RNC-OB PRACTICE 110 Questions with Verified Answers
Dinoprostone (Cervidil) is used for cervical ripening in a woman at 39 weeks gestation. After one
... [Show More] hour, tachysystole develops but the fetal heart rate pattern is normal. Appropriate management is to: - CORRECT ANSWER remove the insert
Nifedipine acts as a tocolytic agent by interfering with: - CORRECT ANSWER availability of calcium
The progression of labor is based on: - CORRECT ANSWER individual factors and clinical conditions
Universal alphafetoprotein sceening should be offered to all women because: - CORRECT ANSWER there is little risk or complications from the testing
A nurse observed a new mother breastfeeding her infant and hears "smacking sounds" as the infant feeds. The nurse should recognize this might indicate a problem with: - CORRECT ANSWER Latch on the breast
A woman with type-1 diabetes at 32 weeks gestation has diabetic ketoacidosis. Before administration of IV potassium, it is important to assure adequate: - CORRECT ANSWER urine output
Increased bloody show In a woman in labor is representative of: - CORRECT ANSWER rapid cervical dilation
According to NICHD terminology, accelerations and decelerations are based on their relationship to" - CORRECT ANSWER fetal heart rate baseline
Hindmilk promotes infant weight gain because of its: - CORRECT ANSWER high fat content
The concept of "day dreaming" is an integral part of the nonpharmacologic pain relief strategy in labor of: - CORRECT ANSWER imagery
After administration of an epidural, a woman experienced respiratory depression. This is likely due to: - CORRECT ANSWER sympathetic blockade
A main disadvantage of fentanyl use for pain relief in labor is: - CORRECT ANSWER short duration of action
The most common umbilical cord complication of monoamniotic twin gestation is: - CORRECT ANSWER entanglement
A potential complication from a vacuum extraction delivery is: - CORRECT ANSWER depression skull fracture
A shorter labor duration is seen with what type of maternal positioning: - CORRECT ANSWER upright
A breastfeeding mother notes that small amounts of milk drool from her infant's mouth after breastfeeding. This is an indication of what: - CORRECT ANSWER a need to evaluate proper latch-on
When administering oxytocin, it is important to understand that 40 minutes after administration: - CORRECT ANSWER a steady state plasma concentration will be reached
In the hypothermin neonate, heat production is accomplished by thermogenesis secondary to: - CORRECT ANSWER brown fat metabolism
Women are most likely to experience trauma leading to injury in pregnancy from: - CORRECT ANSWER intimate partner violence
A contraindication to neuraxial anesthesia during labor is: - CORRECT ANSWER coagulation disorder
A woman at 31 weeks gestation comes to labor and delivery with signs and symptoms of preterm labor. Antenatal steroids are given to: - CORRECT ANSWER promote fetal lung alveoli growth
Symptoms of deep vein thrombosis are most likely due to: - CORRECT ANSWER inflammation
Death from anaphylactoid syndrome of pregnancy(amniotic fluid embolism) is most commonly due to: - CORRECT ANSWER hypoxic-ischemic insult
Reversal of the diabetogenic effects of pregnancy occurs with: - CORRECT ANSWER delivery of the placenta
Rapid bolus of oxytocin after birth places the woman at risk for - CORRECT ANSWER hypercontractility of the uterus
To minimize bias in a research study, the best design includes - CORRECT ANSWER randomized participants
intrauterine growth restriction predisposes the neonate to - CORRECT ANSWER sepsis
Following sustained pushing, a woman in the second stage of labor reports tingling and numbness of the legs. A indicated intervention as she continues to push it to - CORRECT ANSWER place her feet flat on the bed
A woman in labor has just received an epidural anesthesia. Following a test dose of local anesthesia and ephederine, she experiences increased heart rate, palpitations, numbness of tongue and slurred speech and jitteriness. These symptoms reflect - CORRECT ANSWER injection in the spinal fluid
When using an external monitor, the fetal heart rate is detected by - CORRECT ANSWER ultrasound
A renal finding indicative of progressing preeclampsia is decreased - CORRECT ANSWER creatinine clearance
Stripping of membranes to augment labor results in release of - CORRECT ANSWER prostaglandin
Late preterm infants are at increased risk for hyperbilirubinemia because of - CORRECT ANSWER poor feeding
Damage to the myometrium or any process that interferes with placenta migration increases the risk for - CORRECT ANSWER placenta previa
The factor that will most influence whether a woman after having a cesarean can have future vaginal birth is - CORRECT ANSWER type and location of the incision
A factor that decreases the chance of success of external version is - CORRECT ANSWER oligohydramnios
A major contributory factor to the increasing cesarean rate in the U.S is - CORRECT ANSWER decreased opportunity for VBAC trial
When a woman in labor hyperventilates, the underlying physiology is - CORRECT ANSWER poor oxygenation
