Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
الأحد، فبراير 16، 2014
السبت، فبراير 15، 2014
تعلم SPSS الدرس التاسع-تدريبات متنوعة الجزء الرابع
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
تعلم SPSS الدرس الثاني ادخال البيانات-الجزء الاول
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
تعلم SPSS الدرس الاول واجهة البرنامج
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
تعلم SPSS الدرس الثالث عمل الاستبيان-الجزء الاول
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
إدخال البيانات فى برنامج SPSS ... دكتور نصر محمود
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
إدخال البيانات فى برنامج SPSS ... دكتور نصر محمود
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
Descriptive Statistics Inferential Statistics part1
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
Different Statistical Tests
Best Wishes:Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
الرسوم المالية المقررة للاختبار فى مقرات الهيئة داخل المملكة
الرسوم الماليه //
رسوم التصنيف المهني //
درجة أطباء استشاريين
قيمة الرسوم المقررة 1800ريال
درجة أطباء (نائب / نائب أول)
قيمة الرسوم المقررة 1500ريال
درجة أطباء عامون وأسنان
قيمة الرسوم المقررة 1100ريال
درجة أطباء تخصصات فرعية (زمالات دقيقة)
قيمة الرسومالمقررة 1100 ريال +600 ريال لكل زمالة إضافية في نفس الطلب
درجة الصيادلة والاخصائيين الصحيين بكالوريوس/ماجستير
قيمةالرسوم المقررة 1100 ريال
درجة دكتوراه الصيادلة والأخصائيين الصحيين
قيمة الرسوم المقررة 1500 ريال
درجة الفنيين / الممرضين/ المساعدين الصحيين
قيمة الرسوم المقررة 600 ريال
درجة التخصصات الإضافية (لجان) رسومها المعتمدة
قيمة الرسوم المقررة 1500 ريال
درجة بكالوريوس الجامعات السعودية (القرارات المباشرة/أطباء)
قيمة الرسوم المقررة 500 ريال
درجة بكالوريوس الجامعات السعودية (القرارات المباشرة/غيرأطباء)
قيمة الرسوم المقررة 500 ريال
رسوم التسجيل المهني للأطباء//
درجة استشاري
قيمة الرسوم المقررة لمدة سنة واحدة هي 250ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 750 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 1250 ريال
درجة نائب + نائب أول
قيمة الرسوم المقررة لمدة سنة واحدة هي 200ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 600 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 1000 ريال
درجة طبيب مقيم +عام/أسنان
قيمة الرسوم المقررة لمدة سنة واحدة هي 160ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 480 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 800 ريال
ملاحظة : التسجيل المهني لمدة خمس سنوات خاص بالسعوديين
رسوم التسجيل المهني لغير الاطباء//
درجة استشاري
قيمة الرسوم المقررة لمدة سنة واحدة هي 200ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 600 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 1000 ريال
درجة أخصائي أول
قيمة الرسوم المقررة لمدة سنة واحدة هي 160ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 480 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 800 ريال
درجة أخصائي/صيدلي
قيمة الرسوم المقررة لمدة سنة واحدة هي 120ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 360 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 600 ريال
درجة مساعد/فني/فني أول
قيمة الرسوم المقررة لمدة سنة واحدة هي 80ريال وقيمة الرسوم المقررة لمدة ثلاث سنوات هي 240 ريال وقيمة الرسوم المقررة لمدة خمس سنوات هي 400 ريال
ملاحظة : التسجيل المهني لمدة خمس سنوات خاص بالسعوديين
رسوم خدمات اخرى //
قيمة الرسوم المقررة لخدمة الترجمة واعتماد شهادات هي 300 ريال
قيمة الرسوم المقررة لخدمة إصدار شهادة بدل فاقد وتعديل للأطباء والصيادلة والأخصائيين ومن في حكمهم هي 300 ريال
قيمة الرسوم المقررة لخدمة إصدار/ تعديل بطاقة بدل فاقد للتسجيل المهني هي 150 ريال
قيمة الرسوم المقررة لخدمة إصدار شهادة براءة مهنية /مزاولة مهنة هي 300 ريال
اسئلة فني معمل
1.the infective stage of animal parasite
§ Toxoplasma gondii
2.the (u) unit used to evaluation of :
§ Protein in serum
§ Hemoglobin
§ Hormone assay
§ Enzymatic activity
3.the following is ingredient of culture medium:
§ Meat extract
§ Minral salts
§ Agar
§ Peptone
§ Non of the above
§ All of the above
4.a semen specimen, contain sugar source of the spermatozoa energy is:
§ Glucose
§ Mannose
§ Glactose
§ Fructose
§ Sucrose
5.CPD_A anticoagulant used to store blood for:
§ 35 days
§ 45 days
§ 5 days
§ 15 days
§ Non of the above
6During reaction of two chemical substances , the color produced asses by
§ Spectrophotometer
§ Flame photometer
7.glycolysis done in :
§ Nucleus
§ Endoplasmic reticulum
§ Mitochondrion
§ Cytoplasm
§ Non of the above
8.one of the above not present in Diabetic mellitus coma :
§ Hyperglycemia
§ Hypercholesterolemia
§ High number of ketene in urine
§ Non of the above
9.in which substance give blood glucose when hydrolysis :
§ Muscle glycogen
§ Liver glycogen
§ Heart glycogen
§ Unsaturated fat
§ Triglyceride
10.in Anti human globulin test do wash of RBC because all serum contain :
§ Albumin
§ a_glubulin
§ b_ globulin
§ fibrinogen
§ Immunoglobulin
11. the most source of ATP in cell is :
§ Mitochondria
§ Cytoplasm
§ Nucleus
§ Cell wall
12 . H Ag present in :
§ Pilli
§ Capsule
§ Flagella
§ Cell membrane
13. urea is final product of catabolism of:
§ amino acid
§ triglyceride
§ cholesterol
§ polysaccharide
14.Which of White blood cell give immunoglobulin :
§ lymphocyte
§ Neutrophil
§ Basophile
§ Monocyte
§ Eosinophil
15.Blood of Microfilaria infection diagnosis with :
§ Wuchereia bancofti
16.one of the immunoglobulin present in trace amount in serum :
§ IgG
§ IgE
§ IgM
§ IgD
§ IgA
17.gram _ve bacteria colonies color appear :
§ Dark purple
§ Pale to dark red
§ Orange
18. alkali burn treatment by neutralization with :
§ Sodium bicarbonate powder
§ Boric acid
§ Acetic Acid
§ Cold water
§ Hot water
19.reason of false positive ABO in compatibility:
§ Cold agglutination
20. selective and Differential medium of entero pathogen is:
§ Chocolate agar
§ Blood agar
§ DCA medium
§ Meat extract agar
§ Non of the above
21.in O blood group the Ab in serum is :
§ Anti A1B
§ Anti A
§ Anti B
§ Non of the above
§ All of the above
22.Neutrophil is acommn White blood cell present in blood and the percentage of presence is :
§ 90%
§ 15%
§ 75%
23.The leukocyte that involve in Adaptive and Acquired immunity
§ Lymphocyte
§ Monocyte
§ Neutrophil
§ Basophil
§ Eosinophil
24. one of these is prokaryotic cell:
§ Fungi
§ Bacteria
§ Entameba histolytica
§ All of the above
§ Non of the above
25.Most sever (serious) malaria infection caused by:
§ Plasmodium faliceparm
§ Plasmodium Malaria
§ Plasmodium Ovale
§ Plasmodium Vivax
§ All of the above
26.To detect pH from solution use :
§ pH meter
§ Indicator
§ Micrometer
27. one of these organism multiply intracellular parasite:
§ Gardia lamblia
§ Entameba histolytica
§ E. coli
§ Tryponosoma Cruzi
§ Toxoplasma gondii
28.gram-ve rod non motile :
§ Salmonella
§ Yersini pestis
§ Shigella species
§ Vibrio cholerae
29. Leukocyte responsible for cellular immunity:
§ T_ lymphocyte
§ B- lymphocyte
§ Monocyte
§ Basophile
§ Eosinophil
30.one of these org gram +ve cocci arranged in pairs :
§ Staphylococci
§ Streptococci
§ Meningococci
§ entrococci
31. One is not a Romanowsky stain
§ Fields stain
§ Gram stain
§ Geimsa stain
§ Leishman stain
32. Hydrolysis of sucrose result:
§ Only glucose
§ Galactose
§ Fructose + glucose
§ Glucose + Glucose
§ Maltose + Glucose
32.method used to detect horomone in the laboratory :
§ ELIZA
33. one of the following has highest conc. Of cholesterol:
§ Chylomicron
§ LDL
§ HDL
§ VLDL
§ Apolipoprtein
34. oxytocine hormone function :
§ Increase Oogenesis
§ Stimulate contraction of uterus
§ Increase basal metabolic
35. Iodine stain of Entamoeba cyst used to detect (diagnose):
§ Chromatoidal bars
§ Cell wall
§ Nuclei
36. function of Cortisol :
§ Increase Oogenesis
§ Stimulate contraction of uterus
§ Increase basal metabolic
37.infective stage of Ascaris lumbricodes :
§ Larva
§ Cercaria
§ Egg
§ Cyst
§ Metacercaria
38.substance used in catalyse reaction :
H2O2
39. Normal range of erythrocyte
- 4,5- 6,5X 10^9
40.one of these leukocyte have 2_5 lobes in nucleus :
§ Neutrophil
§ Basophil
§ Monocyte
§ Lymphocyte
§ Eosinophil
41. one of these cell the largest leukocyte cell:
§ Neutrophil
§ Basophil
§ Monocyte
§ Lymphocyte
§ Eosinophil
42.Alkline phosphates is the important enzyme to detect function in :
§ Liver
§ Bone
§ Liver and bone
§ Non of the above
43.one of the following anticoagulant used for blood glucose :
§ EDTA
§ Heparin
§ Sodium oxalate
§ Florida Oxalate
§ Sodium citrate
44.AST important enzyme to detect abnormality in:
§ Liver disease
§ Heart disease
§ Liver and heart disease
§ Non of the above
45. the defect of thalassemia occur in:
§ Cycle of heme
§ Glubin chain
§ acute flammable
§ Toxic
§ Corrosive
§ Explosive
(4)
Choose the correct answer:
(1) the best anti coagulant in blood culture is
*sodium oxalate
*sodium citrates
*sodium sulphate
(2) all the following samples are stained using gram stain except?
*water culture
*sputum
*stool
(3) the percentage of sodium chloride in agar culture is?
*0.058%
*58.0%
*0.58%
(4) agar is characterized by all the following except?
*freezing point is 42c & melting point is 100c
*nutritive
*un-nutritive
(5) the normal value of (Na) in serum is?
*135-145 mg/dl
*135-145 mmol/dl
*135-145 mmol/l
(6) gram stain starts with?
*iodine
*crystal green
*methyl violet /
(7) the causative of toxoplasma is?
*flees
*dogs
*cats
(8) gram negative samples are stained with?
