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Worksheets2205 Exam 1 OT pt.2
Total questions: 60
Worksheet time: 30mins
A nurse explains placental abruption. Which statement is accurate?
Separation occurs only before 20 weeks
It is premature separation of the placenta from the uterus after 20 weeks
It is painless bleeding with a nontender abdomen
It is implantation of embryo outside the uterus
Which risk factor is listed for placental abruption?
Cocaine use
Taking prenatal vitamins
First pregnancy at age 25
Ultrasound at 32 weeks
Which additional risk factor is listed for placental abruption?
Daily kick counts
Rh-negative status alone
Trauma
HSV-2 history only
A client with suspected abruption has Class 1 findings. Which set matches Class 1?
Mild uterine tenderness, VS stable, no fetal distress, none to small vaginal bleeding
Rigid board-like abdomen, shock, fetal death
Significant uterine tenderness, tetanic contractions, fetal distress, abnormal clotting factors
Heavy painless bleeding with placenta over os
A client with suspected abruption has a rigid board-like abdomen and shock. Which classification best fits?
Class 0
Class 1
Class 2
Class 3
The nurse prepares labs for suspected placental abruption. Which test is included?
Kleihauer-Betke test
AFP only
Viral culture from lesions
Protein/creatinine ratio only
A client with suspected abruption is unstable. Which action is priority based on the abruption treatment content?
Prepare for emergent cesarean birth
Encourage oral fluids and ambulation
Perform a digital vaginal exam
Delay intervention until ultrasound confirms diagnosis
A nurse is prioritizing interventions for suspected placental abruption. Which is most appropriate?
Start IV with IVF bolus or blood products as indicated
Place client in warm bath to reduce uterine tone
Restrict oxygen to avoid fetal hyperoxia
Send client home if bleeding is minimal
A client with suspected abruption has fetal distress and maternal instability. Which delivery plan aligns with the content?
Reassuring—deliver based on gestational age only
Non-assuring—cesarean birth
Non-assuring—wait 24 hours and repeat NST
Reassuring—perform D&C
A client with hyperemesis gravidarum has UA ketones and high specific gravity. What do these findings suggest?
Dehydration and ketogenesis (body breaking down fat for energy)
Normal pregnancy urine changes
Placenta previa
Cervical insufficiency
Which initial medication approach is described as safe and effective for hyperemesis gravidarum?
High-dose aspirin daily
Pyridoxine (vitamin B6) alone or combined with doxylamine (Unisom)
Glyburide as first-line therapy
Hydralazine IV bolus
A client with hyperemesis gravidarum is dehydrated with low blood volume/low BP. Which fluid is specifically listed for bolus replacement?
Lactated Ringer’s (LR) IVF bolus
D5W at keep-vein-open rate only
Hypertonic saline 3%
Albumin only
The nurse reviews hyperemesis labs. Which electrolyte pattern is included?
Hyperkalemia, hypernatremia
Hypokalemia and hyponatremia
High calcium and low BUN
Elevated platelets with low creatinine
Hyperemesis discharge teaching includes dietary changes. Which option aligns with the listed instructions?
Large meals twice daily
Avoid bland foods and crackers
Advance diet as tolerated with clear/bland foods and frequent small meals (dry toast, crackers)
Nothing by mouth until delivery
A client has refractory (hard to control) hyperemesis gravidarum. Which therapy is listed for refractory cases?
Corticosteroids
Methotrexate
Rhogam
Cerclage
A client is screened for gestational diabetes at 26 weeks. Which screening approach is correct?
1-hour glucose tolerance test; no fasting required
3-hour OGTT; fasting required for all clients initially
AFP screening; no fasting required
24-hour urine test; fasting required
The 1-hour GTT result is 145 mg/dL. What is the next step per the content?
Diagnose GDM immediately
Schedule a 3-hour screening test
Begin glyburide today
Repeat the 1-hour test at 36 weeks
A client asks how the 3-hour OGTT is performed. Which is correct?
50-gram drink, one blood draw at 1 hour
No glucose drink; urine ketones only
100-gram oral glucose load with four blood draws (fasting, then 1, 2, 3 hours)
Continuous glucose monitoring for 24 hours only
Which criterion confirms GDM diagnosis on the 3-hour test per the content?
