Ascent Mid Flashcards
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
RhIG
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
Maintain hydration and electrolyte levels
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?”
“When was the first day of your last menstrual period”
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
Dilatation and Curettage
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
High levels of chorionic gonadotropin
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
Hyperemesis gravidarum
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
Immediately notify the physician
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”
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
Potential fluid volume deficit
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.”
“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
Early miscarriage is largely not preventable because of abnormal chromosome formation and poor uterine implantation.
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.
She should be evaluated for fetal heart rate and check for
prolapsed cord
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?”
“Are you experiencing any shoulder pain?”
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.
Save any clots or material passed for your health care provider to examine.
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
Decreased cardiac output
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
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
regular uterine contractions with cervical dilation
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
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.
When assessing a pregnant client, which question should be
asked by the student nurse 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?
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.
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
Which drug is used to manage preterm labor by causing smooth muscle relaxation?
oxytocin
estrogen
prostaglandin
ritodrine
ritodrine
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
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
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
Infection in the uterus may cause PROM and may also be a complication following PROM.
TRUE OR FALSE
True
Which of the following drugs is given to a patient in preterm labor to specifically prevent surfactant deficiency?
Magnesium
Corticosteroids
Terbutaline
Surfactant
Surfactant
PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid.
TRUE OR FALSE
True
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
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)
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.
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
What may a doctor prescribe to help prevent preterm labor or
birth? Select all that apply
Estrogen
Oxytocin
Cerclage
Nifedipine
Progesterone
Nifedipine
Progesterone
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
Reported history of a large gush of fluid
(NOT nitrazine paper nor ferning)
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
What can be given to women in preterm labor in order to induce fetal surfactant production?
NSAIDs
Glucocorticoids
Mineralocorticoids
Immunomodulators
Sex hormones
Glucocorticoids
The fetal membranes are so strong that blunt trauma to the
abdomen is unlikely to cause PROM.
TRUE OR FALSE
False
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…)
Abruption placenta is most likely to occur in a woman with:
Cephalopelvic disproportion
Hyperthyroidism
Pregnancy-induced hypertension
Cardiac disease
Pregnancy-induced hypertension
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
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
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
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
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
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 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
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
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
Fetal sacral agenesis
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
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
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
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 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
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
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
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
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 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
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
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
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
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 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
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
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
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
Which among the following is a drug of choice for tinea corporis?
Miconazole
Econazole
Penicillin
Erythromycin
Miconazole
Which among the following is a drug of choice for tinea capitis?
Econazole
Fluconazole
Penicillin
Erythromycin
Fluconazole
Which of the following is not classified as personal protective
equipment?
Gloves
Goggles
Hepa B vaccine
Lab coat
Hepa B vaccine
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
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
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
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
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
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
This is being use to measure trunk asymmetry:
Scoliometer
Speedometer
Scalometer
All of the choices
Scoliometer
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
