NURS 444 Final Exam (CSUN Study guide for OB)
Questions With Complete Solutions
2 types of molar pregnancies? Correct Answers 1. complete: no
fetus, only placenta develops
2. partial: fetus is present, but has varying degrees of
development (usually a partial fetus)
ABO incompatibility Correct Answers Hemolytic disease that
occurs when the mother's blood type is O and the newborn's is
A, B, or AB. the mother's immune system may react and make
antibodies against her baby's RBCs
about __% of spontaneous abortions are related to vaginal
bleeding in the __trimester Correct Answers 50%; 1st
abruptio placentae: therapeutic management Correct Answers -
hospitalized & evaluated ASAP
-conservative mgmnt for mild cases/fetus <34 weeks w/no signs
of distress
-If fetal compromise: immediate delivery of baby
-2 large-bore IVs w/blood products on standby
-RhoGAM administration for Rh-negative women to prevent Rh
sensitization
abruptio plcentae: what are the clinical manifestations? Correct
Answers -bleeding (may be evident or concealed behind
placenta)
-uterine tenderness (d/t hematoma developing on uterine wall)
-"board-like" abdomen (firm to touch d/t blood)
,-"port wine" colored amniotic fluid
-nonreassuring FHR patterns
-Signs of hypovolemic shock
AFI (amniotic fluid index) Correct Answers • Ultrasound
screening measures pockets of amniotic fluid. amniotic fluid is
fetal urine shows kidneys working
• Desired measurement 8-24 cm. Abnormal <5 cm
(oligohydramnios); >24 cm (polyhydramnios)
all placenta previas lead to ___? Correct Answers c-section
associated factors with PTL Correct Answers Uterine
Distention, Surgery, Uterine Irritability or Bleeding,
Dehydration, Infection, Anemia, Incompetent Cervix, PROM,
Abnormalities
attitude Correct Answers Relationship of fetal body parts to
one another
NORMAL: flexion
- Full flexion: vertex presentation
Chin to chest, head down, arms in. Will feel posterior fontanel
- Moderate flexion: military presentation
Will feel anterior fontanel
- Poor flexion: brow presentation
Will feel forehead/brow
ABNORMAL: - extension AKA face presentation:
,Worst attitude to have. Face will present. Usually requires a C-
section
audible swallow Correct Answers 0 pt - none
1 pt - few swallows
2 pt - spontaneous swallows
ballard scoring: SGA, LGA, AGA Correct Answers Determine
infant size
AGA: 10th - 90th percentile
SGA: below 10th percentile
LGA: over 90th percentile
ballard scoring: why do it? Correct Answers commonly used to
determine gestational age.
Scores are given for 6 physical (skin, lanugo, plantar surface,
breast buds, eyes/ears, genitals) and 6 nerve and muscle
development (neuromuscular: posture, square window, arm
recoil, popliteal angle, scarf sign, heel to ear) signs of maturity.
The scores for each may range from -1 to 5.
