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Nursing School

Even Longer Practice Quiz
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Holy Cow. This is a long.

1.  T or F:  If your rubella titer is negative or low you a given a post-partum injection to avoid hearing problems in your next child.

*  T

 

2.  Name the TORCH diseases?

*  toxoplasmosis, others (syphilis), rubella, cytomegaly virus, herpes II

 

3.  A pregnant women can get ____from uncooked meat, soil, or cat feces.

*  toxoplasmosis

 

4.  T or F:  you cannot test for TORCH diseases until after the delivery

* T

 

5. T or F:  If baby is suspected to be hypoxic a fetal scalp blood sampling is obtained to identify acid-base balance to determine fetal hypoxia occurring during birth

*  T

 

6.  Station ___ is when fetal head @ ischial spines.

* 0

 

7.  T or F:  the HR of the baby slows as it becomes more mature?

*  T

 

8.  T or F: external fetal heart monitoring has limitations such as frequent adjustments needed, limit mobility, not good for variability, an obesity a problem

*  T

 

9.  A ___ ___ ___ is done for at risk mothers (PIH, diabetic, epilepsy) and shows FHR increase w/ movements; looking to see if baby can recover from increased HR.

*  non stress test

 

10.  Results of the non stress test are ____ which means a good result, and ___ which means CNS problem or placental problem.

*  reactive, non-reactive

 

11.  T or F:  if non-stress test comes out non-reactive further tests are done such as the OCT and biophysical profile

*  T

 

12.  What are the two easiest positions to deliver fetus?

*  LOA and ROA

 

13.  T or F:  internal fetal monitoring is done on high risk moms and whom are in active labor

*  T

 

14.  T or F:  the advantage to internal fetal monitoring includes accurate FHR, beat to beat variability, and allows movement of mother

*  T

 

15.  The primary cause of fetal tachycardia is a maternal ____ and primary cause of bradycardia is _______.

*  fever, hypoxia

 

16.  T or F:  we want constant variability (shows CNS can handle stress)

*  T

 

17.  T or F:  as soon as contraction is over we want FHR to return to baseline

*  T

 

18.  The autonomic nervous system controls the heart rate, the ____ accelerates the heart where as the ____slows the heart rate and regulates the heart as we mature.

*  sympathetic, parasympathetic

 

19.  T or F:  Down’s syndrome or CNS damage will show little variability

*  T

 

20.  ___term variability shows beat to beat changes, where as ___ term variability shows changes from 1 contraction to the next

*  short, long

 

21.  Factors that affect variability include?

*  drugs, prematurely, fetal sleep cycle, CNS anomalies, hypoxia

 

22.  ___changes refer to changes during a contraction where as ___ changes occur outside of a contraction, accelerations usually fetal movement.

*  periodic, non-periodic

 

23. Early decelerations can be caused by ___ ___, variable decelerations caused by ____ ___ and late decelerations caused by ______ _____.

*  head compression, cord compression, utero-placental insufficiency

 

24.  T or F:  late decelerations are always ominous, Interventions include lay mom on side, give her O2 to 8-10L, increase IV (increase BV to baby), turn off pitocin (give baby time to recover) and call MD

*  T

 

25.  ____is used for thinning meconium in utero, oligohydraminos, relieves pressure on cord, and for a IUPC.

*  amnioinfusion

 

26.  An ____ is a catheter placed into the uterus to insert LR into the uterus, LR will float around cord so it is not depressed

*  intrauterine pressure catheter (IUPC)

 

27.  ____ means you are giving something to stop contractions.

*  tocolysis

 

28.  ____ ___ is excessive vomiting during pregnancy that can cause dehydration, weight loss, and electrolyte imbalance; may be caused by ___ imbalance or could be psychological.

*  hyperemesis gravidarum, hcg

 

29. T or F:  Hyperemesis gravidarum puts the fetus at risk for abnormal development, IUGR, hypoxia, and lack of nutrition and could also cause maternal ketoacidosis (using fat stores---ketones)

*  T

 

30.  T or F:  When ketones are passed to baby it can cause IUGR and baby must start breaking down own fat stores which it does not have.

