WorksheetsExam 2 (OB) Part 1
Total questions: 90
Worksheet time: 48mins
What does FHT mean?
Fetal heart tones
Fetal hormone therapy
Functional heart test
Fibrinogen hormone test
What does WNL mean?
Within normal limits
With no lesions
Without noticeable loss
With new lesions
What are the normal parameters for baseline FHTs?
Between 110 and 160 bpm
Below 100 bpm
Above 180 bpm
Between 90 and 100 bpm
What is the normal value for WBCs in an adult female?
4.5-11.1
1.0-3.0
12.0-18.0
0.5-2.0
6.0-13.2
What is the normal value for Hemoglobin in an adult female?
11.7-15.5 g/dL
8.0-10.0 g/dL
16.0-20.0 g/dL
6.5-9.0 g/dL
What is the normal value for Hematocrit in an adult female?
35-48%
10-20%
50-65%
20-30%
What is the normal value for Platelets in an adult female?
150-450 (10^3/microL)
50-100 (10^3/microL)
500-700 (10^3/microL)
10-50 (10^3/microL)
What is the normal value for Sodium?
135-145 mg/dL
120-130 mg/dL
150-160 mg/dL
100-110 mg/dL
What is the normal value for Potassium?
3.5-5.0 mg/dL
1.5-2.5 mg/dL
6.0-7.5 mg/dL
0.5-1.0 mg/dL
What does prenatal mean?
A) before birth
B) during birth
C) after birth
What does antenatal mean?
A) before birth
B) during birth
C) after birth
What does postnatal mean?
before birth
during birth
after birth
Evaluate how to confirm pregnancy. What evidence is required to confirm pregnancy?
Pregnancy can only be confirmed with evidence of a fetus, using either fetal heart tones and/or ultrasound imaging.
A positive urine pregnancy test alone is sufficient to confirm pregnancy.
Morning sickness and missed periods are enough to confirm pregnancy.
Physical examination findings alone are sufficient to confirm pregnancy.
SATA: Which of the following should NOT be present in a normal urinalysis?
ketones
glucose
nitrites
protein
bacteria
How is Naegele's rule used to estimate due dates?
Begin with first day of last menstrual period, subtract 7 months, and add 3 days.
Subtracting 1 year, adding 3 months, and adding 7 days to the first day of the last menstrual period
Begin with first day of last menstrual period, subtract 3 months, and add 7 days.
Subtracting 3 months and adding 10 days to the first day of the last menstrual period
Maternal serum alpha-fetoprotein screening is completed to detect certain fetal abnormalities and is typically performed during which period of pregnancy?
Between 15 and 20 weeks of pregnancy.
Typically performed in the first week.
Typically performed after 30 weeks.
Between 22 and 24 weeks of pregnancy.
Which of the following is NOT a criterion for a pregnant patient to be considered 'high risk'?
Hypothyroidism
IUGR
Preeclampsia
Diabetes Mellitus
Malnutrition
SATA: When would a transvaginal U/S be required?
greater detail of pelvic anatomy is required
can detect intrauterine pregnancy earlier than standard U/s
useful in obese women
useful in very thin women
can detect gestational diabetes, unlike standard U/S
What is a BPP?
A comprehensive test to evaluate the health of the fetus.
A comprehensive test to evaluate the health of the pregnant mother.
A procedure for treating preeclampsia.
A procedure for treating gestational diabetes.
EFM assesses which of the following in the Biophysical Profile (BPP) test?
Fetal heart rate patterns
Amniotic fluid volume
Fetal breathing movements
Fetal kick rates
What is the maximum score each variable receives in the Biophysical Profile (BPP) test?
2
5
10
1
What cumulative score is considered normal in the Biophysical Profile (BPP) test?
8-10
4-6
2-4
0-2
What cumulative score is considered equivocal in the Biophysical Profile (BPP) test?
6
2
8
10
The nurse should teach the patient to do which of the following before performing the Biophysical Profile (BPP) test?
Drink plenty of water to ensure a full bladder
Eat a heavy meal
Take a sedative
Avoid all fluids for 12 hours
What should be recommended to the pregnant patient with a critically poor total BPP score?
Immediate delivery or close monitoring
Magnesium sulfate and labetalol
Increase maternal hydration
Repeat BPP after one month
What is an amniocentesis?
Needle is inserted through abdomen into uterus, under guidance from U/S, to aspirate amniotic fluid.
