Chapter 34 - [additional] Obstetrics and Neonatal Care

Question 1

The first stage of labor ends when:
A. the presenting part of the baby is visible.
B. contractions are less than 10 minutes apart.
C. the mother experiences her first contraction.
D. the amniotic sac ruptures and labor pains begin.

Answer 1

A. the presenting part of the baby is visible

Question 2

A 23-year-old woman, who is 24 weeks pregnant with her first baby, complains of edema to her hands, a headache, and visual disturbances. When you assess her vital signs, you note that her blood pressure is 160/94 mm Hg. She is MOST likely experiencing:
A. eclampsia.
B. preeclampsia.
C. a hypertensive crisis.
D. chronic water retention.

Answer 2

B. preeclampsia.

Question 3

You are transporting a woman who is 8 months’ pregnant. To prevent supine hypotensive syndrome, how should you position this patient?
A. On her right side
B. Supine
C. Semi-Fowler
D. On her left side

Answer 3

D. On her left side

Question 4

Immediately after delivery of the infant’s head, you should:
A. suction the baby’s mouth and then nose.
B. suction the baby’s nose and then mouth.
C. assess the baby’s breathing effort and skin color.
D. check the position of the umbilical cord.

Answer 4

D. check the position of the umbilical cord.

Question 5

Upon delivery of the baby’s head, you note that the umbilical cord is wrapped around its neck. You should:
A. immediately clamp and cut the cord.
B. make one attempt to slide the cord over the head.
C. keep the cord moist and transport as soon as possible.
D. give the mother high-flow oxygen and transport rapidly.

Answer 5

B. make one attempt to slide the cord over the head.

Question 6

The need for and extent of newborn resuscitation is based on:
A. the 1-minute Apgar score.
B. the gestational age of the newborn.
C. the newborn’s response to oxygen.
D. respiratory effort, heart rate, and color.

Answer 6

D. respiratory effort, heart rate, and color

Question 7

The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min, a pink body but blue hands and feet, and rapid respirations. The baby cries when the soles of its feet are flicked and resists attempts to straighten its legs. You should assign an Apgar score of:
A. 4.
B. 6.
C. 8.
D. 9.

Answer 7

C. 8.

Question 8

The MOST effective way to prevent cardiopulmonary arrest in a newborn is to:
A. rapidly increase its body temperature.
B. allow it to remain slightly hypothermic.
C. ensure adequate oxygenation and ventilation.
D. start CPR if the heart rate is less than 100 beats/min.

Answer 8

C. ensure adequate oxygenation and ventilation.

Question 9

While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. She tells you that she feels the urge to push. You should:
A. cover the arm with a sterile towel and transport immediately.
B. encourage her to keep pushing as you prepare for rapid transport.
C. insert your gloved fingers into the vagina and try to turn the baby.
D. instruct the mother to keep pushing and give her high-flow oxygen.

Answer 9

A. cover the arm with a sterile towel and transport immediately.

Question 10

A newborn is considered to be “term” if it is born after ____ weeks and before ____ weeks.
A. 34; 37
B. 37; 42
C. 38; 44
D. 39; 43

Answer 10

B. 37; 42

Question 11

After a baby is born, it is important to:
Select one:
A.
cool the infant to stimulate effective breathing.
B.
ensure that it is thoroughly dried and warmed.
C.
immediately clamp and cut the umbilical cord.
D.
position it so that its head is higher than its body.

Answer 11

B.
ensure that it is thoroughly dried and warmed.

Question 12

Which of the following occurs during true labor?
Select one:
A.
Uterine contractions become more regular.
B.
The uterus becomes very soft and movable.
C.
Uterine contractions last about 10 seconds.
D.
Uterine contractions decrease in intensity

Answer 12

A.
Uterine contractions become more regular.

Question 13

Which of the following statements regarding gestational diabetes is correct?
Select one:
A.
The onset of gestational diabetes typically manifests with hypoglycemia.
B.
Diet and exercise are typically ineffective in controlling gestational diabetes.
C.
In some cases, women with gestational diabetes require insulin injections.
D.
Gestational diabetes results in permanent diabetes mellitus after delivery.

Answer 13

C.
In some cases, women with gestational diabetes require insulin injections.

Question 14

Which of the following is a normal physiologic change that occurs in the mother’s respiratory system during pregnancy?
Select one:
A.
Increased respiratory rate and decreased respiratory reserve
B.
Increased respiratory reserve and decreased oxygen demand
C.
Increased respiratory depth and decreased respiratory rate
D.
Decreased respiratory rate and increased minute volume

Answer 14

A.
Increased respiratory rate and decreased respiratory reserve

Question 15

The vagina and the neck of the uterus comprise the:
Select one:
A.
womb.
B.
cervix.
C.
fundus.
D.
birth canal.

Answer 15

D.
birth canal.

Question 16

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, except:
Select one:
A.
profound tachycardia.
B.
respiratory depression.
C.
premature delivery.
D.
low birth weight.

Answer 16

A.
profound tachycardia.

Question 17

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:
Select one:
A.
mid-back pain.
B.
a bloated feeling.
C.
easier breathing.
D.
an urge to push.

Answer 17

C.
easier breathing.

Question 18

Signs and symptoms of preeclampsia include:
Select one:
A.
dyspnea and bradycardia.
B.
headache and edema.
C.
dysuria and constipation.
D.
marked hypoglycemia

Answer 18

B.
headache and edema.

Question 19

Placenta previa is defined as:
Select one:
A.
development of the placenta over the cervical opening.
B.
abnormal development and functioning of the placenta.
C.
premature placental separation from the uterine wall.
D.
delivery of a portion of the placenta before the baby.

Answer 19

A.
development of the placenta over the cervical opening.

Question 20

In contrast to abruptio placenta, placenta previa:
Select one:
A.
is caused by hypertension or abdominal trauma.
B.
might not present with heavy vaginal bleeding.
C.
might present without significant abdominal pain.
D.
is typically associated with severe abdominal pain

Answer 20

C.
might present without significant abdominal pain.

Question 21

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:
Select one:
A.
clamp and cut the umbilical cord and keep him warm.
B.
keep him warm and ventilate with a bag-mask device.
C.
assess his skin color and give free-flow oxygen as needed.
D.
begin chest compressions and reassess in 30 seconds

Answer 21

B.
keep him warm and ventilate with a bag-mask device.

Question 22

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should:
Select one:
A.
place her in a left lateral recumbent position.
B.
position her supine and elevate her legs 12 inches.
C.
carefully place sterile gauze into her vagina.
D.
ventilate her with a bag-mask device

Answer 22

A.
place her in a left lateral recumbent position.

Question 23

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because:
Select one:
A.
white blood cells decrease during pregnancy, which increases the mother’s risk of an infection.
B.
pregnancy causes an increased number of red blood cells, which predisposes the mother to anemia.
C.
iron makes the blood clot faster, which protects the mother from excessive bleeding during delivery.
D.
the blood naturally thins during pregnancy, which predisposes the mother to severe bleeding

Answer 23

B.
pregnancy causes an increased number of red blood cells, which predisposes the mother to anemia.