*yellow color
*blue color
*red colonies
(9) the color of cholera when cultured on TCBS?
*blue
*green
*yellow
(10) the diameter of micro pore filter used in bacteria filtration is?
*0.033microns
*2.2microns
*.22microns
(11) leishmania is transported by?
*mosquitoes
*pugs
*sand fly
(12) to investigate one sample containing floro-carbon we use which microscope?
*light microscope
*brilliant microscope
*florescent microscope
(13) virus is similar to live organisms in?
*growth
*movement
*reproduction
(14) the largest resolution of the microscope is?
*0.02microns
*2.0microns
*0.2microns
(15) which of the following is liver function test?
*liver enzymes
*serum + urin billrubin
*all of the previous
(16) which of the following causing enlargement of RBCs?
*reticulocytes
*leishmania
*plasmodium
(17) the best sample for the culture of children paralysis virus is?
*anal swab
*blood culture
*stool culture
(18) dry air oven is used to sterilize?
*water
*culture media
*sand
(19) the diabetic patient is going to comma when blood glucose is?
*120 mg/dl
*160 mg/dl
*less than 50mg/dl
(20) to differentiate between the two streptococci group which enzyme is used?
*coagulase
*kinase
*catalase
(21) the microscope which used in investigate syphilis is?
*light microscope
*ultra-violet microscope
*dark field microscope
(22) the antibiotic disc which differentiate between group A streptococci and other groups is?
*neomycin
*tetracycline
*bacitracin
(23) all of the following is true for salmonella except?
*motile
*produces H2S
*oxidase positive
(24) amylase value is high in the following disease?
*salivary glands
*pancreas diseases
*all of the previous
(25) one jaundice patient has yellow skin, his billrubin is:
*2.5mg/dl
*1.2mg/dl
*5.0mg/dl
(26) acute diabetic patient has?
*blood sugar more than 150mg/dl
*blood sugar more than 180mg/dl
*glucose & acetone in urin
(27) the normal value of billrubin is?
*0.2-2.0mg/dl
*less than 2.0mg/dl
*less than 1.0mg/dl
(28) diabetic patient has one of the following symptoms?
*acidosis
*alkalosis
*dryness
(29) insulin is regulating blood sugar by?
*increase the influx of glucose into cells
*activate glycogensis
*all the previous
(30) the nutritive substance in culture media is?
*sugar
*starch
*agar
(31) the best media for urin culture is?
*blood agar
*chocolate agar
*cled agar
(32) the sterilization of autoclave is?
*85c for 30min
*150c for 30min
*121c for 15min
(33) shigella soni colored in maconkey & EMB?
*colorless
*red
*pink
(34) the oil emertion lens is
*10
*40
*100
(35) the dwarf worm is?
*schistosoma
*tenia saginata
*H.nana
(36) all of the following are present in gram stain except?
*safranine
*iodine
*malachite green
(37) the diagnostic stage of amoeba is?
*cyst
*trophozoite
*all previous
(38) to check the intestinal efficacy the following test is done?
*pepsin
*lipase
*stool fats
(39) the worm that causes blood in urin?
*ascaris
*fasciola
*schistosoma haematobium
(40) the significant count of bacteria to be inflammation is?
*less than 10^5
*more than 10^3
*more than 10^5
(41) to investigate gram stained samples we use the following microscope?
*double phase microscope
*florescent microscope
*light microscope
(42) the most important buffer system in blood is?
*acetic acid system
*hemoglobin system
*bicarbonates system
(43) all the following bacteria are interobacter except?
*E.coli
*proteus
*non of the previous
(44) in the microscope when using objective lens 10 & eye lens 10 thee magnification power of the microscope is?
*10
*1000
*100
(45) all the following parameters affecting gram staning except?
*use H2SO4
*add absolute alcohol after washing
*delaying the dryness of the slide
(46) glycogen is stored in?
*liver
*muscles
*all the previous
(47) malaria chizonts are present in?
*reticulo-endothelial
*leukocyte
*RBCs
(48) comma of diabetic patient shows?
*glucose grater than 200mg/dl
*glucose less than 200mg/dl
*glucose grater than 500mg/dl
(49) blood donor selection in KSA are all of the following except?
*Hb% 12.5-16
*free from syphilis
*one year after delivery
(50) solidifying agent in culture media is?
*wax
*starch
*agar
(51) agar which used as a solidifying agent in culture media concentration is?
*5-9%
*4-9%
*1-2%
(52) to sterilize culture media we use?
*boiling
*hot oven
*autoclave
(53) bone matrix can also called?
*vascular tissue
*fibrous tissue
*osteon
(54) unidirectional movement of WBCs directly to its target is?
*sliding
*phagocytes
*chemo taxis
(55) when focusing a stained smear under oil immersion field the magnification is?
*10
*40
*100
(56) in myocardial infection?
*level of LHD high
*level of GOT high
*level of CK-MB high
(57) variation in RBCs size?
*microcytosis
*macrocytosis
*aniso cytosis
(58) pretranfusion test that is performed using the patient red cells and donor plasma?
*Anti body screen
*major x-matching
*minor x-matching
(59) serum LDH is elevated in all the following except?
*skeletal disease
*cardiac/ hepatic diseases
*renal disease
(60) elevated sodium &chloride is seen in?
*shock
*diabetic acidosis
*severe dehydration
(61) which test is better to diagnose chronic bile duct?
*total bilirubin
*S-GOT
*ALP
(62) generally diagnosed by recovery & identification of typical larva in stool?
*hook worms
*t.trichura
*s.stercoralis
(63) enlarged RBCs are common in?
*p.malaria
*p.falciparum
*p.vivax
(64) which of the following is not laying eggs in small intestine?
*hook worm
*t.saginata
*pin worm
(65) blood sample is used to diagnose?
*C.tetani
*C.diphteria
*non from them
(66) how much water should we add to 500ml of a solution of 10% of NAOH to bring it to 7.5%?
*666
*250
*166
(67) while using the pregnancy test we are measuring?
*total HCG
*beta HCG &LH
*beta HCG
(68) with age the renal threshold for glucose?
*increase
*decrease
*does not change
(69) calibrator sera are?
*secondary standards
*internal standards
*primary standards
(70) a buffer made of?
*a strong acid + a strong salt
*a weak acid + a weak salt
*a weak acid + a strong salt
(71) a standard micro plates in ELISA test has?
*98 wells
*94 wells
*96 wells
(72) the enzyme in ELISA testing is present in the?
*buffer
*micro plate
*conjugate
(73) antigen antibody complex are?
*weakly bound
*no bounds
*strongly bound
(74) washing must be done in all heterogeneous ELISA technique because?
*increase the specificity
*increase the sensitivity
*it removes the excess binding
(75) the label in ELISA tests is?
*radio active substance
*antibody
*enzym
(76) the difference between plasma & serum is that plasma?
*does not contain fibrinogen
*has more water
*contains fibrinogen
(77) five ml of colored solution has an absorbance of .500nm
The absorbance of 10ml of the same solution is?
*1.000nm
*0.250nm
*0.500nm
(78) plasma or serum should be separated at the earliest time for estimation of glucose because?
*glucose value increases with time
*lyses of blood will occur
*glucose value decreases with time
(79) sensitivity & specify are?
*directly related
*they mean the same
*non of above
(80) a dichromatic analysis is carried to increase?
*linearity
*specify
*sensitivity
(81) causes of high serum bilirubin are?
*overload on liver
*haemolysis
*all of the previous
(82) polio myeletis is transmitted through?
*skin
*respiration
*feco-oral
(83) malaria does not grow in?
*EDTA blood
*heparin zed blood
*plasma
(84) serious that causes food poisoning?
*staph albus
*salmonella typhi
*salmonella enteritidis
(85) hemophilia man married to normal woman the incidence of his children is?
*carrier male
*diseased female
*carrier female
(86) which of the following causes UTI & INDOL positive?
*klebsiella
*staphylococci
*E.coli
(87) blood transfusion can transmit?
*HIV
*CMV
*all of the previous
(88) ADH is secreted from?
*thyroid gland
*anterior pituitary
*posterior pituitary
(89) one of the following enzymes is effected by hemolysis?
*SGOT
*SGPT
*LDH
(90) HbA1C of diabetic patient is important for?
*he has to come fasting
*short term follow up
*long term follow up
(91) for glucose tolerance test?
*collect 5 blood samples only
*collect 5 urin samples only
*collect 5 blood samples + 5 urin samples
(92) one of the following heart enzymes is measured after 4-8hr of chest pain?
*GOT
*LDH
*CPK
(93) light effects one of the following?
*glucose
*urea
*billrubin
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
دورة الانعاش القلبى - BLS
يسرني ويشرفني طرح بعض المعلومات المهمة عن دورة سبل المحافظة على الحياة (bls ) والتي تقام بجميع مراكزالانعاش القلبي الرئوي بالوزارة
أ - الدورة معترف بها من جمعيةالقلب السعودية وهيئة التخصصات السعودية ويتم تسليم الخريجين شهادة إتمام الدورة وبطاقة الممارسة الخاصة بذلك .
ب - أصبحت الدورة إلزامية على جميع الممارسين الصحيين إبتداء من 1 / 1 / 1430هـ سواء للقطاع الحكومي أو الخاص .
ج - تقام الدورات باللغةالعربية وكذلك باللغة الإنجليزية
هـ - هناك فريق متجول يقوم بالذهاب للمناطق البعيدة لعمل الدورة في نفس مقر العمل .
و - البرنامج :
1 ) يبدأ عند الساعة السابعة بالنصف صباحاً من خلال إنهاء إجراءات التسجيل وتعبئة النموذج الخاص بذلك .
2 ) يبدأ عرض فيلم الفيديوعند الساعة الثامنة صباحاً ولمدة ساعة وعشرين دقيقة وهو فيلم من جمعية القلب الأميركية .
3 ) راحة لمدة نصف ساعة يتخللها تناول طعام الافطار .
4 ) توزيع المتدربين على أربع مجموعات .
5 ) البدء في تطبيق مهارات الانعاش القلبي الرئوي للبالغين ولأطفال والرضع وإنغلاق
مجرى الهواء من خلال أربع محطات تدريب في كل محطة يوجد مدرب يقوم بتدريب المجموعة .
- المحطة الأولى : الانعاش القلبي الرئوي للبالغين بمسعف ومسعفين .
- المحطة الثانية :الانعاش القلبي الرئوي للأطفال والرضع.
- المحطة الثالثة : إنغلاق مجرى الهواء للبالغين والآطفال والرضع .
- المحطة الرابعة :جهاز الصدمات الكهربائية والأدوات المانعة لإنتقال العدوى.
6 ) كل محطة تدريب تستغرقخمسين دقيقة ، ويتخلل المحطات وقت صلاة الظهر .
7 ) الاختبار التحريري :
* ويقام بعد الإنتهاء من التقييم العملي ويتكون من (20 سؤال ) على شكل اختيارات متعدده .
