ATI Maternity Flashcards
1
Q
What are some features of fetal alcohol syndrome in an newborn baby?
A
-Low Nasal Bridge
-Short palpebral fissures
-short nose
-flat midface
-Epicanthal folds
-minor ear abnormalities
-receding jaw
2
Q
Term
A
38-42 Weeks gestation
3
Q
Preterm
A
Born before the completion of 37 weeks
4
Q
Late preterm
A
37 weeks
5
Q
Post term
A
Born beyond 42 weeks
6
Q
What are some Preterm Characteristics?
A
-Poor muscle tone
-Minimal subcut Fat
-plentiful lanugo
-absent creases in soles and palms
-Thin transparent skin
7
Q
What are some Postterm Characteristics?
A
-Dry cracked wrinkled skin
-Meconium stained
- Long thin extremities and long nails
-Thin umbilical cord
8
Q
A baby that is 4,500 grams is considered what?
A
Large for gestational age
9
Q
A baby that is 2, 345 grams is considered what?
A
Small for gestational age
10
Q
Assessment of a baby: His head is larger than his body, he has a scaphoid abdomen and has wide sutures. What would you classify this baby?
A
Small for gestational age
11
Q
A baby that is born to a mother with gestational diabetes and is macrosomic would be classified as?
A
Large for gestational age
12
Q
When a type O mother has a baby that is type A or B. What is the incompatibility considered?
A
ABO incompatibility
13
Q
Which of the following can be causes of jaundice in newborns? (Select all that apply)
A) Fetal-maternal blood group incompatibility
B) Prematurity
C) Asphyxia at birth
D) Insufficient intake of milk
E) Oxytocin administration
F) Gestational diabetes
G) Trauma at birth (cephalohematom)
H) Cutaneous bruising
I) Polycythemia
J) Intrauterine infection
K) Excessive hydration
A
A, B, C,D,G,H,I, J, K
14
Q
What is the primary heat loss mechanism involved when you dry off a wet baby?
A) Conduction
B) Convection
C) Evaporation
D) Radiation
A
C. Evaporation
15
Q
When a baby is placed on a cold scale, what is the primary heat loss mechanism occurring?
A) Conduction
B) Convection
C) Evaporation
D) Radiation
A
A. Conduction
16
Q
What is the primary heat loss mechanism when cold air from an air conditioner is blowing on a baby?
A) Conduction
B) Convection
C) Evaporation
D) Radiation
A
B. Convection
17
Q
Scenario: A nurse is assessing a 2-day-old newborn who becomes fussy when not being held. The nurse gently strokes the baby’s cheek, and the baby turns their head and opens their mouth.
What does this response primarily indicate?
A) The baby is hungry and ready to feed.
B) The baby is experiencing discomfort.
C) The baby has a developmental delay.
D) The baby is startled by the touch.
A
A) The baby is hungry and ready to feed
Rationale: Rooting reflex and presents from birth to 4-6 months
18
Q
What is the primary heat loss mechanism when a baby is placed next to a cold window?
A) Conduction
B) Convection
C) Radiation
D) Evaporation
A
C. Radiation
19
Q
Scenario: While conducting a routine assessment, a sudden loud sound causes the newborn to throw their arms out and then pull them back in. What does the presence of the Moro reflex indicate?
A) The baby is calm and comfortable.
B) The baby has an immature nervous system.
C) The baby’s neurological development is appropriate for their age.
D) The baby may have hearing issues.
A
C) The baby’s neurological development is appropriate for their age.
20
Q
Scenario: During an assessment, the nurse strokes the sole of the newborn’s foot, and the toes fan out while the big toe extends upward.What does the Babinski reflex suggest about the newborn’s neurological function?
A) It indicates proper neurological function.
B) It signals a need for further assessment.
C) It means the baby is in discomfort.
D) It shows the baby is ready for crawling.
A
A) It indicates proper neurological function.
21
Q
Scenario: A healthcare provider is discussing fetal circulation with a nursing student. What is the purpose of the foramen ovale in fetal circulation?
