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OB > FINAL: Test 3 Review > Flashcards

FINAL: Test 3 Review Flashcards

1
Q

T/F: It is common for immigrants coming to the US to choose formula as their prefered method of feeding as a means of acculturation.

A

T

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2
Q

The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome?

A) Hyperglycemia
B) Elevated platelet count
C) Disseminated intravascular coagulopathy (DIC)
D) Elevated liver enzymes

A

Elevated liver enzymes

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3
Q

Which of the following things is it important for a hospital to do in order to be considered ‘Baby Friendly’?

A

Encourage rooming in

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4
Q

What is the most common site of implantation in an ectopic pregnancy?

A

Fallopian Tube

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5
Q

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

A

Cocaine

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6
Q

Which of the following does not put the patient at risk for postpartum hemorrhage?

A

Third stage of labor lasting 15 minutes

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7
Q

A nursing student is preparing a presentation on minimizing heat loss in the newborn. Which of the following would the student include as a measure to prevent heat loss through convection?

  • Placing a cap on the newborn’s head
  • Placing the newborn skin-to-skin
  • Keep the newborn out of direct cool drafts
  • Using a radiant warmer to transport a newborn
A

To prevent heat loss by convection, the nurse would keep the newborn out of direct cool drafts (open doors, windows, fans, air conditioners). In the environment, work inside an isolette as much as possible and minimize opening portholes that allow cold air to flow inside, and warm any oxygen or humidified air that comes in contact with the newborn.

Placing a cap on the newborn’s head would help minimize heat loss through evaporation.

Placing the newborn skin-to-skin with the mother helps to prevent heat loss through conduction.

Using a radiant warmer to transport a newborn helps minimize heat loss through radiation.

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8
Q

What type of exercises can a patient do after delivery to help regain pelvic tone and reduce the likelihood of stress incontinence?

A

Fucking kegels

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9
Q

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?

A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D) Difficulty in arousing

A

Deep tendon reflexes of 2+

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10
Q

A factor from delivery that puts the patient at greater risk for DVT is:

A

Extended time in stirrups for pushing

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11
Q

A woman with gestational hypertension experiences a seizure. Which of the following would be the priority?

A) Fluid replacement
B) Oxygenation
C) Control of hypertension
D) Delivery of the fetus

A

Oxygenation

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12
Q

When a new father is in the reality stage of his role development process, he may:

A

Experience conflict between what the expectations of having a new baby were and what the reality is

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13
Q

Sharp abdominal pain, vaginal bleeding, occurs 6-8 weeks post menstrual cycle

A

cardinal signs and symptoms of ectopic pregnancy

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14
Q

With or without frank red vaginal bleeding, rigid abdomen, abdominal pain

A

cardinal signs and symptoms of abruptio placentae

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15
Q

Painless vaginal bleeding

A

cardinal signs and symptoms of Placenta previa

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16
Q

Vaginal bleeding (light), pelvic heaviness, may or may not have contractions

A

cardinal signs and symptoms of cervical insufficiency

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17
Q

Dark brown to bright red vaginal bleeding during the first trimester, severe nausea and vomiting, vaginal passage of grape-like cysts

A

cardinal signs and symptoms of gestational trophoblastic dz

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18
Q

T/F: By two weeks post partum, the external cervical os will return to its pre-pregnancy appearance.

A

F

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19
Q

After a spontaneous abortion, a woman who is Rh-negative needs to receive:

A

RhoGAM

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20
Q

After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV-positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale?

a) Treatment of opportunistic infections
b) Can cure acute HIV/AIDS infections
c) Reduction in viral loads in the blood
d) Adjunct therapy to radiation and chemotherapy

A

Reduction in viral loads in the blood

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21
Q

Subinvolution of the uterus after delivery can be caused by:

A

a full bladder

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22
Q

The leading cause of maternal death in pregnancy is

A

obstetric hemorrhage

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23
Q

Mrs. Smith delivered a baby girl by C section 2 days ago. Where would you expect to be able to feel her fundus today?

