Proctor Cram

Question 1

What is the primary method for diagnosing HELLP syndrome?

Answer 1

HELLP syndrome is diagnosed primarily by laboratory tests

Question 2

In HELLP syndrome, the ‘H’ stands for Hemolysis, which results in what two clinical findings?

Answer 2

Anemia and jaundice

Question 3

The ‘EL’ in HELLP syndrome stands for Elevated Liver enzymes, which can manifest as what characteristic symptom?

Answer 3

Epigastric pain, as well as nausea and vomiting

Question 4

In HELLP syndrome, a client is considered to have Low Platelets (‘LP’) when their platelet count is less than what value?

Answer 4

Less than 100,000/mm$^3$

Question 5

A severe coagulation problem that can occur as a complication of HELLP syndrome is _____ _____ _____ (DIC).

Answer 5

disseminated intravascular coagulation

Question 6

What is the underlying pathophysiology that drives the progression of preeclampsia?

Answer 6

Vasospasm contributing to poor tissue perfusion

Question 7

What blood pressure reading, measured on two occasions at least 4 hours apart after 20 weeks gestation, defines Gestational Hypertension (GH)?

Answer 7

A blood pressure of $\ge$ 140/90 mm Hg

Question 8

Severe preeclampsia is characterized by a blood pressure reading of $\ge$ _____/_____ mm Hg.

Answer 8

160/110

Question 9

What term describes the visual disturbance of seeing spots or ‘floaters’ in a client with severe preeclampsia?

Answer 9

Scotoma

Question 10

A client with severe preeclampsia may exhibit _____, which is an exaggerated response of deep tendon reflexes.

Answer 10

Hyperreflexia

Question 11

The onset of seizure activity or coma in a client with severe preeclampsia marks the progression to what condition?

Answer 11

Eclampsia

Question 12

What medication is the drug of choice for seizure prophylaxis in clients with severe preeclampsia?

Answer 12

Magnesium sulfate

Question 13

What are the three primary signs of magnesium sulfate toxicity?

Answer 13

Loss of patellar deep tendon reflexes, respirations less than 12/min, and urine output less than 30 mL/hr

Question 14

What is the antidote for magnesium sulfate toxicity?

Answer 14

Calcium gluconate or calcium chloride

Question 15

What are the classic manifestations of Placenta Previa?

Answer 15

Painless, bright red vaginal bleeding with a soft, relaxed, nontender uterus

Question 16

What procedure must be strictly avoided in a client with suspected or confirmed placenta previa?

Answer 16

Vaginal exams

Question 17

What are the classic manifestations of Abruptio Placentae?

Answer 17

Sudden onset of intense localized uterine pain with dark red vaginal bleeding and a board-like uterus

Question 18

What illegal substance is a significant risk factor for abruptio placentae due to its vasoconstrictive effects?

Answer 18

Cocaine

Question 19

What is the management priority for a client with abruptio placentae?

Answer 19

Immediate birth

Question 20

What corticosteroid is administered to promote fetal lung maturation if an early delivery is anticipated?

Answer 20

Betamethasone

Question 21

For an uneventful pregnancy, how often should prenatal visits occur between weeks 29 and 36?

Answer 21

Every 2 weeks

Question 22

Between 18 and 30 weeks of gestation, the fundal height in centimeters is used to approximate what?

Answer 22

The gestational age in weeks

Question 23

When is RhO(D) immune globulin typically administered to an Rh-negative client during pregnancy?

Answer 23

Around 28 weeks of gestation

Question 24

At what gestational age are vaginal and rectal cultures for Group B Streptococcus (GBS) typically performed?

Answer 24

Between 36 0/7 and 37 6/7 weeks

Question 25

A one-hour glucose tolerance test result greater than _____ mg/dL requires follow-up testing.

Answer 25

140

Question 26

A low level on the Maternal Serum Alpha-Fetoprotein (MSAFP) screen is associated with an increased risk for what condition?

