Nursing Practice - Maternal
Health - Galen
Actual Questions and Answers
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Galen College Of Nursing Exam 4
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,What are the 4 factors that influence initiation of the first breath?:
Answer:
- Chemical factors (hypercarbia, acidosis, hypoxia)
- Sensory factors (stimuli such as noise, light, touch)
- Thermal factors (sudden temperature change)
- Mechanical factors (thoracic squeeze during birth clears lung fluid)
Explanation: These factors collectively stimulate the newborn’s respiratory
center to initiate and maintain effective breathing at birth.
2. Why does hypoxia, hypercarbia, and acidosis trigger respirations?:
Answer:
- Hypoxia lowers blood oxygen (PO2) levels and pH, indicating oxygen
deficiency.
- Carbon dioxide (PCO2) levels rise, stimulating the respiratory center in
the medulla to increase respiratory effort.
Explanation: The medullary respiratory center responds to elevated CO2
and lowered O2/pH by triggering spontaneous breathing to oxygenate the
blood and remove excess CO2, essential for neonatal adaptation.
3. Periodic breathing in a newborn is not usually associated with any
change in skin color or HR. How long are these pauses?:
Answer: 5-15 seconds
Explanation: Periodic breathing is a benign, immature breathing pattern in
newborns involving brief pauses, generally up to 10-15 seconds, without
oxygen desaturation or cardiac changes.
,4. What does each APGAR score mean?:
Answer: >7 = normal
4-6 = low
<3 = critical
Explanation: Scores above 7 indicate good newborn status; scores
between 4-6 suggest mild to moderate distress and may require
intervention; a score less than 3 indicates severe distress and urgent
resuscitation is required.
5. When is the APGAR score assigned?:
Answer: At 1 and 5 minutes after birth
Explanation: The APGAR scoring system is a quick and standardized
method to assess the health and immediate adaptation of a newborn at 1
minute and again at 5 minutes after birth. This allows healthcare providers
to determine if the infant needs urgent medical intervention and to evaluate
initial responses to resuscitation efforts.
6. What are the five categories of the APGAR score?:
Answer:
1. Heart Rate (HR)
2. Respiratory Rate (RR)
3. Muscle Tone
4. Reflex irritability (cry)
5. Generalized Skin Color (coloring)
Explanation: These five criteria are evaluated and scored from 0 to 2
based on the newborn’s condition immediately after birth to assess their
physiological stability.
, 7. When the APGAR score is <9 at 5 minutes, it is more important to
stabilize the infant than keep them with mom. T/F?
Answer: True
Explanation: While bonding with the mother is important, an APGAR score
less than 9 indicates the newborn may need immediate interventions to
ensure adequate oxygenation and circulation, making stabilization the
priority.
8. What are indicators of respiratory difficulties in the newborn?:
Answer:
- Apnea >20 seconds
- Expiratory grunting
- Wheezing
- Nasal flaring
- Retractions
- Use of accessory muscles at rest
- Tachypnea (high respiratory rate)
Explanation: These signs indicate increased work of breathing or
respiratory distress and warrant prompt assessment and intervention.
9. What are the five changes for successful cardiopulmonary
adaptation?:
Answer:
- Increased aortic pressure
- Decreased venous pressure
- Increased systemic pressure