MIDTERMS REVIEWER
Abruption placenta is most likely to occur in a woman with: Cephalopelvic disproportion Hyperthyroidism Pregnancy-induced hypertension Cardiac disease
Pregnancy-induced hypertension
A client is admitted to the obstetrical unit at 36 weeks gestation. Which of the following symptoms would indicate a concealed abruption placenta? - Decreased fundal height - A hard, board like abdomen - A fetal heart rate of 180 bpm - Painless, bright red vaginal bleeding
- A hard, board like abdomen
Which of the following assessment findings would indicate that a pregnant client with mild preeclampsia is worsening and the need to notify the physician? - The client complains of a headache and blurred vision - Dependent edema has resolved - Blood pressure reading is at the prenatal baseline - Urinary output has increased
- The client complains of a headache and blurred vision
Which of the following tests is most diagnostic of rupture of membranes? - Maximum vertical pocket less than 2cm on ultrasound - Pooling of amniotic fluid on speculum exam with valsalva - Reported history of a large gush of fluid - Nitrazine paper or swab changing color when placed in the vagina - Ferning of suspected amniotic fluid seen under a microscope
- pooling of amniotic fluid on speculum exam with valsalva (hindi siya nitrazine paper nor ferning)
Which of the following is the firs warning sign of ectopic pregnancy? Headache Nausea and vomiting Pelvic pain and vaginal bleeding Lightheadedness
Pelvic pain and vaginal bleeding
Ms. Cruz is admitted to the ER complaining of a sharp lower right abdominal pain. During the nursing history, she reports that her last menstrual period was 7 weeks ago. A question the nurse would ask is: A) "Are you experiencing any shoulder pain?" B) "Can you feel a hard mass on your right side?" C) "How many children do you have?" D) "Have you ever been pregnant before?"
A) "Are you experiencing any shoulder pain?"
A few hours after being admitted with a diagnosis of inevitable abortion, a client begins to experience bearing-down sensations and suddenly expels the products of conception in bed. To give safe nursing care, the nurse should first: A) Immediately notify the physician B) Give her the sedation ordered C) Check the fundus for firmness D) Take her immediately to the DR
A) Immediately notify the physician
A baby is born with esophageal atresia and tracheoesophageal fistula. Which of the following complications of pregnancy would the nurse expect to note in the mother's history? Polyhydramnios Idiopathic thrombocytopenia Preeclampsia Severe iron deficiency anemia
Polyhydramnios
Myrna had a miscarriage when she was younger, after addressing her immediate psychosocial needs, the nurse identifies which nursing education is best for a woman who says she is miscarrying? A. Save any clots or material passed for your health care provider to examine. B. Continue light activity as usual because most spotting during pregnancy is harmless C. Use tampon to put pressure on your cervix and stop the bleeding D. Lie down and remain on bed rest for 24 hours to stop the bleeding.
A. Save any clots or material passed for your health care provider to examine.
A 40-year-old at 38 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine few hours earlier. Which complication is most likely causing the client's complaint of vaginal bleeding? Abruptio placentae Placenta previa Spontaneous miscarriage H. Mole
Abruptio placentae
Match the items correctly: Absence of cessation of menstrual flow. Abdominal pain during ovulation. Painful menstruation. Abnormally heavy menstrual flow greater than 80ml per menses. Bleeding between menstrual periods mittelschmerz Amenorrhea Metrorrhagia Menorrhagia Dysmenorrhea
Absence of cessation of menstrual flow. - Amenorrhea Abdominal pain during ovulation. - mittelschmerz Painful menstruation. Abnormally heavy - Dysmenorrhea menstrual flow greater than 80ml per menses. - Menorrhagia Bleeding between menstrual periods - Metrorrhagia
A client, G2 P1001, telephones the gynecology office complaining of left-sided pain. Which of the following questions by the triage nurse would help to determine whether the one-sided pain is due to an ectopic pregnancy? A. "When was the first day of your last menstrual period?" B. "How old were you when you first got your period?" C. "When did you have your pregnancy test done?" D. "Did you have any complications with your first pregnancy?"
Answer: A. "When was the first day of your last menstrual period?"
Which among the following skin alterations is characterized by inflammation that results in itchy, red, swollen and cracked skin? Atopic eczema Cellulitis Tinea cruris Impetigo
Atopic eczema
Rina has an Rh-negative blood type. Her electronic record shows she had a previous miscarriage at 16 weeks into her last pregnancy. What medication should the nurse check of what she received following her miscarriage to minimize isoimmunization. A) Packed RBC transfusion B) RhIG C) Ferrous sulfate D) Misoprostol
B) RhIG
A nurse is caring for a 25-year-old client who has just had a spontaneous first trimester abortion. Which of the following comments by the nurse is appropriate? A. "It is probably better this way." B. "I'm here to talk if you would like." C. "You can try again very soon." D. "At least you weren't very far along."