A) It allows blood to bypass the liver.
B) It connects the right atrium to the left atrium, enabling blood to bypass the non-functioning fetal lungs.
C) It serves as a valve to prevent backflow of blood in the heart.
D) It connects the pulmonary artery to the aorta.
A
B) It connects the right atrium to the left atrium, enabling blood to bypass the non-functioning fetal lungs.
22
Q
cenario: During a prenatal assessment, a nurse explains the role of the ductus venosus to expectant parents. What is the primary function of this structure?
A) To shunt blood away from the fetal lungs.
B) To connect the umbilical cord to the inferior vena cava.
C) To allow mixing of oxygenated and deoxygenated blood in the heart.
D) To facilitate nutrient absorption in the fetal gut.
A
B) It is an opening that connects the umbilical cord to the inferior vena cav
23
Q
Scenario: A nurse is reviewing the anatomy of the fetal heart. Which of the following statements correctly describes the function of the ductus arteriosus?
A) It allows blood to flow from the right atrium to the left atrium.
B) It connects the main pulmonary artery to the aorta, bypassing the lungs.
C) It carries oxygen-rich blood from the placenta to the fetus.
D) It drains deoxygenated blood from the fetus to the placenta.
A
B) It connects the main pulmonary artery to the aorta, bypassing the lungs.
24
Q
What 3 medications are given at the time of birth?
A
-Erythromycin
-Vitamin K
-Hepatitis B
25
Shoulder Distocia Risk Factors
-Fetal Macrosomia
-Maternal Diabetes
-Maternal Obesity
-abnormal pelvic structure
26
The nurse is caring for a client at 40 weeks' gestation who has been experiencing prolonged labor. The nurse-midwife estimates the fetal weight at 4600 g. Which complication will the nurse anticipate at the birth?
a. Occiput posterior delivery
b. Meconium aspiration
c. Shoulder dystocia
d. Neonatal sepsis
C) shoulder Dystocia
27
Which of the following actions should the nurse take in response to shoulder dystocia? (Select all that apply.)
A. Instruct the mother to push harder to facilitate delivery.
B. Perform the McRoberts maneuver.
C. Call for additional help from the healthcare team.
D. Use fundal pressure to attempt to dislodge the shoulder.
E. Prepare for an emergency C-section
C, B, D
28
What is the normal temperature for a newborn?
97-99 F (36.5-37.5C)
29
What is the normal heart rate for a newborn?
110-160 bpm
30
What is the normal respiration for a newborn baby?
30-60
31
Where should the uterus be one hour after delivery?
It should be at the umbilicus
32
What is the rate the uterus descends per day?
1 cm per day
33
When should the uterus not be palpable and right above the symphysis pubis?
Day 10-14
34
When should the uterus return to pre-pregnancy size?
Around 6 weeks
35
A new mother reports feeling sad, anxious, and overwhelmed, and experiences frequent crying spells. Which of the following is the most likely condition she is experiencing?
A. Postpartum depression
B. Postpartum psychosis
C. Postpartum blues
D. Adjustment disorder
C) Postpartum Blues
36
Which of the following symptoms is NOT typically associated with postpartum blues?
A. Loss of appetite
B. Severe mood swings lasting several months
C. Difficulty sleeping
D. Crying spells
B.) Severe mood swings lasting several months
37
What medications are used to treat women with Postpartum psychosis?
-Antipsychotics
-Benzodiazepines
-Mood Stabilizers
38
A G1P2 mother who gave birth to twins 4 weeks ago calls the office reporting difficulty sleeping, lack of appetite, and feelings of wanting to avoid her babies. Which of the following statements are appropriate responses or considerations for her situation? (Select all that apply)
A) This may indicate signs of postpartum depression.
B) Encourage her to spend more time alone to relax.
C) Suggest that she come into the office and we may need to treat her with antidepressants
D) Advise her to ignore her feelings, as they will pass.
E) Recommend support groups or psychotherapy.
