AWHONN PEOP UPDATED ACTUAL
Exam Questions and CORRECT Answers
Ms. Linghu arrived at the obstetric care unit for a labor evaluation. She is 28 weeks gestation and
is complaining of a lower back ache and cramping. The physician has asked for assistance in
obtaining a sample to assess for fetal fibronectin (fFN). Which statement about fFN is most
accurate? - CORRECT ANSWER - fFN is a strong predictor or marker for identification
of preterm labor associated with infection.
Risk factors for placenta previa include - CORRECT ANSWER - previous uterine surgery,
smoking, and hypertension.
One of the most common and well documented risk factors for preterm labor is - CORRECT
ANSWER - previous history of preterm birth.
All of the following complications may predispose a pregnant woman to disseminated
intravascular coagulopathy (DIC) except - CORRECT ANSWER - preterm labor.
A cerclage placed in women with documented shortened cervical length by ultrasound
examination is called a(n) - CORRECT ANSWER - therapeutic cerclage.
The most common postpartum complication for mothers with higher-order multiples is -
CORRECT ANSWER - postpartum hemorrhage.
Painless, bright red vaginal bleeding at 28 weeks of gestation is most likely caused by -
CORRECT ANSWER - placenta previa.
Couvelaire uterus is associated with which condition? - CORRECT ANSWER - Placental
abruption
A woman with higher-order multiples is at risk for all of the following except - CORRECT
ANSWER - pyelonephritis.
,Which feature is recommended when monitoring twin gestations to differentiate between fetal
heart rates and maternal heart rate? - CORRECT ANSWER - Maternal pulse oximetry
RhD-negative women may be sensitized with fetal blood during any bleeding episode in the
antepartum period. If a Kleihauer-Betke test determines greater than 15 ml of fetal blood in the
maternal circulation, it is important to recognize that - CORRECT ANSWER - a 300-mg
Rh immunoglobulin dose may not be sufficient to prevent sensitization.
During which phase of the pathophysiologic process of disseminated intravascular coagulopathy
(DIC) do platelets adhere to the surface of the exposed collagen, bind to platelet receptors, and
attach to the damaged tissue creating a platelet plug? - CORRECT ANSWER - Primary
hemostasis
Which of the following is not a contraindication for magnesium sulfate administration? -
CORRECT ANSWER - Hyperkalemia
Current recommendations for antenatal glucocorticoid administration for acceleration of fetal
lung maturation is appropriate - CORRECT ANSWER - for women at 23-36 6/7 weeks
gestation at risk for preterm birth within 7 days.
Amniotic band syndrome is associated with what complication in pregnancy? - CORRECT
ANSWER - Preterm premature rupture of membranes
An ova that is fertilized by one sperm and then divides into two zygotes results in - CORRECT
ANSWER - monozygotic gestation.
Classic signs of placenta previa are - CORRECT ANSWER - painless, bright red bleeding.
Mrs. Jordan has arrived to the unit for a labor evaluation. She is 39 weeks pregnant and is
complaining of continuous abdominal pain. She is having high frequency, low amplitude
contractions and the fetal heart pattern shows minimal variability. You suspect that Mrs. Jordan
may have a - CORRECT ANSWER - placental abruption.
,Intensive nursing and medical management in women with pregestational diabetes should begin
in the
immediate postpartum period.
preconception period.
second trimester of pregnancy.
third trimester of pregnancy. - CORRECT ANSWER - preconception period.
Which of the following types of cardiac lesions are characterized by dysfunction of the cardiac
muscle, resulting in decreased cardiac output?
Aortic stenosis
Cardiomyopathy
Mitral insufficiency
Pulmonic lesions - CORRECT ANSWER - Cardiomyopathy
Mrs. J. has been receiving heparin therapy and is being transitioned to warfarin in the postpartum
period. Which of the following medications may act as antagonists or decrease the actions of
warfarin?
Antacids, antihistamines, and oral contraceptives
Antacids, aspirin, and acetaminophen
Aspirin, acetaminophen, and oral contraceptives
Aspirin, antihistamines, and vitamin K - CORRECT ANSWER - Aspirin, antihistamines,
and vitamin K (WRONG!)
Aspirin, acetaminophen, and oral contraceptives (WRONG)
The period of time during labor and birth when the greatest cardiac stress associated with the
highest cardiac output occurs is the
, early first stage of labor.
immediate postpartum period.
late first stage (transition) of labor.
second stage of labor with fetal descent. - CORRECT ANSWER - immediate postpartum
period.
Maternal cardiac output begins to increase by 5 weeks gestation and peaks at
15-20 weeks gestation.
20-25 weeks gestation.
25-30 weeks gestation.
30-35 weeks gestation. - CORRECT ANSWER - 25-30 weeks gestation.
Mrs. Madison has arrived at her prenatal visit at 36 weeks gestation. She has gestational diabetes,
and her glucose levels have been controlled by diet alone. She documented several high glucose
values over the past week. It is important to discuss that prolonging pregnancy beyond 38 weeks
in women with diabetes may result in fetal
cardiomegaly.
demise.
hyperbilirubinemia.
macrosomia. - CORRECT ANSWER - macrosomia.
In patients with chronic hypertension, elevated uric acid levels in which of the following ranges
may indicate risk for superimposed preeclampsia?