B. "I'm here to talk if you would like."
Ester a 27 y/o who is in her early trimester with OB score of G2P0 was admitted due to abdominal pain and spotting. She ask the nurse "What did I do wrong that time", what is the best response of the nurse? A. Avoid sexual intercourse. B. Early miscarriage is largely not preventable because of abnormal chromosome formation and poor uterine implantation. C. Avoid cigarette smoking D. Avoid alcohol intake.
B. Early miscarriage is largely not preventable because of abnormal chromosome formation and poor uterine implantation.
A client in the 28th week of gestation comes to the emergency department because she thinks that she's in labor. To confirm the diagnosis of PRETERM LABOR, the nurse would expect the physical examinations to reveal: A. irregular uterine contractions with no cervical dilation B. regular uterine contractions with cervical dilation C. painful contractions with no cervical dilation D. irregular uterine contractions without cervical dilation
B. regular uterine contractions with cervical dilation
A 30 year old female came to the clinic, noted to be 33 weeks pregnant with her second child and has uncontrolled hypertension. What risk factor below found in the patient's health history places her at risk for abruptio placentae? Preeclampsia Age Childhood Polio History of Cesarean Section
Preeclampsia
A client, 12 weeks of gestation, comes to the prenatal clinic complaining of severe nausea and frequent vomiting the nurse suspect hyperemesis gravidarum. Which of the following manifestation is frequently associated with this type of condition? A) Slowed secretion of free hydrochloric acid B) Excessive amniotic fluid C) High levels of human chorionic gonadotropin D) A GI history of cholecystitis
C) High levels of chorionic gonadotropin
Hana is brought to the hospital and admitted with a diagnosis of hyperemesis gravidarum. She is 28 weeks pregnant. Which is the priority nursing intervention, until the hyperemesis can be resolved? A) Increase vitamin and iron intake B) Decrease gastrointestinal hypermotility C) Maintain hydration and electrolyte levels D) Encourage unlimited visitors
C) Maintain hydration and electrolyte levels
What is the most appropriate nursing diagnosis for a client with a ruptured ectopic pregnancy would be? A. Altered health maintenance B. Fluid volume excess C. Decreased cardiac output D. Risk for infection
C. Decreased cardiac output
A 25-year-old client is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heartbeat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following? A. Nonstress testing. B. Cervical cerclage. C. Dilation and curettage. D. Amniocentesis.
C. Dilatation and Curettage
A nurse is caring for patient Poly who is diagnosed with preeclampsia. The nurse prepares a plan of care that if Poly progresses from preeclampsia to eclampsia, which of the following should be the nurse's first action? Assess the blood pressure and fetal heart rate Administer magnesium sulfate intravenously Clean and maintain an open airway Administer oxygen by face mask
Clean and maintain an open airway
Which of the following drugs is given to a patient in preterm labor to specifically prevent surfactant deficiency? Magnesium Corticosteroids Terbutaline Surfactant
Corticosteroids
Nausea and vomiting that continues past the first trimester and is severe in nature is termed: A) Toxoplasmosis B) Toxemia of pregnancy C) Morning sickness D) Hyperemesis gravidarum
D) Hyperemesis gravidarum
To which of the following nursing diagnosis should the nurse assign highest priority for the client with hyperemesis gravidarum? A. Risk for fatigue B. Altered health maintenance C. Risk for infection D. Potential fluid volume deficit
D. Potential fluid volume deficit
A pregnant woman arrives at the emergency room with abruptio placentae at 36 weeks' gestation. She's at risk for which of the following blood disorder? Disseminated intravascular coagulation (DIC). Thrombocytopenia Heparin-associated thrombosis and thrombocytopenia (HATT). Idiopathic thrombocytopenic purpura (ITP).
Disseminated intravascular coagulation (DIC).
