NUR 353 Final Exam Spring 2023 ASU Wood/Bowles
Questions With Correct Answers
REP 2: menstrual cycle r/t fertility and infertility issues (1) - ANSWER -28
day cycle
-day 14 ovulation
-most fertile day 9-14; cervical mucus changes (long/stringy/thin)
"spinnbarkeit" and BBT change
-ovum remains viable for 24 hours; sperm remain viable for 2-3 days
-If they have a Positive ovulation kit (shows LH surge) 24-36 hours
BEFORE ovulation
-Increase in basal body temperature (BBT) 0.5-1 degree AFTER ovulation
-s/s of ovulation include increased productivity, increased libido,
headaches, "mittelschmerz" which is pain in abdomen during ovulation,
spotting
-best time to take BBT is before getting out of bed every morning
REP 3: physiological changes and assessments: fundal height normal vs
abnormal findings (2) - ANSWER -presumptive signs (subjective)→ breast
changes, amenorrhea, quickening, fatigue, nausea/vomiting
-probable signs (objective) → positive pregnancy test, Hegar's sign
(softening and compressibility of lower uterus), ballottement (rebound
pressure on cervix), Chadwick's sign (bluish color of cervix), Goodell's sign
(softening of cervix)
-positive signs→ visualization of fetus on ultrasound, FHTs heard, fetal
movements palpated by examiner, fetal movements visible
-pregnancy milestones
First trimester
4 wks gestation→ missed period
8-12 wks→ first prenatal appointment/ultrasound
Second trimester
14-18 wks→ quickening
20 wks→ anatomy ultrasound
,22-24 wks→ viability
28 wks gestation→ Rhogam shot if Rh negative
Third trimester
36-37 wks gestation→ group beta strep vaginal/rectal swab
40 wks→ estimated DOB/ EDD/ estimated date of confinement
-at 22 wks gestation, fundus should be slightly above the umbilicus (1-2
cm)
REP 3: common discomforts of pregnancy and potential
complications/warning signs by trimester (2) - ANSWER -1st trimester→
breast tenderness, N/V, fatigue, ptyalism (excessive salivation), gingivitis,
physiologic anemia
-2nd trimester→ pica, constipation, pyrosis (heartburn), leukorrhea,
headache, carpal tunnel
-3rd trimester→ urinary frequency, Braxton Hicks contractions, round
ligament pain, leg cramps, edema, dyspnea
-1st trimester warning signs, call MD for facial edema (preeclampsia s/s
include water retention which can manifest as facial edema)
REP 4: screening vs diagnostic assessments of fetal well being including
labs, fetal monitoring (2) - ANSWER -examples of screenings→ 20 wk
anatomy ultrasound, fetal kick counting, NST, BPP, genetic testing (cell-
free DNA), glucose 1hr
-examples of diagnostics→ amniocentesis, chorionic villus sampling,
glucose 3hr
*nonreassuring NST? Continue for additional 20 mins, still not reassuring
then BPP*
-NST indications→ for concerns, high risk pregnancies, after 28 weeks
(dec. fetal movement, twins or triplets)
-maternal hypothyroidism is common and not indicative of NST
-maternal fever would need more than just an NST
REP 4: FHR patterns/interventions (2) - ANSWER -VEAL CHOP
-variable decels→ cord compression
-early decels→ head compression
-accelerations→ oxygen good
-late decels→ placental insufficiency
-early decels→ U-shaped curved decels (mirror contractions), always occur
with contractions, no interventions necessary
, -variable decels→ V-shaped decels that take <30 secs to get to their nadir
(abrupt drop in HR from baseline), okay if small and transient not great if
repetitive and large, best intervention is repositioning
-late decels→ decels take >30 sec to get to their nadir, dec in HR where
the nadir occurs after peak of contraction
-prolonged decels→ drop in HR lasting longer than 2 mins, usually occurs
after contraction, suggests poor fetal reserve, intervention intrauterine
resuscitation
-intrauterine resuscitation:
turn off any Pitocin
reposition (side lying is best)
start IV fluid bolus
assess maternal BP
assess uterine contraction pattern
call for assistance
consider cervical exam
prepare for emergent measures
-Category I→ strongly associated w/normal acid base status
-normal
-moderate variability
-no late or variable decels
-early decels present or absent
-accels present or absent *reactive NST
-Category II→ not predictive of abnormal fetal acid base status but
inadequate evidence to classify as normal or abnormal
-intermediate
-FHR tracings that do not meet the criteria for normal or abnormal
-Category III→ predictive of abnormal fetal acid base status
-abnormal
-absent baseline variability
-recurrent late decels
-recurrent variable decels
-bradycardia or sinusoidal rhythm
-ominous sign in FHR→ persistent late decels without return to baseline
REP 5: true vs false labor, 5 Ps, stages/phases of labor assessments and
progression (2) - ANSWER -true labor→ contractions may radiate beyond
abdomen, no intervention will change intensity, longer/stronger/closer