* مدة الاختبار من نصف ساعةإلى ساعة كاملة .
* درجة النجاح في الاختبارالتحريري هو ( 80 % ) ويتجاوز المتدرب الامتحان في
حال لم يتجاوز عدد الأخطاء لديه ( 4 أخطاء ) فقط .
7 ) بعد نهاية الاختبار يتم تصحيح الاجابات ومعرفة النتائج .
8 ) يتم تحديد موعد لإستلام شهادة الدورة وبطاقة الممارسة الخاصة بذلك .
9 ) في حال عدم النجاح يتم التنسيق مع منسق المركز لأخذ موعد إعادة الإختبار .
نقلا عن استاذنا الفاضل/
المدرب الاكلينيكي للتمريض ومدرب الانعاش القلبي الرئوي
ناصر العتيبي
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
مراجع امتحان أمراض سريرية
Hematology
Wintrobe's Clinical Hematology, Lippincott Williams and Wilkins, 12th Edition, 2009
WHO Classification of tumors of haematopoetic and lymphoid tissues. Swerdlow SH, Campo E, Harris NL, et al. IARC press. 2008. 4th Edition
Dacie and Lewis: Practical Hematology. Lewis SM, Bain BJ, Bates I (Eds). 2006, 10th Ed
Haemoglobinopathy Diagnosis. Barbara J. Bain. 2006. 2nd Ed
William's Hematology. Lichtman LA, Beutler E, Kipps TJ, et al. 2007 The McGraw-Hill Companies. 7th Ed
Modern Hematology. Biology and clinical management. 2007, 2nd ed. Munker R, Ed. Humana Press, New Jersey.
Biochemistry
Textbook of Biochecmistry, 7th Edition, Wiley
Davidson's Principles and Practice of Medicine, 20th Edition
Lippincott's illustrated reviews, 4th edition, 2008, Biochemistry, Williams and Wilkins
Harper's Illustrated Biochemistry, 26th Edition, 2003, Murray RK, Granner Dk, Mayes PA, Rodwell VW., Lange Medical Books/McGraw-Hill
Microbiology
Microbiology: Principles and Application, 3rd Edition
Medical Microbiology, Churchill Livingstone, 16th Edition, 2002
Textbook of Microbiology. R Ananthanarayanan, CKJ Paniker. 7th Edition
Bloodbank
AABB Technical Manual. Mark E. Brecher (Ed,) AABB, 2005
Molecular Pathology
Molecular Diagnosis for Clinician Laboratorian. Coleman WB & Tsongalis GJ (Eds). Humana Press.
Clinical Pathology, 2007, Oxford U Press
Immunology
Robbins Basic Pathology. Kumar, Abbas, Fausto, Mitchell, 8th Edition, 2007
Medical Immunology. PArslow TG, Stities DP, Terr Al, Imboden JB., McGraw-Hill, 2001
Transplantation Immunology, methods and protocols. Hornick P, Rose M., 2006, Humana Press, New Jersey ..
------------------------------
طبيعة ومحتوى امتحان أمراض سريرية
Passing Score
Relative Percentage
Content
Evaluation Item
Topics:
(70 MCQs, 2 hours)
60%
30%
Hematology
1.
10%
Blood Bank
2.
26%
Biochemistry
3.
20%
Microbiology
4.
4%
Molecular and Cytogenetics
5.
10%
Immunology and Serology
6.
100%
Total
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
مراجع امتحان أخصائي الصيدلة
Remington “ The Science & Practice of Pharmacy'' Beringer, Paul et al.(Latest Edition)
Goodman & Gilman's "The Pharmacological Basis of Therapeutics" Hardman; Limbird; Gilman. (Latest Edition)
Drugs Facts & Comparisons. (Latest Edition)
Drug Information Handbook. (Latest Edition)
British National Formulary. (Latest Edition)
AHFS Drug Information. (Latest Edition)
Saudi National Formulary. (Latest Edition)
--------
طبيعة ومحتوى امتحان أخصائي الصيدلة
Passing Score
Relative Percentage
Content
Evaluation Item
Topics:
(70 MCQs, 2 hours)
55%
50%
Pharmacology
1.
20%
Pharmaceutics & Biopharmacutics
2.
10%
Pharmacy Calculation 3.
20%
Pharmacy Practice & Clinical Pharmacy 4.
100%
Total
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
مراجع امتحان أخصائي تمريض
All-In-One Care Planning Resource, Swearingen, 2004, Mosby Elsevier
Alexander’s Care of Patient in Surgery, Rothrock, 2003, Mosby Elsevier
Brunner & Suddarth’s Textbook of Medical Surgical Nursing, Smeltzer et al, 11th Edition, 2006, Lippincott Williams and Wilkins
Fundamentals of Nursing, Standards and Practice, DeLaune and Ladner, 3rd Edition 2006, Delmar Cengage
Lippincott Manual of Nursing Practice, Nettina, 8th Edition, 2005, Lippincott Williams and Wilkins
Mosby’s Textbook for Long-Term Care Nursing Assistants, Sorrentino and Gorek, 5th Edition, 2007, Mosby Elsevier
Nursing Assistant: A Nursing Process Approach, Hegner, Acello, and Caldwell, 9th Edition, 2004, Delmar Cengage
-----------
طبيعة ومحتوى امتحان أخصائي تمريض
Passing Score
Relative Percentage
Content
Evaluation Item
:Topics
(70MCQs , 2hours)
50%
10%
1. Assessment
6%
2. Nursing Problem
20%
3. Planning
50%
4. Implementation
14%
5. Evaluation
100%
Total
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
Maternal and Child Health Practice Test Part 1 - nurse exam
nurse exam
========
1. When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion?
A. Sperm count
B. Sperm motility
C. Sperm maturity
D. Semen volume
2. A couple who wants to conceive but has been unsuccessful during the last 2 years has undergone many diagnostic procedures. When discussing the situation with the nurse, one partner states, “We know several friends in our age group and all of them have their own child already, Why can’t we have one?”. Which of the following would be the most pertinent nursing diagnosis for this couple?
A. Fear related to the unknown
B. Pain related to numerous procedures.
C. Ineffective family coping related to infertility.
D. Self-esteem disturbance related to infertility.
3. Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning
4. Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following?
A. Increased plasma HCG levels
B. Decreased intestinal motility
C. Decreased gastric acidity
D. Elevated estrogen levels
5. On which of the following areas would the nurse expect to observe chloasma?
A. Breast, areola, and nipples
B. Chest, neck, arms, and legs
C. Abdomen, breast, and thighs
D. Cheeks, forehead, and nose
6. A pregnant client states that she “waddles” when she walks. The nurse’s explanation is based on which of the following as the cause?
A. The large size of the newborn
B. Pressure on the pelvic muscles
C. Relaxation of the pelvic joints
D. Excessive weight gain
7. Which of the following represents the average amount of weight gained during pregnancy?
A. 12 to 22 lb
B 15 to 25 lb
C. 24 to 30 lb
D. 25 to 40 lb
8. When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following?
A. Thrombophlebitis
B. Pregnancy-induced hypertension
C. Pressure on blood vessels from the enlarging uterus
D. The force of gravity pulling down on the uterus
9. Cervical softening and uterine souffle are classified as which of the following?
A. Diagnostic signs
B. Presumptive signs
C. Probable signs
D. Positive signs
10. Which of the following would the nurse identify as a presumptive sign of pregnancy?
A. Hegar sign
B. Nausea and vomiting
C. Skin pigmentation changes
D. Positive serum pregnancy test
11. Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester?
A. Introversion, egocentrism, narcissism
B. Awkwardness, clumsiness, and unattractiveness
C. Anxiety, passivity, extroversion
D. Ambivalence, fear, fantasies
12. During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition?
A. Prepregnant period
B. First trimester
C. Second trimester
D. Third trimester
13. Which of the following would be disadvantage of breast feeding?
A. Involution occurs more rapidly
B. The incidence of allergies increases due to maternal antibodies
C. The father may resent the infant’s demands on the mother’s body
D. There is a greater chance for error during preparation
14. Which of the following would cause a false-positive result on a pregnancy test?
A. The test was performed less than 10 days after an abortion
B. The test was performed too early or too late in the pregnancy
C. The urine sample was stored too long at room temperature
D. A spontaneous abortion or a missed abortion is impending
15. FHR can be auscultated with a fetoscope as early as which of the following?
A. 5 weeks gestation
B. 10 weeks gestation
C. 15 weeks gestation
D. 20 weeks gestation
16. A client LMP began July 5. Her EDD should be which of the following?
A. January 2
B. March 28
C. April 12
D. October 12
17. Which of the following fundal heights indicates less than 12 weeks’ gestation when the date of the LMP is unknown?
A. Uterus in the pelvis
B. Uterus at the xiphoid
C. Uterus in the abdomen
D. Uterus at the umbilicus
18. Which of the following danger signs should be reported promptly during the antepartum period?
A. Constipation
B. Breast tenderness
C. Nasal stuffiness
D. Leaking amniotic fluid
19. Which of the following prenatal laboratory test values would the nurse consider as significant?
A. Hematocrit 33.5%
B. Rubella titer less than 1:8
C. White blood cells 8,000/mm3
D. One hour glucose challenge test 110 g/dL
20. Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor?
A. Occurring at irregular intervals
B. Starting mainly in the abdomen
C. Gradually increasing intervals
D. Increasing intensity with walking
21. During which of the following stages of labor would the nurse assess “crowning”?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
22. Barbiturates are usually not given for pain relief during active labor for which of the following reasons?
A. The neonatal effects include hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days.
B. These drugs readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection.
C. They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.
D. Adverse reactions may include maternal hypotension, allergic or toxic reaction or partial or total respiratory failure
23. Which of the following nursing interventions would the nurse perform during the third stage of labor?
A. Obtain a urine specimen and other laboratory tests.
B. Assess uterine contractions every 30 minutes.
C. Coach for effective client pushing
D. Promote parent-newborn interaction.
24. Which of the following actions demonstrates the nurse’s understanding about the newborn’s thermoregulatory ability?
A. Placing the newborn under a radiant warmer.
B. Suctioning with a bulb syringe
C. Obtaining an Apgar score
D. Inspecting the newborn’s umbilical cord
25. Immediately before expulsion, which of the following cardinal movements occur?
A. Descent
B. Flexion
C. Extension
D. External rotation
26. Before birth, which of the following structures connects the right and left auricles of the heart?
A. Umbilical vein
B. Foramen ovale
C. Ductus arteriosus
D. Ductus venosus
27. Which of the following when present in the urine may cause a reddish stain on the diaper of a newborn?
A. Mucus
B. Uric acid crystals
C. Bilirubin
D. Excess iron
28. When assessing the newborn’s heart rate, which of the following ranges would be considered normal if the newborn were sleeping?