One centimeter above the umbilicus
Two fingerbreadths below the umbilicus
Midway between the umbilicus and the symphysis pubis
Nonpalpable abdominally

A

2 fingerbreadths below her umbilicus

24
Q

As the nurse caring for a client with hyperemesis gravidarum, you recognize that treatment includes the following (select all that apply)

A

first line: dietary & lifestyle changes
if that fails: hospitalization to reverse fx of severe n/v - fluids (5% dextrose in Lactated ringers w/ vitamins & electrolytes), NPO for bowel rest, antiemetics

If that doesn’t help, may resort to TPN

25
Q

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C) level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes?

a) Abruptio placentae
b) Congenital anomalies
c) Incompetent cervix
d) Placenta previa

A

Congenital anomalies

26
Q

A nursing student is reviewing an article about preterm premature rupture of membranes. Which of the following would the student expect to find as factor placing a woman at high risk for this condition? (select all)

A) High body mass index
B) Urinary tract infection
C) Low socioeconomic status
D) Single gestations
E) Smoking
A

Low socioeconomic status
Smoking
Urinary tract infection

27
Q

T/F: ALL patients who have a placenta previa must have a cesarean section for delivery

A

F

28
Q

After teaching a woman who has had an evacuation for a hydatidiform mole (molar pregnancy) about her condition, which of the following statements indicates that the nurse’s teaching was successful?

A) “I will be sure to avoid getting pregnant for at least 1 year.”
B) “My intake of iron will have to be closely monitored for 6 months.”
C) “My blood pressure will continue to be increased for about 6 more months.”
D) “I won’t use my birth control pills for at least a year or two.”

A

“I will be sure to avoid getting pregnant for at least 1 year.”

29
Q

What is the primary hormone that results in lactation?

Prolactin
Estrogen
Progesterone
Oxytocin

A

prolactin

30
Q

Mothers who choose not to breast feed should:

A

Not provide any stimulation to their breasts for the first few days after delivery

31
Q

A client presents to labor and delivery at 25 weeks gestation. She reports painless bright red vaginal bleeding, but no contractions. Your first priority is to:

A

Obtain vital signs and a fetal heart rate

32
Q

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse’s teaching was successful?

A) “I’ll basically follow the same diet that I was following before I became pregnant.”
B) “Because I need extra protein, I’ll have to increase my intake of milk and meat.”
C) “Pregnancy affects insulin production, so I’ll need to make adjustments in my diet.”
D) “I’ll adjust my diet and insulin based on the results of my urine tests for glucose.”

A

“Pregnancy affects insulin production, so I’ll need to make adjustments in my diet.”

33
Q

After reviewing a client’s history, which factor would the nurse identify as placing her at risk for gestational hypertension?

A) Mother had preeclampsia or gestational HTN.
B) Client has a twin sister.
C) Sister-in-law had gestational hypertension.
D) This is the client’s second pregnancy.

A

Mother had preeclampsia

34
Q

All of the following are indicators of successful breastfeeding except:

A

Infant weight loss greater than 10% within first week of life

35
Q

A nursing instructor is preparing a class on newborn adaptations. When describing the change from fetal to newborn circulation, which of the following would the instructor most likely include? (Select all that apply.)

  • Closure of the ductus venosus eventually forces closure of the ductus arteriosis.
  • Onset of respirations leads to a decrease in pulmonary vascular resistance
  • Decrease in right atrial pressure leads to closure of the foramen ovale.
  • Increase in pressure in the left atrium results from increases in pulmonary blood flow.
  • Increase in oxygen levels leads to a decrease in systemic vascular resistance.
A

Table in page 528

  • Onset of respirations leads to a decrease in pulmonary vascular resistance
  • Decrease in right atrial pressure leads to closure of the foramen ovale.
  • Increase in pressure in the left atrium results from increases in pulmonary blood flow (?)
  • Closure of the ductus venosus eventually forces closure of the ductus arteriosis.
36
Q

A group of students are reviewing information about sexually transmitted infections and their effect on pregnancy. The students demonstrate understanding of the information when they identify which infection as being responsible for ophthalmia neonatorum?

A

Gonorrhea

Chlamydia causes conjunctivitis

37
Q

You are the nurse caring for a client who is 2 weeks postpartum. She complains of breast tenderness, hard breasts and difficulty with having her son latch. Her vital signs are as follows: BP 115/68, HR 64. R 16, T 97.9F. She is afebrile, her breasts are warm to touch, no redness, edema or excoriation noted. You recognize these symptoms to be most commonly associated with which of the following?

