Obstetrics Nursing Quiz

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Questions and Answers

What is the primary purpose of Rhogam administration during pregnancy?

To enhance fetal lung maturity.

To prevent hemolytic disease in a Rh-positive baby. (correct)

To suppress uterine contractions.

To treat maternal hypotension.

Which medication may cause hypotension and should not be administered with magnesium sulfate?

Ampicillin

Betamethasone

Nifedipine (correct)

Methotrexate

What vital sign change is expected during the second trimester of pregnancy?

Decreased diastolic blood pressure (correct)

Increased respiratory rate

Decreased heart rate

Increased systolic blood pressure

What is a primary contraindication for administering magnesium sulfate?

Active vaginal bleeding Signup and view all the answers

What is a common side effect of betamethasone administration in pregnant women?

Hyperglycemia Signup and view all the answers

What is the purpose of the rubella titer test during pregnancy?

To determine immunity to rubella Signup and view all the answers

Which of the following nutritional recommendations is NOT advised during pregnancy?

Consume excessive amounts of fluid Signup and view all the answers

What is a common danger sign of pregnancy?

Persistent vomiting Signup and view all the answers

What should be done if a patient actively has genital herpes during pregnancy?

Start suppression medication at 36 weeks Signup and view all the answers

What is the recommended weight gain during the first trimester of pregnancy?

2-4 pounds Signup and view all the answers

Which statement regarding iron supplementation is correct?

Vitamin C aids in its absorption Signup and view all the answers

When is the glucose challenge test typically administered during pregnancy?

Second trimester Signup and view all the answers

What is a sign of hyperglycemia during pregnancy?

Increased thirst Signup and view all the answers

Which of the following infections is screened for at 35-37 weeks of pregnancy?

Group B Streptococci Signup and view all the answers

What is a recommended approach to manage nausea during pregnancy?

Eat small, frequent meals every 2-3 hours Signup and view all the answers

What is a common symptom of trichomoniasis in women?

Yellow-green vaginal discharge Signup and view all the answers

What is a potential complication of untreated gonorrhea during pregnancy?

Neonatal sepsis Signup and view all the answers

What instruction should be given prior to a chorionic villus sampling procedure?

Empty bladder Signup and view all the answers

What factor does NOT increase the risk of spontaneous abortion?

Regular exercise Signup and view all the answers

What is the purpose of a nonstress test?

To monitor fetal heart rate response to movement Signup and view all the answers

Which treatment is NOT indicated for an ectopic pregnancy?

Oral antibiotics Signup and view all the answers

What symptom is indicative of placenta previa?

Painless bright red bleeding after 20 weeks Signup and view all the answers

What should be avoided when taking Methotrexate for ectopic pregnancy?

Alcohol Signup and view all the answers

In which trimester is amniocentesis typically performed?

Second and third trimesters Signup and view all the answers

Which of the following statements about HPV is true?

It is primarily linked to genital warts and cervical cancer. Signup and view all the answers

Which of the following conditions indicates a need for a biophysical profile?

Oligohydramnios Signup and view all the answers

What finding might indicate a ruptured ectopic pregnancy?

Abrupt unilateral stabbing pain Signup and view all the answers

What is typically done first when diagnosing fetal abnormalities using chorionic villus sampling?

Perform an ultrasound Signup and view all the answers

What is a required step for ultrasound preparation?

Drinking 32 oz of water to fill the bladder Signup and view all the answers

What is a common expected finding in a patient with placental abruption during the third trimester?

Dark red vaginal bleeding Signup and view all the answers

Which risk factor is associated with an increased likelihood of preterm labor?

Multifetal pregnancy Signup and view all the answers

What nursing care should be prioritized in a client presenting with signs of preterm labor?

Administer tocolytics Signup and view all the answers

Which of the following indicates a high risk for infection following premature rupture of membranes (PROM)?

Chorioamnionitis Signup and view all the answers

What is the role of Betamethasone in cases of PROM?

