Maternity Exam 1 Questions with Answers 100% Correctly Verified Updates, Exams of Nursing

Download Maternity Exam 1 Questions with Answers 100% Correctly Verified Updates and more Exams Nursing in PDF only on Docsity! 1 / 20 Maternity Exam 1 Questions with Answers 100% Correctly Verified Updates 1. the uterus grows times its normal non pregnancy state: 20 times larger than non pregnancy state 2.Birth equity advocates focus on...: redressing structural racism and social determinants through systems-level initiatives to improve maternal and infant health 3.Pre Term Birth is about higher among Blacks than Whites: 50% Toxic stress has been proposed as a driving factor behind the higher rates of premature birth in the Black community. 4.Risk factors for a high-risk pregnancy can include: (6): • Existing health conditions, such as high blood pressure, diabetes, or being HIV-positive •A history of prior pregnancy complications •Complications that arise during pregnancy, such as gestational diabetes or preeclampsia •Being overweight or obese •Carrying more than one fetus (twins and higher-order multiples) •Being 18 or younger, or older than 35- Advanced maternal age increases the risk due to preexisting health problems and increased risk of preeclampsia and diabetes. 5.Preterm labor (PTL) is defined as...: regular contractions of the uterus resulting in changes in the cervix before 37 weeks of gestation. 6. late preterm is...: 34 weeks and 0 days through 36 weeks and 6 days 7.PTB is the leading cause of...: neonatal mortality and the most common reason for antenatal hospitalization 8.Very preterm infant: An infant born before...: 32 completed weeks of gestation 9.The threshold for viability is at...: 25 weeks gestation and, rarely, fewer com- pleted weeks of gestation 10.what are the three P's: Preterm Labor Preeclampsia Placenta Problems 11.treatments to prevent PTBs: (3): bedrest, abstention from intercourse and orgasm, and hydration. 12.Tocolytic drugs are medications used to...: suppress uterine 2 / 20 contractions typically administered between 24 to 34 weeks' gestation. Maintain strict input and output (I&O) while on tocolytics and provide oral or IV hydration. 13.Common Tocolytic Agents: (5): ²-adrenergic agonists (²- mimetics) Magnesium Sulfate Cyclooxygenase (prostaglandinsynthetase) inhibitors Calcium channel blockers Betamethasone pg 160 for example of specific med names 14.Fetal fibronectin: tests for risk of preterm labor Positive test puts woman at increased risk of preterm labor. Negative test indicates 99% of time no preterm labor x 7 days 15.Transvaginal Ultrasound - Measures...: cervical length 16.Progesterone supplementation may prevent PTB for women with a history of...: spontaneous PTB 17.are antibiotics used to prolong gestation?: no should only be used for preterm premature rupture of membranes (PPROM) and group B streptococci carrier status 18.Vaginal progesterone is recommended in women with a...: very short cervi- cal length (less than 20 mm) before or at 24 weeks' gestation. 19.A single course of corticosteroids is recommended for pregnant women between 2...: 24 and 34 weeks of gestation who are at risk of preterm delivery within 7 days, including those with ruptured membranes and multiple gestations. 20.Maternal contraindications to tocolysis:: • Active hemorrhage •Severe maternal disease •Fetal compromise •Chorioamnionitis •Fetal death •Previable gestation and PPROM 21.Warning Signs of Preterm Labor: • Bag of waters breaks •Decreased fetal movement •More than 6 contractions in an hour •Low backache, menstrual-like cramps, pelvic pressure, or intestinal cramps with or without diarrhea •Increased vaginal discharge •Fever higher than 100.4°F (38°C) •Feeling that something isn't right 5 / 20 37 weeks of gestation 6 / 20 37.Monozygotic twins are from....: one zygote that divides in the first week of gestation. They are genetically identical, similar in appearance, and always have the same gender. 38.Dizygotic twins result from...: fertilization of two eggs and may be the same or differing genders. If the fetuses are of differing gender, they are dizygotic and therefore dichorionic. 39.Twin pregnancy is associated with higher rates of...: almost every potential complication of pregnancy. 