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UNITEK OB EXAM 1 [CH 3-5]QUESTIONS WITH CORRECT ANSWERS!!, Exams of Nursing

A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse expect? - ANSWERA large amount of bright red vaginal bleeding without pain A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect? - ANSWERPelvic pain

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UNITEK OB EXAM 1 [CH 3-
5]QUESTIONS WITH CORRECT
ANSWERS!!
A nurse is caring for a client who is at 36 weeks of gestation and has suspected
placenta previa. For which of the following findings should the nurse expect? -
ANSWERA large amount of bright red vaginal bleeding without pain
A nurse is caring for a client in the prenatal clinic who has a possible ectopic
pregnancy at 8 weeks of gestation. Which of the following findings should the nurse
expect? - ANSWERPelvic pain
A nurse is reinforcing teaching with a client who is at 6 weeks of gestation. The client
tells the nurse that she smokes one pack of cigarettes per day. The nurse should
instruct the client that her newborn is at increased risk for which clinical
manifestations? - ANSWERLow birth weight
A nurse is preparing to palpate the uterine fundus of a client who is at 22 weeks of
gestation to measure fundal height. At which of the following locations should the
nurse expect to find the fundus? - ANSWERAt the umbilicus
A nurse is reinforcing teaching with a client who is pregnant about expected changes
related to pregnancy. Which of the following statements by the client indicates an
understanding of the teaching - ANSWER"It is normal to have a white vaginal
discharge"
A nurse is reinforcing teaching about a biophysical profile with a client who is at 40
weeks of gestation. The nurse should explain that this profile focus on which of the
following parameters [Select all that apply] - ANSWER- Fetal breathing
- Fetal motion
- Amniotic fluid volume
A nurse is caring for a client who has just learned that she is pregnant. The nurse
should reinforce with the client to call her provider if she experiences any -
ANSWERFacial edema
A nurse is reinforcing teaching about quickening with a client who is at 6 weeks of
gestation. Which of the following information should the nurse include? -
ANSWERQuickening occurs between the fourth and fifth months of pregnancy
A woman is who at 25 weeks pregnancy asks the nurse what her fetus looks like?
What does the nurse explain is one physical characteristic present in a 25 week old
fetus? - ANSWERLanugo covering the body
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UNITEK OB EXAM 1 [CH 3-

5]QUESTIONS WITH CORRECT

ANSWERS!!

A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse expect? - ANSWERA large amount of bright red vaginal bleeding without pain A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect? - ANSWERPelvic pain A nurse is reinforcing teaching with a client who is at 6 weeks of gestation. The client tells the nurse that she smokes one pack of cigarettes per day. The nurse should instruct the client that her newborn is at increased risk for which clinical manifestations? - ANSWERLow birth weight A nurse is preparing to palpate the uterine fundus of a client who is at 22 weeks of gestation to measure fundal height. At which of the following locations should the nurse expect to find the fundus? - ANSWERAt the umbilicus A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching - ANSWER"It is normal to have a white vaginal discharge" A nurse is reinforcing teaching about a biophysical profile with a client who is at 40 weeks of gestation. The nurse should explain that this profile focus on which of the following parameters [Select all that apply] - ANSWER- Fetal breathing

  • Fetal motion
  • Amniotic fluid volume A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences any - ANSWERFacial edema A nurse is reinforcing teaching about quickening with a client who is at 6 weeks of gestation. Which of the following information should the nurse include? - ANSWERQuickening occurs between the fourth and fifth months of pregnancy A woman is who at 25 weeks pregnancy asks the nurse what her fetus looks like? What does the nurse explain is one physical characteristic present in a 25 week old fetus? - ANSWERLanugo covering the body

When preparing to teach a class about prenatal development, the nurse would include information about folic acid supplementation. What is folic acid known to prevent? - ANSWERNeural tube defects A couple just learned they are expecting their first child and are curious if they are having a boy or a girl. At what point of development can the couple first expect to see the sex of their child on ultrasound? - ANSWER10 weeks gestational age The vessels comprising the umbilical cord are cushioned and protected by a substance called - ANSWERWhartons jelly [Q] The normal volume of amniotic fluid is approximately ____ at 37 weeks gestation - ANSWER1000 mL Fetal development - ANSWER- Each body cell contains 46 chromosomes, 22 autosomes, and 1 pair of sex chromosomes

