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Chapter 10: Antepartum Fetal Assessment
MULTIPLE CHOICE
1. A pregnant client’s biophysical profile score is 8. She asks the nurse to explain the results.
What is the nurse’s best response?
a. “The test results are within normal limits.”
b. “Immediate birth by cesarean birth is being considered.”
c. “Further testing will be performed to determine the meaning of this score.”
d. “An obstetric specialist will evaluate the results of this profile and, within the next
week, will inform you of your options regarding birth.”
ANS: A
The normal biophysical score ranges from 8 to 10 points if the amniotic fluid volume is
adequate. A normal score allows conservative treatment of high-risk patients. Birth can be
delayed if fetal well-being is an issue. Scores less than 4 would be investigated, and birth
could be initiated sooner than planned. This score is within normal range, and no further
testing is required at this time. The results of the biophysical profile are usually available
immediately after the procedure is performed.
PTS: 1 DIF: Cognitive Level: Application REF: 179

OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Physiologic Integrity
2. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
a. Biophysical profile
b. Multiple-marker screening
c. Lecithin-to-sphingomyelin ratio
d. Blood type and crossmatch of maternal and fetal serum
ANS: B
Maternal serum can be analyzed for abnormal levels of alpha-fetoprotein (AFP), human
chorionic gonadotropin (hCG), inhibin A, and estriol. The multiple-marker screening may
predict chromosomal defects in the fetus. The biophysical profile is used to evaluate fetal
status during the antepartum period. Five variables are used, but none are concerned with
chromosomal problems. The lecithin-to-sphingomyelin ratio is used to determine fetal lung
maturity. The blood type and crossmatch will not predict chromosomal defects in the fetus.
PTS: 1 DIF: Cognitive Level: Understanding REF: 170

OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity
3. The clinic nurse is obtaining a health history on a newly pregnant client. Which is an
indication for fetal diagnostic procedures if present in the health history?
a. Maternal diabetes
b. Weight gain of 25 lb
c. Maternal age older than 30
d. Previous infant weighing more than 3000 g at birth
ANS: A
Diabetes is a risk factor in pregnancy because of possible impairment of placental perfusion.
Excessive weight gain is an indication for testing. Normal weight gain is 25 to 35 lb. A
maternal age older than 35 years is an indication for testing. Having had another infant
weighing more than 4000 g is an indication for testing.
PTS: 1 DIF: Cognitive Level: Analysis REF: 169

OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Physiologic Integrity
4. When is the most accurate time to determine gestational age through ultrasound?
a. First trimester
b. Second trimester
c. Third trimester
d. No difference in accuracy among the trimesters
ANS: A
Gestational age determination by ultrasonography is increasingly less accurate after the first
trimester. Gestational age determination is best done in the first trimester. There is a
difference in trimesters when doing a gestational age ultrasonography.

5. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to
determine whether the fetus has which?
a. Hemophilia
b. Sickle cell anemia
c. A neural tube defect
d. A normal lecithin-to-sphingomyelin ratio
ANS: C
An open neural tube allows a high level of AFP to seep into the amniotic fluid and enter the
maternal serum. Hemophilia is a genetic defect and is best detected with chromosomal
studies, such as chorionic villus sampling or amniocentesis. Sickle cell anemia is a genetic
defect and is best detected with chromosomal studies such as chorionic villus sampling or
amniocentesis. L/S ratios are determined with an amniocentesis and are usually done in the
third trimester.

6. When is the earliest that chorionic villus sampling can be performed during pregnancy?
a. 4 weeks
b. 8 weeks
c. 10 weeks
d. 12 weeks
ANS: C
Fetal villus tissue can be obtained as early as 10 weeks of gestation and can be analyzed
directly for chromosomal or genetic abnormalities. It is too early to be performed at 4 weeks.
It is too early to be performed at 8 weeks. The test should be performed at 12 weeks, but it can
be done as early as 10 weeks.
7. On which aspect of fetal diagnostic testing do parents usually place the most importance?
a. Safety of the fetus
b. Duration of the test
c. Cost of the procedure
d. Physical discomfort caused by the procedure
ANS: A
Although all these are considerations, parents are usually most concerned about the safety of
the fetus. Parents are concerned about the duration, but it is not the greatest concern. The cost
of the procedure is important to parents, especially those without third-party payers, but is not
the greatest concern. Discomfort of the procedure is important, especially for the mother, but
is not the greatest concern.

8. The nurse’s role in diagnostic testing is to provide which of the following?

a. Advice to the couple
b. Information about the tests
c. Reassurance about fetal safety
d. Assistance with decision making
ANS: B
The nurse should provide the couple with all necessary information about a procedure so that
the couple can make an informed decision. The nurse’s role is to inform, not to advise.
Ensuring fetal safety is not possible with all the diagnostic tests. To offer this is to give false
reassurance to the parents. The nurse can inform the couple about potential problems so they
can make an informed decision. Decision making should always lie with the couple involved.
The nurse should provide information so that the couple can make an informed decision.

9. Which should be considered a contraindication for transcervical chorionic villus sampling?

a. Rh-negative mother
b. Gestation less than 15 weeks
c. Maternal age younger than 35 years
d. Positive for group B Streptococcus
ANS: D
Maternal infection is a risk with this procedure, and it is contraindicated if the client has an
active infection in the cervix, vagina, or pelvic area. This procedure is done between 10 and
12 weeks. This procedure is usually done for women older than 35; however, if the woman is
at high risk for fetal anomalies, her age is not a contraindication. The procedure can still be
performed; however, Rh sensitization may occur if the mother is Rh-negative. Rho(D)
immune globulin can be administered following the procedure.

10. Which nursing intervention is necessary prior to a second-trimester transabdominal
ultrasound?
a. Perform an abdominal prep.
b. Administer a soap suds enema.
c. Ensure the client is NPO for 12 hours.
d. Instruct the client to drink 1 to 2 quarts of water.
ANS: D
When the uterus is still in the pelvis, visualization may be difficult. It is necessary to perform
the test when the woman has a full bladder, which provides a window through which the
uterus and its contents can be viewed. An abdominal prep is not necessary for this procedure.
A soap suds enema is not necessary for this procedure. The client needs a full bladder to
elevate the uterus; therefore, being NPO would not be appropriate.

11. Which is the major advantage of chorionic villus sampling over amniocentesis?
a. It is not an invasive procedure.
b. It does not require a hospital setting.
c. It requires less time to obtain results.
d. It has less risk of spontaneous abortion.
ANS: C
Results from chorionic villus sampling can be known within 24 to 48 hours, whereas results
from amniocentesis require 2 to 4 weeks. It is an invasive procedure. The woman has to be in
a hospital setting for her and the fetus to be properly assessed during and after the procedure.
The risk of an abortion is at the same level for both procedures.

12. What is the purpose of amniocentesis for a client hospitalized at 34 weeks of gestation with
pregnancy-induced hypertension?
a. Determine if a metabolic disorder is genetic.
b. Identify the sex of the fetus.
c. Identify abnormal fetal cells.
d. Determine fetal lung maturity.
ANS: D
During the third trimester, amniocentesis is most often performed to determine fetal lung
maturity. In cases of pregnancy-induced hypertension, preterm birth may be necessary
because of changes in placental perfusion. The test is done in the early portion of the
pregnancy if the metabolic disorder is genetic. Amniocentesis is done early in the pregnancy
to do genetic studies and determine the sex. Identification of abnormal cells is done during the
early portion of the pregnancy.

13. What does nursing care after amniocentesis include?
a. Forcing fluids by mouth
b. Monitoring uterine activity
c. Placing the client in a supine position for 2 hours
d. Applying a pressure dressing to the puncture site
ANS: B
A risk with amniocentesis is the onset of spontaneous contractions. Hydration is important,
but the woman has not been NPO, so this should not be a problem. The supine position may
decrease uterine blood flow; the side-lying position is preferred. Pressure dressings are not
necessary.

14. What is the term for a non–stress test in which there are two or more fetal heart rate
accelerations of 15 or more bpm with fetal movement in a 20-minute period?
a. Positive
b. Negative
c. Reactive
d. Nonreactive
ANS: C
The non–stress test (NST) is reactive (normal) when there are two or more fetal heart rate
accelerations of at least 15 bpm (each with a duration of at least 15 seconds) in a 20-minute
period. A positive result is not used with an NST. The contraction stress test (CST) uses
positive as a result term. A negative result is not used with an NST. The CST uses negative as
a result term. A nonreactive result means that the heart rate did not accelerate during fetal
movement.