*  T

 

31.  Tx of hyperemesis gravidarum includes daily weights, I/O, IV fluids, hyper alimentation, antiemetic meds such as ______ and ______ and B6 pyridoxine stabilize the placenta.

*  antihistamines, phenothiazines

 

32. ____  ___ ____ occurs when membranes break before 38 wks, due to infection, incompetent cervix and trauma; at risk for cord prolapse.

*  premature ruptured membranes

 

33.  ___ is a steroid used to help increase lung maturity for preterm labor, side effects include weakens immune system and mask infection.

*  betamethazone

 

34.  PIH is hypertension that occurs after ___Wks and etiology is unknown, associated w/ vasospasm and vascular endothelial damage.

*  20

 

35.  PIH causes activation of the coagulation system which causes ______ profusion to the placenta, and a ____ in CBV and ___ in platelet aggregation.

*  decrease, decrease, increase

36.  T or F:  risk of PIH to fetus include LBW and prematurity, and IUGR

*  T

 

37.  T or F:  PIH will cause upper extremity swelling because fluid leaving CBV and heart left w/ “sludge: to pump out (RBC)

*  T

 

38.  Women at risk for PIH include those over ___years old and under 18, multiple gestation, chronic disease, poor nutrition.

*  35

 

39.  The ___ panel I and II evals liver changes and increase in blood clotting as well as fibrin levels for PIH sufferers

*  PES

 

40.  Chronic HTN is HTN that occurs before __wks, no edema and no proteinuria.

*  20

 

41.  ____ is associated w/ HTN 30/15, proteinuria, edema of UE, weight gain (4-5lbs in 1 week).

*  preeclampisa

 

42.  T or F:  ecclampsia is when women begins to convulse

*  T

 

43.  Mild PIH is tx w/ bedrest, increase protein in diet w/ no salt restriction, increase calcium, and antihypertensive such ____ ___ ____.

*  methyldopa, hydrolazine, and nifedipine

 

44.  T or F:  bedrest is the only way we know how to get more nutrients and O2 to the fetus

*  T

 

45.  Severe PIH symptoms include the __ __ reflexes, edema, H/A, visual changes, N/V, upper gastric pain (liver involved), CNS irritation

 

46.  ___ refers to deep tendon reflexes (+4 hyper flex) means ready to go into convulsions.

*  clonus

 

47.  Severe PIH is tx w/ ___ ___ via IV, this helps prevent ecclampsia.

*  magnesium sulfate

 

48.  T or F:  Magnesium sulfate prevents excitability of muscles, sedative-like action, decrease respiratory rate, highly absorbed in fetus (affects babies tone)

*  T

 

49.  To reverse effects of low respirations __ ___ is given

*  calcium gluconate

 

50.  When a mom goes into ecclampsia a c-section is needed and she may be given ___ or ___.

* valium or dilantin

 

51. If PIH gets worse you need “HELLP” this stands for?

*  hemolytic anemia, elevated liver enzymes, low platelet count

 

52. T or F:  Symptoms of HELLP include N/V, malaise, flu-like symptoms, epigastric pain, it effects every system, and increases BP.

*  T

 

53.  The big indicator of HELLP is ____ pain, HELLP may occur 2 wks after delivery and is more frequent in older white women.

*  epigastric

 

54.  Premature onset of labor (POL) occurs after __wks and before __wks, it is stimulated by UTI, diarrhea, dehydration, any infection, and s/s include cramps or contractions, and increased d/c.

*  20,  37

 

55.  POL is diagnosed when women has 4 contractions w/in 20minutes, __% effaced and __cm dilated and ROM, we cannot do much to stop labor at this point.