Enhance fetal lung maturity Signup and view all the answers

Which sign is indicative of hypovolemic shock in a patient experiencing excessive bleeding?

High heart rate Signup and view all the answers

Which nursing intervention would be essential for a patient with suspected PPROM?

Daily fetal monitoring Signup and view all the answers

What is a nonpharmacological method of pain management during childbirth that can be effective?

Breathing techniques Signup and view all the answers

Which of the following is a possible complication of PPROM?

Increased risk of infection Signup and view all the answers

Which assessment finding would indicate the onset of preterm labor?

Regular uterine contractions Signup and view all the answers

What is a risk factor for placental abruption?

Cocaine use Signup and view all the answers

Which symptom indicates a possible need for immediate delivery in cases of fetal compromise?

Intense localized pain Signup and view all the answers

What does a positive Nitrazine test indicate?

Presence of amniotic fluid Signup and view all the answers

Which is a key factor influencing pain during childbirth?

Fear and anxiety levels Signup and view all the answers

What change is NOT typically observed in the cardiovascular system during pregnancy?

Decreased heart rate Signup and view all the answers

What is a common result of the uterus growing during pregnancy?

Pressure on the diaphragm Signup and view all the answers

Which of the following is NOT a probable sign of pregnancy?

Fetal movements felt by the examiner Signup and view all the answers

What is the recommended intervention to address supine hypotensive syndrome?

Avoid laying flat and lie on the left lateral side Signup and view all the answers

What aspect of the endocrine system is primarily affected during pregnancy?

Hormones that maintain pregnancy and prepare the body for delivery Signup and view all the answers

Which symptom is commonly associated with gastrointestinal changes in pregnancy?

Nausea and vomiting Signup and view all the answers

What is the primary purpose of the mucus plug that forms during pregnancy?

To create a barrier at the cervix Signup and view all the answers

What is likely to occur if a pregnant person does not maintain proper hydration and physical activity?

Higher likelihood of constipation and urinary stasis Signup and view all the answers

What does Chadwick's sign indicate during a pregnancy examination?

Dark blue color of cervix and vagina Signup and view all the answers

What is the risk associated with the relaxation of muscles in the ureters and bladder during pregnancy?

Risk for urinary stasis and UTI Signup and view all the answers

What is the probable consequence of a mother lying flat on her back during the later stages of pregnancy?

Development of supine hypotensive syndrome Signup and view all the answers

Which of the following indicates a presumptive sign of pregnancy?

Amenorrhea Signup and view all the answers

Which sign indicates the need for further evaluation in the context of a possible ectopic pregnancy?

High hCG levels Signup and view all the answers

What is a critical nursing intervention when performing cervical ripening?

Assess fetal heart rate before and after the procedure Signup and view all the answers

Which indication is NOT a reason for initiating artificial contractions?

History of previous cesarean delivery Signup and view all the answers

What effect does performing amnioinfusion primarily have?

Relieves fetal distress Signup and view all the answers

Which of the following best describes Bishop score criteria for successful labor induction?

A score of 8 or higher Signup and view all the answers

What is the primary risk associated with continuous internal fetal monitoring?

Higher rates of infection Signup and view all the answers

What complication can result from ineffective contractions during labor?

Labor dystocia Signup and view all the answers

Which position is recommended to assist in optimal fetal positioning during labor?

Side-lying position Signup and view all the answers

What is the expected finding in a patient experiencing uterine rupture?

Cessation of contractions Signup and view all the answers

Which fetal presentation typically requires a cesarean delivery?

Transverse lie Signup and view all the answers

What does a non-reassuring fetal heart rate indicate?

Interventions are required Signup and view all the answers

What is a potential risk associated with vacuum-assisted delivery?

Scalp lacerations in the fetus Signup and view all the answers

What should be the mother's position if a prolapsed umbilical cord is detected?

Trendelenburg position Signup and view all the answers

What is the desired effect of cervical ripening agents?

