inpatient obstetric nursing practice exam 121 Questions with Verified Answers
a pt is admitted to the labor unit with possible preterm labor. nitrazine
... [Show More] paper is use to detect amniotic fluid. the result is positive with a reading of - CORRECT ANSWER 7.1
clinical signs of hemorrhage such as BP 90/70; pulse 118, and tachypnea can be seen when the blood loss reaches - CORRECT ANSWER 1500 ml
an appropriante action in response to a non-reactive NST is to - CORRECT ANSWER consider acoustic stimulation
while the exact mechanism of action is not fully known, mag sulfate inhibits smooth muscle contractions by direct effect on myometrial - CORRECT ANSWER calcium activity
which of the following decelerations must drop at least 15 bpm from baseline (early, late, prolonged) - CORRECT ANSWER prolonged
according to the NICHD guidelines recurrent decelerations are defined as decelerations that occur with - CORRECT ANSWER greater or equal to 50% UCs in any 20 minute window
the risk of water intoxication is decreased during induction of labor if oxytocin is given in a/an - CORRECT ANSWER isotonic solution
a fetal heart tracing shows a baseline FHR of 145, moderate variability, early decelerations and no accelerations and no decelerations. This is a NICHD category - CORRECT ANSWER I (110-160) moderate variability, no variables, no late decals or prolonged decals
pain experience in the first stage of labor results primarily from - CORRECT ANSWER pressure on adjacent structures and nerves
what are characteristics of a dizygotic pregnancy? - CORRECT ANSWER 2 placentas, 2 chorions and 2 amniotic sacs
validity as applied to a research instrument demonstrates - CORRECT ANSWER degree to which the instrument measures what is was intended to measure
A pregnant women developed varicella-zoster at 32 weeks gestation. she is now in active labor at 40 weeks gestation. the nurse would expect which of the following to be appropriate? - CORRECT ANSWER take no action since the mother's antibodies will be protective
US for antepartum testing uses high frequency sound waves to produce an image that varies based on the - CORRECT ANSWER density of the structure under the transducer
a pregnancy woman that has a history of herpes simplex virus (HSV). she hasn't had an outbreak for 5 years. the recommendation for this pregnancy is to - CORRECT ANSWER start antiviral at 36 weeks
The goal of neuraxial analgesia is to provide pain relief - CORRECT ANSWER with as little motor block as possible
the STI that is transmitted trans-placentally is - CORRECT ANSWER syphilis
UTI is a concern in the first couple of weeks PP bc of - CORRECT ANSWER dilated ureters and renal pelves
The mechanism of action of sterile water injections for labor pain is thought to be due to - CORRECT ANSWER gate control theory
A normal breathing pattern for two hour old neonate may include - CORRECT ANSWER episodic breathing
A woman at 37 weeks gestation called and reports contractions that occur every 15-25 minutes with cramping in the lower abdomen all afternoon. walking helps give her some relief, but the ctxs return. The nurse/NP knows that these symptoms represent - CORRECT ANSWER false labor
Treating the preterm labor patient with bed rest increases - CORRECT ANSWER glucose intolerance
The fetal attitude in the mother's pelvis describes the relation of the - CORRECT ANSWER fetal parts to each other
The American academy of pediatrics recommends 400 IU vitamin D supplement for all breastfed infants at what age? - CORRECT ANSWER first few days
in a normal pregnancy, there is usually a physiologic drop in BP to its lowest point in the - CORRECT ANSWER second trimester
a clinical sign for placental abruption is - CORRECT ANSWER pain with ctxs not congruent with ctx intensity
spinal HAs can occur as a consequences of epidural anesthesia due to - CORRECT ANSWER unintended dural puncture
A placental condition where the fetal vessels course through the amniotic membranes and are present at the cervical os is - CORRECT ANSWER vasa previa
A category I tracing is a strong indication of - CORRECT ANSWER normal acid base balance
A FHR tracing with absent variability, no accelerations and no decelerations is a NICHD category - CORRECT ANSWER II
Rh immune globulin in an unsensitized Rh-negative woman who is undergoing amniocentesis for genetic testing should be given Rhogam when? - CORRECT ANSWER after the procedure
The tocolytic that places a woman at risk to develop diabetic ketoacidosis is - CORRECT ANSWER terbutaline
At the end of the 3rd stage of labor, the funds is located - CORRECT ANSWER 2cms below the level of the umbilicus
when determining which drug to prescribe for optimal pain relief, the decision must be dependent on which of the following drug characteristics - CORRECT ANSWER efficacy
during a gestational age assessment, the square window is at 90 degrees. this indicates that the newborn is - CORRECT ANSWER preterm
when an IUFD of one twin occurs, it is most common during which trimester - CORRECT ANSWER 1st
a pt had one unsuccessful external cephalic version (ECV). what is the appropriate time the procedure can be repeated - CORRECT ANSWER 7 days
for internal rotation of the fetal head, what percent of rotation occurs with the position of LOA and ROA? - CORRECT ANSWER 45 degrees
A characteristic of a velamentous cord insertion is - CORRECT ANSWER umbilical vessels travel in the membranes beyond the placental margin