Two of the four glucose levels out of range
Any single value out of range
Fasting value normal but 1-hour high
Presence of ketonuria only
A client newly diagnosed with GDM asks what treatment starts first. Best answer based on the content:
Immediate IV insulin infusion for all clients
Diet and exercise modifications initially
Oral meds are always first-line in pregnancy
Bedrest only
A nurse reinforces GDM education. Which is included?
Daily fetal kick counts
Avoid all exercise
No postpartum testing is needed
Stop glucose monitoring once diet begins
A client’s glucose remains uncontrolled despite diet/exercise. Which medication plan is stated?
Most oral meds are preferred; insulin is avoided
Insulin for uncontrolled glucose level
Hydralazine is first-line for glucose control
Methyldopa corrects hyperglycemia
A client asks about oral hypoglycemics in pregnancy for GDM. Which statement matches the content?
All oral meds are recommended without limits
Oral meds are contraindicated, including glyburide without exception
Most oral meds are contraindicated; limited use of glyburide is noted
Oral meds replace fetal surveillance needs
A postpartum client who had GDM asks what follow-up testing is needed. Which response is consistent with the content?
Postpartum lab testing including OGTT and glucose levels
No follow-up if the baby is healthy
Only AFP should be repeated postpartum
Only NST is required postpartum
A client is diagnosed with preeclampsia without severe features. Which BP meets the “without severe features” threshold listed?
≥140/90 mm Hg
≥160/110 mm Hg
≥120/80 mm Hg
≤90/60 mm Hg
A client meets criteria for preeclampsia with severe features. Which BP threshold is listed?
≥130/85 mm Hg
≥160/110 mm Hg
≥140/90 mm Hg only once
≤100/70 mm Hg with edema
Which proteinuria criterion is listed under preeclampsia evaluation?
24-hour urine ≥300 mg
UA specific gravity >1.030 only
Ketones in urine
Viral culture positive
Which additional proteinuria criterion is listed?
Coombs test ≥0.3
Protein/creatinine ratio ≥0.3
Platelets <100,000
AST/ALT ×2 normal
Which finding is listed as a severe feature: persistent headache (HA) unresponsive to analgesics?
Persistent HA without response to analgesics
Mild nausea that improves with crackers
Breast tenderness only
Increased appetite and energy
Which severe feature is listed (define term): pulmonary edema (fluid in the lungs)?
Hyperreflexia only
Pulmonary edema
Mild ankle swelling at end of day
Constipation
Which lab finding is listed as a severe feature: thrombocytopenia (low platelets)?
Platelets <100,000
Platelets >450,000
Hemoglobin 12 g/dL
WBC 9,000
Which renal criterion is listed as a severe feature?
Creatinine ≥1.1 or double baseline
Creatinine <0.4 with ketonuria
UA ketones only
Specific gravity low only
Which liver criterion is listed as a severe feature?
AST/ALT ×2 normal value
Low AFP
High hCG only
Positive viral culture
The nurse notes hyperreflexia with clonus (rhythmic muscle jerking). How is this described in the preeclampsia section?
Not necessarily part of diagnostic criteria but can be present
Required for diagnosis in all cases
Only occurs in placenta previa
Indicates GDM
A client has new-onset seizures in pregnancy with severe preeclampsia history. What is the diagnosis?
Eclampsia
Hyperemesis gravidarum
Placenta previa
Cervical insufficiency
Which statement best defines eclampsia per the content?
HTN after 20 weeks with proteinuria only
New-onset seizures as a manifestation of severe preeclampsia
Painless bleeding with placenta covering os
Implantation outside the uterus
A client has an eclamptic seizure. Which maternal symptom is listed as part of eclampsia clinical presentation?
Severe headache, blurred vision, light sensitivity
Foul-smelling discharge and fever
Dry cough and sore throat only
Tingling lips after eating crackers
First-line treatment for eclampsia is
Hydralazine only
Labetalol only
Magnesium sulfate
Glyburide
Antihypertensive therapy is initiated in eclampsia for BP at or above which level?
≥140/90 mm Hg
≥150/100 mm Hg
≥130/80 mm Hg
≥160/110 mm Hg
Which antihypertensive medications are specifically listed for severe BP management in eclampsia?
