Part 1 book “Midwifery & women’s health nurse practitioner certification review guide” has contents: Strategies for studying and test taking , principles of pharmacology, general health assessment and health promotion, normal gynecology and well-woman care - reproductive years,… and other contents.
Fourth Edition Midwifery & Women’s Health Nurse Practitioner Certification Review Guide Beth M Kelsey, EdD, APRN, WHNP-BC, FAANP Assistant Professor DNP Program Director School of Nursing Ball State University Muncie, Indiana Jamille Nagtalon-Ramos, MSN, WHNP-BC, IBCLC Associate Director Women’s Health Nurse Practitioner Program School of Nursing University of Pennsylvania Philadelphia, Pennsylvania World Headquarters Jones & Bartlett Learning Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com Copyright © 2018 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes All trademarks displayed are the trademarks of the parties noted herein Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, Fourth Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product There may be images in this book that feature models; these models not necessarily endorse, represent, or participate in the activities represented in the images Any screenshots in this product are for educational and instructive purposes only Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only The authors, editor, and publisher have made every effort to provide accurate information However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial Research, clinical practice, and government regulations often change the accepted standard in this field When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product This is especially important in the case of drugs that are new or seldom used 12666-2 Production Credits VP, Executive Publisher: David D Cella Executive Editor: Amanda Martin Acquisitions Editor: Teresa Reilly Editorial Assistant: Christina Freitas Production Assistant: Brooke Haley Marketing Communications Manager: Katie Hennessy Product Fulfillment Manager: Wendy Kilborn Composition and Project Management: S4Carlisle Publishing Services Cover Design: Michael O’Donnell Rights & Media Specialist: Wes DeShano Media Development Editor: Troy Liston Cover Image (Title Page, Part Opener, Chapter Opener): © Kristin/Shutterstock Printing and Binding: Edwards Brothers Malloy Cover Printing: Edwards Brothers Malloy Library of Congress Cataloging-in-Publication Data Names: Kelsey, Beth, editor | Nagtalon-Ramos, Jamille, editor | Preceded by (work): Kelsey, Beth Midwifery and women’s health nurse practitioner certification review guide Title: Midwifery & women’s health nurse practitioner certification review guide/edited by Beth M Kelsey, Jamille Nagtalon-Ramos Other titles: Midwifery and women’s health nurse practitioner certification review guide Description: Fourth edition | Burlington, Massachusetts: Jones & Bartlett Learning, [2018] | Preceded by: Midwifery and women’s health nurse practitioner certification review guide/Beth M Kelsey and Jamille Nagtalon-Ramos Third edition [2015] | Includes bibliographical references and index Identifiers: LCCN 2017000831 | ISBN 9781284118834 (pbk.: alk paper) Subjects: | MESH: Midwifery | Genital Diseases, Female nursing | Nurse Midwives | Nurse Practitioners | Pregnancy Complications nursing | Women’s Health | Examination Questions Classification: LCC RG951 | NLM WY 18.2 | DDC 618.2/0231 dc23 LC record available at https://lccn.loc.gov/2017000831 6048 Printed in the United States of America 21 20 19 18 17 10 Dedication This book is a labor of love dedicated to our women’s health nurse practitioner and midwifery students— past, present, and future Your enthusiasm for learning is energizing I hope Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, Fourth Edition will guide you well in your studies To all our women’s health nurse practitioner and midwifery colleagues who provide care for women and their families, thank you for the work that you - Beth and Jamille This book would not have been possible without my husband, who is always ready to listen and provide love and support Of course, to my children, Leo, Leilani, and Leah, you define love for me in many ways You make me so proud, especially when you use correct anatomical terms when referring to body parts! Thank you, Beth, for the wonderful opportunity to be your writing partner I would have never dreamed that this would be a possibility when I studied for my own boards using your book many years ago Thank you for your friendship and mentorship - Jamille Thank you to my husband Jeff for his loving support and understanding throughout the many hours of work done to complete this book Jamille, it has been a delight to work with you as coeditor, we make a good team - Beth Contents Preface viii Exam Blueprints ix Reviewers x Student Feedback xi Strategies for Studying and Test Taking Beth M Kelsey Strategy 1: Know Yourself Strategy 2: Know the Content to Be Studied Strategy 3: Know Your Strengths