A, C, E
39
What is another treatment besides medications for postpartum psychosis?
-Electroconvulsant Therapy (ECT)
40
Postpartum Hemorrhage medication gold standard
Pitocin
41
A G5P4 woman has just given birth to a healthy baby 2 hours ago. During her postpartum assessment, you note the following vital signs: heart rate of 112 bpm, blood pressure of 94/68 mmHg, respirations at 28 breaths per minute, and a temperature of 99.7°F O2 is 92% Her uterus is deviated to the right and She is experiencing mild dizziness. What interventions do you anticipate performing?
-Call for help
-Straight Cath (Empty Bladder)
-Fundal Massage
-Initiate pitocin
-Establish IV
-Oxygen Face mask
42
What are the 4 most common postpartum infections?
-Endometritis
-UTI
-Mastitis
-Wound Infections
43
32 year old G 2 P 1; Delivered @ 39 weeks 2 days. 2nd degree laceration repaired.
Uncomplicated vaginal delivery 24 hours ago of viable male, Apgar 8/9
Vital Signs: T: 101.5 F (38.6 C), P: 108 BP: 96/50 R: 26 Pulse oximetry 92% on R/A
12 hours postpartum, the patient reports “feeling cold”, appears shaky and asks for more
blankets. Denies shortness of breath. Reports perineal pain 4/10.
Physical Assessment: AAO x 4;
Lungs: Clear x 4 lobes, respirations slightly labored. BS normoactive x 4; Pulses
palpable in all extremities, but thready. Edema: 2+/2+ pedal. Slight perineal swelling
noted; Lochia rubra light; Fundus midline/firm/1 below umbilicusVoided 2 x, unknown amounts, since delivery but has not voided since; No IV fluids .
Labs at 24 hours: WBC 18K, + bands, shift to the left, hemoglobin 9.6, hematocrit 32.0;
platelets: 106K
What would you suspect?
Sepsis
44
What would be expected interventions for this case study?
-Broad Spectrum Antibiotics
-Rapid Fluid resuscitation of 1-2 L of Isotonic Crystalloids
-Vasopressors (norepinephrine or dopamine)
-Labs: Lactate Levels
-Oxygen Supplementation
-Blood products if needed
-transfer to ICU
45
What would you expect to monitor?
-Urine output for Oliguria
-Pulse Oximetry
-Vital signs
-LOC
46
What are characteristics of Sepsis?
-Hypotension
-Edema
-Map <65 mmHg
-Lactate levels >2
-Creatinine >0.9
-Oxygen sat <95%
-WBC >12,000
-RR >20
-HR >90
-Temp >38.3 or <36
-Feels cold and is shivering
-FHR >160 (Sustained)
47
Sarah 47 yo, presents to the clinic for a routine check-up. During her visit, she expresses concerns about her menstrual cycle. She reports that her periods have become increasingly irregular over the past year, with some cycles being heavier and others significantly lighter.
In addition to changes in her menstrual cycle, Sarah mentions experiencing hot flashes that disrupt her daily activities and night sweats that have led to sleep disturbances. She also describes feeling more irritable and experiencing mood swings that are affecting her relationships.
What is she experiencing?
Perimenopause
48
At what age should women start receiving annual clinical breast exams?
A) 25
B) 30
C) 40
D) 50
C
Rationale: Women should receive clinical breast exams annually starting at age 40.
49
Which of the following is NOT a recommended screening tool for ovarian cancer?
A) Transvaginal ultrasound
B) Pap test
C) CA-125 test
D) Mammogram
B
Rationale: The Pap test is for cervical cancer screening, not ovarian cancer.
50
Which of the following is considered a primary prevention strategy in women’s health?
A) Annual health check-ups
B) Breastfeeding for at least 1 year
C) Cancer treatment management
D) Mammogram screenings
B
Rationale: Breastfeeding reduces the number of menstrual cycles and lowers cancer risk.