Julianne is admitted to your care with a diagnosis of ectopic pregnancy. Which of the following actions would you anticipate when taking care of a patient with ectopic pregnancy? Provide enema to the patient as prescribed Encourage patient to have adequate bed rest Instruct patient that she will maintain an NPO status Prepare the patient for an immediate surgery
Prepare the patient for an immediate surgery
A pregnant diabetic has been diagnosed with hydramnios. Which of the following would explain this finding? Recurring hypoglycemic episodes Fetal sacral agenesis Excessive fetal urination Placental vascular damage
Recurring hypoglycemic episodes
This is being use to measure trunk asymmetry: Scoliometer Speedometer Scalometer All of the choices
Scoliometer
A patient is admitted to the hospital after noticing that she is experiencing vaginal bleeding with vesicles that passed out into the vagina. The nurse is discussing to her the possible treatment options for the patient. Identify ALL the treatment options for molar pregnancies? evacuation of molar pregnancy serial hCG levels radiation possible chemotherapy frequent follow ups
evacuation of molar pregnancy serial hCG levels possible chemotherapy frequent follow ups
A client makes a routine visit to the prenatal clinic. Although she's 14 weeks pregnant, the size of her uterus approximates that of a 20-week pregnancy. Dr. Gran diagnoses gestational trophoblastic disease and orders ultrasonography. Which of the following would the nurse expects for the ultrasonography to reveal? an empty gestational sac an extrauterine pregnancy a severely malformed fetus grape-like clusters
grape-like clusters
Which drug is used to manage preterm labor by causing smooth muscle relaxation? oxytocin estrogen prostaglandin ritodrine
ritrodrine
Which among the following assessment findings is least likely to a patient with scoliosis? uneven hips symmetrical rib cage uneven shoulders uneven bra strap marks
symmetrical rib cage
An ultrasound has identified that a client's pregnancy is complicated by hydramnios. The nurse would expect that an ultrasound may show that the baby has which of the following structural defects? Developmental hip dysplasia Ventriculoseptal defect Pulmonic stenosis Tracheoesophageal fistula
tracheoesophageal fistula
Which among the following is a drug of choice for tinea corporis? Miconazole Econazole Penicillin Erythromycin
Miconazole
A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected and the nurse instructs the client regarding management of care. Which statement if made by the client indicated a need for furthers instructions? A) "I will maintain strict bed rest throughout the remainder of the pregnancy." B) "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding." C) "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." D) "I will watch for the evidence of the passage of tissue."
"I will maintain strict bed rest throughout the remainder of the pregnancy."
When teaching students about patient with molar pregnancy, which of the following symptoms occur with the condition? - Fetal cardiac motion after 6 weeks gestation - Benign tumors found in the smooth muscle of the uterus - Heavy, bright red bleeding every 21 days - "Snowstorm" pattern on ultrasound with no fetus or gestational sac
- "Snowstorm" pattern on ultrasound with no fetus or gestational sac
What is true about nifedipine? Select all that apply It is a CNS depressant. It should not be given to clients with hypotension. It is a calcium channel blocker. It aids in relaxing the uterus. It is given by IV.
It should not be given to clients with hypotension. It is a calcium channel blocker. It aids in relaxing the uterus.
The fetal membranes are so strong that blunt trauma to the abdomen is unlikely to cause PROM. True False
False
In which of the following clinical situations would it be appropriate for an obstetrician to order a labor nurse to perform amnioinfusion? Placental abruption Late decelerations Meconium-stained fluid Polyhydramnios
Meconium-stained fluid
What is the main goal of management in a case of congenital hip dislocation? To enlarge and deepen the socket To minimize movement To facilitate ambulation To straighten the lower limbs
To enlarge and deepen the socket
Irene is pregnant in the last trimester and is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse monitors for complications associated with the diagnosis and assesses her for which of the following manifestations? - Periods of fetal movement followed by quiet periods - Complaints of feeling hot when the room is cool - Any bleeding, such as in the gums, petechiae, and purpura. - Enlargement of the breasts
- Any bleeding, such as in the gums, petechiae, and purpura.
A sonogram shows Lorna who is beginning preterm labor, has a placenta previa. The nurse identifies which measure as the priority to ensure her safety? - Keep her physically active to avoid a deep vein thrombosis. - Keep her nothing by mouth (NPC) as she will need an emergency cesarean birth. - Assess for vaginal bleeding and clear fluid leakage every shift. - Perform a daily vaginal exam to assess the extent of the previa.
- Assess for vaginal bleeding and clear fluid leakage every shift.