and Weaknesses Strategy 4: Develop a Study Plan Strategy 5: Get Down to the Business of Studying Strategy 6: Become Testwise Strategy 7: Apply Basic Rules of Standardized Test Taking Strategy 8: Psych Yourself Up Summary 5 Bibliography 6 2 General Health Assessment and Health Promotion Beth M Kelsey Health History Physical Examination (General Screening Examination) 9 Nongynecologic Diagnostic Studies/Laboratory Tests 13 General Health Promotion 16 Preconception Care 21 Parenting 22 Questions 22 Answers with Rationales 25 Bibliography 27 3 Principles of Pharmacology 28 Beth M Kelsey Pharmacokinetics (Study of How the Body Processes Drugs) 28 Pharmacodynamics (Study of Mechanism of Drug Action on Living Tissue) 29 Adverse Reactions—Unintended, Undesired Effects of Drug 29 Drug Interactions 29 Drug Contraindications 29 Pharmacotherapy (Applying Knowledge of Benefits and Risks of Drug Therapy to Individual Care) 30 Client Education 30 Selected Drug Review 30 Questions 34 Answers with Rationales 35 Bibliography 35 4 Normal Gynecology and Well-Woman Care: Reproductive Years 36 Beth M Kelsey Reproductive Anatomy and Physiology 36 Well-Woman Visit: The Reproductive Years 39 Breast Health 40 Sexuality 41 Diagnostic Studies and Laboratory Tests 41 v vi Contents Fertility Control 45 Questions 64 Answers with Rationales 69 Bibliography 72 5 Well-Woman Care: Menopause and Beyond 74 Beth M Kelsey Menopause 74 Well-Woman Visit Ages 40 to 64 76 Vasomotor Symptoms (VMS) 77 Genitourinary Syndrome of Menopause (GSM) 79 Older Adults 80 Well-Woman Visit Age 65 and Beyond 81 Pharmacologic Considerations for Elderly Patients 82 Questions 83 Answers with Rationales 84 Bibliography 86 6 Gynecologic Disorders 87 Beth M Kelsey and Jamille Nagtalon-Ramos Menstrual and Endocrine Disorders 87 Benign and Malignant Tumors/Neoplasms 94 Vaginal Infections 99 Sexually Transmitted Infections (STIs) 101 Urinary Tract Disorders 109 Vulvar Conditions 112 Additional Gynecologic Disorders 113 Congenital and Chromosomal Abnormalities 119 Breast Disorders 120 Questions 122 Answers with Rationales 127 Bibliography 130 Prenatal Care and Fetal Assessment 131 Jamille Nagtalon-Ramos Human Reproduction and Fertilization 131 Development of the Placenta, Membranes, and Amniotic Fluid 131 Embryonic and Fetal Development 133 Diagnosis and Dating of Pregnancy 133 Maternal Physiologic Adaptations to Pregnancy 134 Maternal Psychological/Social Changes in Pregnancy 136 Overview of Antepartum Care 137 Antepartum Visit 137 Common Discomforts of Pregnancy and Comfort Measures 140 Nutrition during Pregnancy 141 The Woman and Her Family and Their Role in Pregnancy 142 Teaching and Counseling 143 Pharmacologic Considerations in the Antepartum Period 144 Techniques Used to Assess Fetal Health 144 Selected Obstetric Complications 146 Medical Complications 158 Questions 166 Answers with Rationales 175 Bibliography 181 Intrapartum and Postpartum 183 Kimberly K Trout and Jamille Nagtalon-Ramos Initial Assessment 183 Physical Examination 184 Diagnostic Studies 186 Management and Teaching 186 Mechanisms of Labor 187 Management of the First Stage of Labor 188 Management of the Second Stage of Labor 192 Delivery Management 193 Management of the Third Stage of Labor 195 Management of Immediate Newborn Transition 196 Special Considerations and Deviations from Normal 196 Normal Postpartum 201 Assessment of Maternal Response to Baby 203 Management Plan for the Postpartum Period 204 Postpartal Discomforts 205 Questions 205 Answers with Rationales 210 Bibliography 213 Contents Midwifery Care of the Newborn 214 Kimberly K Trout Physiologic Transition to Extrauterine Life 214 Ongoing Extrauterine Transition 215 Immediate Care and Assessment of the Healthy Newborn 216 Care during the First Hours after Birth 217 Plan of Care for the First Few Days of Life 218 Discharge Planning 219 Newborn Assessment 221 Primary Care of the Newborn for the First Six Weeks 223 Common Variations from Normal Newborn Findings 224 Deviations from Normal 226 Questions 231 Answers with Rationales 235 Bibliography 237 10 Common Health Problems in Primary Care 238 Beth M Kelsey and Jamille Nagtalon-Ramos Cardiovascular Disorders 238 Eye, Ear, Nose, and Throat Disorders 246 Lower Respiratory Disorders 252 vii Gastrointestinal Disorders 257 Hematologic Disorders 266 Immunologic Disorders 269 Endocrine Disorders 275 Musculoskeletal Disorders 281 Neurologic Disorders 288 Dermatologic Disorders 292 Psychosocial Problems 297 Questions 304 Answers with Rationales 311 Bibliography 316 11 Professional Issues 318 Beth M Kelsey and Kimberly K Trout Advanced Practice Registered Nurse (APRN) 318 Trends and Issues 320 Professional Components of Advanced Practice Registered Nursing 322 Healthcare Delivery Systems 325 Ethical and Legal Issues and Principles 326 Evidence-Based Practice 327 Questions 328 Answers with Rationales 331 Bibliography 333 Index 334 Preface A comprehensive review is essential for those preparing to take the midwifery (American Midwifery