N326
MATCH 1. Shoulder Dystocia 2. Cord Prolapse 3. Abruption/Previa 4. Variable Decels 5. Late Decels 6. Nuchal Cord 7. Seizure 8. PP hemorrhage 9. Prolonged fetal bradycardia A.Remove from neck B.IV, Type & Screen, Ultrasound, IV, to the OR C.McRoberts & Suprapubic pressure D.Find source, IV fluids, Pitocin E.To OR STAT for C/S F.Turn Patient on side G.Knees to chest, to OR H.Fluids, O2, pit off I.Airway & Ativan
1. C 2. G 3. B 4. F 5. H 6. A 7. I 8. D 9. E
4. Fill in the blank Most of the important organs in a fetus are formed by _________________________ weeks.
12
48. Fill in the blank. GBS screening is a standard part of prenatal care at ___________________ weeks.
34-37
24. Fill in the blank At approx how many weeks should the L:S ratio be at its optimum level of 2:1? ___________
36
100. Fill in the blank The average number of wet diapers a newborn should be having is ____________ per day.
6-8
21. At what week is surfactant starting to be produced A Week 24 B Week 20 C Week 30 D Week 31
A
22. What tests are done in third trimester A GBS B Identifying gender C Gestational diabetes D STIs
A (BUT ALSO D IF NEEDED AND GDM SOMETIMES)
140. All of the following are warning signs during pregnancy EXCEPT: A Odorous vaginal discharge. B Edema of the lower extremities. C Rapid weight gain over a short period. D Severe persistent headaches.
B
The best predictor of how a preemie will survive the first few weeks of life is A. The age of the mother B. The L/S ratio C. The sex of the baby D. The amount of passive immunity it received
B
58. Which passenger is ready to begin stage 2 of labor? A Flexed, transverse, cephalic, front, +4, engaged B Flexed, longitudinal, cephalic, back, +2, engaged C Extended, longitudinal, breech, front, +2, engaged D Extended, transverse, shoulder, back, 0, ballotable
B (BUT REALLY CERVICAL DILATION/SOFTENING IMPORTANT TOO)
121. All of the following are proper non-pharmacological ways of managing labor pain EXCEPT: A Hypnosis B Sitting on a yoga ball C Eating comfort foods D Acupuncture
C
1. A woman is pregnant for the second time. Her first pregnancy was a miscarriage at 10 weeks. What are her G's and P's? A G1P1 B G2P1 C G2P2 D G2P0
D
10. What two hormones are responsible for producing and delivering breast milk? A hCG and FSH B hCG and hCS C Estrogen and Relaxin D Prolactin and Oxytocin
D
152. Fill in the blank _______________ is used to test for ROM
NITRAZINE, AMNISURE, LITMUS
116. Fill in the blank Common problems of premature babies are hypoglycemia, hypothermia, _______, and hyperbilirubinemia.
POLYCYTHEMIA
31. True or False: T F Leaking or ruptured membranes (ROM) is a common cause of low Amniotic Fluid Index.
T
32. Fill in the blank A positive or reassuring NonStress Test (NST) involves 2 accels of at least _______ beats lasting 15 seconds.
15
148. Fill in the Blank Preterm labor is the onset of true labor occurring between 20 and ________ weeks gestation.
36 6/7
114. What types of food should you feed a premature baby? A Breastmilk B Formula C High caloric food, low volume through gavage feeding D Low caloric food, high volume through gavage feeding
A
122. A woman in labor is 2 cm dilated. She has already tried changing positions in bed, sitting on a rocking chair, and breathing exercises, but cannot manage her worsening pain and asks for pain medication. As a nurse, you would: A Encourage her to try other non-pharmacological methods first B Offer her pain medication C Inform her she cannot have medication until she is at least 3 cm dilated D Call the provider
A
126. All of the following are correct about duramorph EXCEPT: A Commonly given with epidural B Foley catheter is inserted for 24 hours after dose C Can cause respiratory depression D Used with 3rd and 4th degree lacerations
A
129. Screening for GDM is usually done when: A 24-28th week gestation B 12th week gestation C 3rd trimester D Women are not typically screened for GDM unless there is a family predisposition
A
158. A patient is admitted and is experiencing an umbilical cord prolapse, what is the nurse's priority intervention? A Place patient in knee-chest position B Administer tocolytics C Assess fetal heart rate D Give O2
A
26. Which is a first-line hormone given to stimulate ovulation A FSH B oxytocin C Progesterone D Testosterone
A
46. A urinalysis is a laboratory test that evaluates urine for: A Protein, glucose, ketones, blood, WBC, bacteria, and specific gravity B Protein, glucose, blood, bacteria, and WBC C Protein, blood, bacteria, WBC, DNA, and specific gravity D Protein, ketones, bacteria, WBC, DNA, and hormones
A
54. A 38-year-old woman walks into a clinic for prenatal care for her first child. She then asked a nurse for possible risk factors for miscarriages since her best friend had recently experienced one. What can the nurse say? A Older parental age mother B Euthymia C The mother has A blood type , and the fetus has an AB blood type D Living with her pet dog
A
57. What position is the passenger often in when a woman complains of severe back pain? A Occiput Posterior B Breech C Occiput Anterior D Occiput Transverse
A
70. After the first 24 hours, the most common cause of postpartum hemorrhage is A Retained placenta B Perineal laceration C Uterine atony D Coagulation disorders
A
85. Which of the following is NOT an indication for having a c-section? A A request from the pregnant woman in the absence of a medical necessity B Cord Prolapse during labor C A woman with multiple gestation D A woman with herpes or HIV
A
86. Which of the following is the greatest complication of a woman who attempts a TOLAC (trial of labor after cesarean) that could lead to death? A Uterine rupture B Pre-E C Amniotic fluid embolism D Placenta previa
A
93. With the tonic neck reflex, when the baby's head is turned to one side that arm on that side should A Stretch out while the opposite arm bends in at the elbow B Bend in at the elbow while the opposite arm stretches out. C Stretch out while the opposite arm stretches out too. D Do nothing. The baby's turned head should not affect the arms.
