Question 1

According to research,what are the minimal viability parameters for an infant?

Accepted Answer

A) 20 to 21 weeks' gestation and fetal weight between 500 and 1000 g. 
B) 22 to 23 weeks' gestation and fetal weight between 1000 and 15,000 g. 
C) 23 to 24 weeks' gestation and fetal weight between 500 and 1000 g. 
D) 24 to 25 weeks' gestation and fetal weight between 500 and 1200 g. 
A) 20 to 21 weeks' gestation and fetal weight between 500 and 1000 g. 
B) 22 to 23 weeks' gestation and fetal weight between 1000 and 15,000 g. 
C) 23 to 24 weeks' gestation and fetal weight between 500 and 1000 g. 
D) 24 to 25 weeks' gestation and fetal weight between 500 and 1200 g. C

Question 2

A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.The patient is placed on a magnesium sulfate drip of 3 g/h.After an hour the patient has a seizure.The nurse notifies the practitioner.What order would the nurse anticipate?

Accepted Answer

A)  Administer another 2- to 4-g bolus of magnesium sulfate. 
B)  Increase the magnesium drip at a rate of 1 to 2 g/h. 
C)  Prepare the patient for immediate delivery of the baby. 
D)  Prepare for intubation and mechanical ventilatory support. 
A)  Administer another 2- to 4-g bolus of magnesium sulfate. 
B)  Increase the magnesium drip at a rate of 1 to 2 g/h. 
C)  Prepare the patient for immediate delivery of the baby. 
D)  Prepare for intubation and mechanical ventilatory support. A

Question 3

A patient who is 30-weeks pregnant is admitted with severe asthma.The nurse understands that sufficient fetal oxygenation requires what minimum level of maternal oxygenation?

Accepted Answer

A)  PaO₂ greater than 100 mm Hg 
B)  PaO₂ greater than 70 mm Hg 
C)  Oxygen saturation of 100% 
D)  Oxygen saturation greater than 70% 
A)  PaO₂ greater than 100 mm Hg 
B)  PaO₂ greater than 70 mm Hg 
C)  Oxygen saturation of 100% 
D)  Oxygen saturation greater than 70% C

Question 4

Which statement regarding the use of medications or other therapies for advanced cardiac life support (ACLS)in the pregnant patient is accurate?

Accepted Answer

A)  No contraindications exist for use of atropine in pregnancy. 
B)  Epinephrine is contraindicated because it decreases uteroplacental perfusion. 
C)  Lidocaine is contraindicated because it crosses the placenta and has adverse fetal effects. 
D)  Electric therapies are contraindicated because of the potential for electrocution of the infant. 
A)  No contraindications exist for use of atropine in pregnancy. 
B)  Epinephrine is contraindicated because it decreases uteroplacental perfusion. 
C)  Lidocaine is contraindicated because it crosses the placenta and has adverse fetal effects. 
D)  Electric therapies are contraindicated because of the potential for electrocution of the infant.

Question 5

What are some of the unique causes of septic shock in pregnant patients?

Accepted Answer

A)  Postpartum pyelonephritis 
B)  Ectopic pregnancy 
C)  Chorioamnionitis 
D)  Septic abortion 
E)  Postpartum hemorrhage 
A)  Postpartum pyelonephritis 
B)  Ectopic pregnancy 
C)  Chorioamnionitis 
D)  Septic abortion 
E)  Postpartum hemorrhage

Question 6

What is the second leading cause of maternal death in the United States?

Accepted Answer

A)  Sepsis 
B)  Hemorrhage 
C)  Hypertensive disease 
D)  Disseminated intravascular coagulation 
A)  Sepsis 
B)  Hemorrhage 
C)  Hypertensive disease 
D)  Disseminated intravascular coagulation

Question 7

What conditions or disorders place the obstetric patient at a 25% to 50% risk of maternal mortality?

Accepted Answer

A)  Marfan syndrome with valvular involvement 
B)  Pulmonary hypertension 
C)  Coarctation of aorta with valvular involvement 
D)  Marfan syndrome with aortic involvement 
E)  Mitral stenosis with atrial fibrillation 
A)  Marfan syndrome with valvular involvement 
B)  Pulmonary hypertension 
C)  Coarctation of aorta with valvular involvement 
D)  Marfan syndrome with aortic involvement 
E)  Mitral stenosis with atrial fibrillation

Question 8

A patient has been admitted with severe preeclampsia.The nurse understands the patient is at risk for hemolysis,elevated liver enzymes,and low platelet count (HELLP)syndrome.What clinical manifestations would indicate the patient is developing this condition?