15. What is the purpose of initiating contractions in a contraction stress test (CST)?
a. Increase placental blood flow.
b. Identify fetal acceleration patterns.
c. Determine the degree of fetal activity.
d. Apply a stressful stimulus to the fetus.
ANS: D
The CST involves recording the response of the fetal heart rate to stress induced by uterine
contractions. The CST records the fetal response to stress. It does not increase placental blood
flow. The NST looks at fetal heart accelerations with fetal movements. The NST and
biophysical profiles look at fetal movements.

16. What does a score of 9 on a biophysical profile signify?

a. Normal
b. Abnormal
c. Equivocal
d. Nonreactive
ANS: A
Five parameters of fetal activity—fetal heart rate, fetal breathing movements, gross fetal
movements, fetal tone, and amniotic fluid volume—are used to determine the biophysical
profile. The maximum score is 2 points for each parameter. A score falling between 8 and 10
is considered normal. A score of 4 or less is considered abnormal. Equivocal and nonreactive
are not terms used to describe the results of a biophysical profile.

17. Which response by the nurse is most appropriate to the statement, “This test isn’t my idea, but
my husband insists?”
a. “It’s your decision.”
b. “Don’t worry. Everything will be fine.”
c. “Why don’t you want to have this test?”
d. “You’re concerned about having this test?”
ANS: D
The nurse should clarify the statement and assist the client in exploring her feelings about the
test. “It’s your decision” is a closed statement and does not encourage the woman to express
her feelings. “Don’t worry” is false reassurance and does not deal with the concerns expressed
by the woman. The woman may not be able to answer “why” questions. It may also make her
defensive.

MSC: Client Needs: Psychosocial Integrity
18. A biophysical profile is performed on a pregnant client. The following assessments are noted:
nonreactive stress test (NST), three episodes of fetal breathing movements (FBMs), limited
gross movements, opening and closing of hang indicating the presence of fetal tone, and
adequate amniotic fluid index (AFI) meeting criteria. What would be the correct interpretation
of this test result?
a. A score of 10 would indicate that the results are equivocal.
b. A score of 8 would indicate normal results.
c. A score of 6 would indicate that birth should be considered as a possible treatment
option.
d. A score of 9 would indicate reassurance.
ANS: B
The biophysical profile is used to assess fetal well-being. Five categories of assessment are
used in this combination test: fetal monitoring NST, evaluation of FBMs, gross movements,
fetal tone, and calculation of the amniotic fluid index (AFI). A maximum of 2 points is used if
criteria are met successfully in each category; thus a score in the range of 8 to 10 indicates a
normal or reassuring finding. A score of 6 provides equivocal results and further testing or
observation is necessary. A score of 4 or less requires immediate intervention, and birth may
be warranted. The provided assessments indicate a score of 8 as the only area that has not met
the stated criteria in the NST.
OBJ: Nursing Process Step: Evaluation
MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential/Diagnostic Tests
19. In preparing a pregnant client for a non–stress test (NST), which of the following should be
included in the plan of care?
a. Have the client void prior to being placed on the fetal monitor because a full
bladder will interfere with results.
b. Maintain NPO status prior to testing.
c. Position the client for comfort, adjusting the tocotransducer belt to locate fetal
heart rate.
d. Have an infusion pump prepared with oxytocin per protocol for evaluation.
ANS: C
The nurse must adjust the tocotransducer to find the best location to pick up and record the
fetal heart rate. Positioning the client for comfort during testing is a prime concern. Although
a full bladder may affect client comfort, it will not interfere with testing results. NPO status is
not required for an NST. Instead, a pregnant client should maintain her normal nutritional
intake to provide energy to herself and the fetus. An infusion pump with oxytocin is required
for a contraction stress test (CST).

OBJ: Nursing Process Step: Planning
MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential/Diagnostic Tests
20. The results of a contraction stress test (CST) are positive. Which intervention is necessary
based on this test result?
a. Repeat the test in 1 week so that results can be trended based on this baseline
result.
b. Contact the health care provider to discuss birth options for the client.
c. Send the client out for a meal and repeat the test to confirm that the results are
valid.
d. Ask the client to perform a fetal kick count assessment for the next 30 minutes and
then reassess the client.
ANS: B
A positive CST test is an abnormal finding, and the physician should be notified so that birth
options can be initiated. A positive CST indicates possible fetal compromise. Intervention
should not be delayed by 1 week and results do not have to be trended. Because this is an
abnormal result, there is no need to repeat the test. Sending the client out for a meal will delay
treatment options and may interfere with possible birth interventions if anesthesia is needed.
Fetal kick count assessment is not needed at this time and will further delay treatment
interventions for this abnormal result, which indicates fetal compromise.

MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation/Unexpected Response to
Therapies
21. A pregnant client has received the results of her triple-screen testing and it is positive. She
provides you with a copy of the test results that she obtained from the lab. What would the
nurse anticipate as being implemented in the client’s plan of care?
a. No further testing is indicated at this time because results are normal.
b. Refer to the physician for additional testing.
c. Validate the results with the lab facility.
d. Repeat the test in 2 weeks and have the client return for her regularly scheduled
prenatal visit.
ANS: B
Additional genetic testing is indicated to provide the client with treatment options. A positive
result on a triple-screen test is considered to be an abnormal finding so the client should be
referred to the physician for additional genetic testing. Validation of the test with a lab facility
is not necessary because the client provided you with a copy of the test results. There is no
need to repeat the clinical test because the findings have already been determined.

MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation/Unexpected Response to
Therapies
22. A pregnant woman is scheduled to undergo chorionic villus sampling (CVS) based on genetic
family history. Which medication does the nurse anticipate will be administered?
a. Magnesium sulfate
b. Prostaglandin suppository
c. RhoGAM if the client is Rh-negative
d. Betamethasone
ANS: C
CVS can increase the likelihood of Rh sensitization if a woman in Rh-negative. There is no
indication for magnesium sulfate because it is used to stop preterm labor. There is no
indication for administration of a prostaglandin suppository. Betamethasone is given to
pregnant women in preterm labor to improve fetal lung maturity.

MSC: Client Needs: Physiologic Integrity: Pharmacologic and Parenteral Therapies
23. Which factor serves as a clinical indicator for a third trimester amniocentesis?
a. Sex of the fetus
b. Rh isoimmunization
c. Placenta previa
d. Placental abruption
ANS: B
Rh isoimmunization is a clinical indicator for a third-trimester amniocentesis. Although an
amniocentesis can determine the sex of the fetus, this is not a primary indication for a
third-trimester amniocentesis. Ultrasound imaging would be indicated for evaluation of
placenta previa. Ultrasound imaging would be indicated for evaluation of placental abruption.

MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential
24. For which client would an L/S ratio of 2:1 potentially be considered to be abnormal?
a. A 38-year-old gravida 2, para 1, who is 38 weeks’ gestation
b. A 24-year-old gravida 1, para 0, who has diabetes
c. A 44-year-old gravida 6, para 5, who is at term
d. An 18-year-old gravida 1, para 0, who is in early labor at term
ANS: B
Even though an L/S ratio of 2:1 is typically considered to be a normal finding to validate fetal
lung maturity prior to 38 weeks’ gestation, the result may not be accurate in determining fetal
lung maturity if a client is diabetic.

OBJ: Nursing Process Step: Assessment
25. Which complication could occur as a result of percutaneous umbilical blood sampling
(PUBS)?
a. Postdates pregnancy
b. Fetal bradycardia
c. Placenta previa
d. Uterine rupture
ANS: B
PUBS is an invasive test whereby a needle is inserted into the umbilical cord to obtain blood
as the basis for diagnostic testing with the guidance of ultrasound technology. The most
common complication is fetal bradycardia, which is temporary. PUBS has no effect on
extending the gestation of pregnancy, the development of placenta previa, or uterine rupture.

26. A newly pregnant patient tells the nurse that she has irregular periods and is unsure of when
she got pregnant. Scheduling an ultrasound is a standing prescription for the patient’s health
care provider. When is the best time for the nurse to schedule the patient’s ultrasound?
a. Immediately
b. In 2 weeks
c. In 4 weeks
d. In 6 weeks
ANS: A
An embryo can be seen about 5 to 6 weeks after the last menstrual period. At this time the
crown-rump length (CRL) of the embryo is the most reliable measure of gestational age. Fetal
viability is confirmed by observation of fetal heartbeat, which is visible when the CRL of the
embryo is 5 mm.

OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance
27. The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at
16 weeks’ gestation. The nurse determines that the patient understands the teaching when she
mentions that which fluid will be collected for the initial screening process?
a. Urine
b. Blood
c. Saliva
d. Amniotic
ANS: B
Initial screening is completed with blood. AFP can be detected in amniotic fluid; however,
that procedure is more costly and invasive. Procedures progress from least invasive to most
invasive.

OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Health Promotion and Maintenance
28. A patient at 36 weeks gestation is undergoing a non–stress (NST) test. The nurse observes the
fetal heart rate baseline at 135 beats per minute (bpm) and four nonepisodic patterns of the
fetal heart rate reaching 160 bpm for periods of 20 to 25 seconds each. How will the nurse
record these findings?
a. NST positive, nonreassuring
b. NST negative, reassuring
c. NST reactive, reassuring
d. NST nonreactive, nonreassuring
ANS: C
The presence of at least three accelerations of at least 15 beats, over at least 15 seconds, over a
duration of at least 20 minutes, is considered reactive and reassuring. Nonreactive testing
reveals no or fewer accelerations over the same or longer period. The NST test is not recorded
as positive or negative.

OBJ: Nursing Process Step: Analysis MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE RESPONSE
29. Which clinical conditions are associated with increased levels of alpha fetoprotein (AFP)?
(Select all that apply.)
a. Down syndrome
b. Molar pregnancy
c. Twin gestation
d. Incorrect gestational age assessment of a normal fetus—estimation is earlier in the
pregnancy
e. Threatened abortion
ANS: C, D, E
Elevated APF levels are seen in multiple gestations, underestimation of fetal age, and
threatened abortion. Decreased levels are seen in Down syndrome and a molar pregnancy.

OBJ: Nursing Process Step: Diagnosis
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation/Pathophysiology
30. Transvaginal ultrasonography is often performed during the first trimester. A

6-week-gestation client expresses concerns over the necessity for this test. The nurse should
explain that this diagnostic test may be necessary to determine which of the following? (Select
all that apply.)
a. Multifetal gestation
b. Bicornuate uterus
c. Presence and location of pregnancy
d. Amniotic fluid volume
e. Presence of ovarian cysts
ANS: A, B, C, E
A bicornuate uterus, multifetal gestation, presence of ovarian cysts, and presence and location
of pregnancy can be determined by transvaginal ultrasound in the first trimester of pregnancy.
This procedure is also used for estimating gestational age, confirming fetal viability,
identifying fetal abnormalities or chromosomal defects, and identifying the maternal
abnormalities mentioned, as well as fibroids. Amniotic fluid volume is assessed during the
second and third trimesters. Conventional ultrasound would be used.

OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity
31. A woman who is 36 weeks pregnant asks the nurse to explain the vibroacoustic stimulator
(VAS) test. Which should the nurse include in the response? (Select all that apply.)
a. The test is invasive.
b. The test uses sound to elicit fetal movements.
c. The test may confirm nonreactive non–stress test results.
d. The test can only be performed if contractions are present.
e. Vibroacoustic stimulation can be repeated at 1-minute intervals up to three times.
ANS: B, C, E
Also referred to as VAS or acoustic stimulation, the vibroacoustic stimulator (similar to an
electronic larynx) is applied to the maternal abdomen over the area of the fetal head. Vibration
and sound are emitted for up to 3 seconds and may be repeated. A fetus near term responds by
increasing the number of gross body movements, which can be easily seen and felt. The
procedure can confirm reassuring NST findings and shorten the length of time necessary to
obtain NST data. The test is noninvasive and contractions do not need to be present to perform
the test.

32. The nurse is instructing a client on how to perform kick counts. Which information should the
nurse include in the teaching session? (Select all that apply.)
a. Use a clock or timer when performing kick counts.
b. Your bladder should be full before performing kick counts.
c. Notify your health care provider if you have not felt movement in 24 hours.
d. Protocols can provide a structured timetable for concentrating on fetal movements.
e. You should lie on your side, place your hands on the largest part of the abdomen,
and concentrate on the number of movements felt.
ANS: A, D, E
The nurse should instruct the client to lie on her side, place her hands on the largest part of her
abdomen, and concentrate on fetal movements. She should use a clock or timer and record the
number of movements felt during that time. Protocols are not essential but may give the client
a more structured timetable for when to concentrate on fetal movements. The bladder does not
need to be full for kick counts; it is better to have the client empty her bladder before
beginning the assessment of fetal movements. Further evaluation is recommended if the client
feels no movements in 12 hours; 24 hours is too long before notifying the health care
provider.

33. The nurse is reviewing maternal serum alpha-fetoprotein (MSAFP) results. Which conditions
are associated with elevated levels of MSAFP? (Select all that apply.)
a. Fetal demise
b. Neural tube defects
c. Abdominal wall defects
d. Chromosomal trisomies
e. Gestational trophoblastic disease
ANS: A, B, C
Elevated levels of AFP may indicate open neural tube defects (e.g., anencephaly, spina
bifida), abdominal wall defects (e.g., omphalocele, gastroschisis), or fetal demise. Low levels
of AFP may indicate chromosomal trisomies (e.g., Down syndrome, trisomy 21) or
gestational trophoblastic disease.

34. The nurse is preparing a client for a non–stress test (NST). Which interventions should the
nurse plan to implement? (Select all that apply.)
a. Ensure that the client has a full bladder.
b. Plan approximately 15 minutes for the test.
c. Have the client sit in a recliner with the head elevated 45 degrees.
d. Apply electronic monitoring equipment to the client’s abdomen.
e. Instruct the client to press an event marker every time she feels fetal movement.
ANS: C, D, E
The client may be seated in a reclining chair or have her head elevated at least 45 degrees. The
nurse applies external electronic monitoring equipment to the client’s abdomen to detect the
fetal heart rate and any contractions. The woman may be given an event marker to press each
time she senses movement. Before the NST, the client should void and her baseline vital signs
should be taken. The NST takes about 40 minutes, allowing for most fetal sleep-wake cycles,
although the fetus may show a reassuring pattern more quickly or need more time to awaken
and become active. Fifteen minutes would not allow enough time to complete the test.

MATCHING
Match each term with the correct definition.

a. A test for estimating fetal lung maturity
b. A test to assess blood flow to identify abnormalities
c. A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities
35. Doppler ultrasound

36. Lecithin-to-sphingomyelin (L/S) ratio
37. Chorionic villus sampling (CVS)
35. ANS: B PTS: 1 DIF: Cognitive Level: Understanding

REF: 167 OBJ: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance
NOT: A Doppler ultrasound can assess blood flow to identify abnormalities. A
lecithin-to-sphingomyelin (L/S) ratio is a test for estimating fetal lung maturity. The chorionic villus
sampling (CVS) is a test to diagnose fetal chromosomal, metabolic, or DNA abnormalities.
36. ANS: A PTS: 1 DIF: Cognitive Level: Understanding
37. ANS: C PTS: 1 DIF: Cognitive Level: Understanding
SHORT ANSWER
38. The health care provider has prescribed an initial rate of 1 milliunits (mU)/min of diluted
Pitocin to be started on a client having a contraction stress test (CST). What mL/hr will the
nurse set the infusion pump if the dilution of the Pitocin is 10 units of Pitocin in 1000 mL of
0.25 normal saline? Record your answer as a whole number.
___________ mL/hr
ANS:
6
10 units of Pitocin in 1000 mL of 0.25 normal saline = 10,000 mU/1,000 mL, or 10
milliunits/1 mL. Cross-multiply to get 1 mU/X mL:
10:1::1:X = 10X = 1
X = 0.1 mL/min
Multiply by 60 minutes to get the amount infused per hour:
0.1  60 = 6 mL/hr