40.In multiple gestation pregnancies, there is a increased risk of still- birth and a increased risk of neonatal death: fivefold sevenfold 41.Women at risk for hyperemesis include: (3): multiple gestation, history of migraines and motion sickness, a familial history of hyperemesis 42.Hyperemesis gravidarum is...: vomiting during pregnancy so severe it leads to dehydration, electrolyte and acid-base imbalance, starvation ketosis, and weight loss. weight loss of more than 5% of body weight. 43.Hyperemesis appears to be related to...: rapidly rising serum levels of preg- nancy-related hormones such as chorionic gonadotropin (hCG), progesterone, and estrogen. 44.Signs and symptoms of dehydration include: • Lightheadedness, dizziness, faintness, tachycardia, or inability to keep food or fluids down for more than 12 hours •Dry mucous membranes •Poor skin turgor •Malaise •Low blood pressure 45.Treatment of nausea and vomiting of pregnancy is: vitamin B6 or vitamin B6 plus doxylamine is safe and effective and should be considered first-line pharma- cotherapy 46.Intrahepatic cholestasis of pregnancy (ICP) is the most common...: preg- nancy-specific liver disease it is A reversible type of hormonally influenced cholestasis, it frequently develops in late pregnancy in individuals who are genetically predisposed. 7 / 20 47.Intrahepatic cholestasis of pregnancy can be characterized by...: general- ized itching, often with pruritus/itching of the palms of the hands and soles of the 10 / GDM= fasting 95 mg/dL or higher, 1 hour of 180 mg/dL or higher, 2 hours of 155 mg/dL or higher, and 3 hours of 140 mg/dL or higher 60.Risk Factors for GDM (6): • History of fetal macrosomia •Strong family history of diabetes •Obesity •Polycystic ovarian syndrome •Hypertension •Physical inactivity 61.Risks for newborns born to GDM: Macrosomia IUGR •Hypoglycemia during the first few hours post birth •Hyperbilirubinemia •Shoulder dystocia •Respiratory distress syndrome •Assisted delivery with either a vacuum or forceps •Birth trauma 62.Uncontrolled hyperglycemia may present with:: • Polyuria •Polydipsia •Blurred vision •Polyphagia •Frequent urinary tract infections •Excessive fatigue and hunger •Recurrent vaginal candidiasis •Sudden weight loss 63.For most women with GDM, the condition is controlled with...: well- balanced diet and exercise. up to 40% may need insulin management 64.Cesarean birth is recommended for estimated fetal weight greater than...- : 4,500 g 65.Chronic hypertension is defined as...: hypertension present and observable before pregnancy or diagnosed before 20 weeks' gestation systolic BP of 140 mm Hg or greater or diastolic pressure of 90 mm Hg or greater 66.Chronic hypertension with superimposed preeclampsia includes:: - -Women with hypertension only in early gestation who develop proteinuria after 20 weeks of gestation -Women with chronic hypertension who develop new-onset or increased proteinuria and manifest other signs and symptoms such as an increase 11 / in liver enzymes or creatinine; present with thrombocytopenia 12 / 67.Chronic hypertension with superimposed preeclampsia can manifest with symptoms of...: right upper quadrant pain and headaches, blurred vision, or scotoma; and may develop pulmonary edema or congestion 68.Gestational hypertension:: Systolic BP of 140 mm Hg or greater or diastolic pressure of 90 mm Hg or greater for the first time after 20 weeks, without other signs and systemic finding of preeclampsia. 69.Preeclampsia is a...: multisystem hypertensive disease unique to pregnancy, with hypertension accompanied by proteinuria after the 20th week of gestation. 70.Preeclampsia with severe features is...: preeclampsia plus 71.preeclampsia plus presents with at least one of the following: (8): BP > 160/110 •Persistent/severe headache •Severe epigastric pain/RUQ pain • Visual/cerebral disturbances •Pulmonary edema •Serum creatinine > 1.1 mg/dL •Platelets < 100,000 mcL •Elevated liver enzymes 72.Eclampsia is the onset of...: grand mal convulsions or seizures that cannot be attributed to other causes in a woman with preeclampsia. convulsive manifestation of the hypertensive disorders of pregnancy 73.HELLP syndrome stands for...: hemolysis, elevated liver enzymes, and low platelets 74.HELLP syndrome is a complication of...: preeclampsia or eclampsia. 