A
A 32 week pregnant patient is being seen for a NST. She has a history of 2 year old twins born at 30 weeks, a 1 year old born at 41 weeks and had a miscarriage at 12 weeks. What is her GTPAL? A. 4-1-1-1-3 B. 3-1-1-1-3 C. 4-1-2-1-3 D. 3-1-2-1-3
A
A client in labor, G2P1001, was admitted 1 hour ago at 2 cm dilated and 50% effaced. She was talkative and excited at that time. During the past 10 minutes she has become serious, closing her eyes and breathing rapidly with each contraction. Which of the following is an accurate nursing assessment? A. The client had poor childbirth education prior to labor B. The client is exhibiting an expected behavior for labor C. The client is becoming hypoxic and hypercapnic D. The client needs her AFP levels checked
A
A woman at 37 weeks, calls clinic after awakening in a pool of blood, dizzy and nauseated. She is not in pain. The RN recommends her to go to nearest hospital immediately. Which would be unsafe until you have more information? A. Perform a vaginal exam STAT B. Place an IV STAT C. Put her on the EFM and TOCO D. Do an Ultrasound STAT E. Obtain her BP and HR F. Get H & H
A
During a prenatal visit, the RN explains dietary management to a client with Type 1 Diabetes Mellitus. The RN determines effective teaching occurred if client states? A. My diet and insulin needs will probably change during pregnancy B. I will plan my diet based on results of urine glucose testing C. I will need to eat 600 more calories/day D. I can continue with my same diabetic diet if it remains well balanced
A
Josey has an irregular cycle of 32 days between periods. If she has her period on May 1, when can you expect her to ovulate next. A. May 17-18 B. May 13-15 C. June 1-3
A
What is NOT USEFUL when dealing with pregnant pts who have bad habits (ie ETOH, drugs, poor eating, STDs, etc) A. Remind them how bad these things are and scare them B. Encourage and praise any + changes they make C. Provide resources and support groups for them D. Establish a positive rapport with them
A
56. Fill in the blank After a loss of a baby, hospital staff can put things like baby bands, locks of hair, foot prints, hats, and other sentimental objects inside _________________________box for the family.
A MEMORY
49. What are some health benefits of contraception? Select all that apply. A Acne improves B Dysmenorrhea improves C Reduces endometrial and ovarian cancer D 100% chance of not getting pregnant
A,B,C
A woman has just arrived at the labor and delivery triage. To report the client's status to the primary health care practitioner, which of the following assessments should the nurse perform? Choose all that apply. A. Fetal heart rate B. Contraction pattern C. Urinalysis D. Vital signs E. Biophysical profile F. Membrane Status G. Contraction stress test
A,B,C,D, F
The baby security alarm is activated. Which of the following should be done by the RN? Check all that apply A. Go to nearest exit or stairwell to block exits B. Request pts return to their rooms C. Question anyone suspicious or with a baby, stroller, bulky item or big coat/jacket. D. Allow employees from other parts of the hospital to continue their duties. E. Check rooms, closets, bins, etc for the infant
A,B,C,E
A nurse is caring for a laboring woman who is in transition. Which of the following signs/symptoms would indicate that the woman is progressing into the second stage of labor? Choose all that apply. A. Bulging perineum B. Increased bloody show C. Spontaneous ROM D. Uncontrollable urge to push E. Inability to breathe through contractions F. Rectal pressure/Needing to poop
A,B,D,E,F (C possible, but not always true)
A woman 36 weeks pregnant is admitted to L&D from the clinic. BP=146/98, puffy face and hands, "awful headache and trouble focusing eyes". What assessment warrants further investigation? Choose all that apply A. Resp Rate 10 B. Urine output 100 cc/4 hours C. 02 sat 95% D. Slurred speech E. Lethargy, weakness F. Hot, flushed G. DTRs absent
A,B,D,G
Newborn born via vacuum assisted vaginal delivery. What items should you be alert for? Check all that apply A. Increasing bilirubin levels B. Caput Succedaneum C. Cephalohematoma D. Blood sugar issues E. Discomfort F. Lethargy G. Symmetry
A,C,E,F
Which of the following is a normal medication given to most newborns? Check all that apply A. Vitamin K/Aquametphyton B. Tylenol C. Hep B D. HBIG E. MMR F. Erythromycin Opthalmic
A,C,F
68. Fill in the blank As the placenta peels off, it leaves a wound behind. This is considered an open wound until _________________________ weeks.