  • Determines the sex of the fetus
  • The 46 chromosomes are the diploid number Meiosis - ANSWER- Chromosomes are reduced to half, 23 per chromosomes per cell, and only 1 sex chromosome
  • The 23 chromosomes are the haploid number Fertilization - ANSWER- Occurs when a sperm penetrates an ovum, restoring the number of chromosome to 46
  • Normally occurs in the outer third of the fallopian tube, near the ovary
  • Sperm passes through the cervix and the uterus and into the fallopian tube by flagellar activity within 5 minutes Sex determination - ANSWER- The ovum always gives an X chromosome
  • The sperm can carry an X or Y chromosome
  • The pH of the female repro tract and estrogen levels affect the survival rate of the sperm Genetic testing - ANSWERCan diagnose disorders, predict risk of future disorders, and assist in reproductive decisions Tubal transport of the zygote - ANSWER- Transported from the fallopian tube into the uterus
  • During transport, the zygote goes through rapid mitotic division, or cleave Process of cleavage - ANSWERBegins with the 2 cells, 4, and then 8 to form a blastomere; eventually forming a solid ball called the morula Morula - ANSWER- Enters the uterus on the 3rd day and floats for 2-4 days
  • Forms a cavity with 2 layers
  • Inner layer = blastocyst
  • Outer layer = trophoblast

Age of viability - ANSWER20 weeks of gestation Placenta - ANSWERA temporary organ for fetal respiration, nutrition, excretion and functions as a endocrine gland Placental hormones - ANSWERProgesterone, estrogen, hCG, and hPL Progesterone - ANSWER- Maintains uterine lining for implantation of zygote

  • Reduces uterine contractions
  • Prepares the breasts for lactation
  • Stimulates the tests to produce testosterone Estrogen - ANSWER- Stimulates uterine growth
  • Increases blood flow to uterine vessels
  • Stimulates development of breast ducts for lactation Human chorionic gonadotropin [hCG] - ANSWERCauses the corpus luteum to produce estrogen and progesterone to sustain pregnancy Human placental lactogen [hPL] - ANSWERDecreases insulin sensitivity and makes more glucose available to the fetus Umbilical cord - ANSWER- The lifeline between mom and fetus
  • 2 arteries carry blood away, 1 vein brings blood
  • Wharton jelly covers and cushions the cord vessels, keeping them seperated
  • Normal length of the cord is about 55cm [22 inches] Circulation of blood is established when? - ANSWERAfter the 4th week of gestation Ductus venosus - ANSWERDiverts blood away from the liver as it returns from the placenta Foramen ovale - ANSWERDiverts blood from the right atrium to the left atrium Ductus arteriosus - ANSWERDiverts blood from the pulmonary artery into the aorta 3 phases of pregnancy - ANSWERAntepartum, intrapartum, postpartum Preconception care - ANSWERPregnancy intention, access to care, use of multivitamins and folic acid, smoking, STI's, illicit drug use, and mental health issues Prenatal care - ANSWERInvolves monitoring, care, management of issues rising during pregnancy Intrapartum care - ANSWERInvolves the continuous presence and support, by a labor and delivery nurse or doula during the birth process

Postpartum care - ANSWEREncourage breast feeding, skin to skin contact, and bonding while reducing separations and interruptions Folic acid intake before conception can - ANSWERReduce the incidence of congenital anomalies Prenatal care should begin when? - ANSWERBefore conception or as soon as suspicion is held Prenatal testing - ANSWER- Conception-28 weeks = every 4 weeks