*  80%, 4cm

 

56.  T or F:  POL management includes bedrest, oral hydration, sedation, and FHR monitoring

*  T

 

57.  POL can be tx w/ tocolysis agents such as homecare w/ _____ and in the hospital w/ IV___ ____.

*  turbutaline, magnesium sulfate

 

58.  T or F:  turbutaline is the best homecare drug  stop contractions, may cause mom to be uncomfortable

*  T

 

59.  A test done on urine to check for POL is the fetal ____ test, this is the glue that holds the amnion and uterine lining together, will be found in urine if + POL.

*  fibrinectin

60.  ____ ___is abnormal CHO metabolism and insulin resistance, the placental hormones create insulin resistance.

*  gestational diabetes

 

61.  ___ ___ increases the breakdown of insulin, and increased ___ from adrenals causes increased ____ to be released.

*  placental insulin-ase, cortical, glycogen

 

62.  Plasma glucose after 1 hr should be < ___mg/dl, if result high a 3 hr glucose is done, if this is abnormal than mom has gestational diabetes.

*  140

 

63.  T or F:  if baby > 9lbs than at risk for GD w/ next pregnancy

*  T

 

64.  T or F:  diabetes can cause premature aging of placenta

*  T

 

65.  GD puts the fetus at risk for ___ ___ __.

*  hypoglycemia after birth, hyperbilirubinemia, macrosomia

 

66.  Post-term pregnancy can cause several problems such as umbilical cord compression due to drying of the ___ ___, decreased amniotic fluid, and macrosomia which could cause shoulder dystocia at birth.

*  whartons jelly

 

67.  ___ ____is a premature seperation of the placenta, the number 1 symptom is a painful abdomen w/ or w/out bleeding.

*  abruptio placenta

 

68.  T or F:  the fetus can liver w/ only 50% of the placenta attached

*  T

 

69.  T or F:  Abruption always w/ pain, and placenta previa always w/ bleeding and no pain

*  T

 

70.  The causes of abruption include ___ ___ ____ and the different types of abruption are ___ which is around the edges, ___ in the middle, and ____.

*  HTN, trauma, anemia, marginal, central, complete

 

71.  Abruptio placenta and placenta previa dx w/ ___, pre-natal care is a must.

*  ultrasound

 

72.  Abruptio placenta is treated w/ an emergency c-section, hemorrhage or DIC __ __ ___ can occur which is when the body loses the ability to clot and all the fibrin bleeds out (hypofibrinogenemia).

*  disseminated intravascular coagulation

 

73.  ___ ___ is the improper placement of the placenta and can be total, partial, marginal, and low-lying, always associated w/ bleeding and no pain.

*  placenta previa

 

74.  T or F:  placenta previa is caused by inadequate endometrial lining, increased risk is missed periods and irregular cycles

*  T

 

75.  T or F:  delivery w/ placenta previa usually occurs when amniocentesis shows lung maturity

*  T

 

76.  Placenta___ is when placenta grows thru myometrium, more common in under nourished and low hemoglobin mothers, has a possibility of uterus turning inside out.

*  accreta

 

77.  T or F:  the posterior position causes severe back pain in labor

*  T

 

78.  ___positions are the best positions for labor.

*  anterior

 

79.  Types of presentation include __ ___ ___, the fetal part that is presenting at cervix.

*  cephalic, vertex, breech

 

80.  Three types of breech?

*  frank, complete, single footling

 

81.  A ____score is given for cervical changes (thin and dilate)

*  bishops

 

82.  ___ manuever helps eliminate tears and need for episiotomy w/ gentle lifting of baby over perineum

*  ritgens

 

83.  Baby is going thru cardinal movements during stage ___, this includes engagement, descent, felxion, extention, crowning, internal and external rotation.

*  II

 

84.  Hypotonic contractions are helped w/ use of ____, and hypertonic contractions slowed down w/ ____(baby cannot recover between contractions).

*  oxytocin, stadol

 

85.  T or F:  when the placenta comes out fetal side first it is more intact, may still have fragments left in mom when comes out “dirty Duncan”

*  T

 

86.  CPD is ____ ___ and is biggest reason for C-section, results in long stage II, back labor; head does not fit thru pelvis.