A. 80 beats per minute
B. 100 beats per minute
C. 120 beats per minute
D. 140 beats per minute
29. Which of the following is true regarding the fontanels of the newborn?
A. The anterior is triangular shaped; the posterior is diamond shaped.
B. The posterior closes at 18 months; the anterior closes at 8 to 12 weeks.
C. The anterior is large in size when compared to the posterior fontanel.
D. The anterior is bulging; the posterior appears sunken.
30. Which of the following groups of newborn reflexes below are present at birth and remain unchanged through adulthood?
A. Blink, cough, rooting, and gag
B. Blink, cough, sneeze, gag
C. Rooting, sneeze, swallowing, and cough
D. Stepping, blink, cough, and sneeze
31. Which of the following describes the Babinski reflex?
A. The newborn’s toes will hyperextend and fan apart from dorsiflexion of the big toe when one side of foot is stroked upward from the ball of the heel and across the ball of the foot.
B. The newborn abducts and flexes all extremities and may begin to cry when exposed to sudden movement or loud noise.
C. The newborn turns the head in the direction of stimulus, opens the mouth, and begins to suck when cheek, lip, or corner of mouth is touched.
D. The newborn will attempt to crawl forward with both arms and legs when he is placed on his abdomen on a flat surface
32. Which of the following statements best describes hyperemesis gravidarum?
A. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
B. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
C. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients
D. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding
33. Which of the following would the nurse identify as a classic sign of PIH?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache
34. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy tests?
A. Threatened
B. Imminent
C. Missed
D. Incomplete
35. Which of the following factors would the nurse suspect as predisposing a client to placenta previa?
A. Multiple gestation
B. Uterine anomalies
C. Abdominal trauma
D. Renal or vascular disease
36. Which of the following would the nurse assess in a client experiencing abruptio placenta?
A. Bright red, painless vaginal bleeding
B. Concealed or external dark red bleeding
C. Palpable fetal outline
D. Soft and nontender abdomen
37. Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?
A. Placenta previa
B. Ectopic pregnancy
C. Incompetent cervix
D. Abruptio placentae
38. Which of the following may happen if the uterus becomes overstimulated by oxytocin during the induction of labor?
A. Weak contraction prolonged to more than 70 seconds
B. Tetanic contractions prolonged to more than 90 seconds
C. Increased pain with bright red vaginal bleeding
D. Increased restlessness and anxiety
39. When preparing a client for cesarean delivery, which of the following key concepts should be considered when implementing nursing care?
A. Instruct the mother’s support person to remain in the family lounge until after the delivery
B. Arrange for a staff member of the anesthesia department to explain what to expect postoperatively
C. Modify preoperative teaching to meet the needs of either a planned or emergency cesarean birth
D. Explain the surgery, expected outcome, and kind of anesthetics
40. Which of the following best describes preterm labor?
A. Labor that begins after 20 weeks gestation and before 37 weeks gestation
B. Labor that begins after 15 weeks gestation and before 37 weeks gestation
C. Labor that begins after 24 weeks gestation and before 28 weeks gestation
D. Labor that begins after 28 weeks gestation and before 40 weeks gestation
41. When PROM occurs, which of the following provides evidence of the nurse’s understanding of the client’s immediate needs?
A. The chorion and amnion rupture 4 hours before the onset of labor.
B. PROM removes the fetus most effective defense against infection
C. Nursing care is based on fetal viability and gestational age.
D. PROM is associated with malpresentation and possibly incompetent cervix
42. Which of the following factors is the underlying cause of dystocia?
A. Nurtional
B. Mechanical
C. Environmental
D. Medical
43. When uterine rupture occurs, which of the following would be the priority?
A. Limiting hypovolemic shock
B. Obtaining blood specimens
C. Instituting complete bed rest
D. Inserting a urinary catheter
44. Which of the following is the nurse’s initial action when umbilical cord prolapse occurs?
A. Begin monitoring maternal vital signs and FHR
B. Place the client in a knee-chest position in bed
C. Notify the physician and prepare the client for delivery
D. Apply a sterile warm saline dressing to the exposed cord
45. Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage?
A. More than 200 ml
B. More than 300 ml
C. More than 400 ml
D. More than 500 ml
46. Which of the following is the primary predisposing factor related to mastitis?
A. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts
B. Endemic infection occurring randomly and localizing in the periglandular connective tissue
C. Temporary urinary retention due to decreased perception of the urge to avoid
D. Breast injury caused by overdistention, stasis, and cracking of the nipples
47. Which of the following best describes thrombophlebitis?
A. Inflammation and clot formation that result when blood components combine to form an aggregate body
B. Inflammation and blood clots that eventually become lodged within the pulmonary blood vessels
C. Inflammation and blood clots that eventually become lodged within the femoral vein
D. Inflammation of the vascular endothelium with clot formation on the vessel wall
48. Which of the following assessment findings would the nurse expect if the client develops DVT?
A. Midcalf pain, tenderness and redness along the vein
B. Chills, fever, malaise, occurring 2 weeks after delivery
C. Muscle pain the presence of Homans sign, and swelling in the affected limb
D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery
49. Which of the following are the most commonly assessed findings in cystitis?
A. Frequency, urgency, dehydration, nausea, chills, and flank pain
B. Nocturia, frequency, urgency dysuria, hematuria, fever and suprapubic pain
C. Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever
D. High fever, chills, flank pain nausea, vomiting, dysuria, and frequency
50. Which of the following best reflects the frequency of reported postpartum “blues”?
A. Between 10% and 40% of all new mothers report some form of postpartum blues
B. Between 30% and 50% of all new mothers report some form of postpartum blues
C. Between 50% and 80% of all new mothers report some form of postpartum blues
D. Between 25% and 70% of all new mothers report some form of postpartum blues
الإجابات
1. B. Although all of the factors listed are important, sperm motility is the most significant criterion when assessing male infertility. Sperm count, sperm maturity, and semen volume are all significant, but they are not as significant sperm motility.
2. D. Based on the partner’s statement, the couple is verbalizing feelings of inadequacy and negative feelings about themselves and their capabilities. Thus, the nursing diagnosis of self-esteem disturbance is most appropriate. Fear, pain, and ineffective family coping also may be present but as secondary nursing diagnoses.
3. B. Pressure and irritation of the bladder by the growing uterus during the first trimester is responsible for causing urinary frequency. Dysuria, incontinence, and burning are symptoms associated with urinary tract infections.
4. C. During the second trimester, the reduction in gastric acidity in conjunction with pressure from the growing uterus and smooth muscle relaxation, can cause heartburn and flatulence. HCG levels increase in the first, not the second, trimester. Decrease intestinal motility would most likely be the cause of constipation and bloating. Estrogen levels decrease in the second trimester.
5. D. Chloasma, also called the mask of pregnancy, is an irregular hyperpigmented area found on the face. It is not seen on the breasts, areola, nipples, chest, neck, arms, legs, abdomen, or thighs.
6. C. During pregnancy, hormonal changes cause relaxation of the pelvic joints, resulting in the typical “waddling” gait. Changes in posture are related to the growing fetus. Pressure on the surrounding muscles causing discomfort is due to the growing uterus. Weight gain has no effect on gait.
7. C. The average amount of weight gained during pregnancy is 24 to 30 lb. This weight gain consists of the following: fetus – 7.5 lb; placenta and membrane – 1.5 lb; amniotic fluid – 2 lb; uterus – 2.5 lb; breasts – 3 lb; and increased blood volume – 2 to 4 lb; extravascular fluid and fat – 4 to 9 lb. A gain of 12 to 22 lb is insufficient, whereas a weight gain of 15 to 25 lb is marginal. A weight gain of 25 to 40 lb is considered excessive.
8. C. Pressure of the growing uterus on blood vessels results in an increased risk for venous stasis in the lower extremities. Subsequently, edema and varicose vein formation may occur. Thrombophlebitis is an inflammation of the veins due to thrombus formation. Pregnancy-induced hypertension is not associated with these symptoms. Gravity plays only a minor role with these symptoms.
9. C. Cervical softening (Goodell sign) and uterine soufflé are two probable signs of pregnancy. Probable signs are objective findings that strongly suggest pregnancy. Other probable signs include Hegar sign, which is softening of the lower uterine segment; Piskacek sign, which is enlargement and softening of the uterus; serum laboratory tests; changes in skin pigmentation; and ultrasonic evidence of a gestational sac. Presumptive signs are subjective signs and include amenorrhea; nausea and vomiting; urinary frequency; breast tenderness and changes; excessive fatigue; uterine enlargement; and quickening.
10. B. Presumptive signs of pregnancy are subjective signs. Of the signs listed, only nausea and vomiting are presumptive signs. Hegar sign,skin pigmentation changes, and a positive serum pregnancy test are considered probably signs, which are strongly suggestive of pregnancy.
11. D. During the first trimester, common emotional reactions include ambivalence, fear, fantasies, or anxiety. The second trimester is a period of well-being accompanied by the increased need to learn about fetal growth and development. Common emotional reactions during this trimester include narcissism, passivity, or introversion. At times the woman may seem egocentric and self-centered. During the third trimester, the woman typically feels awkward, clumsy, and unattractive, often becoming more introverted or reflective of her own childhood.
12. B. First-trimester classes commonly focus on such issues as early physiologic changes, fetal development, sexuality during pregnancy, and nutrition. Some early classes may include pregnant couples. Second and third trimester classes may focus on preparation for birth, parenting, and newborn care.
13. C. With breast feeding, the father’s body is not capable of providing the milk for the newborn, which may interfere with feeding the newborn, providing fewer chances for bonding, or he may be jealous of the infant’s demands on his wife’s time and body. Breast feeding is advantageous because uterine involution occurs more rapidly, thus minimizing blood loss. The presence of maternal antibodies in breast milk helps decrease the incidence of allergies in the newborn. A greater chance for error is associated with bottle feeding. No preparation is required for breast feeding.
14. A. A false-positive reaction can occur if the pregnancy test is performed less than 10 days after an abortion. Performing the tests too early or too late in the pregnancy, storing the urine sample too long at room temperature, or having a spontaneous or missed abortion impending can all produce false-negative results.
15. D. The FHR can be auscultated with a fetoscope at about 20 week’s gestation. FHR usually is ausculatated at the midline suprapubic region with Doppler ultrasound transducer at 10 to 12 week’s gestation. FHR, cannot be heard any earlier than 10 weeks’ gestation.
16. C. To determine the EDD when the date of the client’s LMP is known use Nagele rule. To the first day of the LMP, add 7 days, subtract 3 months, and add 1 year (if applicable) to arrive at the EDD as follows: 5 + 7 = 12 (July) minus 3 = 4 (April). Therefore, the client’s EDD is April 12.
17. A. When the LMP is unknown, the gestational age of the fetus is estimated by uterine size or position (fundal height). The presence of the uterus in the pelvis indicates less than 12 weeks’ gestation. At approximately 12 to 14 weeks, the fundus is out of the pelvis above the symphysis pubis. The fundus is at the level of the umbilicus at approximately 20 weeks’ gestation and reaches the xiphoid at term or 40 weeks.