ABOUT 6
138. Fill in the blank: An abnormal placental attachment in which the chorionic villi come into contact with the myometrium is called a placenta _____________.
ACCRETA
105. Select all that apply. Some of the factors that significantly influence the course of treatment for a newborn with hyperbilirubinemia are: A Gestational age at birth B Total serum bilirubin value C Birth weight D Age of newborn
ALL
Which of the following are potential s/sx of infection. Check all that apply A. Baby's temp cold B. FHR 180's C. WBC 18,000 D. Painful fundus
ALL
117. A new mother recalls from one of her prenatal classes that she should attempt to feed her newborn baby when she sees feeding readiness cues from her baby instead of waiting until her infant is crying frantically. Based off of this information, the new mother should feed her infant about every 2 to 3 hours when she: A Has a full diaper B Makes sucking motions C Stretches her arms and legs out straight D Has hiccups
B
133. Which of the following has the lowest risk for Placenta Previa? A A G3P3 mother who had a C/S in her last pregnancy B An 18-year old mom who is going to have her first baby C A G2P1 African American mom who is 28 weeks pregnant D An aspiring mother who routinely smokes during breaks at her part time job
B
141. Which medication is used in the treatment of severe preeclampsia? A Misoprostol B Magnesium Sulfate C Colace D Methergine
B
150.A woman presents to the hospital with premature rupture of membranes. What is she most at risk for? A Preterm Deliver B Intrauterine infection C Preeclampsia D Postpartum Hemorrhage
B
18. The protective coating the fetus develops on its skin during week 20 is called? A Lanugo B Vernix C Epidermis D Myelination
B
25. Which of these infertility treatments does NOT involve pharmacological stimulation of ovulation? A in vitro fertilization B intrauterine insemination C Intracytoplasmic sperm injection D Gamete intrafallopian transfer
B
34. Which type of woman should consider testing via amniocentesis or CVS? A A woman testing to confirm pregnancy B A woman testing for trisomy 21 (down syndrome) C A woman checking fetal well being D A woman checking fetal age and growth
B
39. Which of these is not a risk factor for developing an ectopic pregnancy: A Pelvic Infection Disease B AMA or under 20 years old C Scar tissue in thie reproductive organs D Hx of STIs and fibroids
B
42. A Bishop's Score: A Assesses the risk for fetal asphyxia during an Induction. B Is used to determine the favorability of an Induction and the ripening ability of the Cervix. C Is a scoring process that involves titrating Pitocin until Uterine Contractions are considered adequate, or the fetus experiences a deceleration. D Is used to assess the mother's condition when she is making inadequate progress, is getting sicker, or is having ineffective uterine contractions.
B
5. This process prevents sperm from entering an ovum, which helps to stop multiple sperm from fertilizing the same egg. A Capacitation B Cortical reaction C Spermatogenesis D Acrosomal reaction
B
6. Which hormone stimulates ovulation to occur A Progesterone B FSH C hCG D LH
B
62. Which of these best describes secondary powers? A Responsible for the descent of the fetus B Bearing down movements of the abdomen and diaphragm C Responsible for effacement and dilation of the cervix D Uterine contractions
B
66. A woman just had a successful c-section and gave birth to a healthy 10-pound baby 3 hours ago. She complains about hunger and asks you to grab her something to eat because she hasn't eaten anything in preparation for her procedure. What is the most appropriate nursing intervention for the mother? A Order her something from the kitchen. If she complains of constipation or pain, give her colace and Motrin. B Auscultate stomach to ensure bowel sounds in all 4 quadrants are present. If bowel sounds are present, then start her off with ice chips and eventually work her way up to a light meal. C Auscultate stomach to ensure bowel sounds in all 4 quadrants are present. If bowel sounds are present in all 4 quadrants, then order a meal for her from the kitchen. D Explain to her that, because she had a c-section, her bowel functions are severely reduced and cannot eat anything right now. Doing so would cause an ileus, a painful obstruction in the intestine, that feel like cramps and constipation.
B
73. Skin-to-skin contact between the newborn and the family promotes the process of __________________. A Focus B Attachment C Activity D Love
B
74. Which of these is not one of the 3 phases of maternal adaptation? A Taking in B Giving in C Letting go D Taking hold
B
77. Katherine just delivered a baby girl 2 days ago. A nurse performed a routine vital signs check on her and she suspects Katherine might have postpartum infection based on which of the following signs and symptoms? A Malaise, Chills, urinary retention B Fever (> 100.4 F), chills, foul smelling vaginal discharge C Malaise, constipation, had soaked through a pad 20 minutes ago. D Fever (>100.4 F), constipation, had soaked through a pad 20 minutes ago.