A herpetic lesion on the breast requires what management for the breastfeeding woman? - CORRECT ANSWER use the breast shied so infant has no direct contact with the lesion
The presence of fetal breathing movements on a biophysical profile reflects adequate - CORRECT ANSWER neurologic function
Combination tocolytic therapy of magnesium sulfate and nifedipine can result in - CORRECT ANSWER low calcium levels
A woman is being induced at 38 weeks gestation because of abnormal antenatal screening. What component is most concerning? - CORRECT ANSWER Contraction pattern
The factor that most affects the continuation of prolactin production during lactation is - CORRECT ANSWER infant sucking
The increased incidence of low birthweight neonates in women who smoke cigarettes is dependent on - CORRECT ANSWER number of cigarettes smoked per day
The hematologic change in pregnancy which predisposes the pregnant woman to deep vein thrombosis is increased - CORRECT ANSWER clotting factors
A woman develops varicella in the third trimester. This increases the risk for - CORRECT ANSWER congenital varicella syndrome
This representative of a 20 minute nonstress test. The best interpretation is - CORRECT ANSWER vibroacoustic stimulation should be initiated to induce better fetal response
Pseudomentration can occur in the female neonate due to - CORRECT ANSWER withdrawal of maternal hormones
A primigravida is 8cm dilated after 14 hours of labor. She is frustrated and expresses that she feels this will never end and wants this over with. This behavior is consistent with - CORRECT ANSWER the transition phase
The main cause of labor onset is - CORRECT ANSWER hormonal
After a sudden rupture of membranes, a woman experiences a prolonged deceleration. This is consistent with - CORRECT ANSWER prolapse of the cord
Variable decelerations are often noted with monitoring monochorionic-monoamniotic twins during labor because this type of twin pregnancy is prone to what complication? - CORRECT ANSWER umbilical cord entanglement
With accurate dating of the last menstrual period beginning on December 12, an elective birth can be attempted no sooner than - CORRECT ANSWER September 12
Epidural anesthesia increases the risk of - CORRECT ANSWER persistent occiput-posterior presentation
As the placenta ages with pregnancy continuing beyond term, placental reserve is decreased because of - CORRECT ANSWER amniotic basal membrane thinning
Following birth, a sign of placental separation is - CORRECT ANSWER sudden trickle or spurt of blood
A woman who has positive group B streptococcal screen is having a planned cesarean birth. Administration of prophylactic antibiotics for this patient - CORRECT ANSWER is not required
A woman is admitted to labor and delivery at 38 weeks gestation with an active case of rubella. The risk of the neonate acquiring rubella is - CORRECT ANSWER high
The lower segment transverse incision is most commonly used for cesarean birth because of - CORRECT ANSWER less blood loss
At 37 weeks gestation a woman (G3P1) with current history of alcohol and cocaine use is admitted to labor and delivery. She denies drug use for "several days". She is dilated 4cm. Blood pressure is 148/92 and the pulse is 120. Reflexes were brisk and her urine protein is negative. This patient is at risk for - CORRECT ANSWER withdrawal seizures
The cause of metabolic acidosis is decreased - CORRECT ANSWER alveolar ventilation
Anticipated intrapartum insulin management of women with type 2 diabetes includes recognition that they - CORRECT ANSWER will need less, or no, insulin
A woman feels burning sensation in the perineal area as the fetal head is crowning, this is - CORRECT ANSWER a result of perineal stretching
Cervical ripeing with the use of a transcervical catheter works by releasing - CORRECT ANSWER prostaglandin
When to institute epidural anesthesia to a woman in active labor is based on - CORRECT ANSWER her request for it
Hypertonic contractions in latent labor persist. Appropriate management would be to - CORRECT ANSWER increase hydration
A rigid, painful abdomen that occurs with placental abruption is due to - CORRECT ANSWER myometrial bleeding trapped in the uterus
when R-R intervals are long, the fetal heart rate is - CORRECT ANSWER slow
When care is given based on what a reasonably prudent nurse with similar education and experience would do in a given situation, this is called - CORRECT ANSWER standard of care
During the early second stage of labor, a woman has been pushing but wants to stop for a while. The nurse should - CORRECT ANSWER suggest she change to a different position
In fetal vibroacoustic stimulation, a reactive response is indicated by fetal - CORRECT ANSWER heart rate accelerations
Fetal fibronectin is an early marker for preterm birth because its presence after 20 weeks gestation can indicate - CORRECT ANSWER disruption of the attachment of the fetal membranes
Open glottis pushing results in - CORRECT ANSWER less fetal stress
A 39 year old woman G1 at 40.4 weeks gestation is admitted in early labor. She is 59 inches tall and her prepregnancy weight was 100 pounds. Current weight is 138 pounds. There is an increased risk for - CORRECT ANSWER cephlopelvic disproportion
