ATI MATERNAL NEWBORN NURSING - EXIT EXAM 1 QUESTIONS AND CORRECT ANSWERS 2024/2025

Diaphragm - ANSWER Spermicide must be applied with each act of sexual intercourse and should remain in place 6 hrs after. Empty bladder prior to coitus Transdermal contraceptive patch - ANSWER Patch applied to dry skin overlying subQ tissue, excluding breast Depo-Provera - ANSWER IM injection given every 11-13 weeks (start should be during first 5 days of clients menstrual cycle) Essure - ANSWER Insertion of agent resulting in development of scar tissue in Fallopian tubes. Not reversible Female sterilization - ANSWER Burning or blocking the Fallopian tubes. Not reversible Vasectomy - ANSWER Ligation and severance of vas deferens. Need alternate form of birth control for 20 ejaculations RhoGAM - ANSWER Administered at 28 weeks gestation to a mother who is Rhnegative and gives birth to an Rh-positive infant. Recommended following an amniocentesis Oxytocin (Pitocin) - ANSWER Monitor for water intoxication (lightheaded, n/v, headache, malaise) which can lead to cerebral edema, seizures, coma, and death. Contraindicated based on late decelerations 3 hour glucose tolerance test - ANSWER Screens for gestational diabetes and is done at 28 weeks of gestation Rubella titer - ANSWER Obtained at initial prenatal visit (about 6 weeks gestation) Betamethasone (Celestone) - ANSWER Glucocorticoid administered IM in 2 injections 24 hr apart, given to stimulate fetal lung maturity if early delivery is anticipated and to prevent respiratory distress. Can cause pulmonary edema (crackles, chest pain, SOB) Leopold Maneuver - ANSWER Abdominal palpation of fetus, lie, attitude, helps nurse assess the position of the fetus to determine the optimal placement of the fetal monitoring transducer. Empty bladder beforehand, supine positioning Steps of Leopold Maneuver - ANSWER Palpate client's fundus, determine location of fetal back, palpate fetal part presenting at the inlet, and palpate the cephalic prominence to identify the attitude of the head Ferning test - ANSWER If positive, indicates rupture of membranes Expected newborn temp - ANSWER 36.5-37.2 Expected newborn HR - ANSWER 120-160 Expected newborn RR - ANSWER 30-60 Expected newborn BP - ANSWER 60-80 S, 40-50 D Expected newborn length - ANSWER 45-55 cm Expected newborn weight - ANSWER 2,500-4,000 g What is effleurage? - ANSWER Client strokes abdomen using circular motion during contractions Maternal Serum Alpha-Fetoprotein - ANSWER Screening tool for neural tube defects that is effective between 15 and 22 weeks. levels above indicate the need for an ultrasound Position for transvaginal ultrasound - ANSWER Lithotomy position Biophysical profile assesses? - ANSWER Fetal HR, breathing, body movements, fetal tone, and qualitative amniotic fluid volume What does biophysical profile indicate? - ANSWER The risk of asphyxia Nonstress test - ANSWER Client presses a button whenever they feel fetal movement which allows nurse to assess FHR in relationship to the fetal movement Reactive stress test - ANSWER FHR has moderate variability, accelerated to 15 beats/min for at least 15 seconds and occurs two or more times during a 20 minute period Nonreactive stress test - ANSWER FHR does not accelerate adequately with fetal movement. Does not meet criteria after 40 minutes. Contraction stress test or biophysical profile is indicated Contraction stress test - ANSWER FHR in response to contractions which decreases placental blood flow Amniocentesis - ANSWER Performed after 14 weeks gestation, empty bladder beforehand, client in supine position High levels of AFP - ANSWER Alpha-Fetoprotein is measured between 16 and 18 weeks and is used to detect neural tube defects (anencephaly), spina bifida, and omphalocele Low levels AFP - ANSWER Chromosomal disorders (Down syndrome) Fetal lung tests - ANSWER Lecithin/sphingomyelin ratio- 2:1 indicating lung maturity or 3:1 for diabetes mellitus Percutaneous blood sampling - ANSWER Obtains fetal blood from umbilical cord which evaluates isoimmune fetal hemolytic anemia and assesses need for fetal blood transfusion Chorionic Villus sampling - ANSWER Alternative to amniocentesis (10-12 weeks gestation) Quad marker screening - ANSWER Blood test that ascertains info about likelihood of fetal birth defects. Includes AFP, hCG, Estriol, Inhibin-A Placenta previa - ANSWER Placenta abnormally implants in the lower segment of the uterus near or over the cervix. Results in abnormal bleeding during the 3rd trimester as cervix begins to dilate Placenta previa- marginal or low lying - ANSWER Placenta is attached to lower uterine segment but does not reach cervix Signs of placenta previa - ANSWER Painless vaginal bleeding Abruptio placenta - ANSWER Premature separation of placenta from uterus. Can occur after 20 weeks gestation Signs of abruptio placenta - ANSWER Sudden onset of dark red vaginal bleeding, sharp abdominal pain, and tender rigid uterus (board like) Spontaneous abortion - ANSWER Pregnancy is terminated before 20 weeks or fetal weight is less than 500 g. Vaginal bleeding, uterine cramping, and partial or complete expulsion of products of conception Ectopic pregnancy - ANSWER Abnormal implantation of a fertilized ovum outside the uterine cavity usually in fallopian tubes. Abrupt unilateral lower-quadrant abdominal pain with or without vaginal bleeding, scant dark red vaginal spotting occurring 6-8 weeks after last normal menses