75.diagnosis of preeclampsia: two blood pressure readings of at least 140 mm Hg systolic and/or at least 90 mm Hg diastolic taken at least 4 hours apart after 20 weeks of gestation in a woman with a previously normal blood pressure proteinuria greater than 300 mg in 24 hours Protein/creatinine ratio of 0.3 mg/dL or more or •Dipstick reading of 2+ 76.what are the risks for women with preeclampsia: • Progression of: hyper-re- flexia, headache, visual changes, epigastric/RUQ pain •Seizures, renal failure, and abruptio placentae •DIC •Ruptured liver and pulmonary embolism •HELLP SYNDROME 77.preeclampsia- Risks for the Fetus and Newborn (4): small for gestational 15 / hypoxia 90.what are the five fetal parameters that Biophysical profile (BPP) assess for?: the nonstress test (NST), fetal movement, fetal breathing, wer uterine in the body 16 / fetal tone, amniotic fluid index (AFI) 91.Maternal & Fetal Assessment for preeclampsia: • Lab testing (proteinuria) •Assess for signs/symptoms •Assess DTRs & clonus •BP 2x/wk •Monitor weight gain •Fetal kick counts / NSTs •Monitor for severe features or worsening condition 92.what should a nurse prepare for with Preeclampsia WITH Severe Fea- tures?: Prepare for Delivery 93.management of care for Preeclampsia WITH Severe Features:: • IV Antihy- pertensives - NOW •Anticonvulsants : Magnesium Sulfate •Fluid and electrolyte replacement •Monitor fetal well-being •Administer betamethasone •Strict I/Os •Monitor labs (CBC, CRP, AST, ALT, Serum creatinine) •Assess DTRs, clonus and continued s/s 94.management of care for eclampsia: ensure airway prepare for immediate delivery •Anticonvulsants - Bolus of Magnesium Sulfate •Document seizure characteristics, length, and VS •Sedation and other anticonvulsants: Dilantin •Diuretics for pulmonary edema •Strict I/O 95.Placenta previa occurs when the...: placenta attaches to the lo segment of the uterus, near or over the internal cervical os instead of fundus of the uterus 96.signs of Placenta previa: • Quiet, slow onset •Bright red bleeding • Typically not painful •No uterine tenderness • Tone relaxed 97.Women with placenta previa have an approximately increased risk of antepartum vaginal bleeding.: tenfold 98.Placenta Abruption and Previa Nursing Care: • No vaginal exams! 17 / •2 large bore IV sites 20 / 128. pregnant women should avoid eating and coming in contact with...: Avoid eating raw meat and contact with cat feces. do not clean litter box 21 / 129. can an unvaccinated pregnant woman get the rubella infection vaccine?- : NO wait until until the postpartum period. 130. signs and symptoms of magnesium toxicity. (6): • Decreased reflexes could be a sign of pending respiratory depression. •Loss of DTRs •Respiratory depression: RR lower than 14 •Oliguria, urine output less than 30 mL/hr •Shortness of breath or chest pain •EKG changes 131. Respiration difficulty can occur with magnesium levels above...: 12 mEq/L. 132. what is the therapeutic level of magnesium: 4.8 to 9.6 mg/dL 133. signs, symptoms, and treatment of hypoglycemia: Diaphoresis; tachycar- dia; shakiness; cold, clammy skin; blurred vision; extreme fatigue; mental confusion and irritability; somnolence; and pallor blood glucose lower than 70 mg/dL 134. List important screening tests for ANTEPARTAL care: Amniotic fluid index (AFI) Biophysical profile (BPP Contraction stress test (CST) Daily fetal movement count Multiple marker screening: alpha-fetoprotein screening, triple marker, and quad marker Nonstress test (NST) Ultrasonography Nuchal translucency Umbilical artery Doppler flow Vibroacoustic stimulation 135. List important DIAGNOSTIC tests for ANTEPARTAL care: Amniocentesis Chorionic villus sampling (CVS) Magnetic resonance imaging(MRI) Percutaneous umbilical bloodsampling Ultrasonography 136. Diagnostic testing may be done instead of screening if...: a couple 22 / has a family history of a birth defect, belongs to a certain ethnic group, or already has a child with a birth defect. 