A

Breast engorgement

38
Q

When assessing a newborn’s reflexes, the nurse strokes the newborn’s cheek and the newborn turns toward the side that was stroked and begins sucking. The nurse documents which reflex as being positive?

Palmar
Tonic Neck
Rooting
Moro

A

Rooting reflex - The rooting reflex is elicited by stroking the newborn’s cheek. The newborn should turn toward the side that was stroked and should begin to make sucking movements.

39
Q

elicited by placing a finger on the newborn’s open palm. The baby’s hand will close around the finger. Attempting to remove the finger causes the grip to tighten.

A

palmar grasp reflex

40
Q

elicited by having the newborn lie on the back and turning the head to one side. The arm toward which the baby is facing should extend straight away from the body with the hand partially open, whereas the arm on the side away from the face is flexed and the fist is clenched tightly. Reversing the direction to which the face is turned reverses the position.

A

tonic neck reflex

41
Q

elicited by placing the newborn on his or her back, supporting the upper body weight of the supine newborn by the arms using a lifting motion without lifting the newborn off the surface. The arms are released suddenly and the newborn will throw the arms outward and flex the knees and then the arms return to the chest. The fingers also spread to form a C.

A

moro reflex

42
Q

A complete placental abruption has increased incidence of all of the following except:

A

Hysterectomy

43
Q

Patients who complain of excruciating perineal pain immediately following delivery should be evaluated for the presence of:

A

Perineal hematoma

44
Q

A 30-year-old multiparous woman has a boy who is 2½ years old and now an infant girl. She tells the nurse, “I don’t know how I’ll ever manage both children when I get home.” Which suggestion would best help this woman alleviate sibling rivalry?

Tell the younger child that he is a big boy now and should love his new sister

Let the older child stay with his grandparents for the first 6 weeks to allow him to adjust to the new baby

Ask friends and relatives not to bring gifts to the older sibling, because you don’t want to spoil him

Realize that the babyish behavior in the older child is a typical reaction and that he needs extra love and attention at this time

A

Realize that the regression in habits and behaviors in the older child is a typical reaction and that he needs extra love and attention at this time.

45
Q

Mrs. S. has a CBC scheduled for the morning after delivery. You get the results and notice that her WBC count is 15,000/mm3. When you call the results to her physician, you can reasonably expect him to:

A

do nothing

46
Q

T/F: Women with mastitis are encouraged to refrain from breastfeeding while the infection is active?

A

SO FALSE

47
Q

T/F: Women who have had GDM are seven times more likely to develop type 2 diabetes than women who have not had GDM in pregnancy.

A

True

48
Q

Which assessment finding would lead the nurse to suspect infection as the cause of a client’s PROM?

A) Yellow-green fluid
B) Blue color on Nitrazine testing
C) Ferning
D) Foul smelling odor

A

foul smelling odor

49
Q

When providing discharge teaching to a patient who will be receiving the Rubella vaccine before she goes home, it would be important to educate her to the fact that:

A

She should not get pregnant for a month after receiving the vaccine

50
Q

Because a pregnant client’s diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth?

A) Macrosomia
B) Hyperglycemia
C) Low birthweight
D) Hypobilirubinemia

A

macrosomia

51
Q

The nurse is developing a plan of care for a woman who is pregnant with TWINS. The nurse includes interventions focusing on which of the following because of the woman’s increased risk?

A

preterm labor

52
Q

A group of nursing students are reviewing the changes in the newborn’s lungs that must occur to maintain respiratory function. The students demonstrate understanding of this information when they identify which of the following as the first event?

A

Initiation of respiratory movement

Before the newborn’s lungs can maintain respiratory function, the following events must occur: respiratory movement must be initiated; lungs must expand, functional residual capacity must be established, pulmonary blood flow must increase, and cardiac output must be redistributed.

53
Q

T/F: Advanced maternal age is defined as greater than 35 years of age.

A

True

54
Q

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

A

calcium gluconate

55
Q

For a patient experiencing discomfort from an episiotomy, which of the following would be most helpful to encourage her to use?

A

witch hazel pads

OB (10 decks)

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