MSC: Client Needs: Safe and Effective Care Environment
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alternate years, defects that its high quality cannot overcome.
Monroe originated with a Miss Durham, Penfield, Monroe County,
New York, about the middle of the last century. At one time it was
quoted by nearly all nurserymen but the variety is fast disappearing.
Tree large, vigorous, upright-spreading, hardy, productive; branchlets

covered with fine pubescence; leaves oval, one and three-quarters inches
wide, three and one-half inches long, thick, rugose; margin finely serrate;
petiole tinged red, pubescent, with from one to three small glands.
Fruit matures in mid-season; one and three-eighths inches by one and
one-quarter inches in size, oval, sometimes necked, golden-yellow, often
mottled on the sunny side with red, overspread with thin bloom; stem
adhering poorly to the fruit; flesh golden-yellow, tender, sweet, mild; of
very good quality; stone semi-free or free, three-quarters inch by one-half
inch in size, long and slightly irregular-oval, acute at the base and apex,
with nearly smooth surfaces; ventral suture prominent, blunt.
MOREMAN
Prunus hortulana
1. Montreal Hort. Soc. Rpt. 91. 1885. 2. Cornell Sta. Bul. 38:49, 86.
1892. 3. Mich. Sta. Bul. 123:20. 1895. 4. Vt. Sta. An. Rpt. 11:285. 1898. 5.
Bailey Ev. Nat. Fruits 177, 206. 1898. 6. Am. Pom. Soc. Cat. 40. 1899. 7.
Ia. Sta. Bul. 46:280. 1900. 8. Kan. Sta. Bul. 101:135, 137. 1901, 9. Ohio
Sta. Bul. 162:256, 257. 1905.
Mooreman 1.
Moreman is the hardiest of the Hortulana plums and possibly

worthy of keeping before plum-growers for this reason. Its fruit-
characters are not as satisfactory as those of several other varieties
of its species. Dr. Wayland of Cadiz, Kentucky, according to T. V.
Munson, grew a lot of seedlings from pits of wild plums found in his
vicinity and either from this lot or from a seedling from them, came
the Moreman. The variety was introduced by W. F. Heikes in 1881. It
was listed in the catalog of the American Pomological Society in
1899. The following description is compiled.
Tree vigorous, spreading, hardy, productive; leaves of medium size,

coarsely serrate; petiole usually glandless. Fruit late; small, roundish,
bright red, bloomless; stem long, slender; dots numerous, yellow; flesh
firm, yellow, pleasant in flavor; quality fair; stone small, roundish, clinging.
MOROCCO
Prunus domestica
1. Parkinson Par. Ter. 576. 1629. 2. Rea Flora 207. 1676. 3. Ray Hist.
Plant. 2:1528. 1688. 4. Langley Pomona 91, Pl. XX fig. III. 1729. 5. Miller
Gard. Dict. 3:1754. 6. Knoop Fructologie 56. 1771. 7. Abercrombie Gard.
Ass’t 13. 1786. 8. Forsyth Treat. Fr. Trees 19. 1803. 9. Pom. Mag. 3:103.
1830. 10. Lond. Hort. Soc. Cat. 145, 146, 150. 1831. 11. Prince Pom.
Man. 2:82. 1832. 12. Downing Fr. Trees Am. 306. 1845. 13. Floy-Lindley
Guide Orch. Gard. 282, 382. 1846. 14. Thomas Am. Fruit Cult. 338. 1849.
15. Loudon Enc. Gard. 921. 1834. 16. Ga. Hort. Soc. Rpt. 28. 1876. 17.
Hogg Fruit Man. 714. 1884. 18. Mathieu Nom. Pom. 430. 1889.
Black Morocco 7. Black Morocco 9, 10, 12, 13, 14, 17, 18. Black
Damask 9, 10, 12, 13, 14, 17, 18. Black Damascus 13. Damas Noir 5.
Damas Noir Hâtif 6, 10. Damas Hâtif 10. Damas noir hâtif 11. Early
Damask 5, 8. Early Black Damask 9, 10, 13. Early Damson 10. Early
Morocco 10, 12, 13, 14, 17, 18. Early Damask 9, 10, 11, 12, 13, 14, 15,
17, 18. Early Black Damask 11. Early Black Morocco 12, 18. Frühe
Schwarze Pflaume 18. Frühe Platte Damascene 18. Italian Damask 12
incor., 14. Mogul 16. Morocco 16, 18. Marokko Pflaume 18. Morocco
Plumb 4. Morocco 5, 8, 9. Noire Hâtif 18. Saint Cyr 11.
This variety is not popular in New York nor does it deserve to be,
as there are many better plums of its season. Its faults are small
size, an insipid flavor and poor keeping qualities. Morocco is one of
the oldest of the cultivated plums. It has been known in Europe for
three centuries at least and is undoubtedly much older, its early
history not having been written. It is not known when the variety was
introduced into this country but it has been grown in the Southern
States for many years under the name Mogul. About 1894, it was
reintroduced from England by the W. & T. Smith Nursery Company of
Geneva, New York, under the name Mogul.
Tree large, vigorous, round-topped, rather tender to cold, productive;

branchlets covered with heavy pubescence; leaves oval, one and three-
quarters inches wide, three inches long; margin finely serrate or crenate;
petiole short, thick, with one or two globose glands usually at the base of
the leaf; blooming season intermediate in time and length; flowers
appearing after the leaves, one and one-eighth inches across, white or
creamy as the buds unfold; borne on lateral buds and spurs, singly or in
pairs.
Fruit late, ripening period short; below medium in size, round to oval or
obovate, purplish-black, covered with thick bloom; dots conspicuous; flesh
light golden-yellow, rather dry, moderately firm, sweet next to the skin, but
rather acid near the center; poor; stone clinging, medium to small, oval or
ovate, flattened, with rough surfaces.
MOTTLED PRUNE
Prunus domestica
This plum is placed among the leading varieties only that a full
description of it may be put on record. The fruit is attractive in color
but is inferior in quality. These defects are so prominent that the
variety can hardly become popular. The Mottled Prune originated in
Waterloo, New York, as a chance seedling in 1887; it was introduced
by E. Smith & Sons, Geneva, New York.
Tree large, round and open-topped, very productive; branches stocky;

branchlets heavily pubescent; leaves folded backward or flattened, oval or
obovate, one and three-quarters inches wide, three and one-half inches
long, thick and leathery, rugose; margin crenate, with few, small, dark
glands; petiole thickly pubescent, dull dark red, glandless or with from one
to three smallish glands usually on the stalk; blooming season
intermediate in time and length; flowers appearing after the leaves, one
inch across, white; borne in scattering clusters on lateral buds and spurs,
singly or in pairs; pedicels very pubescent.
Fruit mid-season, ripening period short; one and three-quarters inches
by one and one-half inches in size, ovate, dark purplish-red, somewhat
mottled, covered with thick bloom; dots numerous, conspicuous; flesh pale
yellow, juicy, firm, sweet, mild; of fair quality; stone free, one inch by three-
quarters inch in size, oval, flattened, strongly roughened; ventral suture
deeply furrowed, often with a short wing; dorsal suture with a narrow,
shallow groove.
MYROBALAN
Prunus cerasifera
1. Parkinson Par. Ter. 576, 578. 1629. 2. Gerard Herball 1498, 1500.
1636. 3. Rea Flora 209. 1676. 4. Ray Hist. Plant. 2:1528. 1688. 5.
Duhamel Trait. Arb. Fr. 2:111, Pl. XX fig. 15. 1768. 6. Knoop Fructologie
55, 56. 1771. 7. Forsyth Treat. Fr. Trees 20. 1803. 8. Miller Gard. Dict.
3:1807. 9. Coxe Cult. Fr. Trees 232. 1817. 10. Lond. Hort. Soc. Cat. 144,
150. 1831. 11. Prince Pom. Man. 2:80. 1832. 12. Hoffy Orch. Comp.
2:1842. 13. Downing Fr. Trees Am. 294. 1845. 14. Floy-Lindley Guide
Orch. Gard. 285. 1846. 15. Poiteau Pom. Franc. 1. 1846. 16. Jour. Roy.
Hort. Soc. N. S. 15:360. 1868. 17. Hogg Fruit Man. 690. 1884. 18. Gard. &
For. 1:178. 1888. 19. Mathieu Nom. Pom. 448. 1889. 20. Cal. State Board
Hort. 112, 113. 1891. 21. Cornell Sta. Bul. 38:66. 1892. 22. Rev. Hort. 204.
1894. 23. Neb. Hort. Soc. Rpt. 177. 1895. 24. Guide Prat. 157, 353. 1895.
25. Bailey Ev. Nat. Fruits 190 fig. 27, 209. 1898. 26. Vt. Sta. An. Rpt.
12:211, 212, 215. 1899. 27. S. Dak. Sta. Bul. 93:66. 1905.
Arabische Kirsche 19. Asiatische Kirsche 19. American Cherry Plum 11.
Cerisette 11, 18, 19. Cerizette 11. Ciriselle 6. Cerisette 6, 11. Cerisette
Blanche 6. Cerise 19. Cherry 1, 11. Cherry Plum 7, 8, 11, 16, 19, 20.
Cherry 13, 14, 17. Cherry Plum 9, 10, 18. De Virginie 10, 13, 14.
Damasine 24. D’Amerique Rouge 10, 13, 14. Early Scarlet 10, 11, 13, 17,
19. European Cherry Plum 11. Muscadine ?1. Kirschpflaume 18, 19.
Kleine Kirschpflaume 24. Mirobalan 2. Mirabilon 3. Mirabolan 5.
Myrobolan 13. Mirabolanenpflaume 19. Myrobalans 7. Mirabolane 19.
Mirobalan 9, 11. Myrobalane 19. Mirabolan 14. Myrobalan 10, 11, 14, 17,
18, 19. Mirabelle Rouge 24. Mirabelle Rouge 10. Miser Plum 19. Miser 12,
13, 14, 17. Prune d’Amerique Rouge 19. Prune Cerise 11. Prune Cerizette
8. Prunus Myrobalana 11, 14, 19, 23. Prunus Cerasifera 10, 11, 13, 14, 19.
Prune Ceriset 11. Prune de Virginie 19. Prunier Myrobolan 15, 22. Prune
Cerisette 15. Prunus Cerasifera fructu majore 19. Prunus Myrobolana 13.
Queene Mother ?1. Red Mirobalane 1. Rote Kirschpflaume 19. Red
Mirabelle 12. Rothe Mirabelle 24. Stambul Erik oder Irek 19. Türkische
Kirsche 19. Virginian Cherry 10, 13, 14, 17, 19. White Mirobalane 1. The
Myrobalane Plum 4.
Myrobalan is a group name rather than a varietal one. Plums of