137. A screening test is a test designed to identify those who are...: not affected by a disease or abnormality. Some screening tests are offered to all pregnant women. Other screening tests he proce- ained by CVS ersus 7 to 14 dle is inserted 151. The primary advantage of CVS over amniocentesis is that t durecan be performed earlier in pregnancy and the viable cells obt for analysis allow for shorter specimen processing time (5 to 7 days v days) 25 / 152. Procedure for Chorionic villus sampling (CVS): • The woman is in a supine position or lithotomy position, depending on the route of insertion. •A catheter is inserted either transvaginally through the cervix or abdominally using a needle. With each route, ultrasonography is used to guide placement. Transabdominally, a needle is inserted through the abdomen and uterus to the placenta. •A small biopsy of chorionic (placental) tissue is removed with aspiration. • The villi are harvested and cultured for chromosomal analysis and processed for DNA and enzymatic analysis as indicated 153. risks of CVS sampling: • There is a (1 in 455) fetal loss rate due to bleeding, infection, and rupture of membranes • Ten percent of women experience some bleeding after the procedure •Pregnant women who have hepatitis B virus, hepatitis C virus, or HIV should be counseled about the possibility of an increased risk of transmission to the newborn that may come with CVS or amniocentesis. 154. what should be administered to Rh-negative women post- procedure CVS sampling .: Administer RhoGAM- to prevent antibody formation in Rh-negative women 155. Amniocentesis is the most common technique used for:: obtaining fetal cells for genetic testing 156. what is Amniocentesis: a diagnostic procedure in which a nee through the maternal abdominal wall into the uterine cavity to obtain a Examines fetal chromosomes for genetic disorders 157. what is the amniotic fluid tested for in Amniocentesis: genetic testing, assessment of fetal lung maturity, assessment of hemolytic disease, intrauterine infection and therapy for polyhydramnios. 158. when are Amniocentesis usually preformed?: between 15 and 20 weeks 159. Elevated bilirubin levels indicate: fetal hemolytic disease 26 / 160. risks associated with Amniocentesis: Studies suggest a loss rate as low as 0.1% to 0.3% • Trauma to the fetus or placenta •Bleeding or leaking of amniotic fluid in 1% to 2% of cases mpling the 27 / •Preterm labor •Maternal infection •Rh sensitization from fetal blood into maternal circulation • 161. Pregnant women who have hepatitis B virus, hepatitis C virus, or HIV should be counseled about what when doing a Amniocentesis exam?: about the possibility of an increased risk of transmission to the newborn that may come with CVS or amniocentesis. 162. if the woman is less than 20 weeks' gestation. what might be needed for better ultrasound visualization during a Amniocentesis?: book says: a full bladder may be required for ultrasound visualization ATI says: Emptying the bladder before amniocentesis prevents possible puncture of the bladder and displacement of the uterus and fetus 163. Fetal blood sampling and percutaneous umbilical blood sa (FBS/PUBS), or cordocentesis, is...: the removal of fetal blood from cord 164. the blood collected from the Fetal blood sampling and percutaneous umbilical blood sampling is used to test for...: metabolic and hematological disorders, fetal infection, and fetal karyotyping. 165. when should a Fetal blood sampling and percutaneous umbilical blood sampling (FBS/PUBS) be done?: Usually used after ultrasound has detected an anomaly in the fetus. •Usually performed after 18 weeks' gestation to evaluate results of potential diag- noses and make further recommendations for medical management if necessary 166. what position should a pregnant woman be in during a (FBS/PUBS) exam?: lateral or wedged position to avoid supine hypotension during fetal moni- toring tests. 167. Maternal assays are an increasingly common way to screen pregnant women for...: fetal birth defects or genetic anomalies 168. The goal of Maternal assays are to: offer tests with high detection rates and low false-positive rates that provide patients diagnostic options. 169. Alpha-fetoprotein (AFP) is a...: glycoprotein produced in the fetal liver, gas- trointestinal tract, and yolk sac in early gestation. 170. Alpha-fetoprotein (AFP) assess the...: for the levels of AFP in the maternal blood is a screening tool for certain developmental defects in 30 / counts can be discontinued for the day. In the 1-hour approach, the count is considered reassuring if it equals or exceeds the established baseline; in general, four movements in 1 hour is reassuring. 31 / 185. Fewer than in 2 hours should be reported to the provider: - four fetal movements 186. If fetal movement is decreased, the woman should be instructed to...: eat something, rest, and focus on fetal movement for 1 hour. lie on her side while counting movements 187. The NST is a screening tool that uses...: FHR patterns and accelerations as an indicator of fetal well-being 188. Acceleration in the FHR during NST is a sign of: fetal well-being 189. Procedure for NST test: The FHR is monitored with the external FHR trans- ducer until reactive (up to 40 minutes), while running an FHR contraction strip for interpretation. 