Fetal development
Fertilization begins in the outer portion of the fallopian tube.
True/False
True. Then transported to the uterus by (tubular) muscular movement.
The nurse is caring for a primigravida at about 2 months and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says:
A. “Nausea and vomiting can be decreased if I eat a few crackers before rising.”
B. “If I start to leak colostrum, I should cleanse my nipples with soap and water.”
C. “If I have a vaginal discharge, I should wear nylon underwear.”
D. “Leg cramps can be alleviated if I put an ice pack on the area.”
A. Crackers decrease the discomfort
Which of the following medications are known to cause adverse neonatal outcomes? Select all that apply.
A. Accutane
B. Valproic acid
C. Actifed
D. Chlorpheniramine
E. Clonazepam
A. Not ok-for acne can cause cleft palate and others. is known as a teratogen.
B. Not ok-Valproic Acid Dilantin (antipsychotic) known teratogen.
C. OK-Common decongestant.
D. OK-Antihistamine
E. Not Ok-birth defects (cardiac, resp, neuromuscular)
The nurse knows that preeclampsia tends to occur during what time in a pregnancy?
A. before 20 weeks
B. in the first trimester and postpartum
C. after 20 weeks
D. After 20 weeks and the 4th trimester
E. in the first and second trimester
D. Preeclampsia tends to occur AFTER 20 weeks gestation and may continue OR reoccur within the 1st 12 weeks after delivery (known as the 4th trimester).
Maintaining adequate oxygen to the fetus, encouraging cessation of smoking, avoidance of triggers, and consistent use of ordered medications are goals applicable to which preexisting condition?
A. Placental insufficiency
B. Asthma C. Cystic Fibrosis D. Marijuana use
B is correct: Asthma
An expectant mother discovers her fetus has a serious congenital condition and has decided to terminate. This type of abortion is known as:
A. Abortion
B. Therapeutic abortion
C. Spontaneous abortion
D. Informed abortion
A. Abortion: spontaneous or induced termination of pregnancy before the fetus reaches a viable age
B: CORRECT: Therapeutic abortion. Performed when the pregnancy endangers the mother's mental or physical health or when the fetus has a known condition incompatible with life.
C. Spontaneous: Occurring without apparent cause.
D. This is not a term for abortion.
Bluish discoloration of the cervix.
A. Braxton Hicks
B. Chadwick sign
C. Linea nigra
D. Hegar sign
B is correct; the Chadwick sign appears at 6-8 weeks gestation due to softening of the cervix. Bluish in color.
Braxton Hicks-tightening of the uterus mimicking actual contractions. generally, in 3rd trimester.
Linea nigra-dark line that develops during pregnancy from the navel to the pubic bone. Appears approximately at 20 weeks.
Hegar sign-softening of the portion of the cervix between the uterus and the vaginal portion of the cervix. Usually develops around 6 weeks until 12 weeks. It affects the isthmus, the part of the cervix that connects the vaginal part of the cervix with the uterus.
** Goodell's sign: a probable sign of pregnancy, softening of the cervix. Occurs due to increased blood flow noticed in the cervix 1st 4 to 8 weeks of pregnancy. Velvety in appearance.
Your patient who is 17 weeks pregnant describes to you she has been feeling the baby move. Which terms describe this movement?*
A. Braxton Hick's contractions
B. Quickening
C. Ballottement
D. None of the above because fetal movement isn't felt until 20 weeks gestation
B. Quickening
12. A 37-week pregnant patient is admitted to the OB floor and experiences a tonic-clonic seizure. Which two (2) of the following would the nurse AVOID during the seizure?
A. Placing the patient in a supine position.
B. Holding down the patient’s head to prevent injury.
C. Staying with the patient and activating the emergency response team.
D. Timing the seizure.
E. Providing 8 to 10 L of oxygen.
The answers are A and B. The nurse would want to place the patient on their side to help prevent the tongue from obstructing the airway, preventing aspiration, and improving blood flow to the placenta. In addition, the nurse would NOT want to restrain the patient, which can cause injury. Option C, D, and E are steps the nurse would want to take.
Pregnant women diagnosed with mycobacterium tuberculosis should be treated with Rifampin, isoniazid (INH) and pyroxidine (B6). The same medications that are ordered for all patients diagnosed with TB.
True
False
True. (vit B6) used to prevent peripheral neuropathy associated with INH.
What are the four (4) stages of fetal development?
fertilized egg or zygote
blastocyst
embryo
fetus
A new patient to the OB clinic states to the nurse: I know I'm pregnant because I have been peeing a lot and my breasts are tender". The nurse knows these are _________________signs and may or may not be indicative of pregnancy. new
Probable: Goodell sign, Chadwick sign, Hegar sign, positive serum and urine samples, Braxton Hicks contractions, and ballottement.
Presumptive: Missed period. Nausea and vomiting. Breast changes. Fatigue. Frequent urination. Food cravings.
Positive: hCG, fetal heartbeat, quickening
The nurse is providing nutrition education to the expectant mother and the following is emphasized.
A. Avoid excess of red meat.
B. Avoid excess of fish and shellfish.
C. Avoid excess of root vegetables.
D. Avoid excess of hard cheeses.
B excess of shellfish and fish have elevated mercury and can harm the growing fetus-brain damage and vision/hearing damage.