B
82. An increase of 11 bpm for 14 seconds would be considered an acceleration on a monitoring strip for a fetus at which gestational age? A 41 3/7 weeks B 30 2/7 weeks C 37 5/7 weeks D 33 0/7 weeks
B
89. Which organs is deoxygenated blood shunted away from in the fetal circulatory system? A The spleen and lungs B The lungs and liver C The liver and spleen D The kidneys and lungs
B
90. Which of the following does NOT occur when the fetal circulation transitions to extrauterine circulation A The closure of the ductus arteriosus B A reduction in pulmonary vascular resistance C The systemic vascular resistance decreases D The closure of the foramen ovale
B
A G2P1 at 32 weeks was in a car accident and is complaining of pain in her abdomen. There is no bleeding, but she is contracting a bit and her abdomen is hard. She has a history of a c/s. What do you anticipate? A. Possible Uterine Rupture B. Possible Placental Abruption C. Possible Placenta Previa D. Possible HELLP Syndrome
B
A woman 36 weeks pregnant is admitted to L&D from the clinic. BP=146/98, puffy face and hands, "awful headache and trouble focusing eyes". ADMIT NOTE: Admit: Stat for Preeclampsia. Which order should be questioned? A. Assess reflexes & edema q 4-6 hrs B. Up out of bed, as desired C. Admit and daily weight D. Urine dip for protein q 4 hrs E. Suction and airway at beside
B
You discover a large labial hematoma on the previous pt. What is your next assessment? A. H & H B. Vitals (HR,BP, RR) C. Urine output D. Skin turgor
B
A baby is about to be delivered at 41 weeks vaginally following episodes of fetal distress. The mom has an epidural and a fever and the amniotic fluid is tinged green with solid material in it. To prepare for delivery, the RN should anticipate WHICH of the following: (check as many as apply) A. Stimulate the baby to cry immediately B. Set up suction for the MD to use a the perineum C. Call for additional RNs to assist with delivery D. Help take photos of the delivery E. Set up an newborn oxygen mask and ambu-bag F. Turn on the warmer in the newborn "bed" G. Administer Narcan H. To administer Pitocin following the delivery. I. Prepare to give PPV if the baby is apneic and/or low HR
B,C,E,F,H, I
Who should avoid post partum contraceptives with estrogen (ie oral)? A. Bottle feeding moms B. Mom who's sister had a stoke C. Mom who used to smoke D. Mom with hx of blood clots E. Breastfeeding moms F. Moms who have had a DVT
B,D,E,F
Which of the following are good predictors of ovulation? (check all that apply) A. A sharp temp increase seen B. A slight temp decrease, then an increase C. HCG detected on blood test D. Small amount of cramping or pain on one side E. Ferning of oral mucous on slide F. Menstrual flow stops G. Luteinizing Hormone detected on blood test. H. Cervical mucous thins out, becomes more elastic
B,D,E,G,H
101. Newborn hypoglycemia is often seen in babies with A Meconium aspiration B NEC C Macrosomia D PPHN
C
106. Hyperbilrubinemia can cause: A Meconium Aspiration Syndrome B NEC C Brain damage D PPHN
C
109. Newborn infection symptoms include all of the following, EXCEPT: A Temperature instability B Poor feeding C Bradycardia D Hypotension
C
110. Which is NOT a risk factor for neonatal sepsis? A Chorioamnionitis B Prolonged rupture of membranes less than 18 hours C Maternal intrapartum temperature of 100.4 F (38 C) or greater D Use of fetal scalp electrode
C
113. If a premature baby is showing signs of apnea, what should you do? A Do nothing this is normal B Attempt to bottle feed C Tickle their feet D Perform CPR
C
130. It's important to tell pregnant women that during the Initial Glucose Tolerance test: A Fasting is required B She will be given a 100gm sugar load C No exercising, smoking, eating for an hour after the test starts D She would have to take the oral glucose tolerance test if her blood glucose is >110
C
134. A patient who is 26 weeks pregnant has been diagnosed with partial placental abruption. As the nurse you are educating the patient about the condition. Which statement by the patient indicates that you should re-educate? A "My uterus will feel firm and hard." B "I am at risk for hemorrhage and death." C "My uterus will feel soft and boggy." D "I may start to experience dark red bleeding with pain."