the presence of moderate variability rules out fetal - CORRECT ANSWER metabolic acidemia
the complementary alternative medicine therapy that is based on balancing of energy by centering and invoking an intention to heal is - CORRECT ANSWER therapeutic touch
the establishment of minimum criteria for competent, proficient delivery of nursing care is defined as - CORRECT ANSWER standard of care
the onset of GHTN is most commonly seen in which trimester - CORRECT ANSWER third
The presence of uterine fibroids increase the risk for - CORRECT ANSWER placental abruption
A nurse discovers a cord at the vaginal Introits. the first action is to - CORRECT ANSWER push manually and hold the head off of the cord
fetal and neonatal morbidly resulting from post term pregnancy is primarily due to - CORRECT ANSWER altered placental function
a risk for prenatal toxoplasmosis is - CORRECT ANSWER sushi
When mixing pit solution in 1000ml of IVF, which dilution will give a 1:1 solution? - CORRECT ANSWER 60 U
When a vacuum procedure is performed, the maximum number of attempts or pop offs recommended before declaring the procedure unsuccessful is - CORRECT ANSWER 3 in 20 minutes
which is a risk factor for labor dystocia? - CORRECT ANSWER Advanced maternal age
how should a NB delivered with mec staining who is responsive be managed? - CORRECT ANSWER no suction if baby is active and does not require resuscitation
The term used to describe the fetus settling down in the pelvic inlet (engagement) during pregnancy is - CORRECT ANSWER lightening
Chadwick's sign is - CORRECT ANSWER Cyanosis/purle discoloration of vulva vagina and cervix
Helping the laboring woman into which position may promote rotation from OP to OA - CORRECT ANSWER hands and knees
which of the methods used for induction of labor appears to be effective as prostaglandin E2 gel or intravaginal misoprostol? - CORRECT ANSWER trans-cervical balloon catheter
in the normal NB, serum glucose levels fluctuate for how many hours following birth? - CORRECT ANSWER 2
C/S in a previous pregnancy increases risk for - CORRECT ANSWER placenta accreta
one indication for a classic uterine incision performed during a C/S is - CORRECT ANSWER transverse lie
In a woman experiencing a TOLAC, which of the following is contraindictated - CORRECT ANSWER Prostoglandin E1
in order to address potential GA related problems, an estimation of GA should occur - CORRECT ANSWER within 4 hours of birth
the lactation initiation stage is dependent on - CORRECT ANSWER a cascade of hormonal changes
prostaglandins administered for labor induction act directly on the - CORRECT ANSWER cervix
delayed cord clamping - CORRECT ANSWER decreases the need for blood transfusions
a hematological change in pregnancy that predisposes a patient to venous thrombosis is - CORRECT ANSWER depressed fibrinolytic activity
the main complication that occurs with cordocentisis (percutaneous umbilical blood sampling) is - CORRECT ANSWER fetal loss
a primigravida at 39 weeks gestation has been experiencing painful contractions for 24 hours. she has remained 1-2cm dilated and she verbalized that she is exhausted. the fetal heart rate tracing is normal. the recommended management for the woman is administration of - CORRECT ANSWER morphine for rest
the milk ejection reflex (let-down) occurs when there is a release of - CORRECT ANSWER oxytocin from the posterior pituitary
during the initial assessment of a NB, the nurse palpates the femoral pulses and notes that they are decreased bilaterally. the nurse knows that this indicates - CORRECT ANSWER coarctation of the aorta and requires follow up
a pt has been moved to the surgery suite for a CS. there is an internal fetal scalp electrode in place. this should be removed when the - CORRECT ANSWER abdominal prep is completed
a vitamin k injection is necessary because of which of the following physiological states present in the first few days of life? - CORRECT ANSWER absence of normal flora in the gut
one antenatal factor that predisposes a woman to PP infection is - CORRECT ANSWER anemia
a NB is at the highest risk for jaundice when delivery is - CORRECT ANSWER assisted
The NICHD definition of tachysystole refers to contractions from - CORRECT ANSWER both spontaneous and stimulated labor
In an effort to obtain the reactive NST, the nurse uses vibroacoustic stimulation. the FHR accelerates to 175 bpm for 15 seconds and then drops to a rate of 160. the next step would be - CORRECT ANSWER continue to monitor until baseline is obtained
A woman's last LMP began on March 17th. According to ACOG, what is the first date she is considered to be post term - CORRECT ANSWER January 5
A woman with hydramios is experiencing abdominal pain and dyspnea. Treatment with indomethacin will - CORRECT ANSWER decrease fetal urine production
women with hyperthyroidism are at an increased risk of - CORRECT ANSWER heart failure
A woman with a history of giving birth to an infant with anencephaly should be advised to supplement for diet with foods high in folate along with what dosage of folic acid - CORRECT ANSWER 4.0 mg
The MVU for a woman in the active phase of labor is 225. this indicates - CORRECT ANSWER adequate contraction activity for labor progress
one physiological explanation for a prolonged acceleration is fetal umbilical cord - CORRECT ANSWER vein compression