51
Which of the following are secondary prevention strategies? (Select all that apply)
A) Obtaining a mammogram
B) Regular health check-ups
C) Maintaining a low-fat diet
D) Quit smoking
A, B
Rationale: Secondary prevention focuses on early detection and prompt treatment.
52
A 28-year-old woman presents with painful menstruation and has a family history of endometriosis. Which type of dysmenorrhea is she likely experiencing?
A) Primary
B) Secondary
Secondary
53
A 45-year-old woman comes in for her annual exam and reports irregular periods and hot flashes. What should the nurse consider?
A) Perimenopause
B) Polycystic ovary syndrome (PCOS)
C) Menopause
C
Rationale: This situation involves managing and reducing complications of an existing disease, representing tertiary prevention.
54
Which type of prevention focuses on managing chronic diseases and preventing complications?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
C
Rationale: Tertiary prevention is about managing existing diseases and preventing further complications.
55
Which of the following are considered high-risk HPV types? (Select all that apply)
A) HPV 6
B) HPV 11
C) HPV 16
D) HPV 18
C, D
Rationale: HPV 16 and 18 are considered high-risk types associated with cervical cancer.
56
Which of the following STIs are considered bacterial? (Select all that apply)
A) Gonorrhea
B) Chlamydia
C) Herpes Simplex Virus
D) Syphilis
A, B, D
Rationale: Gonorrhea, Chlamydia, and Syphilis are all caused by bacteria. Herpes is viral.
57
What is the primary hormone responsible for milk production during lactation?
A) Oxytocin
B) Estrogen
C) Prolactin
D) Human Placental Lactogen
C
Rationale: Prolactin is the primary hormone responsible for stimulating milk production in the mammary glands after childbirth.
58
Which hormone is primarily responsible for the milk ejection (let-down) reflex?
A) Estrogen
B) Prolactin
C) Oxytocin
D) Progesterone
C
Rationale: Oxytocin is crucial for the milk ejection reflex, allowing milk to be released from the breasts during nursing.
59
Which of the following statements about lochia are true? (Select all that apply)
A) Lochia rubra lasts for the first 1-3 days postpartum.
B) Lochia serosa appears bright red.
C) Lochia alba is a yellow-white discharge that occurs after 10 days.
D) Lochia should have a foul odor.
A, C
Rationale: Lochia rubra is indeed bright red and lasts for the first 1-3 days, while lochia alba appears yellow-white after 10 days. Lochia should not have a foul odor; this may indicate an infection.
60
A postpartum patient reports bright red vaginal bleeding three days after delivery. What is the expected lochia stage, and what nursing intervention is most appropriate?
A) Lochia alba; reassess in one week
B) Lochia rubra; monitor amount and consistency
C) Lochia serosa; notify the physician immediately
D) Lochia rubra; provide education on expected discharge
B
Rationale: Lochia rubra is expected during the first 1-3 days postpartum. Monitoring the amount and consistency is important to assess for any complications.
61
. What is the expected duration of lochia serosa?
A) 1-3 days
B) 4-10 days
C) 10-14 days
D) 2-6 weeks
B
Rationale: Lochia serosa typically occurs from about 4-10 days postpartum.
62
Which hormone aids in uterine contractions during the postpartum period and helps reduce postpartum bleeding?
A) Prolactin
B) Oxytocin
C) Estrogen
D) Human Placental Lactogen
B
Rationale: Oxytocin helps with uterine contractions post-delivery, aiding in the reduction of postpartum bleeding.
63
Which exercise is commonly recommended to strengthen pelvic floor muscles after delivery?
A) Crunches
B) Kegel exercises
C) Squats
D) Planks
B
Rationale: Kegel exercises are specifically designed to strengthen pelvic floor muscles, which can help with bladder control and recovery after childbirth.
64
Which of the following are characteristics of a spinal headache? (Select all that apply)
A) Occurs when sitting or standing
B) Improved symptoms when lying down
C) Sudden onset of severe pain
D) Typically lasts for several days
A, B, D
Rationale: Spinal headaches are often exacerbated by sitting or standing and improved by lying down. They may last for several days and are characterized by a dull, throbbing pain.