C
146. Which tocolytic medication is contraindicated for pregnant women with cardiac issues in preterm labor? A Methergine B Indomethacin C Terbutaline D Tranexamic Acid
C
153. Which intervention is most commonly used to relieve shoulder dystocia? A Leopold's Maneuver B Muller's Maneuver C McRobert's Maneuver D Heimlich Maneuver
C
154. Which complication related to shoulder dystocia can cause the most damage? A Brachial Plexus Injury B Fractured Clavicle C Baby is stuck prolonging delivery D Cephalhematoma
C
17. At which week of fetal development does a primiparous mother usually begin to feel quickening? A 12-14 weeks B 16-17 weeks C 18-20 weeks D 24-25 weeks
C
2. Which woman will need Rhogam A Pregnant, 28 weeks, blood type O Pos B Postpartum, 41 weeks, blood type AB Neg and baby blood type A Neg C Was 12 weeks pregnant, but had miscarriage this AM. Blood type B Neg D Pregnant with 3rd baby. Blood type B Pos
C
30 minutes after birth of twins, a new mother's fundus is boggy with increased lochia. After massage, fundus firms, and several clots are expressed. What action should occur next? A. Notify MD to locate site of bleeding B. Notify MD for immediate surgery C. Confirm bladder is empty D. Apply new pad and tell her to clamp thighs closed. E. Administer Methergine
C
41. All of the following could be considered suitable reasons for an Induction EXCEPT: A Macrosomia B Prolonged Rupture of Membranes C Low Bishop's Score D Pre-Eclampsia
C
53. A woman is pregnant with G5P1. Her previous pregnancies had ended up with miscarriages. What is NOT a likely cause of her recurrent miscarriages? A Incompetent cervix B Thrombophilia C Healthy diet D Uterine abnormality
C
65. A woman just had a successful NSVD and gave birth to a healthy 9-pound baby. 12 hours after delivery, she looks distressed and embarrassed. She hesitantly asks for her third glass of water to quench her thirst. You check her pad and it is soaked with 400cc of urine. What is the most appropriate therapeutic response for the mother? A "What you're experiencing is completely normal. 12 hours after delivery, your body starts to get rid of extra fluid in your body that has accumulated during pregnancy. It does this by voiding more often and even sweating. This phenomenon is called involution." B "Let me change your pad. How often are you going to the bathroom? I think we need to reduce your intake of fluids because that is what's making you go to the bathroom so often." C "What you're experiencing is completely normal. 12 hours after delivery, your body starts to get rid of extra fluid in your body that has accumulated during pregnancy. It does this by voiding more often and even sweating. You may have limited sensation still, though. This phenomenon is called diuresis and I will check on you hourly to assist you to the bathroom." D "What you're experiencing is completely normal. You're peeing a lot because of the trauma that your pregnancy has caused to your urogenitary area. We should hold your water intake, so you don't keep having those accidents on your pad."
C
69. In the first 24 hours, the most common cause of postpartum hemorrhage is A Retained placenta B Perineal laceration C Uterine atony D Coagulation disorders
C
94. Mom tells you she thinks it is cute when she strokes her baby's cheeks, her baby's head turns toward her finger. You tell her this is which reflex? A Suck Reflex B Moro Reflex C Rooting Reflex D Grasp Reflex
C
A laboring patient at a cervical dilation of 4 cm has a rupture of membranes with mec noted while ambulating. The RN's first priority is? A. Take the woman's temperature B. Time the contractions C. Check the fetal heart rate D. Check the woman's BP E. Call the provider
C
A new mother tells the RN that she plans to breastfeed until the baby is two so she will not have to worry about getting pregnant. Which response shows appropriate teaching? A. Lactation suppresses ovulation, so you should be OK B. You are safe as long as you don't menstruate C. It is best to use some other form of birth control. You may not menstruate, but you may ovulate and can get pregnant D. You'll find you aren't even interested in intercourse until you wean your baby anyway.
C
Best way to tell if a newborn is transitioning well? A. Body flexed B. HR 101 C. crying loudly D. + moro
C
During the placement of an epidural, what should the RN pay most attention to? A. Pt's pain level B. Pt's Sedation C. Mom's BP D. Urine output in foley
C
G2P1 at 32 weeks complains of horrible heartburn at a prenatal appointment to the RN while waiting for the MD. Which is the LOWEST priority for the RN. A. Assess her for edema, HA, blurry vision B. Assess her blood pressure C. Give her tips on how to reduce indigestion D. Check her urine for protein
C
Infant from previous question looking very yellow now on day 2. What is the RN priority? A. Check Rh status B. Perform Coombs test C. Use Transcutaneous bilimeter D. Begin Phototherapy E. Begin IV fluids
C
Postpartum patient 12 hours post delivery with a 3rd◦ episiotomy is complaining of lots of pain (8/10). What is the first priority? A. Ice pack to the perineum B. Offer pain medications C. Assess the perineum D. Sitz bath of warm water x 20 min
C
Which assessment findings indicate a 20 week gestation? A. Lightening, fundus palpable at umbilicus, FHR audible with fetoscope B. Braxton Hicks, ballottement, fundus at umbilicus C. Quickening, FHR audible by doppler, fundus about 20 cm D. Goodell's, Hegar's, Chadwick's present, fundus about 10 cm
C
Which of the following assessments is most concerning in a patient at 38 weeks ? A. +1 protein in the urine B. BP 130/74 C. Temp 101.5 D. +1 Pedal edema
C
Which of the following is normal in a newborn who is bottle feeding? A. Feeding q 2 hours B. White patches in mouth C. Stool q 1-2 days D. Less likely to get resp illness
C
157. What would you expect to see on the fetal heart monitor when assessing for potential cord prolapse? A Early Decelerations B Late Decelerations C Variable Decelerations D Accelerations
C (BUT REALLY A SEVERE BRADYCARDIA)
Which of the following are presumptive predictors of pregnancy ?(check all that apply) A. Breast tenderness B. Amenorrhea C. Hegar's sign D. HCG detected on blood test E. Ultrasound showing fetus F. Abdominal enlargement
C, F
G1P1 had a C-section 3 days ago. During your assessment, you note her breasts are very swollen and engorged. Which of the following will help (check all that apply) A. Warm towels after feeds B. Cool compresses before feeds C. Feeding the baby every 2-3 hrs, even at night D. Motrin E. Gently express a small amount of milk before feeds F. Pumping 5 min on each side after feeds G. Cabbage leaves to breasts after/between feeds H. Tylenol/Acetaminophen I. Supportive bra
C,D,E,G, I
80. Fill in the blank _________________________ are the most common postpartum infections.
CHORIO, ENDOMETRITIS, MASTITIS, UTI
44. Fill in the blank: A ________________ is similar in appearance to a Foley Catheter, but its purpose is to assist in the physical dilation of the Cervix.