benefits of FSE Correct Answers Displays cardiac arrhythmias
Accurately displays FHR between 30-240 bpm
benefits of IUPC Correct Answers Only true accurate
measurement of all uterine activity
, Allows for use of amnioinfusion (flushing out uterus in the event
baby "poops" (meconium) in amniotic fluid)
Bilirubin Correct Answers bilirubin on infants at risk: blood
type O for mom, positive coombs, or jaundice
bilirubin abnormal: cause and treatment Correct Answers
phototherapy, recheck bilirubin q 12 hours
bishop score Correct Answers Determines whether induction is
indicated (who can be induced)
Looks at dialtion, effacemernt, station, consistency of cervix,
position of cervix
The lower the score the higher the increase for a C-section
use prostaglandins and mechanical methods to increase bishop
score
blood is warmed by... Correct Answers circullating through
brown fat
BPP (biophysical profile) Correct Answers Ultrasound to
assess fetal wellbeing based on 5 criteria each worth 2 pts or 0 if
absent. 8 or higher is desired, 6 requires observation 4 or lower
results in c-section
FHR 2pts, Fetal mvmt 2pts, tone 2pts, breathing 2 pts, and AFI 2
pts=10 pts
Questions With Complete Solutions
2 types of molar pregnancies? Correct Answers 1. complete: no
fetus, only placenta develops
2. partial: fetus is present, but has varying degrees of
development (usually a partial fetus)
ABO incompatibility Correct Answers Hemolytic disease that
occurs when the mother's blood type is O and the newborn's is
A, B, or AB. the mother's immune system may react and make
antibodies against her baby's RBCs
about __% of spontaneous abortions are related to vaginal
bleeding in the __trimester Correct Answers 50%; 1st
abruptio placentae: therapeutic management Correct Answers -
hospitalized & evaluated ASAP
-conservative mgmnt for mild cases/fetus <34 weeks w/no signs
of distress
-If fetal compromise: immediate delivery of baby
-2 large-bore IVs w/blood products on standby
-RhoGAM administration for Rh-negative women to prevent Rh
sensitization
abruptio plcentae: what are the clinical manifestations? Correct
Answers -bleeding (may be evident or concealed behind
placenta)
-uterine tenderness (d/t hematoma developing on uterine wall)
-"board-like" abdomen (firm to touch d/t blood)
,-"port wine" colored amniotic fluid
-nonreassuring FHR patterns
-Signs of hypovolemic shock
AFI (amniotic fluid index) Correct Answers • Ultrasound
screening measures pockets of amniotic fluid. amniotic fluid is
fetal urine shows kidneys working
• Desired measurement 8-24 cm. Abnormal <5 cm
(oligohydramnios); >24 cm (polyhydramnios)
all placenta previas lead to ___? Correct Answers c-section
associated factors with PTL Correct Answers Uterine
Distention, Surgery, Uterine Irritability or Bleeding,
Dehydration, Infection, Anemia, Incompetent Cervix, PROM,
Abnormalities
attitude Correct Answers Relationship of fetal body parts to
one another
NORMAL: flexion
- Full flexion: vertex presentation
Chin to chest, head down, arms in. Will feel posterior fontanel
- Moderate flexion: military presentation
Will feel anterior fontanel
- Poor flexion: brow presentation
Will feel forehead/brow
ABNORMAL: - extension AKA face presentation:
,Worst attitude to have. Face will present. Usually requires a C-
section
audible swallow Correct Answers 0 pt - none
1 pt - few swallows
2 pt - spontaneous swallows
ballard scoring: SGA, LGA, AGA Correct Answers Determine
infant size
AGA: 10th - 90th percentile
SGA: below 10th percentile
LGA: over 90th percentile
ballard scoring: why do it? Correct Answers commonly used to
determine gestational age.
Scores are given for 6 physical (skin, lanugo, plantar surface,
breast buds, eyes/ears, genitals) and 6 nerve and muscle
development (neuromuscular: posture, square window, arm
recoil, popliteal angle, scarf sign, heel to ear) signs of maturity.
The scores for each may range from -1 to 5.
benefits of FSE Correct Answers Displays cardiac arrhythmias
Accurately displays FHR between 30-240 bpm
benefits of IUPC Correct Answers Only true accurate
measurement of all uterine activity
, Allows for use of amnioinfusion (flushing out uterus in the event
baby "poops" (meconium) in amniotic fluid)
Bilirubin Correct Answers bilirubin on infants at risk: blood
type O for mom, positive coombs, or jaundice
bilirubin abnormal: cause and treatment Correct Answers
phototherapy, recheck bilirubin q 12 hours
bishop score Correct Answers Determines whether induction is
indicated (who can be induced)
Looks at dialtion, effacemernt, station, consistency of cervix,
position of cervix
The lower the score the higher the increase for a C-section
use prostaglandins and mechanical methods to increase bishop
score
blood is warmed by... Correct Answers circullating through
brown fat
BPP (biophysical profile) Correct Answers Ultrasound to
assess fetal wellbeing based on 5 criteria each worth 2 pts or 0 if
absent. 8 or higher is desired, 6 requires observation 4 or lower
results in c-section
FHR 2pts, Fetal mvmt 2pts, tone 2pts, breathing 2 pts, and AFI 2
pts=10 pts