together, cervical change
Questions With Correct Answers
REP 2: menstrual cycle r/t fertility and infertility issues (1) - ANSWER -28
day cycle
-day 14 ovulation
-most fertile day 9-14; cervical mucus changes (long/stringy/thin)
"spinnbarkeit" and BBT change
-ovum remains viable for 24 hours; sperm remain viable for 2-3 days
-If they have a Positive ovulation kit (shows LH surge) 24-36 hours
BEFORE ovulation
-Increase in basal body temperature (BBT) 0.5-1 degree AFTER ovulation
-s/s of ovulation include increased productivity, increased libido,
headaches, "mittelschmerz" which is pain in abdomen during ovulation,
spotting
-best time to take BBT is before getting out of bed every morning
REP 3: physiological changes and assessments: fundal height normal vs
abnormal findings (2) - ANSWER -presumptive signs (subjective)→ breast
changes, amenorrhea, quickening, fatigue, nausea/vomiting
-probable signs (objective) → positive pregnancy test, Hegar's sign
(softening and compressibility of lower uterus), ballottement (rebound
pressure on cervix), Chadwick's sign (bluish color of cervix), Goodell's sign
(softening of cervix)
-positive signs→ visualization of fetus on ultrasound, FHTs heard, fetal
movements palpated by examiner, fetal movements visible
-pregnancy milestones
First trimester
4 wks gestation→ missed period
8-12 wks→ first prenatal appointment/ultrasound
Second trimester
14-18 wks→ quickening
20 wks→ anatomy ultrasound
,22-24 wks→ viability
28 wks gestation→ Rhogam shot if Rh negative
Third trimester
36-37 wks gestation→ group beta strep vaginal/rectal swab
40 wks→ estimated DOB/ EDD/ estimated date of confinement
-at 22 wks gestation, fundus should be slightly above the umbilicus (1-2
cm)
REP 3: common discomforts of pregnancy and potential
complications/warning signs by trimester (2) - ANSWER -1st trimester→
breast tenderness, N/V, fatigue, ptyalism (excessive salivation), gingivitis,
physiologic anemia
-2nd trimester→ pica, constipation, pyrosis (heartburn), leukorrhea,
headache, carpal tunnel
-3rd trimester→ urinary frequency, Braxton Hicks contractions, round
ligament pain, leg cramps, edema, dyspnea
-1st trimester warning signs, call MD for facial edema (preeclampsia s/s
include water retention which can manifest as facial edema)
REP 4: screening vs diagnostic assessments of fetal well being including
labs, fetal monitoring (2) - ANSWER -examples of screenings→ 20 wk
anatomy ultrasound, fetal kick counting, NST, BPP, genetic testing (cell-
free DNA), glucose 1hr
-examples of diagnostics→ amniocentesis, chorionic villus sampling,
glucose 3hr
*nonreassuring NST? Continue for additional 20 mins, still not reassuring
then BPP*
-NST indications→ for concerns, high risk pregnancies, after 28 weeks
(dec. fetal movement, twins or triplets)
-maternal hypothyroidism is common and not indicative of NST
-maternal fever would need more than just an NST
REP 4: FHR patterns/interventions (2) - ANSWER -VEAL CHOP
-variable decels→ cord compression
-early decels→ head compression
-accelerations→ oxygen good
-late decels→ placental insufficiency
-early decels→ U-shaped curved decels (mirror contractions), always occur
with contractions, no interventions necessary
, -variable decels→ V-shaped decels that take <30 secs to get to their nadir
(abrupt drop in HR from baseline), okay if small and transient not great if
repetitive and large, best intervention is repositioning
-late decels→ decels take >30 sec to get to their nadir, dec in HR where
the nadir occurs after peak of contraction
-prolonged decels→ drop in HR lasting longer than 2 mins, usually occurs
after contraction, suggests poor fetal reserve, intervention intrauterine
resuscitation
-intrauterine resuscitation:
turn off any Pitocin
reposition (side lying is best)
start IV fluid bolus
assess maternal BP
assess uterine contraction pattern
call for assistance
consider cervical exam
prepare for emergent measures
-Category I→ strongly associated w/normal acid base status
-normal
-moderate variability
-no late or variable decels
-early decels present or absent
-accels present or absent *reactive NST
-Category II→ not predictive of abnormal fetal acid base status but
inadequate evidence to classify as normal or abnormal
-intermediate
-FHR tracings that do not meet the criteria for normal or abnormal
-Category III→ predictive of abnormal fetal acid base status
-abnormal
-absent baseline variability
-recurrent late decels
-recurrent variable decels
-bradycardia or sinusoidal rhythm
-ominous sign in FHR→ persistent late decels without return to baseline
REP 5: true vs false labor, 5 Ps, stages/phases of labor assessments and
progression (2) - ANSWER -true labor→ contractions may radiate beyond
abdomen, no intervention will change intensity, longer/stronger/closer
together, cervical change