18. D. Danger signs that require prompt reporting leaking of amniotic fluid, vaginal bleeding, blurred vision, rapid weight gain, and elevated blood pressure. Constipation, breast tenderness, and nasal stuffiness are common discomforts associated with pregnancy.
19. B. A rubella titer should be 1:8 or greater. Thurs, a finding of a titer less than 1:8 is significant, indicating that the client may not possess immunity to rubella. A hematocrit of 33.5% a white blood cell count of 8,000/mm3, and a 1 hour glucose challenge test of 110 g/dl are with normal parameters.
20. D. With true labor, contractions increase in intensity with walking. In addition, true labor contractions occur at regular intervals, usually starting in the back and sweeping around to the abdomen. The interval of true labor contractions gradually shortens.
21. B. Crowing, which occurs when the newborn’s head or presenting part appears at the vaginal opening, occurs during the second stage of labor. During the first stage of labor, cervical dilation and effacement occur. During the third stage of labor, the newborn and placenta are delivered. The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mother’s organs undergo the initial readjustment to the nonpregnant state.
22. C. Barbiturates are rapidly transferred across the placental barrier, and lack of an antagonist makes them generally inappropriate during active labor. Neonatal side effects of barbiturates include central nervous system depression, prolonged drowsiness, delayed establishment of feeding (e.g. due to poor sucking reflex or poor sucking pressure). Tranquilizers are associated with neonatal effects such as hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days. Narcotic analgesic readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection. Regional anesthesia is associated with adverse reactions such as maternal hypotension, allergic or toxic reaction, or partial or total respiratory failure.
23. D. During the third stage of labor, which begins with the delivery of the newborn, the nurse would promote parent-newborn interaction by placing the newborn on the mother’s abdomen and encouraging the parents to touch the newborn. Collecting a urine specimen and other laboratory tests is done on admission during the first stage of labor. Assessing uterine contractions every 30 minutes is performed during the latent phase of the first stage of labor. Coaching the client to push effectively is appropriate during the second stage of labor.
24. A. The newborn’s ability to regulate body temperature is poor. Therefore, placing the newborn under a radiant warmer aids in maintaining his or her body temperature. Suctioning with a bulb syringe helps maintain a patent airway. Obtaining an Apgar score measures the newborn’s immediate adjustment to extrauterine life. Inspecting the umbilical cord aids in detecting cord anomalies.
25. D. Immediately before expulsion or birth of the rest of the body, the cardinal movement of external rotation occurs. Descent flexion, internal rotation, extension, and restitution (in this order) occur before external rotation.
26. B. The foramen ovale is an opening between the right and left auricles (atria) that should close shortly after birth so the newborn will not have a murmur or mixed blood traveling through the vascular system. The umbilical vein, ductus arteriosus, and ductus venosus are obliterated at birth.
27. B. Uric acid crystals in the urine may produce the reddish “brick dust” stain on the diaper. Mucus would not produce a stain. Bilirubin and iron are from hepatic adaptation.
28. B. The normal heart rate for a newborn that is sleeping is approximately 100 beats per minute. If the newborn was awake, the normal heart rate would range from 120 to 160 beats per minute.
29. C. The anterior fontanel is larger in size than the posterior fontanel. Additionally, the anterior fontanel, which is diamond shaped, closes at 18 months, whereas the posterior fontanel, which is triangular shaped, closes at 8 to 12 weeks. Neither fontanel should appear bulging, which may indicate increased intracranial pressure, or sunken, which may indicate dehydration.
30. B. Blink, cough, sneeze, swallowing and gag reflexes are all present at birth and remain unchanged through adulthood. Reflexes such as rooting and stepping subside within the first year.
31. A. With the babinski reflex, the newborn’s toes hyperextend and fan apart from dorsiflexion of the big toe when one side of foot is stroked upward form the heel and across the ball of the foot. With the startle reflex, the newborn abducts and flexes all extremities and may begin to cry when exposed to sudden movement of loud noise. With the rooting and sucking reflex, the newborn turns his head in the direction of stimulus, opens the mouth, and begins to suck when the cheeks, lip, or corner of mouth is touched. With the crawl reflex, the newborn will attempt to crawl forward with both arms and legs when he is placed on his abdomen on a flat surface.
32. B. The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Hyperemesis is not a form of anemia. Loss of appetite may occur secondary to the nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus. Diarrhea does not occur with hyperemesis.
33. B. Edema of the hands and face is a classic sign of PIH. Many healthy pregnant woman experience foot and ankle edema. A weight gain of 2 lb or more per week indicates a problem. Early morning headache is not a classic sign of PIH.
34. C. In a missed abortion, there is early fetal intrauterine death, and products of conception are not expelled. The cervix remains closed; there may be a dark brown vaginal discharge, negative pregnancy test, and cessation of uterine growth and breast tenderness. A threatened abortion is evidenced with cramping and vaginal bleeding in early pregnancy, with no cervical dilation. An incomplete abortion presents with bleeding, cramping, and cervical dilation. An incomplete abortion involves only expulsion of part of the products of conception and bleeding occurs with cervical dilation.
35. A. Multiple gestation is one of the predisposing factors that may cause placenta previa. Uterine anomalies abdominal trauma, and renal or vascular disease may predispose a client to abruptio placentae.
36. B. A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.
37. D. Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.
38. B. Hyperstimulation of the uterus such as with oxytocin during the induction of labor may result in tetanic contractions prolonged to more than 90seconds, which could lead to such complications as fetal distress, abruptio placentae, amniotic fluid embolism, laceration of the cervix, and uterine rupture. Weak contractions would not occur. Pain, bright red vaginal bleeding, and increased restlessness and anxiety are not associated with hyperstimulation.
39. C. A key point to consider when preparing the client for a cesarean delivery is to modify the preoperative teaching to meet the needs of either a planned or emergency cesarean birth, the depth and breadth of instruction will depend on circumstances and time available. Allowing the mother’s support person to remain with her as much as possible is an important concept, although doing so depends on many variables. Arranging for necessary explanations by various staff members to be involved with the client’s care is a nursing responsibility. The nurse is responsible for reinforcing the explanations about the surgery, expected outcome, and type of anesthetic to be used. The obstetrician is responsible for explaining about the surgery and outcome and the anesthesiology staff is responsible for explanations about the type of anesthesia to be used.
40. A. Preterm labor is best described as labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation. The other time periods are inaccurate.
41. B. PROM can precipitate many potential and actual problems; one of the most serious is the fetus loss of an effective defense against infection. This is the client’s most immediate need at this time. Typically, PROM occurs about 1 hour, not 4 hours, before labor begins. Fetal viability and gestational age are less immediate considerations that affect the plan of care. Malpresentation and an incompetent cervix may be causes of PROM.
42. B. Dystocia is difficult, painful, prolonged labor due to mechanical factors involving the fetus (passenger), uterus (powers), pelvis (passage), or psyche. Nutritional, environment, and medical factors may contribute to the mechanical factors that cause dystocia.
43. A. With uterine rupture, the client is at risk for hypovolemic shock. Therefore, the priority is to prevent and limit hypovolemic shock. Immediate steps should include giving oxygen, replacing lost fluids, providing drug therapy as needed, evaluating fetal responses and preparing for surgery. Obtaining blood specimens, instituting complete bed rest, and inserting a urinary catheter are necessary in preparation for surgery to remedy the rupture.
44. B. The immediate priority is to minimize pressure on the cord. Thus the nurse’s initial action involves placing the client on bed rest and then placing the client in a knee-chest position or lowering the head of the bed, and elevating the maternal hips on a pillow to minimize the pressure on the cord. Monitoring maternal vital signs and FHR, notifying the physician and preparing the client for delivery, and wrapping the cord with sterile saline soaked warm gauze are important. But these actions have no effect on minimizing the pressure on the cord.
45. D. Postpartum hemorrhage is defined as blood loss of more than 500 ml following birth. Any amount less than this not considered postpartum hemorrhage.
46. D. With mastitis, injury to the breast, such as overdistention, stasis, and cracking of the nipples, is the primary predisposing factor. Epidemic and endemic infections are probable sources of infection for mastitis. Temporary urinary retention due to decreased perception of the urge to void is a contributory factor to the development of urinary tract infection, not mastitis.
47. D. Thrombophlebitis refers to an inflammation of the vascular endothelium with clot formation on the wall of the vessel. Blood components combining to form an aggregate body describe a thrombus or thrombosis. Clots lodging in the pulmonary vasculature refers to pulmonary embolism; in the femoral vein, femoral thrombophlebitis.
48. C. Classic symptoms of DVT include muscle pain, the presence of Homans sign, and swelling of the affected limb. Midcalf pain, tenderness, and redness, along the vein reflect superficial thrombophlebitis. Chills, fever and malaise occurring 2 weeks after delivery reflect pelvic thrombophlebitis. Chills, fever, stiffness and pain occurring 10 to 14 days after delivery suggest femoral thrombophlebitis.
49. B. Manifestations of cystitis include, frequency, urgency, dysuria, hematuria nocturia, fever, and suprapubic pain. Dehydration, hypertension, and chills are not typically associated with cystitis. High fever chills, flank pain, nausea, vomiting, dysuria, and frequency are associated with pvelonephritis.
50. C. According to statistical reports, between 50% and 80% of all new mothers report some form of postpartum blues. The ranges of 10% to 40%, 30% to 50%, and 25% to 70% are incorrect.
1. When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion?
A. Sperm count
B. Sperm motility
C. Sperm maturity
D. Semen volume
2. A couple who wants to conceive but has been unsuccessful during the last 2 years has undergone many diagnostic procedures. When discussing the situation with the nurse, one partner states, “We know several friends in our age group and all of them have their own child already, Why can’t we have one?”. Which of the following would be the most pertinent nursing diagnosis for this couple?
A. Fear related to the unknown
B. Pain related to numerous procedures.
C. Ineffective family coping related to infertility.
D. Self-esteem disturbance related to infertility.
3. Which of the following urinary symptoms does the pregnant woman most frequently experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning
4. Heartburn and flatulence, common in the second trimester, are most likely the result of which of the following?
A. Increased plasma HCG levels
B. Decreased intestinal motility
C. Decreased gastric acidity
D. Elevated estrogen levels
5. On which of the following areas would the nurse expect to observe chloasma?
A. Breast, areola, and nipples
B. Chest, neck, arms, and legs
C. Abdomen, breast, and thighs
D. Cheeks, forehead, and nose
6. A pregnant client states that she “waddles” when she walks. The nurse’s explanation is based on which of the following as the cause?