Certification Board [AMBC]) examination or the women’s health nurse practitioner certification (National Certification Corporation [NCC]) examination Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, Fourth Edition was developed for both of these nursing specialties because of the many commonalities they share in providing health care for women throughout the life span Experts in the field of women’s health combined their expertise to provide a valuable resource that will assist women’s health nurse practitioners and midwives in their pursuit of success on their respective certification examinations Multiple resources have been utilized to ensure the integrity of this text so that it is representative of the content that may be encountered by both specialties during the examination process Many nurses preparing for certification examinations find that reviewing an extensive body of scientific knowledge requires a very difficult search of many sources that must be synthesized to provide a review base for the examination The purpose of this review guide is to provide a succinct yet comprehensive review of the core material This guide is organized to provide the reader with test-taking and study strategies first (Chapter 1, “Strategies for Studying and Test Taking”) This is a prerequisite for success in the certification examination arena The major content is then provided in Chapter 2, “General Health Assessment and Health Promotion,” Chapter 3, “Principles of Pharmacology,” Chapter 4, “Normal Gynecology and Well-Woman Care: Reproductive Years,” Chapter 5, “Well-Woman Care: Menopause and Beyond,” Chapter 6, “Gynecological Disorders,” Chapter 7, “Prenatal Care and Fetal Assessment,” Chapter 8, “Intrapartum and Postpartum,” Chapter 9, “Midwifery Care of the Newborn,” Chapter 10, “Common Health Problems in Primary Care,” and Chapter 11, “Professional Issues.” Women’s health nurse practitioners and midwives reviewed chapters in the previous edition to provide feedback and recommendations New and revised content reflects this review viii Test questions are included at the end of each chapter These questions are intended to provide the reader with testtaking practice and are representative of those found on the certification examinations The correct answers with rationales are also provided A bibliography is included at the end of each chapter for those who want to review specific content in more detail The coeditors, Beth M Kelsey and Jamille Nagtalon-Ramos, are boardcertified women’s health nurse practitioners Kimberly K Trout, CNM, PhD, APRN, authored Chapter 9, “Midwifery Care of the Newborn” and coauthored Chapter 8, “Intrapartum and Postpartum” and Chapter 11, “Professional Issues.” Dr Trout, a board-certified midwife, is Assistant Professor of Women’s Health at the University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania It is assumed that readers of this review guide have completed a course of study in either a women’s health nurse practitioner and/or midwifery program It is not intended to be a basic learning tool Readers should be aware that practice guidelines; diagnostic criteria; and tests, treatment, and management recommendations/protocols are always evolving The information provided in this review guide was current at the time the guide went to print Jones & Bartlett Learning and the coeditors would like to thank the following individuals for their contributions to the first two editions of this review book: Penelope M Borsage, MSN, WHNP Patricia Burkhardt, PhD, CNM Mary C Knutson, MN, WHNP Anthony A Lathrop, PhD, CNM Anne A Moore, DNP, WHNP/ANP, FAANP Sandra K Pfantz, PhD, ANP Susan P Shannon, MS, CNM Exam Blueprints AMCB Exam Blueprint NCC Exam Blueprint Antepartum: 19–26% Physical Assessment and Diagnostic Testing: 12% Intrapartum: 17–26% Primary Care: 12% Postpartum: 15–18% Gynecology: 38% Newborn: 7–16% Obstetrics: 28% Well Woman/Gyn: 15–18% Pharmacology: 9% Women’s Health/Primary care: 8–16% Professional Issues: 1% Data from American Midwifery Certification Board (2016) AMCB certification exam candidate handbook: Nurse-midwifery and midwifery Retrieved from http://www amcbmidwife.org/docs/default-document-library/candidate-handbook -updated -november-16-2016.pdf?sfvrsn=2 Data from National Certification Corporation (2017) 2017 Candidate guide: Women’s health care practitioner Retrieved from https://www.nccwebsite.org/resources/docs/WHNP -Candidate_Guide.pdf ix ... by (work): Kelsey, Beth Midwifery and women’s health nurse practitioner certification review guide Title: Midwifery & women’s health nurse practitioner certification review guide/edited by Beth... energizing I hope Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, Fourth Edition will guide you well in your studies To all our women’s health nurse practitioner and midwifery. .. or the women’s health nurse practitioner certification (National Certification Corporation [NCC]) examination Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, Fourth Edition