NSG 3500 - MATERNAL EXAM 2
QUESTIONS WITH CORRECT
SOLUTIONS
Indications for Induction - ANSWER-1. Post term pregnancy
2. Gestational HTN
3. Fetal demise
4. PROM
5. Preeclampsia/Eclampsia
6. IUGR
T or F: Oxytocin is a Cervical Ripening Agent - ANSWER-False, cervical ripening
agents are used when oxytocin is not favorable; however, oxytocin may be used after
cervical ripening has occurred to induce labor
What are the 2 most common cervical ripening agents? - ANSWER-1. Prostaglandin E1
(Misoprostol/Cytotek)
2. Prostaglandin E2 (Dinoprostone/Cervidil/Prepidil)
What are the mechanical methods of cervical ripening? - ANSWER-1. Balloon catheter
2. Hydroscopic dilators
3. Amniotomy
What is Cervidil? - ANSWER-Small plastic insert containing prostaglandin with long
string is placed into the posterior fornix of the vagina
How long does cervidil remain in the vagina? - ANSWER-12 Hours
What precautions must a patient receiving cervidil follow? - ANSWER-1. Stay in bed for
first 2 hours (supine or side lying)
2. May get up only for bathroom
3. Stay on monitor
What do you do if tachysystole/hypersystole occurs in a patient receiving cervidil? -
ANSWER-Remove the insert by wrapping fingers in saline soaked gauze and pull then
administer terbutaline
How can you use a foley to cause mechanical cervical ripening? - ANSWER-Insert the
catheter into the intracervical canal to increase pressure on lower uterine segment
T or F: A transcatheter has the highest risk of causing tachysystole? - ANSWER-False,
it is associated with the lowest risk
, What is the maximum dose of oxytocin? - ANSWER-20 mU/min
Which IV hub should oxytocin be ran through? (Location) - ANSWER-Closest to patient
in case of reaction
What are some contraindications to oxytocin? - ANSWER-1. Placenta previa
2. Transverse fetal lie
3. Umbilical cord prolapse
4. Previous c-section
5. Multifetal pregnancy
6. HTN
What are the methods for the augmentation of labor? - ANSWER-1. Amniotomy
2. Oxytocin
3. Nipple stimulation
4. Shower/tub
5. Hydration
6. Ambulation
7. Relaxation
What is the difference between induction and augmentation of labor? - ANSWER-
Induction: Starts labor
Augmentation: Helps progress labor that has already began (seen in hypotonic uterine
activity)
T or F: A patient with preeclampsia would display hyperreflexia - ANSWER-True
What is HELLP syndrome? - ANSWER-Hemolysis, elevated liver function and low
platelets
Why are platelets administered prior to labor with HELLP syndrome? - ANSWER-To
prevent thrombocytopenia
What is "version" in terms of labor? - ANSWER-External or internal turning of a fetus
from one presentation to another
What is shoulder dystocia? - ANSWER-Head is born, but anterior shoulder cannot pass
under pubic arch
What are shoulder dystocia risk factors? - ANSWER-1. Maternal pelvic anomalies
2. Obesity & Diabetes
3. Slow descent
4. Slow progression
5. Fetal macrosomia
QUESTIONS WITH CORRECT
SOLUTIONS
Indications for Induction - ANSWER-1. Post term pregnancy
2. Gestational HTN
3. Fetal demise
4. PROM
5. Preeclampsia/Eclampsia
6. IUGR
T or F: Oxytocin is a Cervical Ripening Agent - ANSWER-False, cervical ripening
agents are used when oxytocin is not favorable; however, oxytocin may be used after
cervical ripening has occurred to induce labor
What are the 2 most common cervical ripening agents? - ANSWER-1. Prostaglandin E1
(Misoprostol/Cytotek)
2. Prostaglandin E2 (Dinoprostone/Cervidil/Prepidil)
What are the mechanical methods of cervical ripening? - ANSWER-1. Balloon catheter
2. Hydroscopic dilators
3. Amniotomy
What is Cervidil? - ANSWER-Small plastic insert containing prostaglandin with long
string is placed into the posterior fornix of the vagina
How long does cervidil remain in the vagina? - ANSWER-12 Hours
What precautions must a patient receiving cervidil follow? - ANSWER-1. Stay in bed for
first 2 hours (supine or side lying)
2. May get up only for bathroom
3. Stay on monitor
What do you do if tachysystole/hypersystole occurs in a patient receiving cervidil? -
ANSWER-Remove the insert by wrapping fingers in saline soaked gauze and pull then
administer terbutaline
How can you use a foley to cause mechanical cervical ripening? - ANSWER-Insert the
catheter into the intracervical canal to increase pressure on lower uterine segment
T or F: A transcatheter has the highest risk of causing tachysystole? - ANSWER-False,
it is associated with the lowest risk
, What is the maximum dose of oxytocin? - ANSWER-20 mU/min
Which IV hub should oxytocin be ran through? (Location) - ANSWER-Closest to patient
in case of reaction
What are some contraindications to oxytocin? - ANSWER-1. Placenta previa
2. Transverse fetal lie
3. Umbilical cord prolapse
4. Previous c-section
5. Multifetal pregnancy
6. HTN
What are the methods for the augmentation of labor? - ANSWER-1. Amniotomy
2. Oxytocin
3. Nipple stimulation
4. Shower/tub
5. Hydration
6. Ambulation
7. Relaxation
What is the difference between induction and augmentation of labor? - ANSWER-
Induction: Starts labor
Augmentation: Helps progress labor that has already began (seen in hypotonic uterine
activity)
T or F: A patient with preeclampsia would display hyperreflexia - ANSWER-True
What is HELLP syndrome? - ANSWER-Hemolysis, elevated liver function and low
platelets
Why are platelets administered prior to labor with HELLP syndrome? - ANSWER-To
prevent thrombocytopenia
What is "version" in terms of labor? - ANSWER-External or internal turning of a fetus
from one presentation to another
What is shoulder dystocia? - ANSWER-Head is born, but anterior shoulder cannot pass
under pubic arch
What are shoulder dystocia risk factors? - ANSWER-1. Maternal pelvic anomalies
2. Obesity & Diabetes
3. Slow descent
4. Slow progression
5. Fetal macrosomia
