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NSPN 7200: Final Exam Guide, Exams of Public Health

Virginia State University (VSU)Public Health

NSPN 7200: Final Exam GuideNSPN 7200: Final Exam Guide

Typology: Exams

2025/2026

Available from 03/06/2026

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NSPN 7200: Final Exam Guide
1.
SDOH:
= the economic and social conditions that influence the health of individuals, communities, etc.
-
Aboriginal
status
-
Early
life
factors
(e.g.
poverty,
housing,
education)
-
Education
-
Employment
&
working
conditions
-
Food
security
(the
ability
to
acquire/
consume
an
adequate
diet
(quality/quantity)
of
food)
-
Gender
-
Health
services
-
Housing
-
Income
(and
distribution)
-
Social
security
(welfare,
EI,
health
care,
etc.)
-
Social
exclusion
-
Unemployment
and
employment
security
2. In Canada, what SDOH contribute to inequalities?: - Housing
-
Work
settings
-
Education
-
Access
to
food
-
Income
3. Who are associated with higher rates of infant mortality?: - Low income
groups in urban
Canada
-
Aboriginal people (1-4X higher)
4. Common causes of post-natal mortality causes: - SIDS
-
Infectious
disease
-
Injuries
5. What do low-income neighbourhoods have increased rates of?: - SGA
-
Preterm
birth
-
Still
birth
-
Neonatal
death
-
Post-neonatal
death
-
adolescent
pregnancy
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19

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NSPN 7200: Final Exam Guide

  1. SDOH: = the economic and social conditions that influence the health of individuals, communities, etc.
  • Aboriginal status
  • Early life factors (e.g. poverty, housing, education)
  • Education
  • Employment & working conditions
  • Food security (the ability to acquire/ consume an adequate diet (quality/quantity) of food)
  • Gender
  • Health services
  • Housing
  • Income (and distribution)
  • Social security (welfare, EI, health care, etc.)
  • Social exclusion
  • Unemployment and employment security
  1. In Canada, what SDOH contribute to inequalities?: - Housing
  • Work settings
  • Education
  • Access to food
  • Income
  1. Who are associated with higher rates of infant mortality?: - Low income groups in urban Canada
  • Aboriginal people (1-4X higher)
  1. Common causes of post-natal mortality causes: - SIDS
  • Infectious disease
  • Injuries
  1. What do low-income neighbourhoods have increased rates of?: - SGA
  • Preterm birth
  • Still birth
  • Neonatal death
  • Post-neonatal death
  • adolescent pregnancy

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  1. How is income associated with adverse perinatal outcomes?: - Lack of communi- ty-based programs for women’no access/limited access to prenatal education and care
  • Limited personal resources (time, transportation and social support)
  • Understanding of care benefits
  • Fear of judgement
  • Negative association with HCP's from past experiences
  1. How do working conditions influence health?: - Lack of job security
  • Lack of control/decision-making
  • Lack of social support in the workplace
  • Part-time/casual/temporary/ contract work may not provide benefits (sick days, Mat. Leave, vacation time, etc.) **Women are overrepresented in part-time/temporary work
  1. What groups are more likely to experience social exclusion in Canada?: - Substance using women
  • Immigrant women
  • Women with disabilities
  • Aboriginal women
  • Women experiencing abuse
  1. What do food security and dietary compromises influence?: - Chronic disease man- agement
  • Body weight
  • Mental health
  • Physical health
  1. What health risks and inequalities do Aboriginal people experience?: - Increased rates of poverty
  • Increased rates of substance use
  • Increased violence and homicide
  • Poor living conditions (mold, poor hygiene, crowded housing)
  • Lack of clean drinking water
  • Less annual income that non-aboriginals
  • Higher rates of unemployment

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  • Intimidation
  • Harassment
  • Social isolation
  • Verbal threats
  • Excessive jealousy
  • Constant criticism
  • False accusations
  1. What are some psychological and psychosocial adaptations women develop to deal with the abuse?: - Injuries
  • Depression
  • Substance use
  • Headaches
  • GI Problems
  • Sleep disorders
  • Fatigue
  • Chronic pain
  • Anxiety
  • Sexual dysfunction
  • Permanent disability
  1. What are adverse pregnancy outcomes related to abuse?: - Depression
  • Later prenatal care
  • Miscarriage
  • Inadequate nutrition
  • Low weight gain
  • Infection
  • Bleeding
  • Trauma to uterus and fetus
  1. What are some ways abusive men exert control over women during preg- nancy?: - Forced abortions
  • Limiting or denying access to prenatal care
  • Denying the child is his

