NURS 242 ACTUAL EXAM LATEST 2024/2025 QUESTIONS
AND VERIFIED CORRECT ANSWERS/ ALREADY GRADED
A++
high-risk pregnancy - ANSWER - One in which a condition exists that
jeopardizes the health of the mother, her fetus, or both.
- The condition may result from the pregnancy, or it may be a condition that
was present before the woman became pregnant.
EX. diabetes, obesity, cardiac issues
Bleeding assessment - pregnancy - ANSWER confirmation of pregnancy,
pregnancy length, duration, intensity, description, frequency, description,
frequency, associated symptoms, action, blood type.
every minute of every day - ANSWER A woman dies in pregnancy or
childbirth
Obstetric hemorrhage - ANSWER - The biggest killer.
- Successful treatment is a challenge for both developed and developing
countries.
Chronic hypertension - ANSWER Hypertension that exists prior to
pregnancy or that develops before 20 weeks' gestation with blood pressure
readings greater than 140/90 mm Hg.
Gestational hypertension - ANSWER A new-onset blood pressure elevation
(140/90 mm Hg) identified after 20 weeks' gestation without proteinuria;
blood pressure returns to normal by 12 weeks' postpartum.
Preeclampsia/eclampsia and HELLP - ANSWER - Most common
hypertensive disorder of pregnancy, which develops with proteinuria after
20 weeks' gestation
- A multisystem disease process, which is accompanied by at least one of
the following: proteinuria, elevated creatinine, liver involvement, epigastric
or abdominal pain, neurologic complications, hematologic complications,
and uteroplacental dysfunction.
- Eclampsia occurs when seizure activity develops.
,Chronic hypertension with superimposed preeclampsia - ANSWER
develops after 20 weeks' gestation and occurs in approximately 25% of
pregnant women with increased maternal and fetal morbidity rates.
Never put hands in... - ANSWER a bleeding cervix
Other bleeding complications - pregnancy - ANSWER blood incompatibility,
amniotic fluid imbalances, multiple gestation, premature rupture of
membranes.
Leading causes of bleeding complications - ANSWER Hemorrhage,
thromboembolism, infection, hypertension of pregnancy, ectopic
pregnancy, spontaneous abortion, gestational trophoblastic disease,
cervical insufficiency.
1st trimester bleeding - ANSWER 1. spontaneous miscarriage
- Threatened (present vag bleeding)
- Imminent (bleeding, uterine contractions, cervical dilation),
- Complete (products expelled)
- Missed (fetus dies in utero but not expelled)
- Incomplete partial expulsion
2. Ectopic pregnancy (can feel in the shoulder, implanted anywhere outside
of the uterus, includes an abdominal pregnancy)
3. Abdominal pregnancy.
2nd trimester bleeding - ANSWER - Gestational trophoblastic disease
(hydatidiform mole),
- Premature cervical dilation
- Disseminated intravascular coagulation (DIC).
3rd trimester bleeding - ANSWER - placenta previa
- abruptio placentae
- preterm labor.
Spontaneous abortion - ANSWER most likely a chromosomal abnormality.
Habitual abortion - ANSWER someone who has had many spontaneous
abortions.
,the most common cause of first-trimester abortions - ANSWER Fetal
genetic abnormalities
SS of hypovolemic shock - ANSWER - tachycardia, hypotension, low LOC,
low Urine output, pale, clammy, sweaty, weak
Testing patient for DIC (quick test) - ANSWER extra clot tube and rotate,
within 5 minutes if there is no clotting seen, patient maybe at risk for DIC.
Gestational Trophoblastic Disease (GTD) - ANSWER Abnormal
proliferation of trophoblastic tissue.
- disorders of placental development (hydatidiform mole) and neoplasms of
the trophoblast (choriocarcinoma).
hydatidiform mole - ANSWER - A benign neoplasm of the chorion in which
the chorionic villi degenerate and become transparent vesicles containing
clear, viscid fluid.
- Hydatidiform mole is classified as complete or partial, distinguished by
differences in clinical presentation, pathology, genetics, and epidemiology
complete mole - ANSWER - Contains no fetal tissue and develops from an
"empty egg," which is fertilized by a normal sperm (the paternal
chromosomes replicate, resulting in 46 all-paternal chromosomes).
- The embryo is not viable and dies.
- No circulation is established, and no embryonic tissue is found.
**The complete mole is associated with the development of
choriocarcinoma.