65
Which interventions are recommended for managing postpartum mood disorders? (Select all that apply)
A) Support groups
B) Increased physical activity
C) Antidepressant medication
D) Isolation from family and friends
A, B, C
Rationale: Support groups, increased physical activity, and antidepressant medication can be effective in managing postpartum mood disorders. Isolation is not recommended and can worsen symptoms.
66
What is the primary indication for using Dinoprostone (Prostin E2) in postpartum care?
A) To manage chronic hypertension
B) To stimulate uterine contractions when bleeding is not controlled by oxytocin
C) To promote lactation
D) To reduce nausea and vomiting
B
Rationale: Dinoprostone is indicated to stimulate uterine contractions to reduce bleeding when oxytocin alone does not effectively control postpartum hemorrhage.
67
Which of the following conditions is a contraindication for administering Dinoprostone (Prostin E2)?
A) Hypertension
B) Asthma
C) Hyperthyroidism
D) Previous uterine surgery
B
Rationale: Dinoprostone is contraindicated in patients with asthma due to the potential for bronchospasm.
68
Which conditions are contraindications for using Prostaglandin (PGF2a) postpartum? (Select all that apply)
A) Asthma
B) Active cardiac disease
C) Mild dehydration
D) Pulmonary disease
A, B, D
Rationale: Prostaglandin (PGF2a) is contraindicated in patients with asthma, active cardiac disease, and pulmonary disease due to the risk of severe complications.
69
In which time frame is early postpartum hemorrhage (PPH) defined? (Select all that apply)
A) Within 24 hours after delivery
B) 24 hours to 6 weeks postpartum
C) Within the first hour after delivery
D) After 6 weeks postpartum
A, C
Rationale: Early postpartum hemorrhage is defined as bleeding that occurs within the first 24 hours after delivery, including the first hour.
70
A patient is one day postpartum and is experiencing significant bleeding. What is the first-line medication you would expect to be administered to stimulate uterine contractions?
A) Dinoprostone (Prostin E2)
B) Methylergonovine maleate (Methergine)
C) Oxytocin (Pitocin)
D) Carboprost (Hemabate)
C
Rationale: Oxytocin is the first-line therapy used to stimulate uterine contractions and control bleeding in the immediate postpartum period.
71
A postpartum patient has been administered magnesium sulfate. How long should the infusion be continued?
A) 12 hours
B) 24 hours
C) 48 hours
D) Until postpartum discharge
B
Rationale: Magnesium sulfate is typically infused for 24 hours postpartum to prevent complications such as seizures.
72
What is the most common cause of subinvolution in the postpartum period?
A) Retained placental fragments
B) Increased estrogen levels
C) Hypertension
D) Infection
A
Rationale: Retained placental fragments are the most common cause of subinvolution, which is the failure of the uterus to return to its pre-pregnancy size.
73
Which of the following are complications of subinvolution? (Select all that apply)
A) Postpartum hemorrhage
B) Delayed uterine involution
C) Deep vein thrombosis
D) Infection
A, B, D
Rationale: Subinvolution can lead to postpartum hemorrhage, delayed uterine involution, and infection due to poor healing. DVT is not a direct complication of subinvolution.
74
Which of the following are early signs of sepsis in a postpartum patient? (Select all that apply)
A) Fever above 100.4°F (38°C)
B) Tachycardia
C) Hypotension
D) Bradycardia
A, B, C
Rationale: Fever, tachycardia, and hypotension are key early signs of sepsis. Bradycardia is not typically seen in sepsis.
75
What is a key sign of a wound infection in a postpartum c-section incision?
A) Redness and warmth around the incision
B) Mild pain at the incision site
C) Increased urine output
D) Clear drainage from the wound
A
Rationale: Redness, warmth, and sometimes purulent drainage around the incision are key signs of wound infection.