Answer 26

Down syndrome

Question 27

What client instruction is essential before an external abdominal ultrasound?

Answer 27

The client should have a full bladder

Question 28

What is the score interpretation for a Biophysical Profile (BPP) result of 8 to 10?

Answer 28

Normal, indicating a low risk of chronic fetal asphyxia

Question 29

What are the criteria for a reactive (normal) Nonstress Test (NST) in a term newborn?

Answer 29

The FHR accelerates at least 15/min for at least 15 seconds, occurring 2 or more times during a 20-minute period

Question 30

What does a positive (abnormal) Contraction Stress Test (CST) indicate?

Answer 30

It is suggestive of uteroplacental insufficiency, as evidenced by late decelerations with 50% or more of contractions

Question 31

What is the underlying cause of late decelerations in fetal heart rate?

Answer 31

Uteroplacental insufficiency causing inadequate fetal oxygenation

Question 32

What is the initial nursing intervention for a client experiencing late decelerations?

Answer 32

Position the client in a side-lying position

Question 33

If a client receiving Oxytocin begins to have late decelerations, what is the immediate nursing action regarding the infusion?

Answer 33

Discontinue the Oxytocin infusion

Question 34

During the active phase of the first stage of labor, cervical dilation progresses from ___ cm to ___ cm.

Answer 34

6 cm to 10 cm

Question 35

In which stage of labor is the placenta delivered?

Answer 35

The third stage

Question 36

What class of medications is administered after delivery of the placenta to prevent hemorrhage?

Answer 36

Oxytocics (e.g., Oxytocin, Methylergonovine, Carboprost)

Question 37

During the fourth stage of labor, how often should the nurse assess the fundus and lochia for the first hour?

Answer 37

Every 15 minutes

Question 38

What must the nurse confirm about fetal position before initiating an Oxytocin infusion for labor induction?

Answer 38

The nurse must confirm the fetus is engaged in the pelvis (minimum of station 0)

Question 39

A nurse should immediately stop an Oxytocin infusion if _____ _____ occurs.

Answer 39

uterine tachysystole

Question 40

What tocolytic medication may be administered subcutaneously to treat persistent uterine tachysystole caused by Oxytocin?

Answer 40

Terbutaline

Question 41

Postpartum administration of Oxytocin can cause what adverse effect on blood pressure?

Answer 41

Hypotension

Question 42

Magnesium sulfate should not be administered concurrently with which other tocolytic medication?

Answer 42

Nifedipine

Question 43

What nursing action is critical prior to administering an epidural block to help prevent maternal hypotension?

Answer 43

Administer a bolus of IV fluids

Question 44

If maternal hypotension occurs after an epidural block, the nurse should be prepared to administer what IV vasopressor?

Answer 44

Ephedrine

Question 45

Due to loss of sensation, a client with an epidural is at risk for _____ _____ and may need to be catheterized.

Answer 45

bladder distention

Question 46

What is the most beneficial and reliable relief measure for a headache caused by a cerebrospinal fluid leak after a spinal block?

Answer 46

An autologous blood patch

Question 47

Postpartum hemorrhage (PPH) is defined as a cumulative blood loss of at least how many milliliters?

Answer 47

$\ge 1,000 \text{ mL}$

Question 48

What is the first-line nursing intervention for a boggy uterine fundus in a postpartum client?

Answer 48

Firmly massage the uterine fundus

Question 49

A distended bladder can cause uterine atony and displacement; therefore, the nurse should ensure the client's bladder is _____.

Answer 49

empty

Question 50

The uterotonic medication Methylergonovine is contraindicated in clients with what condition?

Answer 50

Hypertension

Question 51

What are the characteristic findings of endometritis, a postpartum uterine infection?

Answer 51

Uterine tenderness and malodorous or purulent lochia

Question 52

What is the key patient teaching for a client with mastitis regarding breastfeeding?

