OB EXAM 1 REVIEW
Doppler
12 weeks
What of the following patients are at risk for developing preeclampsia
16 year old first time mom40 year pregnant with twins with her 1st 30 OLD with diabetes21 year with hx of chronic hypertension
Pt is currently pregnant with her 4th child and is 39 weeks pregnant. Her first pregnancy was healthy twins delivered at 36 weeks. Her second pregnancy ended with a delivery all 30 weeks and that infant died 5 days later. Her third pregnancy was a miscarioge at 17 weeks. What is her GTPAL?
40212
Pt is at the clinic for a new OB appointment. Her OB history includes a vaginal delivery of a little boy 10 years ago that was delivered at 40 weeks, a twin pregnancy delivered 5 years ago at 36 weeks, a miscarriege at 8 weeks, triplets stillborn at at 19 weeks, an ectopic pregnancy at 6 weeks, and is now currently pregnant with twins
61133
Pt just delivered at 38 weeks. She has 3 other living kids that were all delivered at term and has been pregnant a total of 7 times. She lost one pregnancy at 17 weeks, had an elective abortion at 6 weeks, and delivered a stillborn at 21 weeks. What is her GIPAL?
7 4 1 2 4
Which of the following patients would the nurse want to assess first in preterm labor?
A G3T2P0A0L2 36 weeks gestation who presents with complaints of persistent low backache for the past 2 hours
pt is 36 weeks pregnant and is undergoing an amniocentesis. Which of the following would indicate fetal lung maturity?
A lecithin/sphingomyelin 2:1 ratio
The nurse is teaching a class about embryonic and fetal development to couples in the early stage of pregnancy.For which reason does the nurse emphasize the first 8 weeks of gestation?
All organ system are developing during the period
A nurse in the ED is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states she missed one menstrual cycle and cannot be pregnant because she has an intrauterine device.The nurse should suspect which of the following?
Ectopic pregnancy
A nurse is providing education to a patient who is a type 1 diabetic with uncontrolled blood sugars. The patient states she hates giving herself injections. What education should the nurse provide about the complications the new newborn can experience related to uncontrolled blood sugars?
a) Neonatal hypoglycemia b) Macrosomia c) Respiratory distress syndrome
The nurse is providing discharge teaching to a patient who is being discharged home after being in preterm labor. The patient is a primigravida at 33 weeks gestation.She received betamethasone x 2 and nifedipine 3 times. What education wil the nurse provide? SATA
a) Nothing in the vagina b) Try to rest on your left side c) Increase fluid intake
A patient presents with a headache, RUQ pain, petechiae and VS 162/116-122-20-95% 98.5F. You are worried that she might be experiencing HELLP. What labs would you expect to see for this patient?
a) Platelets 90,000 b) Ast 800 c) ALT400
A nurse is administering Magnesium Sulfate IV for seizure prophylaxis for a client with severe preeclampsia. Which of the following are signs of magnesium toxicity?
a) Respirations less than 12/min b) Urinary output less than 25ml/hr c) Decreased level of consciousness
A nurse is caring for a client who is at 32 weeks gestation and has a placenta previa. The nurse notes that the client is actively bleeding. Which of the following medications should the nurse expect the provider will prescribe?
betamethasone
You hear a nurse providing education to a pt who reports smoking a pack a day during her pregnancy. You make sure to correct her when she states which of the following.
it is ok to smoke during the pregnancy as long as you stop after 36 weeks as this is when it affects the fetus the most
Caffeine
less than 200
The patient is in active labor and wants pain meds, "give me pain meds". We need to protect the baby from being overmedicated.
Nonmaleficence
What is the name of the ethical duty to do no harm?
Nonmaleficence
The nurse is caring for a patient at 7 weeks gestation. The nurse suspects that the patient may have been using mariivana. With consent, the nurse confirms via urine drug screen. Which statement by the nurse is most appropriate?
"Using marijuana while pregnant ea have a negative effect on the neurological development of your baby."
Anitiverial for what?
