Chapter 18 NR 509 Final || Questions and 100% Verified
Answers.
During the delivery of a male infant, you are there to assess the Apgar score. He was born
through an intact pelvis and had no complications during labor or delivery. At 1 minute he is
pink all over and grimaces. He is flexing his arms and legs occasionally. He is breathing well and
his heart rate is 110. At 5 minutes he is still pink all over but now is crying vigorously, with
active movement. His respiratory effort is good and his heart rate is 130.
What is his Apgar score?
A) 8 at 1 minute, 10 at 5 minutes
B) 7 at 1 minute, 9 at 5 minutes
C) 9 at 1 minute, 10 at 5 minutes
D) 8 at 1 minute, 9 at 5 minutes correct answers A) 8 at 1 minute, 10 at 5 minutes
A 24-year-old mother who is a smoker and cocaine addict gave birth at 39 weeks to a 2,000-
gram female infant who is in the neonatal intensive care unit. Using the Intrauterine Growth
Curve chart, you determine whether the infant's weight is appropriate for her gestational age.
In which category does the infant best fit?
A) Large for gestational age
B) Normal for gestational age
C) Small for gestational age correct answers C) Small for gestational age
A mother brings her 16-month-old son in for an evaluation. She is afraid he is not meeting his
developmental milestones and wants to know if he should be sent to therapy. He was the product
of an uneventful pregnancy and a spontaneous vaginal delivery. His Apgar scores were 7 and 9.
Until reaching a year old the mother believes he was hitting his milestones appropriately. You
decide to administer the Denver Developmental Screening Test. You find that he is using a
spoon to eat with and can take off his own shoes and shirt. He can build a tower of two cubes and
dump raisins. His vocabulary consists of at least 10 words. He can stand alone and stoop and
recover, but he is unable to walk without holding onto someone's hand.
What type of developmental delay does he have?
A) Personal/social
B) Fine motor
C) Language
D) Gross motor correct answers D) Gross motor
A foster mother brings a 4-year-old child to see you for an evaluation. She has had custody of the
girl for 2 weeks. She knows that the child was born in your state and that her maternal
grandmother had custody for 6 months. She received good medical care during that time, but
after her biologic mother obtained custody the child was abused and has had no further medical
care. She says the child has had many behavioral problems and seems to be very behind on her
developmental tasks. When you examine the child you notice short palpebral fissures, a wide
, nasal philtrum, and thin lips. Her cardiac, pulmonary, musculoskeletal, and abdominal
examinations are normal. Her Denver Developmental Screening Test shows most of her
milestones have occurred only through the 24th month.
What form of congenital retardation is she most likely to have?
A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome correct answers A) Fetal alcohol syndrome
A young Hispanic mother brings in her 2-month-old son. She is upset because her neighbors
have threatened to call the Child Protective Agency because they think his birthmark is a bruise.
Her son was the product of an uneventful pregnancy and spontaneous vaginal delivery. On
examination you see a large, smooth-bordered bluish mark on his buttock and lower back.
Otherwise his examination is unremarkable.
What form of birthmark is this likely to be?
A) Café-au-lait spot
B) Salmon patch
C) Mongolian spot correct answers C) Mongolian spot
A 32-year-old white female presents to labor and delivery fully effaced and delivers a 5.8-lb
(2,500-gram) infant female with Apgar scores of 6 and 8. The mother has had no prenatal care
and in the nursery you perform the newborn examination. With the Ballard scoring system, the
neuromuscular examination score is 15. Looking at physical maturity, you see superficial peeling
and few veins on the skin. The lanugo hair has bald areas and the plantar surface of the foot has
creases on two thirds of it. The areola is stippled with a 2-mm bud. The pinna is well curved, is
firm, and has instant recoil. The labia majora and minora are equally prominent.
Add the score of the neuromuscular components to your score of physical maturity to determine
weeks of gestation. How many weeks of gestation has this child had?
A) 34 weeks
B) 36 weeks
C) 40 weeks correct answers B) 36 weeks
A mother brings in her 3-year-old son for a well-child check-up. She is concerned that he seems
different in size from all of the other preschool boys. He was the product of an uneventful
pregnancy and vaginal delivery. He has hit all of his developmental milestones on time. On
examination he is 26 lbs (11.8 kg) and is 35 inches (89 cm) tall. Otherwise his examination is
unremarkable. You give the correct education for his age and then discuss his size.
For his age, what are his growth chart percentiles?
A) Tall and heavy for his age (>95%)
B) Average height and weight for his age (5 to 95%)
C) Small and light for his age (<5%) correct answers C) Small and light for his age (<5%)
Answers.