*  cephalopelvic disproportion

 

87.  ___ ___is when hands are put on abdomen to turn baby who is in breech position.

*  external version

 

88.  When doing external version ____ may be used IV to help relax uterus, once baby turned administer___ to help cause contractions.

*  Terbutaline, oxytocin

 

89.  Labor is induced w/ _____ gel-dinoprostone or w/ ___ or ___ via catheter and diaphragm or ___ as cervical insert

*  prostaglandin, prepidil, cervidil, cytotec

 

90.  ___ means to strip the membranes.

*  amniotomy

 

91.  T or F:  labor may be augmented w/ use of blue or black cohosh, primrose oil, red raspberry tea leaves

*  T

 

92.  T or F:  the use of forceps can help baby w/ rotation

*  T

 

93.  The typical uterine incision is the ____ incision, the ____ incision is done in emergent situations and scare does not stretch as well.

*  transverse, classical

 

94.  T or F:  pregnancy increase sensitivity to all drugs making overdose more likely

*  T

 

95.  T or F:  it is better to give mom medication at beginning of contraction so baby gets less

*  T

 

96.  T or F:  increase risk of pulmonary aspiration due to woman eating before labor begins

*  T

 

97.  Wait until primipara dilated ___-___cm before giving pain meds, and __-__cm for multipara.

*  5-6,  3-4

 

98.  ___ is the relief of pain usually w/ medication (generalized pain decreased) whereas __ is the absence of pain from certain area.

* analgesia, anesthesia

 

99.  ___pain is more localized and to surface (stage II) whereas ___ pain is deep (stage I).

*  somatic, visceral

 

100.  T or F:  early administration of analgesics may prolong labor whereas late administration may cause respiratory depression in neonate w/ little pain relief to mom.

*  T

 

101.  Intravenous narcotics include IV ____ which gives relief in 1-2min and last 1-2hrs.

* stadol

 

102.  Another intravenous narcotic given is ___ , may be given in first stage, rapid onset, short duration, may prolong labor

*  nubain

 

103.  T or F:  agonist-antagonist are never given to clients w/ dependency problems or if mom has already taken a narcotic.

*  T

 

104.  ___ has both a narcotic agonist and antagonist properties, it is an analgesic 7 times more potent than morphine, overdose tx w/ ____.  Morphine not given during labor b/c  increased respiratory depression.

*  Demerol, narcan

 

105.  A ___ is an injection of med into subarchnoid space, injection only given once whereas an epidural uses a catheter for continuous administration.

*  spinal

 

106.  Intrathecal narcotics can be given as an epidural or spinal, these include ____ which is long-acting, used for spinal or stage II and c-sections.

*  duramorph

 

107.   The other intrathecal narcotic is  ___ which is short-acting and does not pass the blood-brain barrier and given via epidural for stage 1 and into stage II.

*  fentanyl

 

108.   T or F:  The advantage of a spinal is immediate onset, small drug volume, fully awake, do not feel any pressure, good relief for 1hour

 

109.  To avoid spinal H/A give pt bolus of 1000-1500 cc ___ before epidural or spinal, a defining symptom of a spinal H/A is skull crushing pain when sits up, ok when lay down again, H/A is caused by leaking of spinal fluid.

*  LR

 

110. T or F:  spinal is good for end of stage I and stage II, whereas epidural better for stage I

*  T

 

111.  A ___ ___ is method to repair tear in dura mater around spinal cord; injection of sterile blood into epidural space to cause a clot for repair.

*  blood patch

 

112.  T or F:  A lumbar epidural is used for stage I and can extend into stage II as long as the catheter is still in, once out cannot do anything except for a spinal.

