NUR 221 EXAM 2
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
Variable decelerations- Fetal Heart Rate
ANSWER
are an abrupt onset of decreased FHR below baseline that may occur with or after a
contraction
-Is usually due to cord compression and may be associated with fetal acidosis.
Intervention- Put mom on left side. Administer 10 L O2 nonrebreather
Question 2.
Hydralazine
ANSWER
Vasodilator; Antihypertensive
S/E: HA, flushing tachycardia, palpitations, N/V, decrease in uteroplacental blood flow
Fetal S/E: tachycardia, late decels
Contraindicated in maternal tachycardia
Can take while breastfeeding
Question 3.
Second stage of labor
ANSWER
Stage of Expulsion
Begins with complete cervical dilation and ends with delivery of fetus
**Baby is moving through the birth canal
Forceful contractions
(Somatic Pain)
PUSHING STAGE
,Question 4.
Cesarean Birth Post op considerations
ANSWER
i. Assess vitals often
ii. Assess s/s infections
iii. NPO until pass gas
iv. Assess incision
v. Splint incision
vi. Ambulation (as often as you can)
vii. Stool Softeners
viii. Pain Relief Management
ix. Incentive Spirometer
x. Do not use straws
xi. Rock in a rocking chair
xii. Lie on left side to help expel gas
Question 5.
Absent FHR variability
ANSWER
amplitude range undetected
Question 6.
Nubain (Nalbuphine)
ANSWER
i. Analgesic, Opioid agonist- antagonist
ii. Pain relief during labor- MOST COMMON
iii. IV PUSH SLOW
,Question 7.
Frequency of contractions are measured from the...
ANSWER
peak of one contraction to the peak of the next contraction (or beginning to beginning)
Question 8.
Fourth stage of labor
ANSWER
Recovery stage
Begins after the delivery of the placenta and continues for one to four hours after the delivery.
**Nursing right after birth will help the uterus to contract and will decrease the amount of
bleeding
Check vitals at least every 15 minutes for the first 2 hours
Fundal check
Newborn exam
Apgar score
Question 9.
Cesarean Birth Indications
ANSWER
i. Maternal cardiac diseases
ii. Nonreassuring fetal status
iii. Malpresentation of fetus (breech or traverse lie)
iv. Active maternal herpes infection
v. Cephalopelvic disproportion
vi. Placental abruption
vii. Placenta previa
viii. History of previous cesarean birth
ix. Cesarean birth on maternal request
, Question 10.
Alternative methods of labor induction
ANSWER
i. castor oil
ii. evening primrose
iii. acupuncture
iv. blue cohosh
Question 11.
Cytotec (misoprostol)
ANSWER
Drug class: Prostaglandin E1 (PGE1)
Preinduction Cervical Ripening
Given before Oxytocin to induce labor
Usual dose/route: 100 or 200 mcg tablet which is prepared in pharmacy to ensure proper
dosage. Initial dose is 25mcg inserted transvaginally into the posterior of the vaginal fornix
using the tips of the index and middle fingers WITHOUT lubricant. Repeat every 3-6 hours up
to 6 doses in a 24 hour period or until and effective contraction pattern is established, the
cervix ripens (Bishop score of 8 or more) or adverse reactions occur.
Side effects: higher doses more likely to cause nausea vomiting, diarrhea, fever, uterine
tachysystole, with or without an abnormal FHR and patterns or fetal passage of meconium.
The risk for adverse reactions is reduced with lower doses at longer intervals between doses.
Use in obstetrics: Used to ripen the cervix making it softer and causing it to begin to dilate and
efface, stimulating contractions.
Do not give if woman has a hx of previous cesasarian birth or other major uterine surgery.
Patient teaching: explain procedure to patient and family. Void before insertion, must maintain
a supine with lateral tilt or side-lying position for 30-40 min after insertion. Avoid taking
antacids
Question 12.
Third stage of labor
ANSWER
Placental stage
Begins immediately after the fetus is born and ends when the placenta is delivered Placenta
usually delivered 5-15 minutes after baby arrives.