During the delivery of a male infant, you are there to assess the Apgar score. He was born
through an intact pelvis and had no complications during labor or delivery. At 1 minute he is
pink all over and grimaces. He is flexing his arms and legs occasionally. He is breathing well and
his heart rate is 110. At 5 minutes he is still pink all over but now is crying vigorously, with
active movement. His respiratory effort is good and his heart rate is 130.
What is his Apgar score?
A) 8 at 1 minute, 10 at 5 minutes
B) 7 at 1 minute, 9 at 5 minutes
C) 9 at 1 minute, 10 at 5 minutes
D) 8 at 1 minute, 9 at 5 minutes correct answers A) 8 at 1 minute, 10 at 5 minutes
A 24-year-old mother who is a smoker and cocaine addict gave birth at 39 weeks to a 2,000-
gram female infant who is in the neonatal intensive care unit. Using the Intrauterine Growth
Curve chart, you determine whether the infant's weight is appropriate for her gestational age.
In which category does the infant best fit?
A) Large for gestational age
B) Normal for gestational age
C) Small for gestational age correct answers C) Small for gestational age
A mother brings her 16-month-old son in for an evaluation. She is afraid he is not meeting his
developmental milestones and wants to know if he should be sent to therapy. He was the product
of an uneventful pregnancy and a spontaneous vaginal delivery. His Apgar scores were 7 and 9.
Until reaching a year old the mother believes he was hitting his milestones appropriately. You
decide to administer the Denver Developmental Screening Test. You find that he is using a
spoon to eat with and can take off his own shoes and shirt. He can build a tower of two cubes and
dump raisins. His vocabulary consists of at least 10 words. He can stand alone and stoop and
recover, but he is unable to walk without holding onto someone's hand.
What type of developmental delay does he have?
A) Personal/social
B) Fine motor
C) Language
D) Gross motor correct answers D) Gross motor
A foster mother brings a 4-year-old child to see you for an evaluation. She has had custody of the
girl for 2 weeks. She knows that the child was born in your state and that her maternal
grandmother had custody for 6 months. She received good medical care during that time, but
after her biologic mother obtained custody the child was abused and has had no further medical
care. She says the child has had many behavioral problems and seems to be very behind on her
developmental tasks. When you examine the child you notice short palpebral fissures, a wide
, nasal philtrum, and thin lips. Her cardiac, pulmonary, musculoskeletal, and abdominal
examinations are normal. Her Denver Developmental Screening Test shows most of her
milestones have occurred only through the 24th month.
What form of congenital retardation is she most likely to have?
A) Fetal alcohol syndrome
B) Congenital hypothyroidism
C) Down syndrome correct answers A) Fetal alcohol syndrome
A young Hispanic mother brings in her 2-month-old son. She is upset because her neighbors
have threatened to call the Child Protective Agency because they think his birthmark is a bruise.
Her son was the product of an uneventful pregnancy and spontaneous vaginal delivery. On
examination you see a large, smooth-bordered bluish mark on his buttock and lower back.
Otherwise his examination is unremarkable.
What form of birthmark is this likely to be?
A) Café-au-lait spot
B) Salmon patch
C) Mongolian spot correct answers C) Mongolian spot
A 32-year-old white female presents to labor and delivery fully effaced and delivers a 5.8-lb
(2,500-gram) infant female with Apgar scores of 6 and 8. The mother has had no prenatal care
and in the nursery you perform the newborn examination. With the Ballard scoring system, the
neuromuscular examination score is 15. Looking at physical maturity, you see superficial peeling
and few veins on the skin. The lanugo hair has bald areas and the plantar surface of the foot has
creases on two thirds of it. The areola is stippled with a 2-mm bud. The pinna is well curved, is
firm, and has instant recoil. The labia majora and minora are equally prominent.
Add the score of the neuromuscular components to your score of physical maturity to determine
weeks of gestation. How many weeks of gestation has this child had?
A) 34 weeks
B) 36 weeks
C) 40 weeks correct answers B) 36 weeks
A mother brings in her 3-year-old son for a well-child check-up. She is concerned that he seems
different in size from all of the other preschool boys. He was the product of an uneventful
pregnancy and vaginal delivery. He has hit all of his developmental milestones on time. On
examination he is 26 lbs (11.8 kg) and is 35 inches (89 cm) tall. Otherwise his examination is
unremarkable. You give the correct education for his age and then discuss his size.
For his age, what are his growth chart percentiles?
A) Tall and heavy for his age (>95%)
B) Average height and weight for his age (5 to 95%)
C) Small and light for his age (<5%) correct answers C) Small and light for his age (<5%)