A client, 42 weeks' gestation, is admitted to the labor and delivery suite with a diagnosis of acute oligohydramnios. The nurse must carefully observe this client for signs of which of the following? Fetal distress Oliguria Dehydration Jaundice
Fetal distress
Which among the following is a drug of choice for tinea capitis? Econazole Fluconazole Penicillin Erythromycin
Fluconazole
What can be given to women in preterm labor in order to induce fetal surfactant production? NSAIDs Glucocorticoids Mineralocorticoids Immunomodulators Sex hormones
Glucocorticoids
Which of the following is not classified as personal protective equipment? Gloves Goggles Hepa B vaccine Lab coat
Hepa B vaccine
When teaching students about molar pregnancy, which term is used to refer to a type of gestational trophoblastic neoplasm? Dermoid cyst Doderlein's bacilli Bartholin's cyst Hydatidiform mole
Hydatidiform mole
What is the primary characteristic of a vesicle? It is filled with serous fluid It flat and circumscribed It has a dry crust It has an eroded and moist surface
It is filled with serous fluid
Alicia is pregnant and diagnosed to have eclampsia, begins to experience a seizure. Which of the following would the nurse in charge do first? Maintain a patent airway Place a pillow under the left buttock Insert a padded tongue blade into the mouth Pad the side rails
Maintain a patent airway
The nurse is monitoring her patient with preeclampsia who is receiving magnesium sulfate. The patient is receiving effective therapy with which of the following manifestations? Seizures do not occur Ankle clonus in noted The blood pressure decreases Scotomas are present
Seizures do not occur
A 36 year old woman is 38 weeks pregnant, reports having dark red bleeding. The patient experienced abruptio placentae with her last pregnancy at 29 weeks. What other signs and symptoms can present with abruptio placentae? SELECT ALL THAT APPLY Decrease in fundal height Tender uterus Hard, rigid abdomen Fetal distress Abnormal fetal position
Tender uterus Hard, rigid abdomen Fetal distress
Infection in the uterus may cause PROM and may also be a complication following PROM. True False
True
When assessing a pregnant client, which question should be asked by the student nursen to rule out preterm labor in a client reporting back pain? - Is the back pain worse when you urinate? - Is the back pain coming and going at regular time intervals? - Is the back pain constant? - Is the back pain worse when you change positions?
- Is the back pain coming and going at regular time intervals?
A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client. SELECT ALL THAT APPLY - Monitor deep tendon reflexes hourly - Monitor I and O's hourly - Notify the physician if respirations are less than 18 per minute. - Monitor renal function and cardiac function closely - Monitor maternal vital signs every 2 hours - Notify the physician if urinary output is less than 30 ml per hour - Keep calcium gluconate on hand in case of a magnesium sulfate overdose
- Monitor deep tendon reflexes hourly - Monitor I and O's hourly - Monitor renal function and cardiac function closely - Notify the physician if urinary output is less than 30 ml per hour - Keep calcium gluconate on hand in case of a magnesium sulfate overdose
A woman, who is on her mid-pregnancy, has a routine ultrasound performed. The ultrasound shows that the placenta is located at the edge of the cervical opening. As the nurse you know that which of the following statement is FALSE about this finding? - The placenta may move upward as the pregnancy progresses and needs to be re-evaluated with another ultrasound at about 32 weeks gestation. - This is known as marginal placenta previa. - The patient will need to have a c-section and cannot deliver vaginally. - The woman should report any bleeding immediately to the doctor.
- The patient will need to have a c-section and cannot deliver vaginally.
Which of the following signs and symptoms will most likely make the student nurse suspect and report that the patient is having hydatidiform mole? Slight bleeding Absence of fetal heart beat Passage of clear vesicular mass per vagina Enlargement of the uterus
Passage of clear vesicular mass per vagina
Which of the following statement is TRUE about abruptio placenta? - Fetal distress is not common in this condition as it is in placenta previa. - A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening. - Nursing interventions for this condition includes measuring the fundal height. - This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical opening.
- Nursing interventions for this condition includes measuring the fundal height.
Lorna's partner brought her to the emergency room due to symptoms of preterm labor. The ER nurse identifies which action is priority? - Obtain blood for an HCG hormone assessment. - Encourage her to carefully walk so the fetal head maintains pressure on her cervix. - Position her in a side lying position and assess fetal heart rate and contractions. - Ensure no one initiates intravenous fluid infusion because hypervolemia exacerbates preterm labor.
- Position her in a side lying position and assess fetal heart rate and contractions.