A. The large size of the newborn
B. Pressure on the pelvic muscles
C. Relaxation of the pelvic joints
D. Excessive weight gain
7. Which of the following represents the average amount of weight gained during pregnancy?
A. 12 to 22 lb
B 15 to 25 lb
C. 24 to 30 lb
D. 25 to 40 lb
8. When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following?
A. Thrombophlebitis
B. Pregnancy-induced hypertension
C. Pressure on blood vessels from the enlarging uterus
D. The force of gravity pulling down on the uterus
9. Cervical softening and uterine souffle are classified as which of the following?
A. Diagnostic signs
B. Presumptive signs
C. Probable signs
D. Positive signs
10. Which of the following would the nurse identify as a presumptive sign of pregnancy?
A. Hegar sign
B. Nausea and vomiting
C. Skin pigmentation changes
D. Positive serum pregnancy test
11. Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester?
A. Introversion, egocentrism, narcissism
B. Awkwardness, clumsiness, and unattractiveness
C. Anxiety, passivity, extroversion
D. Ambivalence, fear, fantasies
12. During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition?
A. Prepregnant period
B. First trimester
C. Second trimester
D. Third trimester
13. Which of the following would be disadvantage of breast feeding?
A. Involution occurs more rapidly
B. The incidence of allergies increases due to maternal antibodies
C. The father may resent the infant’s demands on the mother’s body
D. There is a greater chance for error during preparation
14. Which of the following would cause a false-positive result on a pregnancy test?
A. The test was performed less than 10 days after an abortion
B. The test was performed too early or too late in the pregnancy
C. The urine sample was stored too long at room temperature
D. A spontaneous abortion or a missed abortion is impending
15. FHR can be auscultated with a fetoscope as early as which of the following?
A. 5 weeks gestation
B. 10 weeks gestation
C. 15 weeks gestation
D. 20 weeks gestation
16. A client LMP began July 5. Her EDD should be which of the following?
A. January 2
B. March 28
C. April 12
D. October 12
17. Which of the following fundal heights indicates less than 12 weeks’ gestation when the date of the LMP is unknown?
A. Uterus in the pelvis
B. Uterus at the xiphoid
C. Uterus in the abdomen
D. Uterus at the umbilicus
18. Which of the following danger signs should be reported promptly during the antepartum period?
A. Constipation
B. Breast tenderness
C. Nasal stuffiness
D. Leaking amniotic fluid
19. Which of the following prenatal laboratory test values would the nurse consider as significant?
A. Hematocrit 33.5%
B. Rubella titer less than 1:8
C. White blood cells 8,000/mm3
D. One hour glucose challenge test 110 g/dL
20. Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor?
A. Occurring at irregular intervals
B. Starting mainly in the abdomen
C. Gradually increasing intervals
D. Increasing intensity with walking
21. During which of the following stages of labor would the nurse assess “crowning”?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
22. Barbiturates are usually not given for pain relief during active labor for which of the following reasons?
A. The neonatal effects include hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days.
B. These drugs readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection.
C. They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.
D. Adverse reactions may include maternal hypotension, allergic or toxic reaction or partial or total respiratory failure
23. Which of the following nursing interventions would the nurse perform during the third stage of labor?
A. Obtain a urine specimen and other laboratory tests.
B. Assess uterine contractions every 30 minutes.
C. Coach for effective client pushing
D. Promote parent-newborn interaction.
24. Which of the following actions demonstrates the nurse’s understanding about the newborn’s thermoregulatory ability?
A. Placing the newborn under a radiant warmer.
B. Suctioning with a bulb syringe
C. Obtaining an Apgar score
D. Inspecting the newborn’s umbilical cord
25. Immediately before expulsion, which of the following cardinal movements occur?
A. Descent
B. Flexion
C. Extension
D. External rotation
26. Before birth, which of the following structures connects the right and left auricles of the heart?
A. Umbilical vein
B. Foramen ovale
C. Ductus arteriosus
D. Ductus venosus
27. Which of the following when present in the urine may cause a reddish stain on the diaper of a newborn?
A. Mucus
B. Uric acid crystals
C. Bilirubin
D. Excess iron
28. When assessing the newborn’s heart rate, which of the following ranges would be considered normal if the newborn were sleeping?
A. 80 beats per minute
B. 100 beats per minute
C. 120 beats per minute
D. 140 beats per minute
29. Which of the following is true regarding the fontanels of the newborn?
A. The anterior is triangular shaped; the posterior is diamond shaped.
B. The posterior closes at 18 months; the anterior closes at 8 to 12 weeks.
C. The anterior is large in size when compared to the posterior fontanel.
D. The anterior is bulging; the posterior appears sunken.
30. Which of the following groups of newborn reflexes below are present at birth and remain unchanged through adulthood?
A. Blink, cough, rooting, and gag
B. Blink, cough, sneeze, gag
C. Rooting, sneeze, swallowing, and cough
D. Stepping, blink, cough, and sneeze
31. Which of the following describes the Babinski reflex?
A. The newborn’s toes will hyperextend and fan apart from dorsiflexion of the big toe when one side of foot is stroked upward from the ball of the heel and across the ball of the foot.
B. The newborn abducts and flexes all extremities and may begin to cry when exposed to sudden movement or loud noise.
C. The newborn turns the head in the direction of stimulus, opens the mouth, and begins to suck when cheek, lip, or corner of mouth is touched.
D. The newborn will attempt to crawl forward with both arms and legs when he is placed on his abdomen on a flat surface
32. Which of the following statements best describes hyperemesis gravidarum?
A. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
B. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
C. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients
D. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding
33. Which of the following would the nurse identify as a classic sign of PIH?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache
34. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy tests?
A. Threatened
B. Imminent
C. Missed
D. Incomplete
35. Which of the following factors would the nurse suspect as predisposing a client to placenta previa?
A. Multiple gestation
B. Uterine anomalies
C. Abdominal trauma
D. Renal or vascular disease
36. Which of the following would the nurse assess in a client experiencing abruptio placenta?
A. Bright red, painless vaginal bleeding
B. Concealed or external dark red bleeding
C. Palpable fetal outline
D. Soft and nontender abdomen
37. Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?
A. Placenta previa
B. Ectopic pregnancy
C. Incompetent cervix
D. Abruptio placentae
38. Which of the following may happen if the uterus becomes overstimulated by oxytocin during the induction of labor?
A. Weak contraction prolonged to more than 70 seconds
B. Tetanic contractions prolonged to more than 90 seconds
C. Increased pain with bright red vaginal bleeding
D. Increased restlessness and anxiety
39. When preparing a client for cesarean delivery, which of the following key concepts should be considered when implementing nursing care?
A. Instruct the mother’s support person to remain in the family lounge until after the delivery
B. Arrange for a staff member of the anesthesia department to explain what to expect postoperatively
C. Modify preoperative teaching to meet the needs of either a planned or emergency cesarean birth
D. Explain the surgery, expected outcome, and kind of anesthetics
40. Which of the following best describes preterm labor?
A. Labor that begins after 20 weeks gestation and before 37 weeks gestation
B. Labor that begins after 15 weeks gestation and before 37 weeks gestation
C. Labor that begins after 24 weeks gestation and before 28 weeks gestation
D. Labor that begins after 28 weeks gestation and before 40 weeks gestation
41. When PROM occurs, which of the following provides evidence of the nurse’s understanding of the client’s immediate needs?
A. The chorion and amnion rupture 4 hours before the onset of labor.
B. PROM removes the fetus most effective defense against infection
C. Nursing care is based on fetal viability and gestational age.
D. PROM is associated with malpresentation and possibly incompetent cervix
42. Which of the following factors is the underlying cause of dystocia?
A. Nurtional
B. Mechanical
C. Environmental
D. Medical
43. When uterine rupture occurs, which of the following would be the priority?
A. Limiting hypovolemic shock
B. Obtaining blood specimens
C. Instituting complete bed rest
D. Inserting a urinary catheter
44. Which of the following is the nurse’s initial action when umbilical cord prolapse occurs?
A. Begin monitoring maternal vital signs and FHR
B. Place the client in a knee-chest position in bed
C. Notify the physician and prepare the client for delivery
D. Apply a sterile warm saline dressing to the exposed cord
45. Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage?
A. More than 200 ml
B. More than 300 ml
C. More than 400 ml
D. More than 500 ml
46. Which of the following is the primary predisposing factor related to mastitis?
A. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts
B. Endemic infection occurring randomly and localizing in the periglandular connective tissue
C. Temporary urinary retention due to decreased perception of the urge to avoid
D. Breast injury caused by overdistention, stasis, and cracking of the nipples
47. Which of the following best describes thrombophlebitis?
A. Inflammation and clot formation that result when blood components combine to form an aggregate body
B. Inflammation and blood clots that eventually become lodged within the pulmonary blood vessels
C. Inflammation and blood clots that eventually become lodged within the femoral vein
D. Inflammation of the vascular endothelium with clot formation on the vessel wall
48. Which of the following assessment findings would the nurse expect if the client develops DVT?
A. Midcalf pain, tenderness and redness along the vein
B. Chills, fever, malaise, occurring 2 weeks after delivery
C. Muscle pain the presence of Homans sign, and swelling in the affected limb
D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery
49. Which of the following are the most commonly assessed findings in cystitis?
A. Frequency, urgency, dehydration, nausea, chills, and flank pain
B. Nocturia, frequency, urgency dysuria, hematuria, fever and suprapubic pain
C. Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever
D. High fever, chills, flank pain nausea, vomiting, dysuria, and frequency
50. Which of the following best reflects the frequency of reported postpartum “blues”?
A. Between 10% and 40% of all new mothers report some form of postpartum blues
B. Between 30% and 50% of all new mothers report some form of postpartum blues
C. Between 50% and 80% of all new mothers report some form of postpartum blues
D. Between 25% and 70% of all new mothers report some form of postpartum blues
الإجابات
1. B. Although all of the factors listed are important, sperm motility is the most significant criterion when assessing male infertility. Sperm count, sperm maturity, and semen volume are all significant, but they are not as significant sperm motility.
2. D. Based on the partner’s statement, the couple is verbalizing feelings of inadequacy and negative feelings about themselves and their capabilities. Thus, the nursing diagnosis of self-esteem disturbance is most appropriate. Fear, pain, and ineffective family coping also may be present but as secondary nursing diagnoses.
3. B. Pressure and irritation of the bladder by the growing uterus during the first trimester is responsible for causing urinary frequency. Dysuria, incontinence, and burning are symptoms associated with urinary tract infections.
4. C. During the second trimester, the reduction in gastric acidity in conjunction with pressure from the growing uterus and smooth muscle relaxation, can cause heartburn and flatulence. HCG levels increase in the first, not the second, trimester. Decrease intestinal motility would most likely be the cause of constipation and bloating. Estrogen levels decrease in the second trimester.
5. D. Chloasma, also called the mask of pregnancy, is an irregular hyperpigmented area found on the face. It is not seen on the breasts, areola, nipples, chest, neck, arms, legs, abdomen, or thighs.
6. C. During pregnancy, hormonal changes cause relaxation of the pelvic joints, resulting in the typical “waddling” gait. Changes in posture are related to the growing fetus. Pressure on the surrounding muscles causing discomfort is due to the growing uterus. Weight gain has no effect on gait.