Needle is inserted through abdomen into fallopian tubes, under guidance from CT, to aspirate amniotic fluid.
Needle is inserted through abdomen into ovaries, under guidance from x-ray, to aspirate amniotic fluid.
Needle is inserted through abdomen into placenta, under guidance from MRI, to aspirate amniotic fluid.
What are the fetal risks associated with amniocentesis?
Hemorrhage, infection, direct needle injury.
Premature closure of ductus arteriosus, polyhydramnios, macrosomia.
Neural tube defects, Down syndrome, Turner syndrome.
Placenta previa, gestational diabetes, oligohydramnios.
Which of the following is an expected result of a kick count test?
Mom should feel at least 3 kicks and record them for 60 minute period of testing
Mom should feel at least 10 kicks and record them for 60 minute period of testing
Mom should feel at least 1 kick and record it for 60 minute period of testing
Mom should feel at least 5 kicks and record them for 60 minute period of testing
How often should kick counts be performed according to the protocols?
A) Once a day for 60 minutes
B) 2-3 times a day for 60 minutes each time
D) Both A and B
C) Once a week for 60 minutes
E) A, B, and C
Which of the following can decrease fetal movement?
Fetus is sleeping
Mom is taking antidepressants or other CNS depressants
Alcohol intake and smoking
Maternal obesity
All of the above
During a fetal kick tests, ___ or fewer kicks warrants further investigation. A result of _____ movement for 12 hours is considered a sign of fetal distress.
5, extensive
2, absent
2, extensive
5, absent
SATA: What are some disadvantages of the Nonstress test?
Low false positive rate
High false positive rate
It is highly invasive
It cannot be repeated
Need for frequent retesting
What does a Contraction Stress test identify?
fetal ability to induce contractions
fetal ability to respond to stress of contractions
true contractions versus Braxton Hicks contractions
maternal ability to perform contractions
How long is a Nonstress test typically completed if the fetus is awake?
20 minutes
10 minutes
45 minutes
60 minutes
What is required for a reactive result in a Nonstress test?
2 accelerations are required in a 20 minute period
2 decelerations are required in a 20 minute period
No accelerations for 30 minutes
10 accelerations are required in a 30 minute period
2 accelerations are required in a 30 minute period
What is administered during a Contraction Stress Test to stimulate contractions?
IV infusion with oxytocin
Oral administration of magnesium sulfate
Subcutaneous injection of hydralazine
Inhalation of nitric oxide
The fetal heart rate baseline is assessed by:
Observing the average heart rate over a 10-minute period, excluding periods of variability
Observing the average heart rate over a 10-minute period only during periods of variability
Recording the highest heart rate observed, regardless of periods of variability
Counting the number of fetal movements per period of variability
Observing the average heart rate over a 10-minute period, including periods of variability
Fetal accelerations are:
Temporary increases in fetal heart rate associated with fetal movement
Prolonged decreases in fetal heart rate
Consistent baseline fetal heart rate without variation
Sudden drops in fetal heart rate due to cord compression
The potential results for a Nonstress test are:
Reactive and nonreactive
Positive and negative
Normal and abnormal
High and low
The potential results for a Contraction Stress test are:
Negative, Positive, Suspicious-Equivocal
Normal, Abnormal, Borderline
Reactive, Non-reactive, Equivocal
Elevated, Decreased, Midline
What nutritional supplement should be taken prior to conception to prevent neural tube defects?
Iron
Folic Acid
Vitamin D
Calcium
What is the condition called where the patient craves "unusual foods"? Fill in the blank: The condition is called _______.
Pica
Anorexia
Bulimia
Dysphagia
What is the most common potential complication for a patient who ingests non-food/"unusual foods"?
Iron deficiency
Vitamin B12 deficiency
Folic acid deficiency
hCG deficiency
A pregnant patient who only consumes a vegetarian diet would have which specific dietary needs?
Increased intake of vitamin B12, iron, and protein
Increased intake of saturated fats
Decreased need for calcium
Reduced requirement for folic acid
Morning sickness (N/V) is common for most patients during which trimester?
First trimester has the most morning sickness
Second trimester has the most morning sickness
Third trimester has the most morning sickness
All trimesters equally have morning sickness
Recommendations to help minimize the symptoms of morning sickness (N/V) during pregnancy include:
Eating small, frequent meals throughout the day
Drinking large amounts of water at once
Skipping breakfast to avoid nausea
Consuming spicy foods regularly
What is the condition called when a pregnant patient experiences severe nausea and vomiting in a much stronger intensity than standard morning sickness?