this group are grown from seeds and many varieties have appeared
during the last three centuries, differing in color, shape, stone and in
many minor characters. The red and reddish-purple plums and the
round ones are apparently the most numerous though there are
frequent references to the White Myrobalan and to heart-shaped
fruits in this group. For a further discussion of these plums see
Prunus cerasifera. The Myrobalan plums are used largely as stocks
in the propagation of plums and closely allied plants; occasionally
they are used for culinary purposes though with rather poor results.
NECTARINE
Prunus domestica
1. Pom. Mag. 3:148. 1830. 2. Lond. Hort. Soc. Cat. 150. 1831. 3.
Kenrick Am. Orch. 264. 1832. 4. Downing Fr. Trees Am. 306. 1845. 5.
Horticulturist 1:115. 1846. 6. Cole Am. Fr. Book 215. 1849. 7. Thompson
Gard. Ass’t 518. 1859. 8. Mathieu Nom. Pom. 448. 1889. 9. Guide Prat.
162, 365. 1895.
Bradshaw 6. Caledonian 1, 2, 3. Calvel’s Pfirschenpflaume 8. Goliath of
some 8. Howel’s 3. Howell’s Large 1, 2, 4, 7, 8. Jenkin’s Imperial 2, 4, 7, 8,
9. Louis Phillipe 4. Louis Philippe 6, 7, 8, 9. Large Early Black 6. Nectarine
1, 8, 9. Nectarine Plum 3, 7. Peach Plum 4, 7, 9. Peach 2, 8. Prune Pêche
1, 2, 3, 4, 7, 8. Pêche de Calvel 8. Prune d’Abricot 8. Pêche of some 9.
Rothe Nectarine 9. Rote Nectarine 8. The Nectarine Plum 1.
Much confusion has existed regarding the identity of the

Nectarine, Peach and Goliath plums. These names have been
interchanged indiscriminately for the three plums and it is now
difficult to separate the varieties, especially as they are very similar.
The Goliath, however, may be separated from the other two by its
pubescent shoots, which the others do not have. The Peach plum is
the largest of the three and has a reddish cast whereas the
Nectarine and Goliath are dark purple. The earlier writers knew a
Nectarine as a synonym of Peach but it was not until 1830 that the
Nectarine was finally described as a separate variety. Nectarine is of
unknown origin. The following description is compiled.
Tree vigorous, round-topped, productive; leaves large, oval; branches

glabrous. Fruit early; large, roundish, flattened at the ends, dark purple
with thin bloom; flesh greenish-yellow, tinged red at maturity, rather
coarse, sprightly; fair to good; stone of medium size, compressed, oval,
semi-clinging.
NEWARK
Prunus domestica
This fruit has little to recommend it to the commercial plum-grower;
it is small in size and unattractive in color; the quality, however, is
very good and the variety is worth planting for home use. Newark
originated in Newark, New York, and in 1895 was bought by E. Smith
& Sons of Geneva, New York, who disseminated it two years later.
Tree medium in size and vigor, upright-spreading, rather open, very

productive; branches rough; branchlets marked by scarf-skin, leaf-scars
prominent; leaves flattened, somewhat drooping, oval or obovate, one and
three-quarters inches wide, three and one-half inches long, thick, rugose;
margin coarsely serrate, with small, dark glands; petiole thick, pubescent,
glandless or with one or two smallish glands usually on the stalk; blooming
season intermediate in time and length; flowers appearing after the
leaves, one inch or more across, white with yellowish tinge at the apex of
the petals; borne singly or in pairs; anthers yellow with a trace of red.
Fruit early, season short; one and one-half inches by one and three-
eighths inches in size, oval, dull yellow mottled with red at full maturity,
covered with thin bloom; dots numerous, conspicuous; flesh light
greenish-yellow, rather dry, firm, sweet, mild; good to very good; stone
free, three-quarters inch by one-half inch in size, irregular-oval, flat, with
finely pitted surfaces; ventral suture usually winged; dorsal suture with a
shallow, narrow, indistinct groove.
NEWMAN
NEWMAN
Prunus munsoniana
1. Horticulturist 22:271. 1867. 2. Downing Fr. Trees Am. 934. 1869. 3.

Am. Jour. Hort. 5:142. 1869. 4. Mich. Pom. Soc. Rpt. 39. 1874. 5. Am.
Pom. Soc. Cat. 36. 1875. 6. Barry Fr. Garden 418. 1883. 7. Ia. Hort. Soc.
Rpt. 286. 1887. 8. Cornell Sta. Bul. 38:63, 86. 1892. 9. Mich. Sta. Bul.
123:20. 1895. 10. Wis. Sta. Bul. 63:49. 1897. 11. Me. Sta. An. Rpt. 12:66.
1896. 12. Bailey Ev. Nat. Fruits 200 fig., 201. 1898. 13. Rural N. Y. 59:450.
1900. 14. Ia. Sta. Bul. 46:282. 1900. 15. Ohio Sta. Bul. 162:256, 257.
1905.
Warren? 8.
Newman is one of the oldest but still one of the standard varieties
of its species. Its fruits are characterized by a firm, meaty flesh,
which fits it well for shipping and storing; the plums are also
attractive in shape and color but are too small and too low in quality
to make the variety a first-rate one. The trees are large and vigorous
and in all respects very satisfactory orchard plants. Both fruits and
trees are usually reported as fairly free from diseases and insects.
While the variety is gradually going out it still has some value for its
crops and ought to make a good parent from which to breed a race
of vigorous, firm-fleshed Munsonianas.
The origin of this plum is uncertain. In 1867 a Mr. Elliott of
Cleveland, Ohio, reported in the Horticulturist that he had received
samples of the “Newman Plum” from D. L. Adair, Esq., of Hawesville,
Kentucky, and gave a brief description of the fruit which seems to
tally with that of the variety under discussion. The American
Pomological Society added this plum to its fruit catalog list in 1875
and removed it in 1891.
Tree large, vigorous, spreading, low and flat, dense-topped, hardy at