Answer 52

Continue to breastfeed frequently, starting on the affected side, to prevent milk stasis

Question 53

To prevent UTIs, clients should be taught proper perineal hygiene, which involves wiping in what direction?

Answer 53

Front to back

Question 54

To prevent pulmonary complications after a cesarean birth, the nurse should encourage the client to turn, cough, and deep breathe while doing what?

Answer 54

Splinting the incision with a pillow

Question 55

Prolonged retention of a dead fetus ($\ge 6$ weeks) places the client at risk for what hematologic complication?

Answer 55

Disseminated Intravascular Coagulation (DIC)

Question 56

What is the most characteristic CNS finding in a newborn experiencing neonatal abstinence syndrome (NAS)?

Answer 56

A high-pitched, shrill cry

Question 57

What nursing intervention helps manage CNS irritability in a newborn with NAS?

Answer 57

Swaddle the newborn with legs flexed

Question 58

Interventions for newborn hypoglycemia are typically initiated when blood glucose levels fall below what range?

Answer 58

40 to 45 mg/dL

Question 59

What is a common physical manifestation of newborn hypoglycemia?

Answer 59

Jitteriness or tremors

Question 60

Pathologic jaundice is characterized by its appearance at what time?

Answer 60

Before 24 hours of age

Question 61

Untreated, severe hyperbilirubinemia can lead to _____, a form of brain damage.

Answer 61

Kernicterus

Question 62

During phototherapy, why must lotions or ointments be avoided on the newborn's skin?

Answer 62

They can absorb heat and cause burns

Question 63

How often should a newborn undergoing phototherapy be repositioned?

Answer 63

Every 2 hours to expose all body surfaces to the light

Question 64

What should be applied to the penis with each diaper change for at least 24 hours following a Gomco clamp circumcision?

Answer 64

Sterile petroleum jelly

Question 65

Parents should be taught not to wash off the _____ _____ that may form on the penis by day two after a circumcision.

Answer 65

yellowish mucus film

Question 66

What is the standard antiretroviral therapy given to HIV-positive clients during pregnancy to decrease vertical transmission?

Answer 66

Triple therapy, including oral Zidovudine

Question 67

In the United States, what is the recommendation regarding breastfeeding for clients who are HIV-positive?

Answer 67

Breastfeeding is not recommended

Question 68

What is the recommended treatment for Group B Strep (GBS) positive clients during labor?

Answer 68

Penicillin G or Ampicillin IV

Question 69

Combined oral contraceptives are contraindicated for clients over 35 who also have what habit?

Answer 69

Smoking

Question 70

A significant adverse effect of injectable progestins (Medroxyprogesterone) is the risk of decreased _____ _____ _____.

Answer 70

bone mineral density

Question 71

Intrauterine devices (IUDs) increase the risk of _____ _____ _____ and are best used by clients in a monogamous relationship.

Answer 71

pelvic inflammatory disease (PID)

Question 72

All breastfed newborns should receive a daily supplement of what vitamin?

Answer 72

400 IU of Vitamin D

Question 73

When breastfeeding, how should a parent break the suction before removing the newborn from the breast?

Answer 73

By inserting a finger in the side of the newborn's mouth

Question 74

What is the proper way to thaw frozen breast milk to preserve its immunoglobulins?

Answer 74

Thaw it in the refrigerator for 24 hours

Question 75

Why is propping a bottle for a formula-fed newborn contraindicated?

Answer 75

It poses a risk for aspiration

Question 76

To reduce the risk of Sudden Unexplained Infant Death (SUID), newborns should always be placed in what position for sleep?

Answer 76

In the supine position (on the back)

Question 77

How should the diaper be positioned to care for the umbilical cord stump?

Answer 77

It should be folded down and away from the umbilical stump

Question 78

Infants should be placed in a _____-facing car seat in the _____ seat of the vehicle.

Answer 78

rear; back

Question 79

What is the antidote for opioid analgesics like Fentanyl or Morphine?

Answer 79

Naloxone