What are the expected signs and symptoms are expected of pregnant client with placenta previa? SELECT ALL THAT APPLY Painless bright red bleeding Hard, tender uterus Normal fetal heart rate Abnormal fetal position Abnormal fetal position Rigid abdomen
Painless bright red bleeding Normal fetal heart rate Abnormal fetal position Abnormal fetal position
When administering Magnesium Sulfate (MgSO4) to a pregnant client diagnosed with preeclampsia, which of the following indicates that the nurse understands that the drug is given to? Reduce blood pressure Increase dieresis Slow the process of labor Prevent seizures
Prevent seizures
Match column A to B: Skin alterations with their causative agent Tinea pedis Cellulitis Scabies Tinea capitis Impetigo Trichophyton rubrum Trichophyton tonsurans Sarcoptes scabies Staphylococcus aureus
Tinea pedis - Trichophyton rubrum Tinea capitis - Trichophyton tonsurans Scabies - Sarcoptes scabies Impetigo - Staphylococcus aureus Cellulitis - Streptococcus
A diabetic pregnant client has developed polyhydramnios. The client should be taught to report which of the following? Uterine contractions Reduced urinary output Puerperal rash Marked fatigue
Uterine contractions
A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the obstetrics unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present? Uterus is tender to palpate Painless, bright red vaginal bleeding Absence of abdominal pain A soft abdomen
Uterus is tender to palpate
A client comes into the labor and delivery suite stating that her membranes ruptured 5 hours ago and not having labor contractions. She wants to examine to see if she is dilating. She states that her baby has stopped moving, but she wants to return to work if she is not in labor. What will be the nurse priority action? A. The client should be sent home to rest in a familiar environment until she is in true labor B. Following a vaginal examination to check for dilation, the client will most likely be allowed to return to work until her contractions are in a regular pattern. C. The client will be routinely admitted because she will most likely develop a regular contraction pattern soon. D. She should be evaluated for fetal heart rate and check for prolapsed cord.
D. She should be evaluated for fetal heart rate and check for prolapsed cord.
A woman who is at 32 weeks gestation has had ruptured membranes for 26 hours. A nurse should assess the woman for which of the following manifestations? Proteinuria Dependent edema Constipation Elevated temperature
Elevated temperature
Which of the following are specific manifestations indicative of Preeclampsia? SELECT ALL THAT APPLY Facial edema Negative urinary protein Elevated blood pressure Increased respirations
Facial edema Elevated blood pressure
Your patient who is 34 weeks pregnant is diagnosed with total placenta previa. The patient is A positive. What nursing interventions below will you include in the patient's care? SELECT ALL THAT APPLY Monitoring CBC and clotting levels Monitoring pad count Assess internal fetal monitoring Placing patient on side-lying position Routine vaginal examinations Administer RhoGAM per physician's order
Monitoring CBC and clotting levels Monitoring pad count Placing patient on side-lying position (0.75 lang, pero parang mali si ma'am...)
Nurse Evie is preparing to care for a patient who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. Nurse Evie develops a plan of care for the client and determines that which of the following nursing actions is the priority for her patient with ectopic pregnancy? Monitoring weight Monitoring temperature Monitoring apical pulse Assessing for edema
Monitoring apical pulse
What may a doctor prescribe to help prevent preterm labor or birth? Select all that apply Estrogen Oxytocin Cerclage Nifedipine Progesterone
Nifedipine Progesterone
As Nurse Evie is preparing for her care to a patient with ectopic pregnancy, which of the following would be the priority nursing diagnosis? Pain Anticipatory Grieving Knowledge Deficit Risk for infection
Pain
A patient is diagnosed with Pregnancy-Induced-Hyperetension (PIH). Which of the following symptoms indicates the presence of the problem? Proteinuria, double vision, uterine contractions Headaches, double vision, vaginal bleeding Proteinuria, headaches, double vision Proteinuria, headaches, vaginal bleeding
Proteinuria, headaches, double vision
A pregnant client diagnosed with preeclampsia is receiving magnesium sulfate therapy to help control seizure. A nurse discover that the client is experiencing toxicity from the medication in which of the following assessment? Serum magnesium level of 7 mEq/L Positive for deep tendon reflex Respiratory rate of 10 breaths per minute Urine output of 30 ml/hr
Respiratory rate of 10 breaths per minute
Which among the following types of OI is a mild manifestation of the disease? Type 1 & 4 Type 1 & 3 Type 3 & 4 Type 2 & 3
Type 1 & 4
What is the type of fracture where the fracture is at the right angles of the long axis of the bone? Oblique fracture Spiral fracture Transverse fracture Communited fracture
Transverse fracture
Match Column A to B: Types of fracture Tranverse Spiral Greenstick Oblique Communited - Fracture that results in 3 or more bone fragments - One part of the bone has been twisted - Fracture is at the right angles of the long axis of the bone - Fracture on side of the bone - Fracture is diagonal to a bone's long axis
Tranverse - Fracture is at the right angles of the long axis of the bone Spiral - One part of the bone has been twisted Greenstick - Fracture on side of the bone Oblique - Fracture is diagonal to a bone's long axis Communited - Fracture that results in 3 or more bone fragments
PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid. True False
True