7. C. The average amount of weight gained during pregnancy is 24 to 30 lb. This weight gain consists of the following: fetus – 7.5 lb; placenta and membrane – 1.5 lb; amniotic fluid – 2 lb; uterus – 2.5 lb; breasts – 3 lb; and increased blood volume – 2 to 4 lb; extravascular fluid and fat – 4 to 9 lb. A gain of 12 to 22 lb is insufficient, whereas a weight gain of 15 to 25 lb is marginal. A weight gain of 25 to 40 lb is considered excessive.
8. C. Pressure of the growing uterus on blood vessels results in an increased risk for venous stasis in the lower extremities. Subsequently, edema and varicose vein formation may occur. Thrombophlebitis is an inflammation of the veins due to thrombus formation. Pregnancy-induced hypertension is not associated with these symptoms. Gravity plays only a minor role with these symptoms.
9. C. Cervical softening (Goodell sign) and uterine soufflé are two probable signs of pregnancy. Probable signs are objective findings that strongly suggest pregnancy. Other probable signs include Hegar sign, which is softening of the lower uterine segment; Piskacek sign, which is enlargement and softening of the uterus; serum laboratory tests; changes in skin pigmentation; and ultrasonic evidence of a gestational sac. Presumptive signs are subjective signs and include amenorrhea; nausea and vomiting; urinary frequency; breast tenderness and changes; excessive fatigue; uterine enlargement; and quickening.
10. B. Presumptive signs of pregnancy are subjective signs. Of the signs listed, only nausea and vomiting are presumptive signs. Hegar sign,skin pigmentation changes, and a positive serum pregnancy test are considered probably signs, which are strongly suggestive of pregnancy.
11. D. During the first trimester, common emotional reactions include ambivalence, fear, fantasies, or anxiety. The second trimester is a period of well-being accompanied by the increased need to learn about fetal growth and development. Common emotional reactions during this trimester include narcissism, passivity, or introversion. At times the woman may seem egocentric and self-centered. During the third trimester, the woman typically feels awkward, clumsy, and unattractive, often becoming more introverted or reflective of her own childhood.
12. B. First-trimester classes commonly focus on such issues as early physiologic changes, fetal development, sexuality during pregnancy, and nutrition. Some early classes may include pregnant couples. Second and third trimester classes may focus on preparation for birth, parenting, and newborn care.
13. C. With breast feeding, the father’s body is not capable of providing the milk for the newborn, which may interfere with feeding the newborn, providing fewer chances for bonding, or he may be jealous of the infant’s demands on his wife’s time and body. Breast feeding is advantageous because uterine involution occurs more rapidly, thus minimizing blood loss. The presence of maternal antibodies in breast milk helps decrease the incidence of allergies in the newborn. A greater chance for error is associated with bottle feeding. No preparation is required for breast feeding.
14. A. A false-positive reaction can occur if the pregnancy test is performed less than 10 days after an abortion. Performing the tests too early or too late in the pregnancy, storing the urine sample too long at room temperature, or having a spontaneous or missed abortion impending can all produce false-negative results.
15. D. The FHR can be auscultated with a fetoscope at about 20 week’s gestation. FHR usually is ausculatated at the midline suprapubic region with Doppler ultrasound transducer at 10 to 12 week’s gestation. FHR, cannot be heard any earlier than 10 weeks’ gestation.
16. C. To determine the EDD when the date of the client’s LMP is known use Nagele rule. To the first day of the LMP, add 7 days, subtract 3 months, and add 1 year (if applicable) to arrive at the EDD as follows: 5 + 7 = 12 (July) minus 3 = 4 (April). Therefore, the client’s EDD is April 12.
17. A. When the LMP is unknown, the gestational age of the fetus is estimated by uterine size or position (fundal height). The presence of the uterus in the pelvis indicates less than 12 weeks’ gestation. At approximately 12 to 14 weeks, the fundus is out of the pelvis above the symphysis pubis. The fundus is at the level of the umbilicus at approximately 20 weeks’ gestation and reaches the xiphoid at term or 40 weeks.
18. D. Danger signs that require prompt reporting leaking of amniotic fluid, vaginal bleeding, blurred vision, rapid weight gain, and elevated blood pressure. Constipation, breast tenderness, and nasal stuffiness are common discomforts associated with pregnancy.
19. B. A rubella titer should be 1:8 or greater. Thurs, a finding of a titer less than 1:8 is significant, indicating that the client may not possess immunity to rubella. A hematocrit of 33.5% a white blood cell count of 8,000/mm3, and a 1 hour glucose challenge test of 110 g/dl are with normal parameters.
20. D. With true labor, contractions increase in intensity with walking. In addition, true labor contractions occur at regular intervals, usually starting in the back and sweeping around to the abdomen. The interval of true labor contractions gradually shortens.
21. B. Crowing, which occurs when the newborn’s head or presenting part appears at the vaginal opening, occurs during the second stage of labor. During the first stage of labor, cervical dilation and effacement occur. During the third stage of labor, the newborn and placenta are delivered. The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mother’s organs undergo the initial readjustment to the nonpregnant state.
22. C. Barbiturates are rapidly transferred across the placental barrier, and lack of an antagonist makes them generally inappropriate during active labor. Neonatal side effects of barbiturates include central nervous system depression, prolonged drowsiness, delayed establishment of feeding (e.g. due to poor sucking reflex or poor sucking pressure). Tranquilizers are associated with neonatal effects such as hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days. Narcotic analgesic readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection. Regional anesthesia is associated with adverse reactions such as maternal hypotension, allergic or toxic reaction, or partial or total respiratory failure.
23. D. During the third stage of labor, which begins with the delivery of the newborn, the nurse would promote parent-newborn interaction by placing the newborn on the mother’s abdomen and encouraging the parents to touch the newborn. Collecting a urine specimen and other laboratory tests is done on admission during the first stage of labor. Assessing uterine contractions every 30 minutes is performed during the latent phase of the first stage of labor. Coaching the client to push effectively is appropriate during the second stage of labor.
24. A. The newborn’s ability to regulate body temperature is poor. Therefore, placing the newborn under a radiant warmer aids in maintaining his or her body temperature. Suctioning with a bulb syringe helps maintain a patent airway. Obtaining an Apgar score measures the newborn’s immediate adjustment to extrauterine life. Inspecting the umbilical cord aids in detecting cord anomalies.
25. D. Immediately before expulsion or birth of the rest of the body, the cardinal movement of external rotation occurs. Descent flexion, internal rotation, extension, and restitution (in this order) occur before external rotation.
26. B. The foramen ovale is an opening between the right and left auricles (atria) that should close shortly after birth so the newborn will not have a murmur or mixed blood traveling through the vascular system. The umbilical vein, ductus arteriosus, and ductus venosus are obliterated at birth.
27. B. Uric acid crystals in the urine may produce the reddish “brick dust” stain on the diaper. Mucus would not produce a stain. Bilirubin and iron are from hepatic adaptation.
28. B. The normal heart rate for a newborn that is sleeping is approximately 100 beats per minute. If the newborn was awake, the normal heart rate would range from 120 to 160 beats per minute.
29. C. The anterior fontanel is larger in size than the posterior fontanel. Additionally, the anterior fontanel, which is diamond shaped, closes at 18 months, whereas the posterior fontanel, which is triangular shaped, closes at 8 to 12 weeks. Neither fontanel should appear bulging, which may indicate increased intracranial pressure, or sunken, which may indicate dehydration.
30. B. Blink, cough, sneeze, swallowing and gag reflexes are all present at birth and remain unchanged through adulthood. Reflexes such as rooting and stepping subside within the first year.
31. A. With the babinski reflex, the newborn’s toes hyperextend and fan apart from dorsiflexion of the big toe when one side of foot is stroked upward form the heel and across the ball of the foot. With the startle reflex, the newborn abducts and flexes all extremities and may begin to cry when exposed to sudden movement of loud noise. With the rooting and sucking reflex, the newborn turns his head in the direction of stimulus, opens the mouth, and begins to suck when the cheeks, lip, or corner of mouth is touched. With the crawl reflex, the newborn will attempt to crawl forward with both arms and legs when he is placed on his abdomen on a flat surface.
32. B. The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems. Hyperemesis is not a form of anemia. Loss of appetite may occur secondary to the nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus. Diarrhea does not occur with hyperemesis.
33. B. Edema of the hands and face is a classic sign of PIH. Many healthy pregnant woman experience foot and ankle edema. A weight gain of 2 lb or more per week indicates a problem. Early morning headache is not a classic sign of PIH.
34. C. In a missed abortion, there is early fetal intrauterine death, and products of conception are not expelled. The cervix remains closed; there may be a dark brown vaginal discharge, negative pregnancy test, and cessation of uterine growth and breast tenderness. A threatened abortion is evidenced with cramping and vaginal bleeding in early pregnancy, with no cervical dilation. An incomplete abortion presents with bleeding, cramping, and cervical dilation. An incomplete abortion involves only expulsion of part of the products of conception and bleeding occurs with cervical dilation.
35. A. Multiple gestation is one of the predisposing factors that may cause placenta previa. Uterine anomalies abdominal trauma, and renal or vascular disease may predispose a client to abruptio placentae.
36. B. A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.
37. D. Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.
38. B. Hyperstimulation of the uterus such as with oxytocin during the induction of labor may result in tetanic contractions prolonged to more than 90seconds, which could lead to such complications as fetal distress, abruptio placentae, amniotic fluid embolism, laceration of the cervix, and uterine rupture. Weak contractions would not occur. Pain, bright red vaginal bleeding, and increased restlessness and anxiety are not associated with hyperstimulation.
39. C. A key point to consider when preparing the client for a cesarean delivery is to modify the preoperative teaching to meet the needs of either a planned or emergency cesarean birth, the depth and breadth of instruction will depend on circumstances and time available. Allowing the mother’s support person to remain with her as much as possible is an important concept, although doing so depends on many variables. Arranging for necessary explanations by various staff members to be involved with the client’s care is a nursing responsibility. The nurse is responsible for reinforcing the explanations about the surgery, expected outcome, and type of anesthetic to be used. The obstetrician is responsible for explaining about the surgery and outcome and the anesthesiology staff is responsible for explanations about the type of anesthesia to be used.
40. A. Preterm labor is best described as labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation. The other time periods are inaccurate.
41. B. PROM can precipitate many potential and actual problems; one of the most serious is the fetus loss of an effective defense against infection. This is the client’s most immediate need at this time. Typically, PROM occurs about 1 hour, not 4 hours, before labor begins. Fetal viability and gestational age are less immediate considerations that affect the plan of care. Malpresentation and an incompetent cervix may be causes of PROM.
42. B. Dystocia is difficult, painful, prolonged labor due to mechanical factors involving the fetus (passenger), uterus (powers), pelvis (passage), or psyche. Nutritional, environment, and medical factors may contribute to the mechanical factors that cause dystocia.