* T

 

113.  A lumbar epidural uses a local anesthetic such as ___ or ___ and an opiod such as ____.

*  bupivacaine, marcaine, fentanyl

 

114.  T or F:  disadvantages of epidurals include undesirable for rapid labor, eliminates urge to push, hypotension, purities, and urinary retention

* T

 

115.  T or F:  may give a bolus before pull out epidural cath such as fentanyl, duramorph or demeral that will last up to 24-48hrs after delivery for pain relief

*  T

 

116.  The epidural injection site is between the ____ and the _____.

*  ligamentum flavum and dura mater

 

117.  Regional anesthesia does not have systemic effects or side effects and includes the ____which is given into the cervix on both sides, the ___ ___ which given on either side of ischial spines and the ____ ____ which is best anesthesia for stage 2 for an episiotomy.

*  paracervical, pudendal block, local infiltration

 

118. Paracervical is only used in stage 1, ___ or ___ used as anesthetic agent, good for 1hr, in that time cervix dilates, once wears off pain is more intense, associated w/ respiratory depression of neonate

*  paracervical

 

119.  The pudendal block is given for stage __ labor and helps w/ tears, episiotomy, and big shoulders, forceps and vaccuum delivery, lasts one hour.

*  2

 

120.  Local infiltration is given during stage ___ and can give as much meds as you want, baby already out, last one hour.

*  2

 

121.  General anesthesia is given during emergency c-sections, given amnesia such as ___ ___ and analgesia such as ___, muscle relaxation with___ ___.

*  sodium pentothal, fentanyl, nitrous oxide

 

122.  Intubations done to prevent aspiration, ___ is drug used to paralyze the gag reflex.

*  curare

 

123.  ___ is when the uterus goes thru autolysis (self-destruction), fundus descends one finger breadth/day  for about 7-10 days.

*  involution

 

124.  Involution ends in ___wks, the uterus will descend slower in multipara and c-section moms.

*  6

 

125.  ___ a form of oral oxytocin may be give (q4hrs x 6 doses) to clean out uterus and help clamp it down and contract.

*  methergine

 

126.  Lochia rubra lasts __-__days, serosa __-___ days, and alba __-__ days.

*  1-3,   4-10,   11-21

 

127.  ___ is an astringent made of witch hazel that shrinks hemorrhoids.

*  TUCKS

 

128.  T or F”  the cervix is permanently changed, changes to a dimple like opening to a slit appearance

*  T

 

129.  The cervix is open while shedding lochia, change of infection for first 6wks, the cells are easy to damage “_____.”

*  friable

130.  T or F:  uterus contracting is more painful for multipara and breast feeders.

*  T

 

131.  Low ___ after delivery and breastfeeding may cause decreased lubrication.

*  estrogen

 

132.  T or F:  rugae in the vagina return 2-4 wks after birth and take longer in breast feeders

*  T

 

133.  Mom’s HR slows immediately after birth, tachycardia related to ___ ____.

*  blood losss

 

134. T or F:  Fibrinogen levels increase for 1wk increasing risk of thrombophlebitis and mom in a hypercoaguability state for 6wks.

*  T

 

135.  T or F:  WBC may increase for a day or two after delivery

*  T

 

136.  Menstruation resumes in __-__wks for non-lactating moms and longer for breast feeders.

*  6-8

 

137.  ____ is when uterus will not progress to lower abdomen, stays elevated, usually due to retained placental tissue or loss of muscle tone.

*  sub involution

 

138.  Complications of 4th degree laceration?

*  cytokine, rectocele, uterine prolapse, infection from e.coli

 

139.  ___ is a plastic device put into vagina to hold uterus in place.

*  pessary

 

140.  ___ is an infection around pelvic reproductive organs.

*  parametritis

 

141.  The 3 phases of psychosocial changes in post-partum ?

*  taking in , taking hold, letting go

 

142.  ___ is when the infant moves toward the parents voice

*  entrainment

 

143.  The ___ phase is when mom talks openly about her birth experience, usually immediately after birth.

*  honeymoon

 

144.  ___ is when it is hard to bond w/ more than one child at a time (twins, triplets)

*  monotrophy

 

145.  REEDA stands for?

*  redness, edema, ecchymosed, discharge, approximation

 

146.  T or F:  this is a lot of damn questions?

T

 

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