Geneva, productive, subject to attacks of shot-hole fungus, the trunk
shaggy; branches dark ash-gray, rough and shaggy, thorny, zigzag, with
numerous, rather inconspicuous, large, elongated lenticels; branchlets
very slender, twiggy, with internodes of average length, greenish-red,
changing to dark brown, glabrous, with few, conspicuous, large, raised
lenticels; leaf-buds small, short, obtuse, plump, nearly free.
Leaves lanceolate, peach-like, one and one-quarter inches wide, four
inches long, thin; upper surface smooth, glabrous, with a grooved midrib;
lower surface glabrous except along the midrib and larger veins; apex
taper-pointed, base acute, margin finely crenate, with small, amber
glands; petiole slender, seven-eighths inch long, lightly pubescent along
one side, reddish, glandless or with from one to four very small, globose,
yellowish-red glands on the stalk.
Blooming season late and long; flowers appearing after the leaves,
three-quarters inch across, in the buds tinged yellow, changing to white on
expanding, odor disagreeable; borne in clusters on lateral spurs and buds,
in twos or in threes; pedicels eleven-sixteenths inch long, slender,
glabrous, greenish; calyx-tube green, campanulate, glabrous; calyx-lobes
small, narrow, slightly obtuse, pubescent on the inner surface, glandular-
serrate and with marginal hairs, erect; petals ovate or oval, crenate,
tapering at the base into long, narrow claws; anthers yellow, tinged with
red; filaments five-sixteenths inch long; pistil slender, glabrous, equal to
the stamens in length.
Fruit mid-season, ripening period very long; one inch by seven-eighths
inch in size, strongly oval, not compressed, halves equal; cavity shallow,
narrow, flaring; suture a distinct dark red line; apex depressed; color bright
currant-red, with thin bloom; dots grayish, rather conspicuous, clustered
near the apex; stem very slender, seven-eighths inch long, glabrous,
adhering well to the fruit; skin thin, very tough, astringent, separating
readily; flesh deep yellow, juicy, tender and melting, sweetish next to the
skin, but tart at the center; fair in quality; stone clinging, five-eighths inch
by three-eighths inch in size, long-oval, turgid, necked at the base, blunt-
pointed at the apex, with finely pitted surfaces; ventral suture narrow,
inconspicuous; dorsal suture with a narrow, shallow groove.
NEW ULM
NEW ULM
Prunus americana
1. Minn. Hort. Soc. Rpt. 126. 1890. 2. Wis. Sta. Bul. 63:49 fig., 50. 1897.
3. Ia. Hort. Soc. Rpt. 111. 1899. 4. Am. Pom. Soc. Cat. 37. 1899. 5. Ia.
Sta. Bul. 46:282 fig. 1900. 6. Waugh Plum Cult. 158. 1901. 7. Ont. Fr. Gr.
Assoc. 143. 1901. 8. S. Dak. Sta. Bul. 93:26. 1905. 9. Ill. Hort. Soc. Rpt.
422. 1905. 10. Ia. Sta. Bul. 114:141. 1910.
Snooks 10.
New Ulm is worthy of attention because of its large, handsome,

well-formed fruits. The plums are further distinguished by a peculiar
flavor, somewhat suggesting that of the mandrake, pleasant to some
but disagreeable to others. The flesh is a little too juicy for pleasant
eating but the fruits ship well, the tough, thick skin firmly holding its
contents. The fruits, however, do not keep well, for, despite the thick
skin, the spores of the brown-rot find entrance and thrive so that the
variety rots badly. The trees are hardy and productive but ill-shaped
and hard to manage in either the orchard or the nursery for which
reason the culture of the variety is discouraged by nurserymen and it
is now almost impossible to buy New Ulm trees. The illustration of
this variety shows well the characters of the western type of Prunus
americana in leaf, fruit and stone.
New Ulm was raised from seed of a wild variety that grew in the
neighborhood of the originator and introducer, C. W. H. Heideman,
New Ulm, Minnesota. The fruit was exhibited at the Minnesota State
Fair in 1890 where it attracted much attention, being the largest plum
of fifty varieties exhibited. In 1899 the American Pomological Society
placed the variety on its fruit catalog list. The Minnesota State
Horticultural Society, in spite of the fact that this plum has gained a
good reputation for its size and productiveness, removed it from its
recommended fruit list in 1904 because of the difficulty of growing
the trees in the nursery.
Tree of medium size, spreading and drooping, irregular, low and dense-
topped, undesirable in habit of growth, hardy, usually productive, subject
to attacks of shot-hole fungus; branches very rough and shaggy, zigzag,
thorny, dark ash-gray, with large lenticels; branchlets thick, long, willowy,
with long internodes, green, with a faint yellow tinge, changing to light and
dark, dull reddish-brown, glabrous, with numerous, conspicuous, large,
raised lenticels; leaf-buds small, pointed, strongly appressed.
Leaves drooping, folded upward, oval or ovate, two inches wide, four
and three-eighths inches long, thin; upper surface dark green, changing to
reddish-yellow late in the season, glabrous, with a grooved midrib; lower
surface silvery green, lightly pubescent; apex taper-pointed, base abrupt,
margin coarsely and doubly serrate, eglandular; petiole slender, five-
eighths inch long, pubescent, tinged with red which deepens in color at the
base, glandless or with from one to three globose, greenish-brown glands
usually on the stalk.
Flowers intermediate in time and length of blooming season, appearing
after the leaves, showy on account of the numerous pure white petals, one
and one-sixteenth inches across, white; borne in dense clusters on lateral
spurs and buds, usually in threes; pedicels seven-sixteenths inch long,
thick, glabrous, greenish; calyx-tube red, campanulate, glabrous; calyx-
lobes long, narrowly obtuse, lightly pubescent on the inner surface, thickly
pubescent along the glandular-serrate margin, erect; petals oval, entire or
incised, tapering below to narrow claws of medium length and with reddish
base; anthers yellow; filaments seven-sixteenths inch in length; pistil
glabrous, much shorter than the stamens.
Fruit mid-season, intermediate in length of ripening period; about one
and three-eighths inches in diameter, roundish-ovate, halves equal; cavity
markedly shallow, very narrow; suture a line; apex roundish or slightly
pointed; color carmine over a yellow ground, overspread with thin bloom;
dots very numerous, russet; stem five-eighths inch long, glabrous,
adhering somewhat to the fruit; skin thick and tough, astringent, adhering
strongly; flesh golden-yellow, very juicy and fibrous, granular, tender and
melting, sweet with a strong aromatic flavor; good; stone adhering, seven-
eighths inch by nine-sixteenths inch in size, oval, slightly flattened, blunt at
the base, pointed at the apex, with smooth surfaces; ventral suture
distinctly winged; dorsal suture narrow, shallow, grooved.
NICHOLAS
Prunus domestica
1. Am. Pom. Soc. Rpt. 61. 1887. 2. Kan. Sta. Bul. 101:121, 124 fig.
1901. 3. Budd-Hansen Am. Hort. Man. 327. 1903.
Arab No. 2 Bielaya Nicholskaya 1. White Nicolas 1. White Nicholas 2, 3.
Although a fairly good early dessert plum it is doubtful if Nicholas

has any commercial value as it is inferior in most characters of fruit
and tree to standard varieties; in particular it drops badly as it begins
to ripen. “White,” as formerly and usually now put in the name, is a
misnomer, as the fruit is red; how it came to be applied to this fruit
does not appear. Nicholas was imported from Dr. Regel of St.
Petersburg, Russia, by Professor J. L. Budd of the Iowa Experiment
Station in the winter of 1881-82 and in 1888 was sent out for testing
under the name Arab No. 2.
Tree of medium size, round-topped, productive; trunk rough; branches

smooth except for the raised lenticels and longitudinal cracks in the bark;
branchlets slender; leaves falling early, folded upward, obovate or oval,
one and five-eighths inches wide, three and three-eighths inches long,
rugose; margin serrate, with few, small, dark glands; petiole pubescent,
tinged red, sometimes with several small glands; blooming season
intermediate in time, short; flowers appearing after the leaves, one inch or
more across, white, tinged with yellow near the apex of the petals; borne
on lateral buds and spurs, in scattering clusters, singly or in pairs.
Fruit early, one and three-eighths inches by one inch in size, long-oval,
dark red, covered with thick bloom; stem adhering poorly to the fruit; flesh
light yellow, juicy, fibrous, tender, sweet, mild; good; stone free, one inch
by five-eighths inch in size, flattened, oval, somewhat obliquely acute at
the base, with granular surfaces; ventral suture prominent, rather narrow,
blunt; dorsal suture with a narrow, shallow groove.
OCCIDENT
Prunus triflora
1. Rural N. Y. 57:653. 1898. 2. Am. Gard. 19:826. 1898. 3. Burbank Cat.