Complete mole SS - ANSWER Vaginal bleeding, anemia, excessively
enlarged uterus, preeclampsia, and hyperemesis.
partial mole - ANSWER - A triploid karyotype (69 chromosomes) because
two sperm cells have provided a double contribution by fertilizing the ovum.
Partial mole SS - ANSWER Women with a partial mole usually present with
the clinical features of a missed or incomplete abortion, including vaginal
bleeding and a small- or normal-sized-for-date uterus.
, trophoblastic cells - ANSWER - Should normally form the placenta
proliferate and the chorionic villi become edematous. The latter changes
become the grape-like clusters that characterize the molar pregnancy
Remarkable features about molar pregnancies, including: - ANSWER -
Ability to invade into the wall of the uterus
- Tendency to recur in subsequent pregnancies
- Possible development into choriocarcinoma, a virulent cancer with
metastasis to other organs
- Influence of nutritional factors, such as protein deficiency
- Tendency to affect older women more often than younger women
Molar pregnancy results in... - ANSWER loss of the pregnancy and the
possibility of developing choriocarcinoma, a chorionic malignancy from the
trophoblastic tissue.
most frequent sites of metastases - ANSWER lungs, lower genital tract,
brain, and liver.
Trophoblastic tissue/hydatidiform mole TX - ANSWER - Extensive follow-up
therapy for the next 12 months and may include:
- Baseline hCG level, chest radiograph, and pelvic ultrasound
- D&C to remove remaining products
- Quantitative hCG levels every week until undetectable for three
consecutive weeks; then serial hCG levels monthly for 1 year
- Chest radiograph every 6 months to detect pulmonary metastasis
- Prophylactic chemotherapy
**No pregnancy for up to 1 year
**Use of a reliable contraceptive for at least 1 year
Cervical insufficiency - ANSWER premature dilation of the cervix
Cerclage - ANSWER - Suturing of the cervix to prevent it from dilating
prematurely during pregnancy, thus decreasing the chance of a
spontaneous abortion.
- Removed at 37-38 wks to allow vaginal delivery
Ectopic pregnancy management - ANSWER - Before rupture -
methotrexate, prostaglandins, misoprostol, and actinomycin
- After rupture - laparoscopy
AND VERIFIED CORRECT ANSWERS/ ALREADY GRADED
A++
high-risk pregnancy - ANSWER - One in which a condition exists that
jeopardizes the health of the mother, her fetus, or both.
- The condition may result from the pregnancy, or it may be a condition that
was present before the woman became pregnant.
EX. diabetes, obesity, cardiac issues
Bleeding assessment - pregnancy - ANSWER confirmation of pregnancy,
pregnancy length, duration, intensity, description, frequency, description,
frequency, associated symptoms, action, blood type.
every minute of every day - ANSWER A woman dies in pregnancy or
childbirth
Obstetric hemorrhage - ANSWER - The biggest killer.
- Successful treatment is a challenge for both developed and developing
countries.
Chronic hypertension - ANSWER Hypertension that exists prior to
pregnancy or that develops before 20 weeks' gestation with blood pressure
readings greater than 140/90 mm Hg.
Gestational hypertension - ANSWER A new-onset blood pressure elevation
(140/90 mm Hg) identified after 20 weeks' gestation without proteinuria;
blood pressure returns to normal by 12 weeks' postpartum.
Preeclampsia/eclampsia and HELLP - ANSWER - Most common
hypertensive disorder of pregnancy, which develops with proteinuria after
20 weeks' gestation
- A multisystem disease process, which is accompanied by at least one of
the following: proteinuria, elevated creatinine, liver involvement, epigastric
or abdominal pain, neurologic complications, hematologic complications,
and uteroplacental dysfunction.
- Eclampsia occurs when seizure activity develops.
,Chronic hypertension with superimposed preeclampsia - ANSWER
develops after 20 weeks' gestation and occurs in approximately 25% of
pregnant women with increased maternal and fetal morbidity rates.
Never put hands in... - ANSWER a bleeding cervix
Other bleeding complications - pregnancy - ANSWER blood incompatibility,
amniotic fluid imbalances, multiple gestation, premature rupture of
membranes.
Leading causes of bleeding complications - ANSWER Hemorrhage,
thromboembolism, infection, hypertension of pregnancy, ectopic
pregnancy, spontaneous abortion, gestational trophoblastic disease,
cervical insufficiency.