Hydralazine and labetalol
Doxylamine and pyridoxine
Acyclovir and valacyclovir
Methotrexate and Rhogam
A client has chronic hypertension in pregnancy. Which medication is listed as 1st-line with favorable maternal/neonatal outcomes?
Methyldopa
Metoclopramide
Glyburide
Misoprostol
A client with chronic/gestational HTN needs first-line therapy. Which medication is listed as first-line for chronic and gestational HTN?
Thiazide diuretic
Labetalol
Aspirin high-dose
Valacyclovir
A provider orders a calcium channel blocker for overall BP control in pregnancy. Which medication is listed?
Hydralazine
Methyldopa
Nifedipine
Doxylamine
A client presents with acute severe hypertension in pregnancy. Which medication is listed for acute severe HTN?
Insulin
Acyclovir
Pyridoxine
Hydralazine
A nurse teaches a pregnant client at risk for hypertensive disease about prophylaxis. Which is listed?
Low-dose aspirin for at-risk clients
High-dose aspirin for all clients
Glyburide daily to prevent HTN
Methotrexate weekly to prevent preeclampsia
A client has cervical insufficiency risk factors and asks what findings might occur. Which is included?
Severe cough and sore throat
Pelvic pressure and changes in vaginal discharge
Painless bleeding with placenta seen on speculum exam
Fruity breath and flushing
Cervical insufficiency etiology is best described as
Structural cervical weakness related to prior cervical/uterine surgery or congenital abnormality
Infection of fetal membranes from HSV
Premature separation of placenta after 20 weeks
Excessive placental growth with vesicles
A client is diagnosed with cervical insufficiency. Which medical management is listed?
Progesterone injection or vaginal suppository
Low-dose aspirin only
Glyburide only
D&C only
A prophylactic cerclage is planned. When is placement described?
13–14 weeks up to 24 weeks
Only after 32 weeks
Only postpartum
Only before 8 weeks
Cerclage removal is planned for what timing?
20–22 weeks
24–28 weeks
32–34 weeks
36–37 weeks
A client has genital herpes (HSV-2). Which expected finding is listed for an initial outbreak?
Lesions with pain/itching at infection site and dysuria
Painless vaginal bleeding with nontender abdomen
Rigid board-like abdomen with tetanic uterus
Persistent vomiting with ketonuria only
The nurse explains HSV lesions. What progression is listed?
Macules/papules → vesicles/ulcers → encrust within ~2 weeks
Petechiae → jaundice → cyanosis within 24 hours
Which diagnostic test is listed as preferred for HSV due to high sensitivity?
24-hour urine protein
PUQE score
NAAT virologic testing
Kleihauer-Betke test
Which antiviral plan is listed for HSV prophylaxis in pregnancy?
Glyburide in third trimester
Hydralazine in third trimester
Methotrexate in third trimester
Acyclovir in the third trimester
HSV client education includes partner notification. Which instruction is listed?
Inform all sexual partners
Partners do not need to be informed if lesions are absent
Only inform partners postpartum
Inform partners only if NAAT is negative
The nurse teaches HSV lesion care. Which instruction is listed?
Scrub vigorously with alcohol to dry lesions
Keep lesions covered with occlusive dressing at all times
Wash with mild soap and water; dry gently
Apply heat packs continuously for 24 hours
A pregnant client asks about COVID-19 vaccination. Which statement matches the content?
CDC and ACOG recommend all pregnant women get vaccinated
COVID-19 vaccination is contraindicated in pregnancy
Only postpartum vaccination is recommended
Vaccination is recommended only if the client has HSV
A client with suspected endometriosis asks what it is. Which definition is included?
Infection of the endometrium caused by HSV
Growth of endometrial tissue outside the uterus
Placenta implanted over the cervical os
Premature separation of placenta after 20 weeks
A nurse reviews the diagnostic approach for endometriosis included in the file. Which is correct?
Diagnosis includes history/evaluation, ultrasound, and surgery to visualize & biopsy lesions
Diagnosis is confirmed by 1-hour GTT
Diagnosis is confirmed by Kleihauer-Betke test
Diagnosis is confirmed by NST alone
A client with endometriosis asks about medication options listed. Which is included?
Rhogam
Valacyclovir only
NSAIDs and GnRH agonists (e.g., leuprolide) are listed under medications/therapeutic procedures
Hydralazine for pain control