190.........................................................................The NST is considered reactive when the FHR............................................increases 15 beats above baseline for 15 seconds twice or more in 20 minutes In fetuses less than 32 weeks' gestation, two accelerations peaking at least 10 bpm above baseline and lasting 10 seconds in a 20-minute period is reactive 191. Nonreactive NST is one without....: sufficient FHR accelerations in 40 min- utes and should be followed up with further testing such as an ultrasound or biophysical profile 192. what position should a pregnant patient be placed in for a NST: - semi-Fowler's or lateral position 193. The contraction stress test (CST is a screening tool to assess the: ability of the fetus to maintain a normal FHR in response to UCs in women with a nonreactive NST at term gestation. 194. The CST is considered negative or normal when there are no: significant variable decelerations or no late decelerations in a 10- minute strip with three UCs in more than 40 seconds 195. The CST is positive when there are: late decelerations of FHR with 50% of UCs. 196. A positive CST result has been associated with an increased rate of...: - fetal death, fetal growth restriction, lower 5-minute Apgar scores, cesarean section, and the need for neonatal resuscitation due to neonatal depression. This requires further testing such as BPP. 197. The AFI is a screening tool that measures the...: volume of amniotic fluid with ultrasound to assess fetal well-being and placental function. 32 / 198. The amniotic fluid level is based on....: fetal urine production, which is the predominant source of amniotic fluid and is directly dependent on renal perfusion 199. AFI is a strong indicator of..: fetal status, as it is accurate in detecting fetal hypoxia. 200. Average measurement of AFI in pregnancy is: 8 cm to 24 cm 35 / 218. is ibuprofen okay to use during pregnancy?: not recommended 219. when would a prescription for Rho (d) immunoglobin be given to a woman post partum?: women who are Rh negative following exposure to Rh positive blood, such as from a fetus who is Rh positive. mom Rh negative, fetus Rh positive Rho (D) immunoglobulin is not necessary if the newborn is Rh negative 220. can a A fetoscope detect FHT?: not in early pregnancy can be used for FHT later in the pregnancy, around 16 to 20 weeks 221. To locate and listen for FHT in early pregnancy, the nurse auscultates at the...: client's midline and just above the symphysis pubis. because The uterus is not greatly enlarged at 12 weeks of gestation. 222. When examining the abdomen, the nurse should...: support the client's head on a pillow, the client should have an empty bladder, and the client should be observed for signs of supine hypotension. 223. what should a. nurse use to detect FHT for gestation under 16 weeks?: - The nurse should use a Doppler or ultrasound stethoscope. 224. The Apgar score is a....: a test given to newborns soon after birth. 225. Apgar stands for and assesses...: Respiratory effort Heart rate Muscle tone Reflex activity color 0-2 points for each category 226. what is considered a normal apgar score?: 7-10 •0 to 3 indicates severe distress. •4 to 6 indicates moderate difficulty with transition to extrauterine life. •7 to 10 indicates stable status. 227. when should an apgar score be taken: should be obtained at 1 minute and 5 minutes after birth. 228. The client who has preeclampsia is encouraged to drink...: six to eight 8-ounce glasses of water (48 to 64 ounces) per day. avoid alcohol limit intake of caffeinated beverages. 229. what should be consumed to reduce the incidence of neural tube defects in the developing fetus.?: consumption of folic acid 230. The classic signs of abruptio placentae include...: vaginal bleeding, abdom- inal pain, uterine tenderness, and contractions. 36 / 231. how to calculate estimated date of birth?: Determine the first day of your LMP 37 / Count back three calendar months from that date Add one year and seven days to that date 232. A finding of 1+ to 2+ proteinuria is expected in a client who has...: mild preeclampsia