76
A postpartum patient presents with symptoms of deep vein thrombosis (DVT). Which assessment findings would support the diagnosis?
A) Sudden onset of chest pain and shortness of breath
B) Edema and tenderness in one leg
C) Elevated heart rate
D) Normal capillary refill
B
Rationale: DVT often presents with unilateral leg edema, tenderness, and sometimes warmth, especially in the calf area.
77
A normal blood loss for a vaginal delivery is considered to be:
A) 250 mL
B) 500 mL
C) 1000 mL
D) 1500 mL
B
Rationale: The normal blood loss for a vaginal delivery is up to 500 mL. Anything above this may indicate postpartum hemorrhage.
78
What is the normal blood loss for a cesarean section delivery?
A) 250 mL
B) 500 mL
C) 750 mL
D) 1000 mL
D
Rationale: The normal blood loss for a cesarean section is up to 1000 mL. Excessive blood loss beyond this may indicate hemorrhage.
79
At what percentage of blood loss does hemorrhagic shock occur in a postpartum patient?
A) 5%
B) 10%
C) 25%
D) 30%
D
Rationale: Hemorrhagic shock typically occurs when a patient loses 30% or more of their blood volume.
80
A postpartum patient with a c-section incision develops signs of infection. Which is the most appropriate initial intervention?
A) Apply heat to the incision site
B) Administer antibiotics
C) Perform a wound debridement immediately
D) Encourage increased fluid intake
B
Rationale: The initial treatment for a wound infection is the administration of antibiotics. If the infection worsens or abscess forms, debridement may be necessary.
81
At which of the following times is Rh immunoglobulin (RhoGAM) administered to a Rh-negative pregnant woman? (Select all that apply)
A) At 28 weeks gestation
B) Within 72 hours after childbirth
C) During the second trimester
D) After a miscarriage or abortion
A, B
Rationale: RhoGAM is administered at 28 weeks gestation to prevent Rh sensitization and again within 72 hours after childbirth to protect future pregnancies from Rh incompatibility. It is not routinely given during the second trimester or specifically after a miscarriage unless there are concerns about Rh status.
82
Which of the following are common signs and symptoms of hypoglycemia in a newborn? (Select all that apply)
A) Jitteriness
B) Hypotonia
C) High-pitched cry
D) Feeding intolerance
E) Respiratory distress
A, B, C, D
Rationale: Common signs and symptoms of hypoglycemia in newborns include jitteriness, hypotonia (decreased muscle tone), high-pitched crying, and feeding intolerance. Respiratory distress is not a typical sign of hypoglycemia in newborns and may indicate other underlying issues.
83
Phytonadione (Vitamin K) is administered to newborns to prevent which condition?
A) Jaundice
B) Vitamin D deficiency
C) Hemorrhagic disease
D) Hypoglycemia
C
Rationale: Phytonadione (Vitamin K) is given to prevent hemorrhagic disease of the newborn, as newborns have low vitamin K levels at birth.
84
A newborn baby girl is delivered vaginally at 39 weeks gestation. At 1 minute of life, the baby has a heart rate of 105 bpm, is crying loudly, has active motion of all limbs, grimaces when her nose is suctioned, and her body is pink with blue hands and feet.
What is the baby’s 1-minute APGAR score?
A) 8
B) 9
C) 7
D) 10
A 8
85
Which fetal shunt typically closes first after birth?\
A) Ductus venosus
B) Foramen ovale
C) Ductus arteriosus
D) Umbilical artery
A
Rationale: The ductus venosus, which bypasses the liver in utero, is the first to close after birth, followed by the foramen ovale and the ductus arteriosus.
86
Which reflex is characterized by the baby’s toes fanning out when the sole of the foot is stroked?
A) Moro reflex
B) Babinski reflex
C) Rooting reflex
D) Grasp reflex
B
Rationale: The Babinski reflex is present when the sole of the newborn’s foot is stroked, causing the toes to fan out.