Hyperemesis Gravidarum
Gestational Diabetes
Preeclampsia
Placenta Previa
Is vaping or cigarette use okay during pregnancy?
No
Yes
Second hand smoke can cause problems in pregnancy.
True
False
What are the recommendations for pregnant women who smoke?
Stop smoking
If cessation not possible, reduce amount of smoking
If partner smokes, they should smoke outside and wear designated cig clothes
All of the above
Babies can be born undergoing __________ from opioids, which can be life threatening.
withdrawals
seizures
shrinkage
immunity
The HCP should place patient on __________ or __________ if opioid abuse is present during pregnancy.
Subutex or Suboxone
Methadone or Morphine
Ibuprofen or Acetaminophen
Naloxone or Naltrexone
Lunch meats pose a risk of __________ in pregnancy.
Listeria
Salmonella
E. coli
Toxoplasma
Fish can pose a __________-poisoning risk in pregnancy.
mercury
calcium
aluminum
lead
SATA: Select all of the pertinent topics for a nurse to educate a pregnant patient who is in the third trimester.
signs of real labor vs false labor (Braxton Hicks)
tracking fetal movement and kick counts
resources on infant CPR classes
creating a birth plan for healthcare staff and family members to follow
strategies for managing morning sickness
SATA: What nursing interventions would help to promote comfort if a pregnant patient is scheduled for an ultrasound (U/S)?
allow parents to see the monitor
point out possible malformations
let patient know that a full bladder is required to displace the uterus for standard U/S
educate parents on the possible diagnoses that you see during the U/S
allow patients receiving a transvaginal U/S to empty their bladder prior to the scan
Which deep tendon response score would be considered normal?
0+
1+
2+
3+
4+
The maternal serum alpha-fetoprotein test is a screening tool for _______________ disorders and defects of the developing fetus.
placental structure
iron deficiency
neural tube
ophthalmic
mucociliary
The BPP uses two different modalities, which are:
U/S and CT
EFM and CT
U/S and EFM
EFM and FMRI
SATA: When using ultrasound for a BPP, which factors are being assessed?
amniotic fluid volume
fetal breathing movements
fetal tone
general fetal movement
reactive nonstress test results
What should a pregnant patient do JUST prior to a BPP to maximize fetal activity?
empty their bladder
eat or drink
take misoprostol
take magnesium sulfate
SATA: Select some implications for performing a BPP.
maternal severe asthma
maternal diabetes mellitus
pregnancy of more than one baby
fetus that is LGA or SGA
gestational age of over 41 weeks
A BPP score of 0 would be given for which result regarding fetal breathing movements?
Absent or no episode of fetal breathing movement over 30 seconds in 30 min
Absent or no episode of fetal breathing movement over 30 seconds in 10 min
Absent or no episode of fetal breathing movement over 10 seconds in 10 min
Absent or no episode of fetal breathing movement over 60 seconds in 20 min
A BPP score of 0 would be given for which result regarding general fetal movements?
Less than 3 episodes of body or limb movements in 10 minutes
Less than 10 episodes of body or limb movements in 30 minutes
Less than 3 episodes of body or limb movements in 30 minutes
Less than 10 episodes of body or limb movements in 60 minutes
A BPP score of 0 would be given for which result regarding EFM?
Less than 2 episodes of decelerations or deceleration of less than 15 bpm in 20 min
Less than 2 episodes of accelerations or acceleration of less than 15 bpm in 20 min
Less than 20 episodes of accelerations or acceleration of less than 15 bpm in 2 min
Less than 5 episodes of accelerations or acceleration of less than 40 bpm in 20 min
A BPP score of 0 would be given for which result regarding amniotic fluid volume?