HIV positive and herpes
A couple has been unable to conceive. The mom has 1 previous child from a previous relationship and the father has a history of 2 children with a previous relationship. He then had a vasectomy and has had it reversed, A sement analysis was completed and WNL. What tests would the nurse expect the provider to order next?
a) Hormonal levels of mom b) post coital analysis
Kinsely is a G5P0 at 30 years old. She has a history if 5 miscarriages, all before 20 weeks gestation. What tests?
a) Hormone analysis (progesterone) b) Ultrasound (fibroids) c) Genetic Testing (incompatibility)
A nurse is presenting at a local highschool about risks associated with teen pregnancies. What of the following would she mention as a risk then mom might experience during her pregnancy?
a) Increased risk of STI b) Increased risk of hypertension
The patient presents to the clinic 36 weeks for a routine prenatal appointment. The provider collects a GBS swab. The mom asks what GBS is and why she is being tested for it. How should the nurse respond? SATA
a) It can cause fetal death b) Your baby will be monitored for signs of induction after delivery
A patient presents to the hospital at 28 weeks in labor. The nurse knows that the provider might order which of the following?
a) Magnesium sulfate b) Nifedipine c) Terntaline d) Indomethacin e) betamethasone
Maladaptation
a) Military b) Lqbtq c) IVF d) Homeless e) Teen (body image)
A patient had a BPP performed. The score was 6/10. What is an appropriate next intervention?
Retest in 12-24 hours
The nurse is counseling a patient regarding pregnancy. The patient lost her first 2 pregnancies in the second trimester of gestation for undetermined reasons. What initial advice would you give
Seek genetic studies
A couple presents to the clinic for a follow up appointment after being sent home from the hospital with PTL at 24 weeks. She is now 26 weeks. The husband is asking about when it is safe to resume sexual intercourse. What Is an appropriate response?
Sex can cause preterm labor
A patient presents in preterm labor at 32 weeks. The nurse administers betamethasone and nifedipine. The contractions space out. The patient asks why she needs the shot of betamethasone. How should the nurse respond?
The betamethasone will help your babies lungs develop
The nurse is discussing genetically linked disease with a couple planning a pregnancy. The female states, "I am concerned because there is a history of sickle-cell disease in my family." Which information from the nurse is correct?
The male partner needs genetic testing
During a routine prenatal appointment, the patient is tested for STI's and is positive for gonorrhea. She is asking questions about why it is important to get treated for this. The nurse responds by saying?
Untreated gonorrhea can have complications for you and for the fetus
Ms. Volz is a G5PO. She is able to conceive but unable to stay pregnant.Which of the following do you think could be contributing to her infertility?
Uterine fibroids/tumors
What maternal health conditions are associated with maternal obesity? SATA a) Gestational diabetes b) Pre-eclampsia c) Thromboembolism d) Gestational hypertension
a) Gestational diabetes b) Pre-eclampsia c) Thromboembolism d) Gestational hypertension
A G3T2P0A0L2 patient at 35 weeks gestation is sent to the labor unit after a clinical appointment. She has a history of chronic hypertension and type 1 diabetes. She had a non stress test performed in the clinic and it was nonreactive. She was sent to the hospital for further monitoring. What additional test will be needed to assess fetal wellbeing in-utero?
Biophysical profile
A patient is 28 weeks pregnant and in preterm labor. The provider orders nifedipine to be given. The nurse knows the medication is a successful tocolytic when what occurs?
Contractions decrease and space out
Healthy people 2030 goal?
Decrease death mortality rate
The nurse is providing teaching at a 28 week appointment to a patient about fetal kick counts. The nurse asks the patient to teach back the information. The nurse knows that the patient understands when she says what?
I should feel 10 kicks in 2 hours
A patient at 30 weeks presents to the hospital with intense abdominal pain. Her abdomen palpates firm and tender to the touch. She denies any leaking of fluid or vaginal bleeding. The nurse applies the monitors to obtain a nonstress test and its nonreactive. The nurse notifies the provider about the finding and suspects what to be occurring?
Placental abruption
. A G4T0P3A0L3 at 16 weeks was prescribed vaginal progesterone. She has a history of delivering at 28, 26,and 25 weeks. She is asking why she needs to be on this medication because she does not like inserting it. What education does the nurse provide?
It can decrease your chances of delivering early
A patient and spouse to the clinic after their 3rd failed IVF transfer. They sit as far apart as possible in the exam room. The wife is tearful, and the husband appears upset and mad. He makes a comment about how expensive this has been. They have a small fight about this comment in front of the nurse. What is an appropriate response from the nurse?
It is very common for couples experiencing infertility to need therapy
During a 16 week prenatal appointment, the patient asks about why she feels lightheaded when she lays on her back. The nurse explains to her that this is caused by what?
Laying flat on her back can cause pressure on the vena cava
Ms. Hall presents to the clinic for an OB appointment at 16 weeks. She asks about available screening to detect neural tube defects in the fetus. What screening is appropriate to perform first?
