OB NCLEX Exam #1 TOP Questions and answers, 100% Accurate, rated A

OB NCLEX Exam #1 TOP Questions and answers, 100% Accurate, rated A In a routine pregnancy, how often are prenatal doctor visits made? - -every 4 wks for 28wks, every 2 wks during 28-36 wks, every wk from 36-41qks, twice weekly after that What things are done during the initial prenatal visit? - -done at 8 weeks gestation; determine EDD; obtain hx; risk assessment; vital signs/weight/urinalysis; physical exam; FHR assessment (doppler); and labs What are things done during the ongoing prenatal visits? - -vs, weight, urinalysis; fundal height measurement (>20wks); Leopold's Maneuver (>34 weeks); FHT; fetal activity (daily kick counts >28 weeks); signs of labor; ultrasound screening; glucose screening; cervical checks (during last month of gestation) What items should be included in health promotion education? - -avoiding OTC and RX meds unless obstetrician has knowledge of this; avoid alcohol and tobacco use; avoid substance abuse; flu vaccination is encouraged; tx current infections; genetic testing/counseling; avoid use of hot tubes; moderate exercise; consuming 2-3L of water/day; Presumptive signs of pregnancy - -changes that make the woman suspect she is pregnanct; subjective information; amenorrhea, fatigue, n&v, urinary frequency, breast changes, fetal movements felt by the woman, uterine enlargment, linea nigra, chloasma, striae gravidarum Probable signs of pregnancy - -changes that make the examiner suspect a woman is pregnant (signs can be caused by other physiological factors); abdominal enlargment, cervical changes, Braxton hick's contractions, positive pregnancy test, fetal outline felt by examiner Positive signs of pregnancy - -signs that can only be explained by pregnancy; fetal heart sounds, visualization of fetus by ultrasound, fetal movement palpated by an experienced examiner Hegar's sign - -softening and compressibility of lower uterus Chadwick's sign - -deepened bluish color of vaginal mucosa Goodell's sign - -softening of cervical tip Ballottement - -rebound of unengaged fetus Nagele's rule - -way to calculate estimated due date; first day of LMP, subtract 3 months, then add 7 days McDonald's method - -way to calculate estimated gestational age; after 20 wks, measure fundal height and # of centimeters should correlate with # of weeks of gestation gravidity - -number of pregnancies Nulligravida - -a woman who has never been pregnant Primigravida - -a woman in her first pregnancy Multigravida - -a woman who has been pregnant more than once Parity - -number of pregnancies in which the fetus reached viable age (20 wks) Nullipara - -no pregnancies in which fetus reached viable age Primipara - -one pregnancy in which fetus reached viable age Multipara - -more than one pregnancy in which the fetus reached viable age What does GTPAL stand for when using the 5 stage system? - -Gravida (# of pregnancies); Term(> 38 wks); Preterm(<38 weeks); Abortion; Living Chloasma - -mask of pregnancy Linea nigra - -dark line of pigmentation from the umbilicus to the pubic area Striae gravidam - -stretch marks mostly found on abdomen and thighs How should a nurse evaluate a client's nutritional choices? - -Have the client keep a food journal; calculate amount of calories in each food eaten; have the client fill out questionnaires; monitor weight during visits; lab work What is the recommended increase of calories per day in the second trimester? - -340 What is the recommended increase of calories per day in the third trimester? - -452 How many mcg of folic acid should be taken during pregnancy and lactation? - -600 and 500 What are some supplements that should be taken during pregnancy? - -calcium and iron What can be used to help manage constipation associated with taking iron supplements? - -stool softeners How many liters of fluid are recommended during pregnancy? - -2-3 Caffeine should be limited to how many mg/day? - -300 What are some risk factors that could affect the adequacy of nutritional intake during pregnancy? - -age, culture, socioeconomic status, education level and specific circumstances that could occur during pregnancy (n&v, etc) How much weight should be gained during the first trimester and thereafter during pregnancy? - -up to 4 lbs during the first trimester, then 1lb per week for the last two trimesters What birth defect can result from folic acid deficiency during pregnancy? - -neural tube defects What are some foods that are high in calcium? - -dark green, leafy vegetables (ex. spinach) What birth defect can result from calcium deficiency? - -poor teeth and bone formation What birth defect can result from maternal obesity? - -macrosomic fetus What foods are rich in iron? - -chicken, meat, and fish What vitamin aids in the absorption of iron? - -vitamin C What complications could be the cause of vaginal bleeding during the first trimester? - -abortion or ectopic pregnancy What complications could be the cause of vaginal bleeding during the second trimester? - -gestational trophoblastic disease What complications could be the cause of vaginal bleeding during the third trimester? - -placenta previa; abruptio placenta; vasa previa incompetent cervix - -painless dilation of the cervis in the absence of uterine dilation; cervis is incapable of supporting the weight of the fetus hyperemesis gravidarum - -excessive nausea and vomiting (related to elevated hCG levels) that is prolonged past 12 weeks of gestation and results in a 5% weight loss from prepregnancy weight, electrolyte imbalance, acetonuria, and ketosis Iron-deficiency anemia - -due to inadequacy in maternal iron stores and consuming insufficient amounts of dietary iron gestational diabetes mellitus - -impaired tolerance to glucose with the first onset or recognition during pregnancy gestational hypertension - -begins after the 20th week of pregnancy, describes hypertensive disorders of pregnancy whereby the woman has an elevated blood pressure at 140/90 mm Hg or greater, or a systolic increase of 30 mm Hg or a diastolic increase of 15 mm Hg from the prepregnancy baseline mild preeclampsia - -GH with the addition of proteinuria of 1 to 2+ and a weight gain of more than 2 kg (4.4 lb) per week in the second and third trimesters severe preeclampsia - -consists of blood pressure that is 160/100 mm Hg or greater, proteinuria 3 to 4+, oliguria eclampsia - -severe preeclampsia symptoms along with the onset of seizure activity or coma gestation - -# of weeks of pregnancy since the first day of the LMP viability - -when a fetus reaches a gestational age that he/she can survive outside the womb term - -38-42 weeks gestation