43. A. With uterine rupture, the client is at risk for hypovolemic shock. Therefore, the priority is to prevent and limit hypovolemic shock. Immediate steps should include giving oxygen, replacing lost fluids, providing drug therapy as needed, evaluating fetal responses and preparing for surgery. Obtaining blood specimens, instituting complete bed rest, and inserting a urinary catheter are necessary in preparation for surgery to remedy the rupture.
44. B. The immediate priority is to minimize pressure on the cord. Thus the nurse’s initial action involves placing the client on bed rest and then placing the client in a knee-chest position or lowering the head of the bed, and elevating the maternal hips on a pillow to minimize the pressure on the cord. Monitoring maternal vital signs and FHR, notifying the physician and preparing the client for delivery, and wrapping the cord with sterile saline soaked warm gauze are important. But these actions have no effect on minimizing the pressure on the cord.
45. D. Postpartum hemorrhage is defined as blood loss of more than 500 ml following birth. Any amount less than this not considered postpartum hemorrhage.
46. D. With mastitis, injury to the breast, such as overdistention, stasis, and cracking of the nipples, is the primary predisposing factor. Epidemic and endemic infections are probable sources of infection for mastitis. Temporary urinary retention due to decreased perception of the urge to void is a contributory factor to the development of urinary tract infection, not mastitis.
47. D. Thrombophlebitis refers to an inflammation of the vascular endothelium with clot formation on the wall of the vessel. Blood components combining to form an aggregate body describe a thrombus or thrombosis. Clots lodging in the pulmonary vasculature refers to pulmonary embolism; in the femoral vein, femoral thrombophlebitis.
48. C. Classic symptoms of DVT include muscle pain, the presence of Homans sign, and swelling of the affected limb. Midcalf pain, tenderness, and redness, along the vein reflect superficial thrombophlebitis. Chills, fever and malaise occurring 2 weeks after delivery reflect pelvic thrombophlebitis. Chills, fever, stiffness and pain occurring 10 to 14 days after delivery suggest femoral thrombophlebitis.
49. B. Manifestations of cystitis include, frequency, urgency, dysuria, hematuria nocturia, fever, and suprapubic pain. Dehydration, hypertension, and chills are not typically associated with cystitis. High fever chills, flank pain, nausea, vomiting, dysuria, and frequency are associated with pvelonephritis.
50. C. According to statistical reports, between 50% and 80% of all new mothers report some form of postpartum blues. The ranges of 10% to 40%, 30% to 50%, and 25% to 70% are incorrect.
Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
فروع الهيئة السعودية للتخصصات الصحية في مناطق المملكة + الكروكي
المنطقة : الوسطى ( الرياض )
مدينة : الرياض
العنوان : حي السفارات - بجوار سفارة جمهورية مصر العربية
رقم الهاتف :4800800-01 تحويلة :صفر
رقم الفاكس :4800800-01 تحويلة : 800
ص.ب :94656 المدينة : الرياض الرمز البريدي : 11614
المنطقة : الغربية
مدينة : جدة
العنوان : مستشفى الملك عبد العزيز بجدة
رقم الهاتف :6402946-02 أو 2521056-02 أو 2521057-02
رقم الفاكس :6402946 تحويلة : 26
ص.ب :12653 المدينة : جدة الرمز البريدي : 21483
المنطقة : الشرقية
مدينة : الخبر
العنوان : مستشفى الملك فهد بالخبر
رقم الهاتف : 8966760-03 رقم الفاكس : 8966750
ص.ب : 40109 المدينة : الخبر الرمز البريدي : 31952
المنطقة : القصيم
مدينة : بريدة
العنوان : مستشفى الملك فهد التخصصي ببريدة مبنى رقم 1 الدور الثالث
رقم الهاتف :3258062-06
رقم الفاكس :3258064
المنطقة : عسير
مدينة : أبها
العنوان : ابها الجديدة فيلا رقم 143
رقم الهاتف :2261106-07 رقم الفاكس :2261106-07
تحويلة : 106 ،ص.ب : 3884 الرمز البريدي : 61481
منطقة : الاحساء
مدينة : الهفوف
العنوان : مقابل مستشفى الملك فهد بالهفوف
رقم الهاتف :5730451-03
رقم الفاكس :5730451
المنطقة : جازان
مدينة : جازان
رقم الهاتف :3229100-07
رقم الفاكس :3229200-07
المنطقة : الجنوبية
مدينة : الباحة
رقم الهاتف :7247460-07
المنطقة : نجران
مدينة : نجران
رقم الهاتف :5220484-07
المنطقة :الشمالية
مدينة : تبوك
رقم الهاتف :- 4281054
المنطقة : الشمالية
مدينة : حائل
رقم الهاتف :5321183-06
مدينة : حفر الباطن
المنطقة : الجوف
مدينة : الجوف
رقم الهاتف :6242579-04
المنطقة : المدينة المنورة
مدينة : المدينة المنورة
رقم الهاتف :48267071-04
مدينة : مكة المكرمة
العنوان : شارع العزيزية العام مركز التجارة العالمي الدور السادس
رقم الهاتف :25577966-02 تحويلة 100-101-102-103
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Best Wishes: Dr.Ehab Aboueladab, Tel:+201007834123,Email:ehab10f@gmail.com
حجز امتحانات البرومترك ( الهيئة السعودية للتخصصات الصحية) - مواقع الامتحانات بكافة مناطق المملكه
عناوين مراكز الامتحان للتصنيف المهني بواسطة الحاسب الآلي
مدينة الرياض : *فئة الرجال *الهيئة السعودية للتخصصات الصحية*حي السفارات*البوابة الجنوبية*بجوار السفارة المصرية*تلفون *014800800 * تحويله * 1345 / 1346
مدينة الرياض : *فئة النساء *الهيئة السعودية للتخصصات الصحية*حي السفارات*البوابة الجنوبية*بجوار السفارة المصرية*تلفون *014800800 * تحويله * 1312 / 1334
مدينة جده : *فئة النساء*معهد نيوهورايزن*حي الروضة *شارع الأمير عبدا لله *بجانب مطعم الشاليه*تلفون *6642277*تحويلة* 475
مدينة جده : * فئة الرجال *معهد نيوهورايزن *حي الروضة* شارع الأمير عبدا لله* بجانب مطعم الشاليه*تلفون* 6642277 *تحويلة*731
مدينة المدينة المنورة :*فئة النساء *معهد الخليج لللتدريب والتعليم *حي سلطانه * شارع سلطانه *خلف سوق منقو*تلفون* 8472044
مدينة المدينة المنورة فئة الرجال * معهد الخليج لللتدريب والتعليم *حي الكردي *شارع خالد بن الوليد *((شارع الجوالات))*تلفون* 8223333
مدينة تبوك : *فئة النساء*معهد نيوهورايزن*حي المروج *دوار المروج *بجانب مدارس دار الراي*تلفون*4211111*تحويلة*133
مدينة تبوك فئة الرجال *معهد نيوهورايزن*حي المروج - دوار المروج *بجانب مدارس دار الراي*تلفون*4211111*تحويلة*128
مدينة القصيم:*فئة النساء*معهد الخليج للتدريب والتعليم*بريدة * حي المنتزه *غرب مستشفى الولادة*تلفون*3833777*تحويلة*ص
مدينة القصيم:*فئة الرجال*معهد الخليج للتدريب والتعليم*بريدة* حي المنتزه *غرب مستشفى الولادة*تلفون*38279990
مدينة الاحساء:*فئة النساء*معهد الخليج للتدريب والتعليم*المبرز* شارع الثريات *بجانب الغرفة التجارية*تلفون*5822228*مباشر
مدينة الاحساء:*فئة الرجال*معهد الخليج للتدريب والتعليم*المبرز* حي المنح *شارع الظهران *مبنى مكتبة جرير* الدور الثاني*تلفون*5305007*تحويلة*22
مدينة مكةالمكرمة:*فئة النساء*معهد الخليج للتدريب والتعليم*حي النزهه*خلف سوق المرسى التجاري*5433000*مباشر
مدينة مكةالمكرمة:*فئة الرجال*معهد الخليج للتدريب والتعليم*حي العزيزية *طريق الطايف الجنوبي *عمارة القمرية*تلفون*5536666*مباشر
مدينة الدمام: *فئة النساء*الخبر شارع الكورنيش*بمبنى المركز التجاري *النسائي التابع للغرفة التجارية*تلفون*8323205*مباشر
مدينة الدمام: *فئة الرجال*غرفة التجارة والصناعة *مركز التدريب*(الدمام بجوار مكتب الجوازات) *وشارع الملك خالد*تلفون*8347454*مباشر
مدينة أبها:* فئة النساء*معهد نيوهورايزن *حي شمسان * كبري شمسان*تلفون*2297900
مدينة أبها:*فئة الرجال*معهد نيوهورايزن *حي القابل*الحزام الدائري*مقابل مفرق السودة*تلفون*2282700*تحويلة*10
مدينة الطائف:*فئة النساء*معهد العالمية للحاسب والتقنية*حي شهار* طريق الشفا *قبل محطة المورد*تلفون7400009 *تحويلة*220
مدينة الطائف:*فئة الرجال*معهد العالمية للحاسب والتقنية*حي الفيصيلية *امام اشارة الدلال *مبنى البنك الأهلي التجاري*تلفون7329293 *تحويلة*225
مدينة حائل :*فئة النساء*معهد العالمية للحاسب والتقنية*حي الجامعيين * شارع ابن باز *مقابل اسواق سعودي*تلفون*5381111*مباشر
مدينة حائل :*فئة الرجال*معهد العالمية للحاسب والتقنية*طريق الدائري الجنوبي *حي النخيل*تلفون*5317477*مباشر
مدينة جيزان:*فئة النساء*معهد الخليج للتدريب والتعليم*حي الروضة * شارع الملك فهد*تلفون*3170911*تحويلة*110
مدينة جيزان:*فئة الرجال*معهد الخليج للتدريب والتعليم*حي الروضة * شارع الملك فهد*تلفون*3170911*تحويلة*111
مدينة نجران:*فئة النساء*معهد الخليج للتدريب والتعليم*حي الفيصيلية *شارع الملك فيصل*تلفون*5226666*تحويلة*صفر
مدينة نجران:*فئة الرجال*معهد الخليج للتدريب والتعليم*حي الفيصيلية *شارع ابو بكر الصديق*(الخزان قديماً)*تلفون*52254440*تحويلة*
بيشة:*فئة النساء*معهد الخليج *شارع مكتب العمل*جوار مدرسة القدس*تلفون*076225893-07622371
بيشة:*فئة الرجال*معهد الخليج *شارع البلدية *جوار ثانوية الملك عبدالله*تلفون*076225876-076227
مدينة القريات:*فئة النساء*المعهد الاهلي*شارع الأربعين*أمام الدوار *تلفون*046414895
مدينة القريات:*فئة الرجال*المعهد الاهلي *شارع الأربعين *أمام الدوار*تلفون*046414895
الخبر لايوجد فيه موقع للامتحان....فقط بالاحساء كما هو موضح
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