1st trimester bleeding - ANSWER 1. spontaneous miscarriage
- Threatened (present vag bleeding)
- Imminent (bleeding, uterine contractions, cervical dilation),
- Complete (products expelled)
- Missed (fetus dies in utero but not expelled)
- Incomplete partial expulsion
2. Ectopic pregnancy (can feel in the shoulder, implanted anywhere outside
of the uterus, includes an abdominal pregnancy)
3. Abdominal pregnancy.
2nd trimester bleeding - ANSWER - Gestational trophoblastic disease
(hydatidiform mole),
- Premature cervical dilation
- Disseminated intravascular coagulation (DIC).
3rd trimester bleeding - ANSWER - placenta previa
- abruptio placentae
- preterm labor.
Spontaneous abortion - ANSWER most likely a chromosomal abnormality.
Habitual abortion - ANSWER someone who has had many spontaneous
abortions.
,the most common cause of first-trimester abortions - ANSWER Fetal
genetic abnormalities
SS of hypovolemic shock - ANSWER - tachycardia, hypotension, low LOC,
low Urine output, pale, clammy, sweaty, weak
Testing patient for DIC (quick test) - ANSWER extra clot tube and rotate,
within 5 minutes if there is no clotting seen, patient maybe at risk for DIC.
Gestational Trophoblastic Disease (GTD) - ANSWER Abnormal
proliferation of trophoblastic tissue.
- disorders of placental development (hydatidiform mole) and neoplasms of
the trophoblast (choriocarcinoma).
hydatidiform mole - ANSWER - A benign neoplasm of the chorion in which
the chorionic villi degenerate and become transparent vesicles containing
clear, viscid fluid.
- Hydatidiform mole is classified as complete or partial, distinguished by
differences in clinical presentation, pathology, genetics, and epidemiology
complete mole - ANSWER - Contains no fetal tissue and develops from an
"empty egg," which is fertilized by a normal sperm (the paternal
chromosomes replicate, resulting in 46 all-paternal chromosomes).
- The embryo is not viable and dies.
- No circulation is established, and no embryonic tissue is found.
**The complete mole is associated with the development of
choriocarcinoma.
Complete mole SS - ANSWER Vaginal bleeding, anemia, excessively
enlarged uterus, preeclampsia, and hyperemesis.
partial mole - ANSWER - A triploid karyotype (69 chromosomes) because
two sperm cells have provided a double contribution by fertilizing the ovum.
Partial mole SS - ANSWER Women with a partial mole usually present with
the clinical features of a missed or incomplete abortion, including vaginal
bleeding and a small- or normal-sized-for-date uterus.
, trophoblastic cells - ANSWER - Should normally form the placenta
proliferate and the chorionic villi become edematous. The latter changes
become the grape-like clusters that characterize the molar pregnancy
Remarkable features about molar pregnancies, including: - ANSWER -
Ability to invade into the wall of the uterus
- Tendency to recur in subsequent pregnancies
- Possible development into choriocarcinoma, a virulent cancer with
metastasis to other organs
- Influence of nutritional factors, such as protein deficiency
- Tendency to affect older women more often than younger women
Molar pregnancy results in... - ANSWER loss of the pregnancy and the
possibility of developing choriocarcinoma, a chorionic malignancy from the
trophoblastic tissue.
most frequent sites of metastases - ANSWER lungs, lower genital tract,
brain, and liver.
Trophoblastic tissue/hydatidiform mole TX - ANSWER - Extensive follow-up
therapy for the next 12 months and may include:
- Baseline hCG level, chest radiograph, and pelvic ultrasound
- D&C to remove remaining products
- Quantitative hCG levels every week until undetectable for three
consecutive weeks; then serial hCG levels monthly for 1 year
- Chest radiograph every 6 months to detect pulmonary metastasis
- Prophylactic chemotherapy
**No pregnancy for up to 1 year
**Use of a reliable contraceptive for at least 1 year
Cervical insufficiency - ANSWER premature dilation of the cervix
Cerclage - ANSWER - Suturing of the cervix to prevent it from dilating
prematurely during pregnancy, thus decreasing the chance of a
spontaneous abortion.
- Removed at 37-38 wks to allow vaginal delivery
Ectopic pregnancy management - ANSWER - Before rupture -
methotrexate, prostaglandins, misoprostol, and actinomycin
- After rupture - laparoscopy