1899. 4. Vt. Sta. An. Rpt. 12:229. 1899. 5. Rural N. Y. 60:658 fig., 662.
1901. 6. Budd-Hansen Am. Hort. Man. 320. 1903. 7. Ga. Sta. Bul. 68:11,
37. 1905. 8. Rural N. Y. 65:730. 1906.
Burbank’s Sultan 6. Garnet 1. Garnet 2. Occident 8. Oval Blood
(unpublished). Sultan 2, 3, 5, 8. Sultan 4, 7.
Occident differs little from Apple in horticultural characters and

need not be discussed at length as the reader can readily turn to the
color-plate and description of the last named variety. At best this sort
can hardly be called more than a curiosity, though an interesting one,
of use, if at all, only for cooking and as a long-keeping, rot-resistant
plum. It will add novelty to any amateur’s collection because of the
size, shape, color, flavor and red flesh of the fruits.
This variety was grown by Burbank and introduced by him in 1899
under the name Sultan. H. E. Van Deman, in the Rural New Yorker
(References, 1), says that Occident is a cross between Wickson and
Satsuma and that the name Garnet which he suggested, owing to
the color of its flesh and skin, had been accepted by Mr. Burbank.
About two months later the Division of Pomology of the United
States Department of Agriculture called attention to the fact that
“Garnet” had been previously given to another variety and the name
was changed to Sultan. Waugh in 1899 substituted “Occident” for
Sultan as the latter is the name of a European plum; Waugh’s name
has been accepted by all recent writers. Occident undoubtedly
contains Satsuma blood but it has but few characters that suggest
Wickson, and if a cross, which is likely, the other parent is
undeterminable. The following description is compiled:
Tree vigorous, slow of growth, straggling, somewhat variable in habit,

late in coming into bearing, productive; leaves numerous, large.
Fruit ripens with Burbank, keeps and ships unusually well, resistant to
rot; large, roundish; cavity of medium depth; suture shallow, distinct; color
dark red over a greenish ground; dots many, yellowish; stem thick, short,
adhering to the fruit; skin somewhat thin, tough, slightly astringent; flesh
dark red, firm, sweet, rather acid, changing to subacid as maturity
advances, sprightly; good to very good; stone free or semi-clinging, of
medium size, roundish, turgid, winged, rough.
OCHEEDA
Prunus americana
1. Cornell Sta. Bul. 38:41. 1892. 2. Wis. Sta. An. Rpt. 11:344. 1894. 3.
Ia. Hort. Soc. Rpt. 34:112. 1899. 4. Am. Pom. Soc. Cat. 37. 1899. 5.
Waugh Plum Cult. 159. 1901. 6. Can. Exp. Farm Bul. 43:31. 1903. 7. Ill.
Hort. Soc. Rpt. 420. 1905. 8. S. Dak. Sta. Bul. 93:28. 1905.
Ocheda 7.
This variety is generally regarded as one of the valuable native
plums but in New York it is surpassed by a number of other plums of
its species in size of fruit and color though the quality is very good.
We must rank it in this State as second rate among Americanas.
Ocheeda was found by P. L. Hardow in 1872 growing wild on the
banks of Ocheeda Lake, Minnesota, and in 1892 was introduced by
H. J. Ludlow of Worthington, Minnesota.
Tree large, vigorous, spreading, open-topped, unproductive; branches

shaggy, thorny, with large lenticels; branchlets willowy, pubescent; leaves
folded upward, oval, nearly two inches wide, three and one quarter inches
long; margin coarsely and doubly serrate; petiole densely covered with
short hairs; blooming season intermediate in time and length; flowers
appearing after the leaves, seven-eighths inch across, dull white; borne in
scattering clusters almost entirely on one-year-old wood, many lateral
buds remaining undeveloped, the bare limbs carrying tufts or clusters of
blossoms, in threes or fours; petals long-obovate, nearly three times as
long as wide, tapering to long claws, reddish at the base; stigma distinctly
reddish when the flowers first open.
Fruit mid-season, ripening period long; one inch by seven-eighths inch
in size, ovate or roundish-ovate, slightly oblique, dull light to dark carmine
over a yellow ground, somewhat mottled, overspread with thick bloom;
skin slightly astringent; flesh dark golden-yellow, tender, melting, sweet,
aromatic, pleasant in flavor; fair to good; stone dark colored, nearly free,
three quarters inch by one-half inch in size, roundish-oval, turgid with
smooth surfaces; ventral suture markedly winged.
OCTOBER
Prunus triflora
1. Cornell Sta. Bul. 106:58. 1896. 2. Cal. State Bd. Hort. 52. 1897-98. 3.
Am. Gard. 20:162 fig. 1899. 4. Rural N. Y. 59:104, 690. 1900. 5. Am.
Gard. 21:36, 660. 1900. 6. Nat. Nur. 8:109, 123. 1900. 7. Waugh Plum
Cult. 139. 1901. 8. Rural N. Y. 62:756. 1903. 9. Ohio Sta. Bul. 162:250
fig., 256, 257. 1905. 10. Mass. Sta. An. Rp. 17:160. 1905.
October Purple 1, 2, 3, 4, 5, 6, 8, 9, 10. October Purple 7.
There are but few late plums in Prunus triflora worth cultivating
and one of the needs of horticulture is a late plum of superior quality
in this species. At present October is the nearest approach to the
plum desired but because of several faults it falls considerably short
of filling the need. The fruits are large, attractive-looking, fairly
suitable for dessert, very good for culinary purposes, hang well to the
tree and keep and ship much better than the average Triflora variety;
but still they are not far enough from mediocrity to make the variety
especially desirable. The trees are well shaped, usually robust and
healthy and the fruit is well borne on lateral spurs distributed over the
old wood; but in New York, at least, the trees are very tardy in
coming in bearing and cannot be depended upon to bear satisfactory
crops regularly—a fatal fault in a Triflora plum. October might be
sparingly planted in New York to the pleasure of the amateur and
possibly to the profit of the commercial fruit-grower who has a good
local market.
October is said to be a cross of Satsuma and a seedling Triflora
plum; it was first fruited by Luther Burbank in 1892 and was
introduced by Stephen Hoyt’s Sons, New Canaan, Connecticut, in
1897. The variety was named October Purple by Burbank but
“Purple” has been dropped in accordance with the rules of the
American Pomological Society.
Tree variable in size and vigor, upright-spreading, open-topped, hardy

for a Triflora, not uniform in productiveness, healthy; branches rough,
dark, dull ash-gray, with numerous, small lenticels; branchlets slender,
long, with internodes of average length, greenish-red changing to dull
reddish-brown, often with a green tinge on the winter shoots, glabrous;
lenticels numerous, small; leaf-buds small, short, obtuse, free.
Leaves falling early, sparse, folded upward, oval or obovate, one and
three-eighths inches wide, three and one-quarter inches long, thin and
leathery; upper surface slightly rugose, with a broad groove on the lightly
pubescent midrib; lower surface very thinly pubescent; apex and base
acute, margin glandular, doubly serrate or crenate; petiole one-half inch
long, hairy along the upper side, green, with from one to three small,
globose, yellowish glands variable in position.
Blooming season early to medium, of average length; flowers appearing
before the leaves, thirteen-sixteenths inch across, white; borne in dense
clusters on lateral spurs and buds, in pairs; pedicels one-half inch long,
slender, glabrous, greenish; calyx-tube green, campanulate, glabrous;
calyx-lobes obtuse, glandular-serrate, with numerous hairs along the
edge, pubescent, somewhat erect; petals broadly ovate, entire, tapering to
short, blunt claws; anthers yellow; filaments three-sixteenths inch long;
pistil glabrous, longer than the stamens.
Fruit mid-season or later, ripening period long; one and seven-eighths
inches in diameter, roundish-cordate or slightly oblate, halves unequal;
cavity deep, wide, flaring, with streaks radiating from the cavity; suture
shallow or a line; apex roundish to slightly pointed; color dark red over a
yellowish-green ground, with bloom of medium thickness; dots numerous,
large, russet, conspicuous, clustered about the apex; stem somewhat
slender, five-eighths inch long, glabrous, adhering well to the fruit; skin
thin, tough, sour, separating readily; flesh light yellow frequently tinged
with red, very juicy, slightly fibrous, variable in firmness, sweet, mild,
lacking the strong characteristic Triflora flavor; good; stone clinging,
seven-eighths inch by five-eighths inch in size, roundish-oval, blunt but
with a small tip, somewhat rough, ridged along the ventral, grooved on the
dorsal suture.
OGON
Prunus triflora
1. Ga. Hort. Soc. Rpt. 29. 1886. 2. Ibid. 35, 58. 1888. 3. Ibid. 53, 99.
1889. 4. Col., O., Hort. Soc. Rpt. 81. 1892. 5. Cornell Sta. Bul. 62:27, 28
fig. 1894. 6. Ga. Hort. Soc. Rpt. 95. 1895. 7. Cornell Sta. Bul. 106:59.
1896. 8. Ibid. 131:194. 1897. 9. Ibid. 139:45. 1897. 10. Am. Pom. Soc.
Cat. 26. 1897. 11. Rural N. Y. 57:562. 1898. 12. Colo. Sta. Bul. 50:43.
1898. 13. Mich. Sta. Bul. 169:242, 249. 1899. 14. Cornell Sta. Bul.
175:138 fig. 1899. 15. Ohio Sta. Bul. 113:157. 1899. 16. Waugh Plum Cult.
139. 1901. 17. Ga. Sta. Bul. 68:6 32. 1905. 18. Miss. Sta. Bul. 93:15.
1905.
Ogan 5. Ogden 1. Ogon 5. Shiro Smomo 6. Yellow Nagate 2.
Ogon, the Japanese for gold, is the name for one of the
comparatively few varieties of Prunus triflora having a yellow color.
This variety is further distinguished by being the only freestone sort
of its species under cultivation in America. Ogon also has a flavor
quite distinct, resembling somewhat that of the apricot, which is
agreeable to some and not so to others; as the variety grows on the
grounds of this Station it cannot be considered of high quality even
for an early plum. The fruits crack rather badly on the tree and seem
to be unusually susceptible to the attacks of curculio. In some of the
references given, it is reported as making a poor tree and as having
a weak constitution, and practically all agree that the variety is
unproductive. These faults preclude its use in commercial
plantations. The variety is distinct and interesting not only in its fruits
but in its flowers which bear comparatively few stamens, many of
which are abortive and show all degrees between perfect stamens
and perfect petals.
Ogon was imported from Japan by H. H. Berger and Company,
San Francisco, California. It was first mentioned as the Ogden in the
Georgia Horticultural Society Report for 1886 and in the 1888 report
of the same Society it was described as a new fruit. In 1897, the
American Pomological Society added Ogon to its fruit catalog list.
Tree medium to large, vigorous, vasiform, dense-topped, hardy at