2.5-4.0 mg/dl (149-238 umol/l)
3.5-5.0 mg/dl 208-297 umol/l)
4.5-6.0 mg/dl (268-357 umol/l)
5.5-7.0 mg/dl (327-416 umol/l) - CORRECT ANSWER - 4.5-6.0 mg/dl (268-357 umol/l)
Exam Questions and CORRECT Answers
Ms. Linghu arrived at the obstetric care unit for a labor evaluation. She is 28 weeks gestation and
is complaining of a lower back ache and cramping. The physician has asked for assistance in
obtaining a sample to assess for fetal fibronectin (fFN). Which statement about fFN is most
accurate? - CORRECT ANSWER - fFN is a strong predictor or marker for identification
of preterm labor associated with infection.
Risk factors for placenta previa include - CORRECT ANSWER - previous uterine surgery,
smoking, and hypertension.
One of the most common and well documented risk factors for preterm labor is - CORRECT
ANSWER - previous history of preterm birth.
All of the following complications may predispose a pregnant woman to disseminated
intravascular coagulopathy (DIC) except - CORRECT ANSWER - preterm labor.
A cerclage placed in women with documented shortened cervical length by ultrasound
examination is called a(n) - CORRECT ANSWER - therapeutic cerclage.
The most common postpartum complication for mothers with higher-order multiples is -
CORRECT ANSWER - postpartum hemorrhage.
Painless, bright red vaginal bleeding at 28 weeks of gestation is most likely caused by -
CORRECT ANSWER - placenta previa.
Couvelaire uterus is associated with which condition? - CORRECT ANSWER - Placental
abruption
A woman with higher-order multiples is at risk for all of the following except - CORRECT
ANSWER - pyelonephritis.
,Which feature is recommended when monitoring twin gestations to differentiate between fetal
heart rates and maternal heart rate? - CORRECT ANSWER - Maternal pulse oximetry
RhD-negative women may be sensitized with fetal blood during any bleeding episode in the
antepartum period. If a Kleihauer-Betke test determines greater than 15 ml of fetal blood in the
maternal circulation, it is important to recognize that - CORRECT ANSWER - a 300-mg
Rh immunoglobulin dose may not be sufficient to prevent sensitization.
During which phase of the pathophysiologic process of disseminated intravascular coagulopathy
(DIC) do platelets adhere to the surface of the exposed collagen, bind to platelet receptors, and
attach to the damaged tissue creating a platelet plug? - CORRECT ANSWER - Primary
hemostasis
Which of the following is not a contraindication for magnesium sulfate administration? -
CORRECT ANSWER - Hyperkalemia
Current recommendations for antenatal glucocorticoid administration for acceleration of fetal
lung maturation is appropriate - CORRECT ANSWER - for women at 23-36 6/7 weeks
gestation at risk for preterm birth within 7 days.
Amniotic band syndrome is associated with what complication in pregnancy? - CORRECT
ANSWER - Preterm premature rupture of membranes
An ova that is fertilized by one sperm and then divides into two zygotes results in - CORRECT
ANSWER - monozygotic gestation.
Classic signs of placenta previa are - CORRECT ANSWER - painless, bright red bleeding.
Mrs. Jordan has arrived to the unit for a labor evaluation. She is 39 weeks pregnant and is
complaining of continuous abdominal pain. She is having high frequency, low amplitude
contractions and the fetal heart pattern shows minimal variability. You suspect that Mrs. Jordan
may have a - CORRECT ANSWER - placental abruption.
,Intensive nursing and medical management in women with pregestational diabetes should begin
in the
immediate postpartum period.
preconception period.
second trimester of pregnancy.
third trimester of pregnancy. - CORRECT ANSWER - preconception period.
Which of the following types of cardiac lesions are characterized by dysfunction of the cardiac
muscle, resulting in decreased cardiac output?
Aortic stenosis
Cardiomyopathy
Mitral insufficiency
Pulmonic lesions - CORRECT ANSWER - Cardiomyopathy
Mrs. J. has been receiving heparin therapy and is being transitioned to warfarin in the postpartum
period. Which of the following medications may act as antagonists or decrease the actions of
warfarin?
Antacids, antihistamines, and oral contraceptives
Antacids, aspirin, and acetaminophen
Aspirin, acetaminophen, and oral contraceptives
Aspirin, antihistamines, and vitamin K - CORRECT ANSWER - Aspirin, antihistamines,
and vitamin K (WRONG!)
Aspirin, acetaminophen, and oral contraceptives (WRONG)
The period of time during labor and birth when the greatest cardiac stress associated with the
highest cardiac output occurs is the
, early first stage of labor.
immediate postpartum period.
late first stage (transition) of labor.
second stage of labor with fetal descent. - CORRECT ANSWER - immediate postpartum
period.
Maternal cardiac output begins to increase by 5 weeks gestation and peaks at
15-20 weeks gestation.
20-25 weeks gestation.
25-30 weeks gestation.
30-35 weeks gestation. - CORRECT ANSWER - 25-30 weeks gestation.
Mrs. Madison has arrived at her prenatal visit at 36 weeks gestation. She has gestational diabetes,
and her glucose levels have been controlled by diet alone. She documented several high glucose
values over the past week. It is important to discuss that prolonging pregnancy beyond 38 weeks
in women with diabetes may result in fetal
cardiomegaly.
demise.
hyperbilirubinemia.
macrosomia. - CORRECT ANSWER - macrosomia.
In patients with chronic hypertension, elevated uric acid levels in which of the following ranges
may indicate risk for superimposed preeclampsia?
2.5-4.0 mg/dl (149-238 umol/l)
3.5-5.0 mg/dl 208-297 umol/l)
4.5-6.0 mg/dl (268-357 umol/l)
5.5-7.0 mg/dl (327-416 umol/l) - CORRECT ANSWER - 4.5-6.0 mg/dl (268-357 umol/l)