Cervical dilation and effacement Signup and view all the answers

What does VEALCHOP acronym stand for in fetal heart rate monitoring?

Variable decelerations, Early decelerations, Accelerations, Late decelerations, Cord compression, and Oligohydramnios Signup and view all the answers

Study Notes

Medications

Rhogam: Blood product, 2 RN CHECK.
- Im injection.
- Mother gets another dose after baby is born.
Methotrexate: Suppresses contractions but may cause hypotension. (Give hypotensive education; do not give with mag sulfate).
- Mag Sulfate: must have no contraindications; antidote is calcium gluconate.
Active vaginal bleeding
Dilation of cervix > 6 cm
Greater than 34 weeks
Acute fetal distress
Chorioamnionitis
Nifedipine: Suppresses contractions but may cause hypotension.

Gynecological Exam

Gynecologic Exam: 1 point
Contraception: 2 points
Pregnancy & Antepartum Nursing Care: 7 points
Nutrition for Childbearing: 4 points
Infections During Pregnancy 2 points
Fetal Assessment: 2 points
Hemorrhagic Conditions: 4 points
Preterm Labor & PROM/PPROM: 6 points
Process of Birth/ Factors Affecting Labor: 7 points
Pain Management During Childbirth: 3 points
Intrapartum Fetal Surveillance: 4 points
Nursing Care During Labor: 4 points
Labor Complications: 1 point
Antepartum & Intrapartum Nursing Care (Total): 50 points

