perinatal quizzes

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Initial treatment of mild postpartum hemorrhage is

uterotonic agents

Found in the blastocyst at implantation and is detected in maternal serum and urine at the time of implantation

Human Chorionic Gondotropin

A client asks, "How does my baby get air inside my uterus?" The correct response is

"The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream."

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor. Her labor is being controlled with tocolytic medications. She asks when she would be able to go home. Which response by the nurse is most accurate?

"When we can stabilize your preterm labor."

An appropriate recommended weight gain for a woman with a BMI greater than 30 would be

11 to 20 lb

Vital signs within normal limits do not rule out hypovolemic shock during postpartum hemorrhage because alternations in vital signs do not occur until there is loss of what percent of the total blood volume?

15% to 20%

The nurse is caring for a client whose labor is being augmented with oxytocin. He or she recognizes that the oxytocin should be discontinued immediately if there is evidence of

A fetal heart rate of 18 with absence of variability

In the women without pre-existing diabetes, the best time to screen for gestational diabetes is

26 weeks gestation

The therapeutic range of serum magnesium during magnesium sulfate therapy to prevent eclamptic seizures is

5 to 8 m/dl

A biophysical profile with a score of ____ or great is considered a sign of fetal well-being

8

A high probability of successful induction of labor is associated with a Bishop score of

>8

Critical to fetal growth because it alters maternal protein, carbohydrate, and fat metabolism and acts as an insulin antagonist

Human Placental lactogen

A presumptive sign/symptom of pregnancy

Amenorrhea

A positive sign of pregnancy is

Fetal movement palpated by a health care provider

The labor and delivery nurse understands that increases in fetal heart rate 15 beats/minute above baseline last approximately 15 seconds:

Are caused by umbilical compression

Factors predictive of a successful VBAC include which nonrecurring indication for a Cesarean delivery:

Breech presentation

Antibiotic prophylaxis often used for cesarean delivery is

Cefazolin (Ancef)

Risk factors of postpartum hemorrhage include

Cesarean birth, Induction of labor, precipitous labor and birth

The _____ is/are responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream

Chorionic villi

Compared to non-pregnant women, a pregnant woman in her third trimester has a

Decreased fasting serum glucose level

An indication of impending magnesium sulfate toxicity in the patient being treated for preeclampsia is the absence of

Deep tendon reflexes

To minimize fluctuations in cardiac output during the second stage of labor and birth the nurse should

Encourage passive fetal descent, maintain strict I and O with fluid restriction as ordered, monitor closely for symptoms of postpartum hemorrhage

In the OR, the circulating nurse is responsible for

Ensuring instrument count is correct

Helps prepare breasts for lactation, increases blood flow to the uterus and increases growth of the uterine muscle mass

Estrogen

During the past several years, rates of preterm births have stabilized

False

The nurse should administer brethine (Terbutaline) per order, regardless of the maternal pulse.

False

The nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate the need to contact a health provider?

Fetal heart rate of 180 beats per minute

Maternal risks associated with maternal obesity during pregnant, labor and birth include:

Gestational diabetes, surgical site infections, breastfeeding difficulties

Of the following, which is considered normal for pregnancy?

Glycosuria

Which of the following is not a common symptom of preterm labor?

Headache

Of the following, which response would you classify a pregnant woman as being most at risk for substance use during pregnancy?

I smoked one to two packs of cigarettes per day the month before I became pregnant

Of the following, which would be considered normal for a woman in her second trimester?

Increased pulse rate

A nurse should monitor a client who is postpartum for a forceps delivery for which of the following complications?

Infection

The first stage of labor includes which of the following

Latent phase 0 to 5 cm

An involuntary urge to push is most likely a sign of

Low fetal station

A maternal indication of the use of vacuum extraction is

Maternal cardiac disease

During the second trimester, nasal congestion and occasional epistaxis may be attributed to:

Normal respiratory changes in pregnancy caused by elevated levels of estrogen

Possible causes of the onset of labor include all of the following except:

Pregnancy reached 40 weeks gestation

Required for implantation. Also helps maintain pregnancy by inhibiting prostaglandin production that stimulates uterine contractions

Progesterone

The hormone essential for maintaining pregnancy is

Progesterone

Diagnosis of preeclampsia requires the presence of hypertension and

Proteinuria

Cervidil (prostaglandin) has been ordered for a pregnany woman at 43 weeks of gestation. The nurse recognizes that this medication will be administered to

Ripen the cervix in preparation for labor induction

The blood pressure should be recorded with the pregnant women in the _____ position

Semi-Fowler's

Severe preeclampsia can be diagnosed in the presence of

Serial diastolic blood pressures of at least 110 mm Hg

Your patient has experienced a blood loss of greater than 1500 ml. What PPH stage has she reached

Stage 3

Fetal and infant risks associated with maternal obesity during pregnancy, labor, and birth include

Stillbrith, Low Apgar Scores, Intrauterine growth restriction

The nurse is caring for a client who has been prepared for cesarean delivery. After the client is transferred to the delivery room table, the client should be placed in what position?

Supine with wedge under the right hip

A women at 26 weeks gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates that preterm labor is occurring?

The cervix is effacing and dilated to 2 cm.

Of the following, which best describes the primary purpose of electronic fetal monitoring during labor>

To provide information regarding fetal heart response to uterine contractions (UCs)

Surgical, medical, or mechanical methods may be used for labor induction. Which technique is considered a mechanical method of induction?

Transcervical catheter

Patient characteristics that pose additional risk for surgical site complications include: prolonged labor, diabetes, smoking and poor nutritional status

True

Subgaleal hemorrhage is a potential complication of vacuum extracted delivery

True

The urge to push during the second stage of labor is triggered by the Ferguson reflex

True

Uterotonics should be immediately available on the labor and delivery and postpartum units so that they can be rapidly accessed for PPH management

True

Women laboring for the first time usually experience complete cervical effacement prior to dilation

True

Prevention of surgical site infection includes which of the following (select all that apply)

Using clippers to remove hair, antibiotic administration 30 minutes to one hour prior to incision, removal of surgical dressing within four hours post-op

Amnioinfusion is reasonable therapeutic option when there are recurrent

Variable decelerations

To accurately be considered preterm, an infant must be

born at gestational age < 37 weeks

Fetal decelerations that are benign and do not require intervention are

early

A pregnant woman with New York Heart Association (NYHA) class II cardiac disease is symptomatic with

heavy exertion

The time during the perinatal period when cardiac output increased the most is during

immediate postpartum period

A hemodynamic change during the immediate postpartum period that would be considered normal is

increased cardiac output

The increased rate of placenta previa is most likely due to

increased rate of cesarean birth

Invasion of the trophblastic cells into the uterine myometrium is called placenta:

increta

Hematologic changes that occur during the postpartum period include

leukocytosis of 25,000 to 30,000/microliter

Maternal serum alpha-fetoprotein specifically screens for

neural tube defects

An electronic fetal monitoring tracing with moderate variability, no accelerations and early decelerations would be classified as

normal (category I)

Painless bright red bleeding at 28 weeks is most likely due to

placenta previa

Teaching pregnant women about the symptoms of preterm labor

should be ongoing throughout pregnancy


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