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  • Restricting access to food
  • Controlling decision-making about pain relief in labor
  • Making negative comments about the gender of the baby
  • Forbidding her to breastfeed
  • Putting down her parenting abilities
  • Threatening to abduct or take custody of the baby
  1. Why do you think women stay in abusive relationships?: - Financial reasons
  • Fear of not being believed
  • Pressured by family, friends and clergy to stay and make it work
  • Feeling responsible for the abuse
  • Feeling powerless
  • Fear of being killed
  • Fear for infant's safety
  1. What are some barriers to barriers to treatment for substance use problems for pregnant women?: - Fear of losing children
  • Lack of child care services during treatment
  • Stigma attached to pregnant women or mothers using substances
  • Internal feelings of guilt
  • Fear
  • Shame
  • Lack of specific treatment programs specific for pregnant women
  1. What are 5 reasons why you think people use drugs?: - Experience pleasure
  • Cope with pain, fear, loneliness, rejection
  • To be accepted by social groups
  • Habit
  • Get sleep
  • Deal with anger or stress
  1. Risk factors for perinatal depression: - Hx Depression
  • Hx postpartum depression
  • Family Hx Depression

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  • Teach infant cues
  • Rooming-in
  1. Providing adequate fluid and nutrition:
  • Support mother in making an informed choice of feeding method
  • In &outs
  • Keep track of weight
  • Minimal handling after feeds
  • Support and teaching regarding signs of adequate intake
  1. Promoting attachment:
  • Rooming-in
  • Include family/partner in teaching care
  • Provide positive reinforcement of parenting tasks
  • Teach parents of withdrawal
  • Role model soothing/comforting techniques
  1. What does exposure to SSRIs in pregnancy increases the risk of?: - Preterm delivery
  • LBW
  • Lower APGAR scores
  • Neurobehavioral abnormalities
  • Cardiac abnormalities
  • Respiratory abnormalities
  1. What complications are associated with withdrawal or discontinuation syn- drome from SSRI exposure?: - Feeding diflculties
  • Sleep disturbances
  • Irritability
  • Altered tone
  • Respiratory distress
  • Jaundice (7X higher)
  1. What factors contribute to increasing rates of preterm birth?: - Multiple births (ART and increased maternal age)

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  • Increases in obstetric interventions (C-section, medically indicated labor induction)
  • Increases in the use of US-based estimates of GA
  1. Risk factors for PTL?: 1) Altered Uterine and Cervical Factors:
  • MG
  • Polyhydramnios
  • Uterine anomalies
  • Trauma, MVA
  • ART
  • Cervical injury from an elective abortion or prior cervical surgery related to treatment of HPV or DES exposure
  • Short interconception interval
  • Smoking (decreases vit C levels Vit C is important for collagen formation and strength of the cervix; increased sensitivity of the myometrium to oxytocin)
  1. Placental Ischemia:
  • Abruptio placentae
  • GDM
  • GHTN
  • Hereditary Thromboembolic disorder
  • Obesity
  • CVD
  • Renal disease
  • Hep
  • Cholestasis (liver disease=itching d/t increase hormones)
  • Smoking
  • Alcohol/illicit drug use
  • Altered nutrition that leads to low BMI
  1. Inflammation:
  • Bacterial infections
  • Gonorrhea or chlamydia
  • Symptomatic bacterial vaginosis (BV) or trichomoniasis

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  • Rest periods
  • Appropriate exercise
  1. What are key potential health consequences of PTL for the infant?: - Respiratory distress
  • Asphyxia
  • Hyperbilirubinemia
  • Metabolic disturbances
  • Fluid and electrolyte imbalances
  • Neurologic and behavioural problems
  • Infection
  • Nutritional deficits
  • Inettective thermoregulation
  • Cardiovascular disturbances
  • Hematologic disturbances
  1. How does the infant physiologically respond to hypothermia/cold stress?: - vasoconstriction and initiation of thermogenesis--> thermogenesis increases O2 consumption and depletes glycogen stores--> hypoxia and metabolic acidosis can lead to pulmonary vasoconstriction--> blood flow to vital organs may be reduced
  2. What are S+S of infant hypothermia?: - Pale mottled skin
  • Acrocyanosis
  • Respiratory distress
  • Apnea
  • Bradycardia
  • Irritability, then lethargy
  • Hypotonia
  • Weak cry
  • Metabolic acidosis
  • Hypoglycemia
  1. What are the benefits of breast-feeding the preterm infant?: - Protection from NEC
  • Protection from infection