Other

Betamethasone: Enhances fetal lung maturity, may cause hyperglycemia in mother.
Ampicillin: Commonly used to treat chorioamnionitis.
Epidural: Causes hypotension; Ephedrine is used to treat.
Contraception: 1st trimester (weeks 1-13): fetal organ development; Physical changes are not obvious, pregnancy is more noticeable. 2nd trimester (weeks 14-27): rapid physical changes in abdomen and breasts; May affect mobility, skin, balance, back, or leg discomfort; Risk of negative body image. 3rd trimester (weeks 28-42): fetal tissue growth; Changes in vital signs (HR increases, RR slightly increases, BP may decrease); Side-lying position relieves pressure on major blood vessels; Reproductive changes (uterus grows, fundus at xiphoid process, SOB).
Gyne Exam: Physical changes.
Pregnancy and Antepartum: Physical changes.
Musculoskeletal: Posture, gait, and balance changed; Risk of falls and sprains; Sway back; Waddling gate; Diastasis recti (separation of abdominal muscles).
Endocrine: Hormones' role in pregnancy and delivery; Human Chorionic Gonadotropin (hCG); Progesterone; Estrogen; Human Chorionic Somatomammotropin (hCS); Relaxin.
Confirmation of pregnancy: Presumptive changes (amenorrhea, fatigue, nausea & vomiting, urinary frequency, breast changes, hyperpigmentation, quickening, uterine enlargement); Probable changes (uterine enlargement, cervical softening, changes in uterine consistency, Braxton Hicks contractions, positive pregnancy test, palpation of fetal outline, ballottement).
Antepartum assessment, care, and education: Need baseline vitals; Establish GTPAL (term is 37 weeks); Estimated delivery date; Routine Labs (CBC, blood type & Rh factor, VDRL/RPR, rubella titer, hepatitis B, HIV).
Infections during pregnancy: HIV, Hep B, Rubella, HSV, Group B Strep (screened at 35-38 weeks), Syphilis, Chlamydia, Trichomoniasis, HPV.
Fetal assessment: Ultrasound (full bladder), transabdominal (1st trimester), transvaginal (2nd and 3rd trimester), Nonstress test, Biophysical profile.
Chorionic villus sampling: Diagnoses fetal chromosomal, metabolic, and DNA abnormalities.
Amniocentesis: Assess for neural tube defects or chromosomal disorders (done in 2nd and 3rd trimester); Education prior - Empty bladder; Education after - spotting/bleeding like a period, clots/tissue passage, cramping, leaking fluid, temperature of 100.4. Complications include amniotic fluid embolism, maternal or fetal hemorrhage, maternal or fetal infection, and miscarriage.
Hemorrhagic conditions of early pregnancy: Spontaneous abortion (pregnancy ends before 20 weeks). Risk factors: chromosome abnormalities, advanced maternal age, premature cervical dilation, chronic maternal infections, maternal malnutrition, substance use, trauma or injury.
Ectopic pregnancy: Implantation of ovum outside uterus; Risk factors: STI, tubal surgery, IUDs, multiple induced pregnancies.
Bleeding: Missed period, abdominal pain, vaginal bleeding; RUPTURE; Abrupt unilateral stabbing pain in lower abdomen with or without vaginal bleeding.
Management: Methotrexate, surgical (salpingectomy), ligation of bleeding vessels.
Hemorrhagic conditions of late pregnancy: Placenta previa; Risk factors: advanced maternal age, multiparas, previous c-section, prior placena previa, multifetal pregnancy, smoking.
PROM / PPROM & preterm labor: Uterine contractions - weeks 20-36; Risk factors: Infections (UTI, STIs, HIV, HSV, chorioamnionitis), prior preterm birth, multifetal pregnancy.
Labor complications: Prolapsed umbilical cord, high station (-3), breech or transverse lie, SGA. Expected findings: FHR shows prolonged decelerations after ROM, visual/palpable umbilical cord through vagina, lack of progress in dilation, effacement, or fetal descent, ineffective pushing, persistent occiput posterior presentation, hypotonic uterus.
Nursing actions: Monitor maternal VS's & FHR, ensure client NPO, apply SCDs, assess client post-delivery for decreased uterine tone. Premonitory signs of labor: lightening, increased energy level, bloody show, Braxton hicks. Processes of birth: cervical dilation and effacement, length of labor, assessment, risks. Stages of birth: stage 1 (longest), stage 2 (pushing), stage 3 (placenta), stage 4(recovery). Factors affecting labor: passage, passenger, powers, position, psyche.
Post-term labor: Indications; Increase readiness for labor (softening of cervix); interventions; Complications; Risks (infection, cord compression).
Operative Delivery: Indications (maternal exhaustion, fetal distress); Vacuum-assisted (risks: scalp lacerations, fetal cephalohematoma, maternal vaginal trauma); Forceps-assisted (risks: maternal vaginal trauma, facial nerve palsy, facial bruising).
Episiotomy: Manual cutting of perineum; Shortens second stage of delivery; Prevents cerebral hemorrhage (fragile preterm fetuses); Facilitates birth of a large infant.
C-section: Indications (Breech presentation, non-reassuring fetal heart tones, placenta previa, placental abruption, previous c-section, umbilical cord prolapse); High-risk pregnancy.
Vaginal Birth after c-section (VBAC): criteria to deliver vaginally; reason for previous c-section (dysfunctional labor, breech, or abnormal FHR pattern).
Factors affecting labor: Passage (birth canal - size and shape); Passenger (fetus, placenta – size of head, presentation, lie, attitude, position); Powers (contractions - frequency, duration, intensity; maternal pushing efforts); Position (maternal posture); Psyche (feelings, fears).
Powers (contractions): Primary (involuntary utering contractions), Secondary (voluntary maternal pushing).
Hypertonic uterus: Excessively frequent, strong intensity, inadequate relaxation; Interventions; Risk factors; Expected findings; Nursing care (prepare for emergency c-section); Other complications (meconium-stained amniotic fluid, hypoxia).
Amniotic fluid emboli: Related to hypertonic uterine dysfunction.

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Description

Test your knowledge on important obstetric concepts such as Rhogam administration, medication contraindications, vital signs during pregnancy, and side effects of betamethasone. This quiz covers key information relevant to nursing practice in the field of obstetrics.