Geneva, unproductive; branches slender, roughened by numerous spurs,
sparingly thorny, dark gray, with numerous, small lenticels; branchlets
sometimes swollen at the tips, of medium thickness and length, with
internodes of average length, dark brown often with some green, partly
overspread with gray scarf-skin, glossy, glabrous; lenticels medium in
number and size, raised; leaf-buds small, short, obtuse, plump, free.
Leaves few, oblanceolate, peach-like, variable in size, averaging one
and one-eighth inches wide, four inches long, thin; upper surface light
green, shining, glabrous, narrowly grooved along the midrib; lower surface
light yellowish-green, glabrous except at the base of the veins; margin
finely crenate, with small, dark amber glands; petiole one-half inch long,
glandless or with from one to four globose, greenish glands on the stalk.
Blooming season early and of medium length; flowers appearing after
the leaves, thirteen-sixteenths inch across, white; borne in clusters on
lateral spurs and buds, in threes or in fours; pedicels five-sixteenths inch
long, glabrous, greenish; calyx-tube green, obconic, glabrous; calyx-lobes
narrow, acute, slightly glandular-serrate, faintly pubescent, erect; petals
broadly ovate, entire, tapering below to short claws; anthers yellowish,
with a little pink; filaments three-sixteenths inch long; pistil glabrous, equal
to the stamens in length.
Fruit early, season short; one and one-quarter inches by one and three-
quarters inches in size, roundish-oblate, oblique, halves equal; cavity
narrow, regular, flaring; suture variable in depth, prominent; apex roundish
or slightly flattened; color lemon-yellow, with thin bloom; dots numerous,
small, whitish, inconspicuous; stem slender, one-half inch long, glabrous,
separating readily; skin thin, tough, astringent, inclined to crack, slightly
adhering; flesh pale or amber-yellow, not as juicy as many of the Trifloras,
firm and meaty, sweet, mild; of fair quality; stone free, five-eighths inch by
one-half inch in size, roundish-oval, turgid, blunt but with a small short tip,
oblique, slightly pitted; ventral suture faintly ridged and furrowed; dorsal
suture not grooved.
ORANGE
Prunus domestica
1. Lond. Hort. Soc. Cat. 150. 1831. 2. Downing Fr. Trees Am. 282.
1845. 3. Cole Am. Fr. Book 214. 1849. 4. Mas Le Verger 6:25. 1866-73. 5.
Mathieu Nom. Pom. 442. 1889. 6. Budd-Hansen Am. Hort. Man. 320.
1903.
Orange 5. Orange Gage 2, 5, 6. Pomeranzen Zwetsche 5. Wager 5, 6.
Orange belongs to the Reine Claude group. Taking its characters

all in all it cannot compete with even the average varieties of the
plums with which it should be compared. This variety was introduced
by A. J. Downing who secured it from a Mr. Teller of Rhinebeck,
Dutchess County, New York. Although Rhinebeck is probably its
place of origin, it is not likely that Teller first grew the variety since it
was quite generally disseminated in that vicinity at the time of its
introduction. It is fast passing from cultivation.
Tree large, vigorous, upright, productive; branches roughened by the

raised lenticels; branchlets numerous, pubescent; leaves oval or slightly
obovate, two inches wide, four inches long, thick; margin crenate or
serrate, with small grands; petiole tinged red, pubescent, with from two to
three globose glands.
Fruit matures in mid-season; about one and one-half inches in diameter
roundish-truncate, light amber-yellow with a blush, overspread with thin
bloom; stem slender, adhering strongly to the fruit; flesh pale yellow, firm,
sweet; of good quality; stone free or nearly so, one inch by five-eighths
inch in size, obovate, acute at the apex, blunt at the base, with thickly
pitted surfaces; ventral suture wide, usually blunt but sometimes distinctly
winged; dorsal suture with a deep groove.
OREN

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Maternal and Child Nursing Care 6th Edition Perry Test

PTS: 1 DIF: Cognitive Level: Application REF: 179

PTS: 1 DIF: Cognitive Level: Understanding REF: 170

PTS: 1 DIF: Cognitive Level: Analysis REF: 169

PTS: 1 DIF: Cognitive Level: Understanding REF: 167

PTS: 1 DIF: Cognitive Level: Understanding REF: 168

PTS: 1 DIF: Cognitive Level: Understanding REF: 165

8. The nurse’s role in diagnostic testing is to provide which of the following?

PTS: 1 DIF: Cognitive Level: Understanding REF: 179

9. Which should be considered a contraindication for transcervical chorionic villus sampling?

PTS: 1 DIF: Cognitive Level: Analysis REF: 170

PTS: 1 DIF: Cognitive Level: Application REF: 168

PTS: 1 DIF: Cognitive Level: Understanding REF: 170

PTS: 1 DIF: Cognitive Level: Analysis REF: 172

PTS: 1 DIF: Cognitive Level: Application REF: 171

PTS: 1 DIF: Cognitive Level: Analysis REF: 174

PTS: 1 DIF: Cognitive Level: Understanding REF: 176

16. What does a score of 9 on a biophysical profile signify?

PTS: 1 DIF: Cognitive Level: Understanding REF: 178

PTS: 1 DIF: Cognitive Level: Application REF: 174

PTS: 1 DIF: Cognitive Level: Analysis REF: 174

PTS: 1 DIF: Cognitive Level: Analysis REF: 176

PTS: 1 DIF: Cognitive Level: Analysis REF: 170

PTS: 1 DIF: Cognitive Level: Analysis REF: 170

PTS: 1 DIF: Cognitive Level: Analysis REF: 172

PTS: 1 DIF: Cognitive Level: Analysis REF: 172

PTS: 1 DIF: Cognitive Level: Analysis REF: 173

PTS: 1 DIF: Cognitive Level: Application REF: 167

PTS: 1 DIF: Cognitive Level: Understanding REF: 169

PTS: 1 DIF: Cognitive Level: Analysis REF: 175

PTS: 1 DIF: Cognitive Level: Analysis REF: 169

30. Transvaginal ultrasonography is often performed during the first trimester. A

PTS: 1 DIF: Cognitive Level: Analysis REF: 167

PTS: 1 DIF: Cognitive Level: Application REF: 176

PTS: 1 DIF: Cognitive Level: Application REF: 179

PTS: 1 DIF: Cognitive Level: Analysis REF: 169

PTS: 1 DIF: Cognitive Level: Application REF: 174

Match each term with the correct definition.

35. Doppler ultrasound

35. ANS: B PTS: 1 DIF: Cognitive Level: Understanding

PTS: 1 DIF: Cognitive Level: Application REF: 170

Tree large, vigorous, upright-spreading, hardy, productive; branchlets

Moreman is the hardiest of the Hortulana plums and possibly

Tree vigorous, spreading, hardy, productive; leaves of medium size,

Tree large, vigorous, round-topped, rather tender to cold, productive;

Tree large, round and open-topped, very productive; branches stocky;

Myrobalan is a group name rather than a varietal one. Plums of

Much confusion has existed regarding the identity of the

Tree vigorous, round-topped, productive; leaves large, oval; branches

Tree medium in size and vigor, upright-spreading, rather open, very

1. Horticulturist 22:271. 1867. 2. Downing Fr. Trees Am. 934. 1869. 3.

Tree large, vigorous, spreading, low and flat, dense-topped, hardy at

New Ulm is worthy of attention because of its large, handsome,

Although a fairly good early dessert plum it is doubtful if Nicholas

Tree of medium size, round-topped, productive; trunk rough; branches