Accepted Answer

A)  Nausea, vomiting, and epigastric pain 
B)  Jaundice, pruritus, and flank pain 
C)  Hypoactive bowel sounds, bleeding at puncture sites, and back pain 
D)  Fever, jugular vein distention, and chest pain 
A)  Nausea, vomiting, and epigastric pain 
B)  Jaundice, pruritus, and flank pain 
C)  Hypoactive bowel sounds, bleeding at puncture sites, and back pain 
D)  Fever, jugular vein distention, and chest pain

Question 9

A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.What is the treatment goal for this patient?

Accepted Answer

A)  Maintaining maternal blood pressure greater than 140/90 mm Hg 
B)  Delaying delivery of the fetus as long as possible 
C)  Preventing maternal seizures, which may compromise fetal oxygenation 
D)  Limiting fluid intake to avoid postpartum edema. 
A)  Maintaining maternal blood pressure greater than 140/90 mm Hg 
B)  Delaying delivery of the fetus as long as possible 
C)  Preventing maternal seizures, which may compromise fetal oxygenation 
D)  Limiting fluid intake to avoid postpartum edema.

Question 10

Which obstetric conditions may precipitate disseminated intravascular coagulation (DIC)in an obstetric patient?

Accepted Answer

A)  Abruptio placentae 
B)  Amniotic fluid embolism 
C)  Asthma 
D)  Intracranial hemorrhage 
E)  Bacterial pneumonia
F) Dead fetus syndrome 
A)  Abruptio placentae 
B)  Amniotic fluid embolism 
C)  Asthma 
D)  Intracranial hemorrhage 
E)  Bacterial pneumonia
F) Dead fetus syndrome

Question 11

The treatment plan for management of an obstetric patient with peripartum cardiomyopathy (PPCM)includes which interventions?

Accepted Answer

A)  Oxygen therapy, pain management, and preload enhancement 
B)  Walking exercises, diuretics, and anticoagulants 
C)  Diuretics, digoxin, and anticoagulation 
D)  Fluid resuscitation, beta-blockers, and vasoconstrictors 
A)  Oxygen therapy, pain management, and preload enhancement 
B)  Walking exercises, diuretics, and anticoagulants 
C)  Diuretics, digoxin, and anticoagulation 
D)  Fluid resuscitation, beta-blockers, and vasoconstrictors

Question 12

What is the most common cause of obstetric cardiac arrest in pregnancy?

Accepted Answer

A)  Anesthetic complications 
B)  Idiopathic peripartum cardiomyopathy 
C)  Pregnancy-induced hypertension 
D)  Hemorrhage 
A)  Anesthetic complications 
B)  Idiopathic peripartum cardiomyopathy 
C)  Pregnancy-induced hypertension 
D)  Hemorrhage

Question 13

When is the greatest risk for the patient who has had a cesarean section to develop a pulmonary embolism?

Accepted Answer

A)  First time patient gets out of bed 
B)  Postoperative day 2 
C)  During the procedure 
D)  Immediate postpartum period 
A)  First time patient gets out of bed 
B)  Postoperative day 2 
C)  During the procedure 
D)  Immediate postpartum period

Question 14

A patient who is 32 weeks pregnant is admitted with a pneumothorax.What must the practitioner consider when placing a chest tube?

Accepted Answer

A)  The diaphragm has been displaced 4 cm upward from its original location. 
B)  The diaphragm has been flattened and displaced 2 cm downward. 
C)  The lungs have shrunk to accommodate for the increase in abdominal size. 
D)  The lower lobes are one-half of their original size. 
A)  The diaphragm has been displaced 4 cm upward from its original location. 
B)  The diaphragm has been flattened and displaced 2 cm downward. 
C)  The lungs have shrunk to accommodate for the increase in abdominal size. 
D)  The lower lobes are one-half of their original size.

Question 15

The nurse is caring for a patient with preexisting spinal cord injury (SCI)who is 37 weeks pregnant.The SCI occurred at T₄.Which intervention would be added to the plan of care when the patient goes into labor?