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  • Increase feeding tolerance
  • Earlier attainment of full entral feedings
  • Decreased risk for later allergy
  • Improved retinal function
  • Improved neurocognitive development
  • Suppression of oxidative stress
  • Reduced heart disease later in life
  1. Jorgensen's 4 U's of late preterm: - unrecognized as preterm
  • underestimated for mobility and mortality
  • unpredictable timing of presentation
  • understudied population
  1. What are late preterm infants at risk for?: - Respiratory distress
  • Apnea and bradycardia
  • Sepsis
  • Feeding difficulties
  • Hypoglycemia
  • Thermal instability
  • Hyperbilirubinemia
  1. What are the criteria for Preeclampsia?: 1) HTN
  1. Proteinuria
  2. Adverse conditions
  • Persistent or new/unusual headache
  • Visual disturbances
  • Persistent abdominal or RUQ pain
  • Severe N+V
  • Chest pain or dyspnea
  • Pulmonary edema
  • Suspected placenta abruption
  • Abnormal lab values
  • IUGR
  • Oligohydramnios

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  • Maternal high BP (impaired perfusion and oxygenation to major organs including the placenta and uterus)
  • Risk for IUGR
  • Risk for internal bleeding
  1. What strategies can perinatal nurses implement in order address the con- cept of delayed mothering?: - Address her concerns about her infant being in the NICU
  • Encourage her to ask questions and express her concerns
  • Get her to hand express/ pump
  • Give her updates about her infant
  • Have her partner take photos and share photos or videos (this can help support attachment)
  1. Side effects of Magnesium Sulphate: - Lethargy
  • Sensations of heat or burning
  • Headache
  • N+V
  • Metallic taste in mouth
  1. S+S of Magnesium toxicity: - Resp. depression
  • Loss of deep tendon reflexes
  • Cardiac arrest
  • Flushing
  • Drowsiness
  • Slurred speech
  • Weakness
  • Double vision
  1. Antidote for Mg toxicity: Calcium gluconate (10cc of 10% solution (1g) IV push)
  2. Conditions that are associated with placental abruption: - Previous abruption
  • Smoking
  • Trauma
  • Cocaine use
  • Thrombophilia
  • PROM

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  1. Pathophysiology of placental abruption: - Commonly caused by degeneration of the spiral arterioles that nourish the decidua and supply blood to the placenta
  • causes decidua basalis necrosis in the presence of arteriole bleeding
  • rupture of a spiral arteriole causes bleeding and hemorrhage
  • separation of the placenta
  1. S+S of Placental Abruption: - Dark vaginal non-clotting bleeding
  • Abdominal or low back pain
  • Uterine hypertonus
  • Uterine contractions
  • Uterine tenderness
  • Fetal distress signs or signs of fetal death
  • Signs of hypovolemia beyond expected
  1. Ongoing Assessments for Placental Abruption: - Uterine activity
  • Fetal well-being
  • Bloodwork (CBC and Coagulation studies)
  • Maternal VS
  • Assessment for blood loss
  1. What are the perinatal nurse's priorities when dealing with a woman who presents with antepartum bleeding?: - Assess maternal and fetal well- being
  • Assess BP, RR, HR, FHR, amount and colour of blood loss
  • Abdominal pain or tenderness
  • Uterine contractions
  • Women's LOC, skin colour, temp, O2 sat
  • Apt test (green/brown colour change after sodium hydroxide exposure if blood is maternal; will stay pink if fetal)
  • No VE!!
  1. What are the S+S of hypovolemic shock?: - Hypotension
  • Tachycardia
  • Increased RR
  • Cold clammy skin
  • Pallor