Pockets of amniotic fluid absent or pocket less than 1 cm in 6 perpendicular planes
Pockets of amniotic fluid absent or pocket less than 4 cm in 10 perpendicular planes
Pockets of amniotic fluid absent or pocket less than 2 cm in 4 perpendicular planes
Pockets of amniotic fluid absent or pocket less than 1 cm in 2 perpendicular planes
SATA: Select all of the potential maternal complications of an amniocentesis.
amniotic fluid leakage
hemorrhage
preterm labor
miscarriage
infection
A Nonstress test is used to determine:
if fetus can handle contractions
if fetus has developed lungs
if fetus is active
if fetus is an appropriate size for gestational age
When performing a Nonstress test, _____ is recorded with a doppler transducer, and the mother will _____ every time a fetal movement is felt.
fetal movement, yell
fetal heart rate, push a button
fetal tone, induce a contraction on demand
placental perfusion, roll into the left lateral position
During a Nonstress test, a reactive result is possible WITHOUT recognized fetal movement from mom, as the 2 accelerations are the benchmark for test results.
True
False
SATA: What happens when contractions are induced in a Contraction stress test?
uterine blood flow decreases
uterine blood flow increases
placental perfusion decreases
placental perfusion increases
fetus undergoes temporary hypoxia
During a Contraction stress test, fetal hypoxia SHOULD cause ______ of the FHR if the fetus is able to respond to the stress of contractions.
decelerations
accelerations
variables
no change
A Contraction stress test involves ___ contraction(s) of at least ___ seconds, over a total time period of ____ minutes.
10, 3, 30
3, 40, 10
3, 30, 20
4, 10, 30
For a period of variability to be considered a fetal acceleration or deceleration, they need to be at least ___ bpm above or below baseline FHR, and last at least ___ seconds.
15, 40
40, 15
15, 15
40, 40
A normal result of a Contraction stress test would show:
negative: no late decelerations
positive: no late decelerations
negative: less than 3 late decelerations
positive: less than 3 late decelerations
A positive result for a Contraction stress test would be considered _____, and would indicate that the fetus ______ handle the stress of contractions and labor.
normal, can
normal, cannot
abnormal, can
abnormal, cannot
A positive result for a Contraction stress test would indicate that late decelerations occur with 50% or more of contractions. What would a result of suspicious-equivocal indicate?
late decelerations do not occur with more than 25% of contractions
late decelerations occur, but with less than 50% of contractions
late decelerations do not occur with more than 10% of contractions
late decelerations occur with at least 75% of contractions
Pregnant women are recommended to take 800-1,000 mg of folic acid daily. What dosage should women who are capable of becoming pregnant and planning on having a baby be taking daily?
100 mg
200 mg
400 mg
2 g
100 g
Would a strict vegan have any additional needs during pregnancy?
No.
Yes, they will be deficient in Vitamin D which MUST be supplemented.
Yes, they will be deficient in Vitamin A which MUST be supplemented.
Yes, they will be deficient in Vitamin C which MUST be supplemented.
SATA: What dietary needs would there be if a pregnant patient only consumes a vegetarian diet, besides iron?
vitamin B12
vitamin D
zinc
calcium
omega 3 fatty acids
SATA: Select all of the consequences of hyperemesis gravidarum.
severe fluid loss
severe hypervolemia
severe fluid/electrolyte imbalance
severe dehydration
ketones in the urine
The RN should educate a patient with hyperemesis gravidarum to be in the ______ position after meals.
Supine
Sims
High Fowlers
Left Lateral
Right Lateral
While alcohol is not recommended during pregnancy, there is a quantifiable safe level of alcohol consumption during pregnancy, and OBGYNs can help patients figure out this level.
True
False
Alcohol during pregnancy is linked to birth defects, fetal alcohol syndrome, and stops maternal absorption of _______ and ______.
zinc, omega 3 fatty acids
vitamin D, vitamin B12
folic acid, calcium
magnesium, phosphate
SATA: What are some potential consequences of smoking or vaping during pregnancy?
stillbirths
low birth weight babies
placenta previa
abruptio placenta
reduced IQ (of the baby)
In a patient who uses nicotine products during pregnancy, the complication risk is DIRECTLY linked to amount of cigs smoked/amount vaped.
True
False
A pregnant patient can contract toxoplasmosis from raw/undercooked meats, as well as:
all cats
fresh cat litter
the litter of infected cats
dog litter
Small portions of food and adherence to the _____ diet is recommended for patients suffering from hyperemesis gravidarum.
FAT
SHAT
BRAT
CAT
What cumulative score is considered critical in the Biophysical Profile (BPP) test and requires prompt action and likely hospital admission?
8 or below
6 or below
5 or below
4 or below
For the Biophysical Profile (BPP) test, what cumulative score would warrant further investigation?
10 or below
8 or below
15 or below
12 or below