COOKS
102. A newborn presents with a blood sugar of 42 at 12 hours of life. Each of the following is a helpful/required EXCEPT A Document the finding B Encourage more frequent breastfeeding C Assess the newborn's vitals D Feed the baby 20 cc of sugar water or formula.
D
118. Which of the following is not a contraindication for breastfeeding? A Mothers with active TB B Mother that is Hepatitis B positive C Mother with HIV D Maternal use of statins
D
125. Cassandra is G3P2 (L2) and has been rushed to the hospital after SROM at home. When the nurse performs a SVE she is 8cm/80%/+1. Cassandra is insisting on pain medications, which is the best option based on her progression of labor and assuming the baby's EFM is reassuring? A Rhogam IM B Morphine IV C Butorphanol IM D Fentanyl IV
D
13. A 21-year-old woman at 4 weeks' gestation is wondering if she could listen to her baby's heartbeat. What is the best response? A "It's too early for you to be able to hear it." B "No, fetal heart rates cannot be heard until 9 weeks' gestation." C "Sure, I'll get the Doppler ready." D "Typically, fetal heartbeats are detectable around 6-8 weeks, sometimes a bit earlier."
D
137. A mother is G3P1 at 36 and 2/7 weeks and has just finished dinner. She has become increasingly anxious that she can't remember feeling her baby move over the past 12 hour period. She should: A Immediately drive to the hospital for an emergency induction.. B Wait until the morning, as this is a normal finding at this stage of pregnancy. It is late at night and she can see if the baby is more active the next day. C Begin a vigorous exercise routine to get her own heart rate elevated and wake the baby up, as the baby has likely been sleeping all day in utero. D Drink a glass of orange juice and lay down on her left side to count kicks for an hour. If she continues to feel no movement, phone her provider.
D
14. For low-risk pregnancies, which routine fetal assessments are performed during the first trimester? A Maternal serum alpha-fetoprotein, hCG, & inhibin-A B Pregnancy-associated plasma protein and hCG (blood tests) & nuchal translucency (ultrasound) C Maternal serum alpha-fetoprotein & Nuchal translucency (ultrasound) D Fetal survey ultrasound & hCG
D
142. How is preeclampsia cured? A Antihypertensive drugs B Bed rest C Betamethasone D Birth and removal of placenta
D
145. A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates that preterm labor is occurring? A Decreased fetal cortisol and increased progesterone B Mild uterine contractions are occurring every 12 to 15 minutes. C Fetal fibronectin is negative in vaginal secretions. D The cervix is effacing and dilated to 2 cm.
D
29. Which of the following does the Biophysical Profile NOT evaluate? A Fetal breathing movements B Fetal Tone C NonStress Test D Genetic abnormalities
D
30. Which of the following fetal well-being tests is done on every mother? A Non Stress Test (NST) B Amniotic Fluid Index (AFI) C Coombs Test D Biophysical Profile (BPP)
D
33. The following are potential risks of conducting amniocentesis or CVS procedures EXCEPT: A Maternal or fetal infection B Miscarriage C Leaking of amniotic fluid D Placenta accreta
D
40. How long should HCG levels be monitored after a molar pregnancy A Does not need to be monitored B At least 3 months C At least 6 months D At least a 12 months
D
45. What is NOT the purpose of an ultrasound in prenatal care? A Measure the AFI B Help determine the BPP C Detect ectopic and molar pregnancies D Determine the results of NST
D
50. All of the following are barrier methods EXCEPT? A Cervical Cap B Diaphragm C Female Condom D Monitoring ovulation
D
61. The contraction has three phases. Which best describes the acme phase? A The buildup phase of the contraction B The relaxation of the uterine muscle and the second shortest phase C The longest phase of a contraction D The peak and shortest but most acute phase of the contraction
D
78. Which of the following conditions put a woman at risk for postpartum infection? A C-section B Precipitous labor C HELLP syndrome D Frequent catheterization
D
81. If an early deceleration is present on a strip for FHR monitoring, what is likely happening to the fetus? A Placental deterioration B Cord compression C Fetal movement D Head compression
D
9. After ovulation, how long can an ova be viable for fertilization? A 1-4 hr B An entire month C 6-24 hrs D 1-48 hrs
D
98. A newborn has good flexion, a heart rate over 100bts/min, acrocyanosis, and a good cry. What is the newborns APGAR score? A 3 B 5 C 7 D 9
D
A RN has just received report on 4 patients. The RN should assess which patient first? A. A primiparous pt in active labor B. A multiparous pt admitted for induction of labor C. Pt with suspected PROM, but not contracting D. Pt who just received loading dose of IV Magnesium Sulfate for preterm labor
D
A woman who states that she "thinks" she is in labor enters the labor suite. Which of the following assessments will provide the nurse with the most valuable information regarding the client's labor status? A. Leopold's maneuvers B. Fundal contractility C. Fetal heart assessment D. Vaginal examination