one absolute contraindication of epidural anesthesia - CORRECT ANSWER coagulopathy
one of the goals in the conservative management of placenta prevue is to - CORRECT ANSWER prolong the pregnancy until fetal lung maturity is achieved
a low level of alpha fetoprotein is indicative of - CORRECT ANSWER downs syndrome
one theory of labor initiation is an increase in - CORRECT ANSWER increased corticotrophin-releasing hormone (CRH) synthesis
post bariatric surgery, pregnancy woman are at risk for deficiencies in - CORRECT ANSWER iron and folate
which of the following types of drugs used during labor have a ceiling-effect, in that additional doses have no additional effect on respiratory depression? - CORRECT ANSWER narcotic agonist-antagonists
compared to non-pregnant values, the maternal arterial pH during pregnancy is - CORRECT ANSWER slightly increased
forceps delivery can result in what complication in the NB? - CORRECT ANSWER facial injuries
the process where families engage in identification of the new baby to other family members is - CORRECT ANSWER claiming
the primary action of misoprostol (Cytotec) is to - CORRECT ANSWER soften and thin the cervix
most persistent fevers after childbirth are caused by - CORRECT ANSWER genital tract infections
a pregnant woman in HIV positive and is taking Zidovudine (ZDV). she asks about continuing the medication during labor. the nurse should explain the ZDV will be given - CORRECT ANSWER IV during labor
a prolonged acceleration is an acceleration that lasts - CORRECT ANSWER 2-10 minutes
a prenatal woman with a negative Rh antibody screen should receive immune globulin (RhoGam) 300 mcg at what stage of her pregnancy - CORRECT ANSWER 28 weeks
The nurse performs scalp stimulation for a tracing with minimal variability and there is no acceleration of FHR. this means that the fetus's acid-base status is - CORRECT ANSWER undetermined
poor obstetric outcomes can occur up to six times higher in patients who abuse - CORRECT ANSWER opiates
During labor and delivery, the cardinal movement of restitution describes - CORRECT ANSWER rotation of the fetal head 45 degrees after head delivery
research has shown that administration of IVF during preterm labor - CORRECT ANSWER increases risks when combined with tocolytics
during the bearing down phase of the second stage of labor, the nurse should help facilitate the woman's perineum to stretch by - CORRECT ANSWER no action
during pregnancy, which of the following carviovascular parameters decreases by at least 20%? - CORRECT ANSWER Systemic vascular resistance
an episiotomy is selectively used for - CORRECT ANSWER abnormal FHR pattern
a class of antihypertensive that is contraindicated in women considering pregnancy and during pregnancy is - CORRECT ANSWER ACE inhibitors (Captopril, enalapril, ramipril)
in postterm pregnancies, the most important US parameter is - CORRECT ANSWER amniotic fluid index
FDA warns against use of oral or injectable Terbutaline (brethine) longer than 72 hours due to - CORRECT ANSWER cardiac complications and death
which statement best describes the relationship between maternal and fetal hemoglobin levels? - CORRECT ANSWER fetal hemoglobin is higher than maternal hemoglobin
20 minutes into an NST the patient still has not felt the baby move. you have 2 accelerations of 15 beats by 15 beats. you would - CORRECT ANSWER consider this a reactive NST and discontinue monitoring
in most cases the vertex enters the pelvis with the saggital suture in what position - CORRECT ANSWER transverse
after delivery, the placental site heals by the process of - CORRECT ANSWER exfoliation
the nurse working with a diabetic in preterm labor (PTL) should know that which class of medication used for treating PTL can cause maternal hyperglycemia? - CORRECT ANSWER beta-mimetics
competencies related to evidence-based practice include - CORRECT ANSWER use of data to evaluate outcomes of care
the cardiac output during pregnacy - CORRECT ANSWER increases 30-50%
The hallmark of HELLP syndrome is - CORRECT ANSWER hemolysis (microangiopathic hemolytic anemia)
the decelerations whose primary response is mediated by baroreceptors is - CORRECT ANSWER variable
a potential maternal complication that occurs more frequently when corticosteroids are administered simultaneously is - CORRECT ANSWER hyperglycemia
the greatest complication of tocolytic therapy for women with multiple gestation is the high risk of - CORRECT ANSWER pulmonary edema
during labor and delivery , Cardiac output is the highest in the - CORRECT ANSWER immediate period after delivery
a woman is diagnosed with oligohydramnios during her pregnancy. the fetus/ NB should be evaluated for - CORRECT ANSWER polycystic kidney disease
a woman who has a CS birth is more likely to be re-hospitalized with what PP complication - CORRECT ANSWER wound infection
which of the following parenteral analgesics has the most rapid peak effect? - CORRECT ANSWER fentanyl (sublimaze)
which medication is known to cross the placenta and provide sedation but not to have an effect on neonatal respiration? - CORRECT ANSWER Promethazine HCL (Phenergan)
A woman is 36 weeks gestation. her son was diagnosed with Influenza B. the recommendation is for her to start - CORRECT ANSWER Tamiflu immediately
physiologic anemia of pregnancy occurs due to - CORRECT ANSWER proportionately greater increase in plasma than red cell volume [Show Less]