(Visceral pain similar to first stage)
UPDATED ACTUAL QUESTIONS WITH CORRECT
ANSWERS
Question 1.
Variable decelerations- Fetal Heart Rate
ANSWER
are an abrupt onset of decreased FHR below baseline that may occur with or after a
contraction
-Is usually due to cord compression and may be associated with fetal acidosis.
Intervention- Put mom on left side. Administer 10 L O2 nonrebreather
Question 2.
Hydralazine
ANSWER
Vasodilator; Antihypertensive
S/E: HA, flushing tachycardia, palpitations, N/V, decrease in uteroplacental blood flow
Fetal S/E: tachycardia, late decels
Contraindicated in maternal tachycardia
Can take while breastfeeding
Question 3.
Second stage of labor
ANSWER
Stage of Expulsion
Begins with complete cervical dilation and ends with delivery of fetus
**Baby is moving through the birth canal
Forceful contractions
(Somatic Pain)
PUSHING STAGE
,Question 4.
Cesarean Birth Post op considerations
ANSWER
i. Assess vitals often
ii. Assess s/s infections
iii. NPO until pass gas
iv. Assess incision
v. Splint incision
vi. Ambulation (as often as you can)
vii. Stool Softeners
viii. Pain Relief Management
ix. Incentive Spirometer
x. Do not use straws
xi. Rock in a rocking chair
xii. Lie on left side to help expel gas
Question 5.
Absent FHR variability
ANSWER
amplitude range undetected
Question 6.
Nubain (Nalbuphine)
ANSWER
i. Analgesic, Opioid agonist- antagonist
ii. Pain relief during labor- MOST COMMON
iii. IV PUSH SLOW
,Question 7.
Frequency of contractions are measured from the...
ANSWER
peak of one contraction to the peak of the next contraction (or beginning to beginning)
Question 8.
Fourth stage of labor
ANSWER
Recovery stage
Begins after the delivery of the placenta and continues for one to four hours after the delivery.
**Nursing right after birth will help the uterus to contract and will decrease the amount of
bleeding
Check vitals at least every 15 minutes for the first 2 hours
Fundal check
Newborn exam
Apgar score
Question 9.
Cesarean Birth Indications
ANSWER
i. Maternal cardiac diseases
ii. Nonreassuring fetal status
iii. Malpresentation of fetus (breech or traverse lie)
iv. Active maternal herpes infection
v. Cephalopelvic disproportion
vi. Placental abruption
vii. Placenta previa
viii. History of previous cesarean birth
ix. Cesarean birth on maternal request
, Question 10.
Alternative methods of labor induction
ANSWER
i. castor oil
ii. evening primrose
iii. acupuncture
iv. blue cohosh
Question 11.
Cytotec (misoprostol)
ANSWER
Drug class: Prostaglandin E1 (PGE1)
Preinduction Cervical Ripening
Given before Oxytocin to induce labor
Usual dose/route: 100 or 200 mcg tablet which is prepared in pharmacy to ensure proper
dosage. Initial dose is 25mcg inserted transvaginally into the posterior of the vaginal fornix
using the tips of the index and middle fingers WITHOUT lubricant. Repeat every 3-6 hours up
to 6 doses in a 24 hour period or until and effective contraction pattern is established, the
cervix ripens (Bishop score of 8 or more) or adverse reactions occur.
Side effects: higher doses more likely to cause nausea vomiting, diarrhea, fever, uterine
tachysystole, with or without an abnormal FHR and patterns or fetal passage of meconium.
The risk for adverse reactions is reduced with lower doses at longer intervals between doses.
Use in obstetrics: Used to ripen the cervix making it softer and causing it to begin to dilate and
efface, stimulating contractions.
Do not give if woman has a hx of previous cesasarian birth or other major uterine surgery.
Patient teaching: explain procedure to patient and family. Void before insertion, must maintain
a supine with lateral tilt or side-lying position for 30-40 min after insertion. Avoid taking
antacids
Question 12.
Third stage of labor
ANSWER
Placental stage
Begins immediately after the fetus is born and ends when the placenta is delivered Placenta
usually delivered 5-15 minutes after baby arrives.
(Visceral pain similar to first stage)