D
Following delivery of a healthy infant, what is the 1st priority? A. Weigh the baby B. Do a complete head to toe assessment C. Administer Vitamin K injection D. Dry and stimulate, checking for adequate respirations and heart rate. E. Assign APGARS
D
Infant just had circumcision. Which is the first priority or step? A. Give sugar water on pacifier B. Give PRN meds like Tylenol C. Wrap and send back to mom to feed D. Vaseline/Aquaphor & gauze on the site E. Check bleeding at the site after 30 min
D
Patient at 32 weeks with a history of cardiac disease is seen in labor triage because she is contracting. Which MD order would you question? A. Betamethasone 12 mg IM x 2 doses, 12 hrs apart B. Sterile Speculum Exam C. CBC & Heplock/IV ACCES D. Terbutaline (Brethine) 0.25mg SQ STAT E. Urine Dip & NST
D
Pregnant pt is anemic at 22 weeks. What would you advise her to eat? A. Sweet potato B. Yogurt C. Cheese D. Chicken liver
D
Pt who is 31 weeks pregnant and has heart disease is contracting and making cervical change. She has been on magnesium to slow/stop the contractions. Which medication(s) would also be indicated at this time? Check all that apply A. Narcan B. Misoprostol C. Rhogam D. Betamethasone E. Methergine F. Terbutaline
D
Which woman is at highest risk for pre term labor? A. Pregnant woman with full time job B. Twin pregnancy C. Gained 35lbs by 36 weeks D. Person with history of 2 preterm births
D
132. Fill in the blank: The "cure" for Gestational Diabetes Mellitus is_____________________________
DELIVERY
104. Fill in the blank: Mother's who are ______________ are more likely to have a baby with hypoglycemia
DIABTEIC
A RN in the labor room is caring for a patient in ACTIVE labor. The nurse notes a late deceleration on the monitor. The most appropriate nursing action to do 1st is? A. Administer O2 via facemask B. Have mom turn to her side C. Increase rate of oxytocin IV D. Document findings and continue to monitor E. Increase IV fluids
E
112. Fill in the blank: ___________ prevents ophthalmia neonatorum related to gonorrheal or chlamydial infection.
ERYTHROMYCIN
12. Fill in the blank During the end of menses there is low ______________________.
ESTROGEN (LH ALSO OK)
11. True or False T F Levels of hCG continue to rise during pregnancy, returning to normal after delivery.
F
119. True or False: T F When formula feeding a baby, you should feed every two hours because it is easier for the baby to digest.
F
127. True or False: T F Spinal anaesthesia is longer acting than an epidural and a common side effect is a spinal headache.
F
149. True or False Premature rupture of membranes (PROM) can cause umbilical cord prolapse, seizures, and placental abruption.
F
155. True or False: T F Fundal message is a method to relieve shoulder dystocia.
F
159. True or False: T F Most instances of cord prolapse can be resolved with interventions and delivery can proceed vaginally
F
23. True or False: T F Gaining 40 lbs during pregnancy is appropriate for a mother with a normal pre pregnancy BMI
F
3. True or False: T F Placenta previa is caused by too little folic acid in a woman's diet
F
47. True or False: T F A woman is diagnosed with GDM when there are one or more abnormal value(s) in the OGTT (oral glucose tolerance test).
F
59. True or False: T F An Anthropoid pelvis type is typical in 50% of females and is usually adequate for labor.
F
67. True or False: T F The fundus is palpable 1-2cm below the umbilicus immediately after birth.
F
7. True or False: T F A molar pregnancy occurs when the embryo implants somewhere other than the uterus
F
75. True or False T F Postpartum depression and baby blues are very similar in their presentation
F
83. True or False: The tocodynamometer detects the fetal heart rate when performing fetal monitoring
F
87. True or False T F During c-section surgery, a circulating nurse needs to stay sterile, hand instruments to MD, and count laps and needles.
F
79. True or False: T F Soft boggy uterus or fundus around 1 to 3 postpartum days are indications of postpartum infection.
F (ADD "CAN BE")
8. Fill in the blank In a normal pregnancy, fertilization occurs in the _______________________.
FALLOPIAN TUBES
92. Fill in the blank Oxygen poor blood leaves the fetal circulation via the _______________________
FETAL ARTERIES
84. Fill in the blank Fetal heart rate variability is an indicator of ___________________ when performing fetal monitoring.
FETAL OXYGENATION
16. Fill in the blank The majority of congenital defects develop during which trimester ____________________.
FIRST
120. Fill in the blank When breastfeeding in the _________________________ position, the newborn is positioned to the side of the mother under her arm. The head is supported by the mother's hand.
FOOTBALL
36. Fill in the blank. An amniocentesis is performed between weeks 15 - 20 with a _______________ badder.
FULL
20. Fill in the blank At 24 weeks, the fetus begins secreting _______________________ and _______________which are necessary for the development of its lungs.