87
A newborn boy is delivered via emergency cesarean section at 37 weeks gestation. At 1 minute of life, his heart rate is 80 bpm, he has weak, irregular breathing, some flexion of the arms and legs, no response to nasal suction, and his body is pale.
What is the baby’s 1-minute APGAR score?
A) 3
B) 5
C) 4
D) 6
A) 3
88
Which of the following statements correctly differentiates Small for Gestational Age (SGA) from Intrauterine Growth Restriction (IUGR)?
A) SGA refers to a fetus that has not reached growth potential due to genetic factors, while IUGR is always caused by placental insufficiency.
B) SGA babies are always premature, while IUGR babies are always full-term.
C) SGA refers to a baby that is below the 10th percentile for gestational age but may be healthy, while IUGR involves a pathologic restriction of growth that affects fetal development.
D) SGA is diagnosed via ultrasound measurements, while IUGR is diagnosed based on postnatal weight.
C)
Rationale: SGA describes a baby who is small for its gestational age, but this could be due to normal factors like genetics. IUGR, on the other hand, is a condition where the baby has restricted growth due to underlying pathology, such as placental insufficiency.
89
What is the primary characteristic of ABO incompatibility?
A) Anemia in the mother
B) Jaundice in the newborn
C) Increased risk of sepsis
D) Hemophilia
B
Rationale: ABO incompatibility occurs when the mother’s blood type is O and the baby’s is A, B, or AB, leading to hemolysis and jaundice in the newborn.
90
Which of the following features are associated with fetal alcohol syndrome? (Select all that apply)
A) Smooth philtrum
B) Large ears
C) Thin upper lip
D) Microcephaly
A, C, D
Rationale: Fetal alcohol syndrome (FAS) is characterized by distinct facial features such as a smooth philtrum, thin upper lip, and microcephaly. These features result from prenatal alcohol exposure.
91
Which of the following maneuvers is commonly used during shoulder dystocia to relieve impaction?
A) McRoberts maneuver
B) Trendelenburg position
C) Leopold’s maneuver
D) Lithotomy position
A
Rationale: The McRoberts maneuver involves flexing the mother’s legs toward her abdomen to widen the pelvis and help dislodge the baby’s shoulder during shoulder dystocia.
92
Which of the following are recognized risk factors for a newborn being classified as Small for Gestational Age (SGA)? (Select all that apply)
A) Maternal smoking during pregnancy
B) Gestational diabetes
C) Maternal hypertension
D) Advanced maternal age
E) Excessive weight gain during pregnancy
A, C, D
Rationale: Maternal smoking, hypertension, and advanced maternal age are all recognized risk factors that can contribute to a newborn being classified as SGA. Gestational diabetes typically leads to larger infants (macrosomia), and excessive weight gain during pregnancy is not a risk factor for SGA; rather, it is often associated with higher birth weights.
93
A nurse is caring for a patient who is being treated with misoprostol (Cytotec) for postpartum hemorrhage. Which of the following contraindications should the nurse monitor for in this patient? (Select all that apply)
A) History of asthma
B) Allergies to the medication
C) Active cardiovascular disease
D) Mild hypertension
E) Pulmonary disease
A, B, C, E
Rationale: Misoprostol should be used cautiously in patients with asthma, allergies, and active cardiovascular or pulmonary diseases due to potential adverse effects.
94
A postpartum patient is being treated with methylergonovine maleate (Methergine) to prevent postpartum hemorrhage. What is a key contraindication that the nurse should be aware of before administering this medication?
A) Hypertension
B) Asthma
C) Diabetes
D) Anemia
A
Rationale: Methylergonovine maleate is contraindicated in patients with hypertension due to the risk of further increasing blood pressure, which can lead to serious cardiovascular complications. While asthma is a concern, it is not specifically contraindicated; caution is advised, as uterine contractions may exacerbate bronchospasm in some cases. Diabetes does not contraindicate the use of methylergonovine, although careful management is essential, and anemia is not a contraindication either, as treating postpartum hemorrhage is crucial for preventing the exacerbation of this condition.
95