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  • Fetal congenital anomalies
  1. Common Problems experienced by IUGR infants: - Perinatal asphyxia
  • Hypoglycemia
  • Polycythemia
  • Heat loss
  • Temp. instability
  • Persistent pulmonary hypertension of the newborn
  • Meconium aspiration
  1. What are some characteristics of Asymmetric IUGR?: - Large head with under growth trunk
  • Small scaphoid appearing abdomen
  • Little subcutaneous fat, loose dry skin
  • Thin umbilical cord
  • Anxious/hyperalert
  • Jittery and hypertonic
  1. What are women with Advanced Maternal Age (>35) more likely to experi- ence?: - MG
  • Placenta Problems
  • C Section
  • Preterm birth
  • LBW and SGA
  • Increased risk of still birth for older women compared to women under 30
  1. Risks of ART: - Ovarian hyperstimulation syndrome
  • MG
  • Increased rates of labor induction
  • Increased rates of c-section
  • Congenital structural anomalies
  • Chromosomal abnormalities
  • Increased rates of GHTN
  • Increased rates of GDM
  • Increased of placenta previa and placental abruption

17 / 25

  • Some research suggesting increased rates of ovarian cancer but not necessarily the case
  1. What would you anticipate that might be different when caring for a women with multiple gestation in active labor?: - Ongoing assessment of maternal and fetal well-being
  • GA
  • SFH measurements
  • Abdominal palpation position, presentation, lie of each fetus
  • Assessment of contraction frequency, strength, duration and resting tone
  • Continual fetal monitoring
  • Ensure room is set up to accommodate the birth of both twins
  1. What are the cardinal signs of respiratory distress for a newborn?: - Grunting
  • Nasal flaring
  • In drawing
  1. What strategies can you use to promote attachment between parents and a twin in the NICU?: - Encourage frequent visits
  • Encourage parents to participate in care as much as possible
  • Skin-to-skin contact if possible
  • Hand expressing and breast pumping
  • Take pictures
  • Otter emotional support
  1. What complications is LBW associated with?: - Neurological disorders
  • Learning disabilities
  • Delayed development
  1. What are causes of SGA infants?: - MG--> IUGR
  • Maternal smoking
  • Undernutrition
  • Anemia
  • Congenital anomalies
  • Chronic fetal stress
  • Intrauterine infection

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  1. Postmaturity syndrome: result of placental insufficiency
  • loss of subcutaneous fat
  • loss of muscle mass
  • meconium stained skin and nails
  • dry cracked peeling skin
  1. What are the possible reasons for meconium in amniotic fluid?: - normal physio- logic function that occurs with maturity or breech position
  • result of hypoxia-induced peristalsis and sphincter relaxation
  • it may be a sequel to umbilical cord compression induced vagal stimulation in mature fetuses
  1. Pathophysiology of Meconium Aspiration: the pathophysiology can be a result of both the direct ettects of meconium and the mechanisms that caused fetal stress in utero
  • airway obstruction
  • inflammation and chemical pneumonitis
  • air trapping
  • inhibition of surfactant function
  • atelectasis
  1. What complications are women with pre-gestational diabetes experience at higher rates?: - HTN
  • Preterm delivery
  • LGA infants
  • C-Section
  • Neonatal morbidities
  1. What are adverse outcomes with GDM?: - macrosomia
  • dystocia in labor
  • shoulder dystocia
  • C-section
  • delayed lung maturity
  • neonatal hypoglycemia
  1. Risk factors for developing GDM: - previous diagnosis of GDM or delivery of a macrocosmic infant
  • age > 35

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  • member of the high-risk population (African American, Asian, Hispanic, Aboriginal)
  • BMI > 30
  • polycystic ovary syndrome
  • corticosteroid use
  1. Complications of GDM for developing fetus: - fetal hyperinsulinemia
  • increased birthweight
  • high rates of C-section
  • neonatal hypoglycemia
  1. What an initial assessment would you perform on a patient with diabetes who is being admitted?: - How are they monitoring blood sugars at home?
  • what are her normal ranges?
  • when did you last eat? What did she eat?
  • Perform at CBG
  1. What are pregnant obese women at a greater risk for developing?: - GDM
  • spontaneous abortion
  • hypertensive disorders of pregnancy
  • thromboembolism
  • Labor induction
  • c-section
  • wound infections postpartum
  1. What are fetal and neonatal risks associated with maternal obesity?: - congenital abnormalities
  • fetal and neonatal death
  • macrosomia
  • admissions to the NICU
  • stillborn birth
  1. What challenges might you anticipate when caring for an overweight/ obese woman during the perinatal period?: - Difficulty to see field structures and US due to excess adipose tissue in obese women
  • auscultation of the FHR might also be challenging