Accepted Answer

A)  Instruct the patient to let the nurse know when labor starts. 
B)  Administer steroids at the onset of labor. 
C)  Monitor the patient for signs of autonomic dysreflexia. 
D)  Prepare the patient for a cesarean section. 
A)  Instruct the patient to let the nurse know when labor starts. 
B)  Administer steroids at the onset of labor. 
C)  Monitor the patient for signs of autonomic dysreflexia. 
D)  Prepare the patient for a cesarean section.

Question 16

What is the leading cause of maternal trauma?

Accepted Answer

A)  Burns 
B)  Motor vehicle accident 
C)  Falls 
D)  Domestic violence 
A)  Burns 
B)  Motor vehicle accident 
C)  Falls 
D)  Domestic violence

Question 17

The mnemonic "tone,tissue,trauma,and thrombosis" refers to potential causes of which disorder?

Accepted Answer

A)  Hypoxia 
B)  Abruptio placentae 
C)  Postpartum hemorrhage (PPH) 
D)  Trauma 
A)  Hypoxia 
B)  Abruptio placentae 
C)  Postpartum hemorrhage (PPH) 
D)  Trauma

Question 18

A patient has been admitted with preeclampsia.The nurse understands that this disorder is characterized by what widespread physiologic changes?

Accepted Answer

A)  Increase in circulating plasma volume 
B)  Vasospasms in the arterial system 
C)  Disseminated intravascular coagulation 
D)  High systemic vascular resistance 
A)  Increase in circulating plasma volume 
B)  Vasospasms in the arterial system 
C)  Disseminated intravascular coagulation 
D)  High systemic vascular resistance

Question 19

What is the leading cause of cardiac arrest in pregnancy?

Accepted Answer

A)  Sepsis 
B)  Pregnancy-induced hypertension 
C)  Hemorrhage 
D)  Pulmonary embolism 
A)  Sepsis 
B)  Pregnancy-induced hypertension 
C)  Hemorrhage 
D)  Pulmonary embolism

Question 20

A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.In addition to her clinical signs and symptoms,the patient's laboratory studies demonstrate hemolysis of red blood cells,elevated liver enzymes,and a low platelet count.What would be anticipated as an additional diagnosis?

Accepted Answer

A)  Disseminated intravascular coagulopathy (DI
C)  
B)  Dead fetus syndrome 
C)  Amniotic fluid embolism 
D)  HELLP syndrome 
A)  Disseminated intravascular coagulopathy (DI
C)  
B)  Dead fetus syndrome 
C)  Amniotic fluid embolism 
D)  HELLP syndrome

Exam 38: The Obstetric Patient

According to research,what are the minimal viability parameters for an infant?

A patient who is 30-weeks pregnant is admitted with severe asthma.The nurse understands that sufficient fetal oxygenation requires what minimum level of maternal oxygenation?

Which statement regarding the use of medications or other therapies for advanced cardiac life support (ACLS)in the pregnant patient is accurate?

What are some of the unique causes of septic shock in pregnant patients?

What is the second leading cause of maternal death in the United States?

What conditions or disorders place the obstetric patient at a 25% to 50% risk of maternal mortality?

A patient has been admitted with severe preeclampsia.The nurse understands the patient is at risk for hemolysis,elevated liver enzymes,and low platelet count (HELLP)syndrome.What clinical manifestations would indicate the patient is developing this condition?

A multiparous woman was admitted at 36 weeks' gestation for nausea,vomiting,and severe epigastric pain.The fetal heart rate was normal.Severe preeclampsia was diagnosed.What is the treatment goal for this patient?

Which obstetric conditions may precipitate disseminated intravascular coagulation (DIC)in an obstetric patient?

The treatment plan for management of an obstetric patient with peripartum cardiomyopathy (PPCM)includes which interventions?

What is the most common cause of obstetric cardiac arrest in pregnancy?

When is the greatest risk for the patient who has had a cesarean section to develop a pulmonary embolism?

A patient who is 32 weeks pregnant is admitted with a pneumothorax.What must the practitioner consider when placing a chest tube?

The nurse is caring for a patient with preexisting spinal cord injury (SCI)who is 37 weeks pregnant.The SCI occurred at T₄.Which intervention would be added to the plan of care when the patient goes into labor?

What is the leading cause of maternal trauma?

The mnemonic "tone,tissue,trauma,and thrombosis" refers to potential causes of which disorder?

A patient has been admitted with preeclampsia.The nurse understands that this disorder is characterized by what widespread physiologic changes?

What is the leading cause of cardiac arrest in pregnancy?

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