Fetal heart block is most likely to occur when a pregnancy is complicated by - CORRECT ANSWER systemic lupus erythematosus
Oxygenation of the fetal blood occurs in the - CORRECT ANSWER placenta
A late preterm birth is defined by - CORRECT ANSWER gestational age
Oxytocin is discontinued after tachysystole develops. One hour later, the infusion is to be restarted. The dose should be started - CORRECT ANSWER at the initial starting dose
A management consideration when using Indomethacin as a tocolytic agent is it - CORRECT ANSWER should be used only if gestational age is <34 weeks
Breech presentation occurs more frequently - CORRECT ANSWER with macrosomia
An application of the ethical principle of autonomy is - CORRECT ANSWER informed consent
Oxytocin has been classified as a high alert medication by the institute for safe medication practices. This means - CORRECT ANSWER there is a heightened risk for significant patient harm when used in error
Indomethacin is contraindicated for tocolysis in a woman who has - CORRECT ANSWER diabetes
A consequence of twin to twin transfusion is - CORRECT ANSWER hypertension in the recipient twin
Following fetal scalp stimulation with minimal variability, there are no induced accelerations. This response would be classified as - CORRECT ANSWER indeterminate (category 2)
A primigravida at term has been in labor for 10 hours. For the past two hours, she has been 5cm dilated. The cervix is 100% effaced and the vertex is at 0 station. The fetal heart rate is 140 bpm and variability is moderate. Contractions by palpation are easily indentable. This scenario is consistent with - CORRECT ANSWER prolonged latent phase
A woman at 22 weeks gestation presents with dysuria, suprapubic and lumbar pain, general malaise, loss of appetite, nausea, and vomiting. VS (T 102.6, HR 116, RR 26, and FHR 175) These symptoms are consistent with - CORRECT ANSWER pyelonephritis
As the parasympathetic nervous system matures and exerts control over the fetal heart activity, the fetal heart rate - CORRECT ANSWER slows
According to the joint commission sentinel event data, the number one cause of patient injuries is - CORRECT ANSWER failure to follow the steps of unit policies or protocols
Bleeding into the decidua basalis occurs with - CORRECT ANSWER placenta accreta
In neonatal resuscitation, if the heart rate is 80 bpm, the next step is - CORRECT ANSWER bag mask and ventilation
Amniotomy performed before active labor is established carries what risk? - CORRECT ANSWER cesarean birth
A maternal behavior a first time mother might perform in the immediate postpartum period that would require follow-up is that she - CORRECT ANSWER is most concerned with her diet and exercise program so she will look like she never had a baby
The second stage of labor covers the period of time of - CORRECT ANSWER complete dilation to birth of the baby
Return of blood to the venous circulation that was formerly supplying the uteroplacental unit increases cardiac output in the postpartum period secondary to increased - CORRECT ANSWER systemic vascular resistance
Preeclampsia is an abnormal vascular response involving dysfunction of the - CORRECT ANSWER endothelium
Piggybacking to oxytocin to the primary IV at the point closest to the IV insertion site will - CORRECT ANSWER allow for rapid discontinuation
In the neonate, the rise of PaO2 after birth is the potent stimulus for the closure of the - CORRECT ANSWER foramen ovale
Palpation of neonate's head at 3 hours of age reveals a soft edematous area that crosses suture lines. This is consistent with - CORRECT ANSWER caput succadenum
Coaching women to push with every other of third contraction during the second stage of labor is indicated when the - CORRECT ANSWER fetal heart rate is abnormal
A management strategy for prolonged latent phase of labor is a multigravid woman is - CORRECT ANSWER oxytocin
Immunoassay testing for premature rupture of membranes involves analysis of amniotic fluid for - CORRECT ANSWER pH determination
Misoprostol compared to other cervical ripening agents has - CORRECT ANSWER a higher rate of tachysystole
The fetal heart rate should be assessed on what time interval in a patient without complications in the active stage of labor? - CORRECT ANSWER 30 minutes
Transient loss of variablity as an intact fetus physiologically responds to hypoxic stress demonstrates - CORRECT ANSWER ongoing fetal hypoxia
The differences in side effects of parenteral analgesic medications given for pain relief in labor relate to the drug's - CORRECT ANSWER half life
Absorption of local anesthetic agents administered to a woman in labor depends primarily on the - CORRECT ANSWER biovailability of the specified drug
When tachysystole of hypertonus occurs with induction of labor with oxytocin, this results in - CORRECT ANSWER decreased uterine blood flow
The effect of prolonged use of the valsalva maneuver during second stage of labor is - CORRECT ANSWER respiratory alkalosis
The biophysical profile result of a woman at 37 weeks gestation is 6. The amniotic fluid volume was normal. The test should be repeated - CORRECT ANSWER within 24-48 hours [Show Less]