines to manufacturers who do not provide flow restrictors.
B. a strong signal being sent to manufacturers that flow restrictors are considered an important
safety feature to help reduce accidental overdoses.
C. uniform standards for manufacturing of flow restrictors.
D. FDA supervision of development and production of flow restrictors.
4-6 After 28 weeks’ gestation, all women should perform fetal movement counts
(FMCs). Which of the following statements is true regarding FMCs?
A. Counts should be done as the woman is going about her work.
B. Ten movements should be obtained in 1 hour.
C. Ten movements should be obtained in 2 hours.
D. If decreased activity is perceived, a nonstress test (NST) should be performed at the next
obstetric visit.
4-7 Pregnancy following the rapid weight loss and weight stabilization phase of bariatric
surgery appears to be safe. Which nutritional deficiency is the most common problem
related to pregnancy following bariatric surgery?
A. Vitamin A
B. Iron
C. Vitamin K
D. Vitamin C
4-8 Care of the infant experiencing neonatal abstinence syndrome due to maternal
substance abuse should include which of the following?
A. Placing stuffed animals and mobiles in the crib to provide visual stimulation
B. Positioning the infant’s crib in a quiet corner of the nursery
C. Avoiding the use of pacifiers
D. Spending extra time holding and rocking the baby
4-9 Mrs. Marcello calls you in a panic because her 8-year-old daughter has head lice.
Which of the following medications is not recommended as a first-line therapy?
A. Lindane shampoo
B. Permethrin (Nix)
C. Piperonyl butoxide/pyrethrins (Rid)
D. Malathion (Ovide)
4-10 Sally and June report the news of their upcoming international adoption. The clinician
should discuss the baby’s need for follow-up examination within how long after arrival in
the United States?
A. 2 weeks
B. 4 to 6 weeks
C. 6 to 8 weeks
2
, D. 72 hours
4-11 During Kim’s first prenatal visit, she denies having had rubella or the rubella
vaccine. Based on this information, which of the following is the most appropriate action?
A. Administer the rubella vaccine.
B. Take a blood sample to assess the rubella titer.
C. Tell the client to avoid infection with rubella during her pregnancy because it will result
in a preterm birth.
D. Tell the client that because rubella has little effect on the fetus, she should not worry
about exposure to the disease.
4-12 An example of an X-linked recessive condition or trait is
A. muscular dystrophy.
B. hemophilia.
C. sickle cell anemia.
D. cystic fibrosis.
4-13 Which of the following antibiotics is the best choice for acute pyelonephritis when
it occurs during the seventh month of pregnancy?
A. Nitrofurantoin (Furadantin)
B. Trimethoprim and sulfamethoxazole (Bactrim, Septra)
C. Ampicillin (Principen, Polycillin)
D. Tetracycline (Panmycin, Achromycin V)
4-14 Marta asks you how pregnancy will affect her rheumatoid arthritis. You respond,
A. “There is a one-third rule: One-third get better, one-third remain the same, and one-
third get worse.”
B. “Pregnancy will have no effect on your rheumatoid arthritis.”
C. “Seventy-five percent of women experience remission of the disease during pregnancy.”
D. “It is advised that you don’t get pregnant with this condition.”
4-15 When counseling a pregnant woman about the use of drugs, alcohol, and
teratogenic agents, you share that the brain configuration of a fetus is roughly complete
at
A. 4 weeks’ gestation.
B. 12 weeks’ gestation.
C. 20 weeks’ gestation.
D. 24 weeks’ gestation.
4-16 According to the International Association of Diabetes and Pregnancy Study Group,
screening for gestational diabetes mellitus (GDM) should be done on which of the
following women?
A. All pregnant women at 24 to 28 weeks
3
, B. Women aged 40 or older
C. All women with threatened miscarriage
D. Women who report hypoglycemic symptoms
4-17 What is the presumptive symptom of pregnancy that involves tingling or frank pain of
the breasts?
A. Montgomery’s tubercles
B. Colostrum secretion
C. Melasma
D. Mastodynia
4-18 Ginny, who is planning on getting pregnant, is taking phenytoin (Dilantin). She asks
you if she should switch to another medication. What do you tell her?
A. While there is positive evidence of human fetal risk, the benefits may outweigh risks in
certain situations.
B. Animal studies have not demonstrated a fetal risk, but there are no human studies in
pregnant women; or animal studies have shown an adverse effect that was not confirmed
in human studies.
C. Studies or experience have shown fetal risk that clearly outweighs any possible benefits.
D. Controlled studies in women failed to demonstrate a risk to the fetus in the first
trimester, and fetal harm appears remote.
4-19 The American Academy of Pediatrics policy on medical marijuana use in children
A. recognizes that some exceptions should be made for compassionate use in children
with debilitating or life-limiting diseases.
B. discourages use in children and teenagers under any circumstances.
C. recommends stricter penalties for marijuana-related offenses.
D. supports legalization for medical use of marijuana.
4-20 Mrs. Sullivan shares concerns about her 5-year-old son’s frequent bedwetting. She
asks you about medication she has read about on the Internet. The clinician knows that
desmopressin acetate (DDAVP) can be used for primary nocturnal enuresis in children
older than
A. 6 years.
B. 5 years.
C. 4 years.
D. 3 years.
4-21 Who answers the questions included in the Ages and Stages ASQ-3 questionnaire®?
A. School nurse
B. Health-care provider
C. Parent or caregiver
4