MSAFP
The nurse is experiencing an ethical dilemma when confronted with a situation in which either the mother or fetus is predicted to die. The nurse feels bound by the ANA Code of Ethics to protect both patients.Which aspect of care during an ethical dilemma will guide her the most?
Maternity nurses are bound to advocate first and foremost for the well-being of the mother
A patient presents at 7 weeks to the emergency department with intense abdominal pain. An ultrasound is performed to confirm the pregnancy and the fetus is noted to be implanted in one of the fallopian tubes. During SBAR to the provider, the nurse recommends which medication to help with this condition?
Methotrexate
The nurse on a maternity unit is an orthodox jew whose rabbi teaches that pregnancy terminates are permitted only to save the life of the mother. Which situation becomes possible if the nurse puts aside personal values and assists elective terminations?
Moral distress
A paint presents with bright red vaginal bleeding at 34 weeks gestation. She has no history of prenatal care of ultrasounds during this pregnancy. She denies feeling any contractions and states that the fetus is active. What action should the charge nurse stop the primary nurse from performing?
Performing a sterile vaginal exam
A patient has a birth plan that includes no IV during labor and a vaginal delivery. At a 20 week ultrasound it was discovered that the patient has a placenta accreta. The patient is asking the nurse what this means. What education would the nurse provide?
Your placenta is embedding into the uterus and are at risk for a hemorrhage
A provider orders a BPP on a patient with gestational diabetes. Which of the following findings would score 2 points on the BPP(What are we doing with the score?)
a) 3 fetal movements b) At least 2 breathing motions during 30 minutes c) Reactive NST
Folic Acid
a) 400 normal b) 600 high risk (neural tube)
A nurse is providing discharge education to a patient after a chorionic villus sampling procedure. What would warrant further teaching to be needed?
a) A. Iris ok o Take ibuprofen to help with the cramping b) B: It is normal to leak clear fluid after this procedure O c) C: A temperature of 100.5 F is expected for 1-2 days
A patient presents to the clinic wih the complaints of a severe vaginal infection. She denies being pregnant but the nurse thinks she probably is. Which of the following ore probable signs of pregnancy? SATA
a) Abdominal growth b) Chadwicks signs
A patient presents to the clinic for her 16 weeks appointment. She states she has been vomiting for days and is unable to keep anything down. Her weight is down 10 pounds since her last appointment 4 weeks ago. What pharmacological interventions are expected?
a) Administer vitamin B6 b) Antiemetic
What structure provides cushioning and warmth to the fetus?
a) Amniotic fluid
The nurse is caring for a 14 year old patient who is 32 weeks pregnant. Positive for syphilis and gential sores and discomfort and teus is at risk for what?
a) Blindness
Most common infertility
a) Comid b) Ovulation issue
A patient presents for an initial prenatal appointment. SHe is unsure of how far along she is or when her LMP was. How can her EDC be determined?
a) Fundal Height b) Ultrasound
A nurse hears a student nurse is teaching another student nurse about preeclampsia. Which of the following things that the nurse overhears should she clarify with the student's nurse? SATA
a) Preeclampsia can develop at anytime during pregnancy b) Preeclampsia is preventable c) Preeclampsia can be cured with medication d) Preeclampsia is defined as a blood pressure less than 140/90
A patient presents to the hospital at 25 weeks gestation with complaints of her water breaking 12 hours ago. She states she only came into the hospital because her mom made her and she doesn't feel like she needs to be there. She denies feeling any contractions and states that the baby is active. The nurse educates the patient about ways to decrease her risk of complications from premature rupture of membranes including SATA
a) Refraining from intercourse b) No tub baths c) Encourage increased hydration
A patient has decided to undergo chorionic villus sampling to detect genetic chromosomal abnormality in her fetus. What complication should she be aware of prior to the procedure?
a) Risk for miscarriages b) Infection c) Water breaking
June and husband have been attempting to get pregnant for 2 years.She has a history of never being pregnant. Her husband has 3 kids from a previous relationship, had a vasectomy and now has the vasectomy reversed. What is the appropriate next steps to take?
a) Semen analysis
a nurse is providing teaching to a student nurse about the
progesterone
A patient is diagnosed with preeclampsia and stated
stop the magnesium infusion
A nurse is caring for a client who has suspected hyperemesis gravidarum and is reviewing the client's laboratory reports. Which of the following findings is a manifestation of this condition?
urine ketone present
A patient presents to labor and delivery at 37 weeks with complaints of a severe headache, occasional contraction and normal fetal movement.What assessment should be performed next?
vital signs