A patient at 34 weeks gestation is seen by the midwife all v/s are WNL except the B/P which is 140/90. The midwife prescribes Labetalol. Patient instructions regarding the reason for the medication would include which of the following?
A. This medication will help prevent premature rupture of membranes
B. This medication will reduce the chances of developing placenta previa
C. This medication will reduce the chance of a premature delivery
D. This medication will reduce the symptoms of Preeclampsia
Correct is D: Preeclampsia
Labetalol is a beta blocker and is an antihypertensive medication. it increases uteroplacental blood flow compared with other β-blockers.
A nurse is educating a client with Type 1 Diabetes about how to know if she can have a healthy pregnancy. Which statement indicates the client understood the teaching?
A. “If I find I don’t have to take as much insulin.”
B. “I need my hemoglobin A1C to be less than 6.”
C. “If I find I’m taking a lot of insulin.”
D. “As long as I take my oral antidiabetic medications as scheduled.”
B. The normal A1C is under 5.7-6.4
The umbilical cord generally has ____veins, ____Arteries. And is surrounded by a specialized connective tissue known as _______________.
1 large vein and 2 smaller arteries ( AVA)
Whartons Jelly which cushions and protects the umbilical cord.
The nurse is educating the expectant parents on healthy eating. The nurse knows further instruction is needed when the expectant parent states:
A. If I eat too much, my baby may be born with diabetes.
B. If I eat too much my baby may be born with low blood sugar.
C. If I eat too much, I may have a difficult delivery.
D. If I don't eat enough my baby may be born prematurely.
A. If a baby is born with diabetes it is type 1 and is due to a genetic abnormality and not due to the pregnancy. The infant may however be born with hypoglycemia. Why? Think of an LGA baby
If a woman reports her LMP was Oct 14, 2022, using Nagel's rule when is her estimated date of birth?
A. July, 14, 2023
B. July 21, 2023
C. July 7, 2023
D. None of the above
B is correct.
1st day of LMP
Subtract 3 mos.
Add 7 and a year
+ or - 2 weeks.
The nurse enters the room of a patient in early labor. The patient is experiencing muscle twitching and muscle rigidity. The nurse suspects eclampsia. What interventions are initiated? Select all that apply.
A. Perform an assessment of reflexes.
B. Lower the HOB.
C. Assess Blood pressure.
D. Initiate Magnesium Sulfate protocol.
E. Assess Fetal HR.
F. Initiate Oxytocin protocol.
Correct; C, D, F
A 6-pound newborn-tests positive for HSV. The neonatal nurse knows that parenteral acyclovir is the treatment for neonatal HSV infections.
The order reads acyclovir 60 mg/kg per day in 3 divided doses,
1. What is the correct dose for each administration?
1. 6/2.2= 2.72kg
2. 60mg/kg=2.72x60=163.2mg
3. TID. 163.2/3=54.4mg per dose.
A new mother states to the nurse, my baby's pediatrician told me that something in the heart hasn't closed yet. Does this mean my baby needs heart surgery?
A. There are three structures in the heart that the baby no longer needs after birth. It is highly unlikely surgery would be indicated.
B. I will ask the pediatrician which structure didn't close, in order to answer your question.
C. I thought I heard a murmur. The baby may need surgery if the murmur persists.
D. Heart surgery is not performed on newborns. The baby will be reevaluated for surgery at 6 months.
CORRECT answer:
A. Foramen ovale: Between 2 atria closes typically 1-2 h after birth.
Ductus Venosas: Between inferior vena cava and umb. cord. closes with the clamping of the umbilical cord.
Ductus Arteriosus: Prevents backflow from the aorta to the pulmonary artery (due to the first gasp of air-high pressure). Preliminary closing within 72 hours-2 to 3 weeks.
Which one of the following manifestations is not common during pregnancy?
A. Striae Gravidarum
B. Linea Nigra
C. Ambivalence
D. Spotting of blood
E. Positive Babinski
Correct is E. A Positive Babinski occurs in normal neonates when the sole of the foot is stroked upward toes flair. Reflex disappears around 2 yr. This is not a manifestation of pregnancy.
The nurse identifies the following assessment findings in a patient who is 36 weeks’ gestation. Which should be reported to the provider immediately?
A. BP of 148/93 mm/Hg
B. Positive Hep B serum antibody titer
C. Leukorrhea discharge
D. Blood type O positive
Correct A. This may indicate preeclampsia.
+antibodies indicate the patient is protected against Hepatitis B.
Leukorrhea is common in pregnant women.
Normal blood type.
A 36-week pregnant patient is admitted to the ER the nurse suspects HELLP syndrome after an initial assessment and review of the lab work. Which of the following are consistent with HELLP syndrome?
A. Abdominal pain, anemia, thrombocytopenia, hypertension.
B. Abdominal pain, lowered liver function tests (LFTs), polycythemia, hypertension.
C. Nausea and Vomiting, abdominal pain, hypotension. anemia, thrombocytosis.
D. Abdominal pain, N&V, hypertension, thrombocytosis.
A is correct.
HELLP: hemolysis, elevated liver enzymes, and low platelets.
A woman in labor arrives in the ER. She reports a history of illicit drug use and is on buprenorphine. The nurse knows that this medication treatment is primarily used for addiction to which type of drug?
A. Cocaine
B. Heroin
C. Methamphetamines
D. Ecstasy
B. is correct
While there are studies showing that it can also be useful for meth. and other non-opioid drugs.