  • 29-36 weeks = every 2-3 weeks
  • 37 weeks-birth = weekly Estimated date of delivery [EDD] - ANSWER- Calculated based on LNMP
  • An ultrasound may be done to confirm EDD Routine assessments - ANSWER- Review of risk factors
  • Obtaining blood pressure
  • Checking if pattern of weight gain is normal
  • Urinalysis for protein, glucose, and ketone levels
  • Obtain blood glucose 24-28 weeks of gestation
  • Hematocrit, strept, STI at 36 weeks of gestation
  • Fundal height for expected fetus growth
  • Leopold's maneuvers to assess presentation and position by abdominal palpation at 36 weeks of gestation
  • Fetal activity, kick count at 28 weeks of gestation
  • Review of nutrition, calorie and specific nutrients Hegars sign - ANSWERSoftening of the lower uterine segment Striae - ANSWERstretch marks Endocrine system - ANSWER- Hormones are essential to maintain pregnancy
  • Increase in hormones during pregnancy
  • Hormones are produced by the corpus luteum, then by the placenta later Uterus - ANSWERExpands during pregnancy by increasing myometrial cells and individual cells Cervix - ANSWER- Changes in color
  • Chadwicks and goodwells sign appear
  • Mucous plug seals the cervical canal Obestric history - ANSWERNumber of pregnancies [OB] Menstrual history - ANSWER- Usual frequency of menstrual cycles and duration of flow
  • First day of last menstrual period, any spotting Family history - ANSWERGenetics or other factors

Chadwicks sign - ANSWERPurple or blue discoloration of the cervix, vagina, vulva Ovaries - ANSWERDo not produce ova during pregnancy Vagina - ANSWER- Blood supply increases

  • Vaginal mucosa thickens
  • Vaginal secretions increase; pH becomes more acidic, but increased level of glycogen Breasts - ANSWER- Aerola becomes pigmented
  • Sebaceous glands in the nipples become prominent
  • Tubercles secrete a lubricant for the nipples
  • Colostrum may be expressed from the breasts
  • Colostrum contains antibodies to mother's diseases and is secreted 2-3 days after birth Respiratory system - ANSWER- Female breathes more deeply; respiratory rate increases
  • Oxygen consumption increases 15% during pregnancy
  • Increased estrogen levels because of edema or swelling of the nose, pharynx, mouth, and trachea Cardiovascular system - ANSWER- Displaces the heart to the upper left
  • Blood volume increases to 45% [Hypervolemia]
  • B/P does not increase
  • B/P of 140/90 or above should be reported Baby bath temp - ANSWER38-40C, 100-104F If a newborn baby has signs of jaundice - ANSWERReview bilirubin level BMI levels - ANSWER- BMI of 18.5-24.9 = normal weight
  • BMI of 25-25.9 = overweight
  • BMI of 30 or higher = OBESE Weight gains [lbs] - ANSWER- Normal weight = 25-
  • Underweight = 28-
  • Overweight = 15-
  • OBESE = 11-
  • Generally gain 4.4 during first trimester, then 1 per week Hypervolemia in CVS provides - ANSWER- Exchange of nutrients, oxygen, waste products with in the placenta
  • Needs of expanded maternal tissue
  • Reserve for blood loss at worth Supine hypotension syndrome / Aortocaval compression - ANSWER- Occurs when woman lies on her back
  • Position allows the uterus to compress her inferior vena cava, reducing the amount of blood returned to the heart Signs and symptoms of supine hypotension syndrome - ANSWERFaintness, lightheadedness, dizziness, and agitation GI system - ANSWER- Increased saliva secretion, affecting taste and smell
  • Acidity of gastric secretion is decreased
  • Emptying of the stomach and motility of intestines are slower
  • Bloating, constipation, hemorrhoids, pyrosis Integumentary system - ANSWER- Sweat and sebaceous glands become more active to dissipate heat
  • Small red elevations of skin with lines radiating from the center [spider nevi] may occur
  • Palms of the hands may become red A nurse is caring for a client in the prenatal clinic who is at 7 weeks of gestation. The client reports urinary frequency and asks the nurse if this will continue throughout her pregnancy. Which of the following responses by the nurse is appropriate? - ANSWER"No, it should only last until your 12th week, but will return near the end of the pregnancy" A nurse is assisting with the care of a client who has severe preeclampsia and is receiving magnesium sulfate IV at g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion? - ANSWERRespiratory rate of 16 breaths/min Signs of preeclampsia - ANSWERHeadache, visual disturbances, swelling, and epigastric pain Nonstress test - ANSWERAssesses fetal heartrate, movement, and well being