LECITHIN, SPHINGOMYLIN
144. Fill in the blank The "LP" in HELLP stands for ___________________________. What is the normal value for this _____________________________
LOW PLATELETS 150,000
52. Fill in the blank The Plan B is OTC with one ingredient 1.5 mg of ________________________.
Levonorgestrel
72. Fill in the blank _______________ is a common drug used to treat postpartum hemorrhage, but is contraindicated for a hypertensive patient.
METHERGINE
38. Fill in the blank: GTD is also referred to as a __________________ pregnancy
MOLAR, HYDITAFORM MOLE
28. Fill in the blank A rapid increase in abdominal girth is a sign of ______________ _________ (two words), a potentially dangerous side effect of fertility medication.
OVARIAN HYPERSTIMULATION
124. Fill in the blank Pain _____________ varies greatly from person to person depending on gender, age, culture, anxiety, fatigue, previous experience, coping style, and family support.
PERCEPTION, PAIN LEVELS, TOLERANCE
76. Fill in the blank. Postpartum depression is very treatable if it is _________________________
RECOGNIZED, DIAGNOSED, NOTICED, CAUGHT
128. Fill in the blank A common side effect of IV narcotics is urinary _____________.
RETENTION
SKIP
SKIP
96. Fill in the blank The Moro Reflex is also called the __________________________ reflex.
STARTLE
88. Fill in the blank Indications for a/an ________________ c-section or emergency c-section are bad strip with decels and poor variability, cord prolapse, and/or failure to progress during labor.
STAT OR UNPLANNED
60. Fill in the blank SVE requires the supplies: _______________ and _______________ to prevent infection and allow the provider to assess the cervix.
STERILE GLOVE AND WATER BASED LUBE
136. Fill in the Blank: Administration of _______ to hasten fetal lung maturity is one of the most important initial managements in a woman who presents signs of bright red and painless bleeding.
STEROID, BMZ
103. True or false: T F Hypoglycemia is can a sign of newborn infection
T
108. True or False: The onset of some jaundice in the first 24 hours postpartum is normal and usually resolves within a few days.
T
111. True or false: T F GBS infection in the neonate typically manifests as sepsis, pneumonia, or meningitis.
T
115. True or False: T F If premature baby is anemic, administer Fe (iron) and E-Poeitin (erythropoietin)
T
123. True or False: T F Women in labor can have pain medication whenever they ask, whether they are 0 cm or 10 cm dilated.
T
131. True or False: T or F Gestational Diabetes mellitus is the hardest to control in the 3rd trimester
T
135. True or False: T F Many placenta previas are low lying at first but move up and out of the way as the pregnancy continues.
T
139. True or False: T F During normal fetal growth and development the placenta develops with an amnion which surrounds the embryo, and a chorion which attaches to the serosa or perimetrium of the uterus.
T
143. True or False? Preeclampsia risk increases with maternal age younger than 20 and older than 45 years old.
T
147. True or False T F A nurse is educating a pregnant client that lower back pain, leg pain, and irregular contractions are signs of preterm labor.
T
15. True or False: T F Common discomforts during the first trimester include urinary frequency, breast tenderness, & cravings.
T
27. True or False: T F A body mass index over 30 may contribute to female infertility
T
35. True or false. T F An amniocentesis procedure is done by inserting a long thin needle into the abdomen, where a CVS procedure is done by removing a small sample or placenta tissue.
T
37. True or False: T F Gestational Trophoblastic Disease can become cancerous if not treated.
T
43. True or False: T F The Pitocin infusion rate should be turned down after Artificial, or Spontaneous, Rupture of Membranes (AROM/SROM)
T
51. True or False: T F The combined oral contraceptive is more effective than the progestin-only contraceptive.
T
55. True or False: T F A serious potential complication from miscarriage is hemorrahge
T
63. True or False: T F Anxiety, stress, and fear can reduce pain tolerance and delay the progress of labor.
T
71. True or False: T F 700ml of blood loss in the first 24 hours after a Cesarean delivery is considered normal.
T
91. True or False: T F The placenta acts as the organ of gas exchange and waste removal for the fetus
T
95. True or False: T F Having the baby's toes curl in during a Babinski Reflex is normal.
T
99. True or False: T F A newborn is placed is weighed on a cold scale and loses body heat. This type of heat loss is called conduction.
T
160.Fill in the blank When indicated, the most common tocolytic administered in the case of a cord prolapse is _____________________
TERBUTALINE
19. True or False: T F At 24 weeks, the fetus' lungs begin to fill with amniotic fluid and it assists with practicing breathing motions.
TRUE
156. Fill in the blank ________________ sign is often the first indication of shoulder dystocia.
TURTLE
107. Fill in the blank. The most common cause of physiological neonatal jaundice is elevated levels of _______________________ bilirubin.
UNCONJUGATED, INDIRECT
64. Fill in the blank The primary power of the bearing down reflex, the _____________ reflex, is cued when the presenting part of the fetus reaches the pelvic floor.
VAGAL, VALSALVA, FERGUSENS
Which types of patients are at higher risk for PP depression or risk or difficulty transitioning, select all that apply A. Primips B. Multips C. 35 year old single mother with lots of family and friends D. Women who have just immigrated here E. 18 living with partner and parents
•A,D
