NR 602 MID TERM questions with correct answers
Signs of presumptive pregnancy Correct Answer--Amenorrhea
-Nausea & vomiting
-Breast enlargement
-Darkening of the areolas
-Breast tenderness
-Fatigue
-Slight increase in body temperature: Rise in temperature coincides with
luteal phase and is the result of increased progesterone
-"Quickening" Mother feels the baby's movements for the 1st time; starts
at 16 weeks
Signs of Probable pregnancy Correct Answer--Positive urine or blood
pregnancy test
-PREGNANCY TESTS ARE CONSIDERED PROBABLE BECAUSE
B-HCG ALSO PRESENTS IN MOLAR PREGNANCIES &
OVARIAN CANCER
-Goodell's sign: cervical softening (around 4 weeks)
-Chadwick's sign: Blueish coloration of the vagina and cervix (6 to 8
weeks)
-Enlarged uterus
Signs of positive pregnancy Correct Answer--Palpation of the fetus by
the health care provider
-Ultrasound and visualization of the fetus
,-Fetal Heart Tones (FHT) auscultated by the health care provider
Fundal height Correct Answer-Can provide valuable information on
assessing the gestational age of the fetus as well as to monitor fetal
growth.
Naegele's rule Correct Answer--The Estimated Due Date is calculated by
adding 7 days to the first day of the last menstrual period, subtracting 3
months and adding 1 year
-For example, if the patient's last menstrual period was on August 10,
2019, the EDD would be calculated as follows: LMP equals August 10,
2019 plus 7 days equals August 17, 2019, minus 3 months equals May
17, 2019 plus one year equals May 17, 2020.
Hematological changes during pregnancy Correct Answer--Blood
volume increases by 30 to 50%, or 1,100 to 1,600 mL and peaks at 30 to
34 weeks gestation
-The increase in blood volume improves blood flow to the vital organs
and protects against excessive blood loss during birth
-Fetal growth during pregnancy and newborn weight are correlated with
the degree of blood volume expansion
-Of the blood volume expansion during pregnancy, 75% is considered to
be plasma
-The blood volume changes result in hemodilution, which leads to a
state of physiologic anemia during pregnancy
,Hemoglobin changes during pregnancy Correct Answer-Normal Hgb
12-16 g/dL
First trimester: 11.6-13.9 g/dL
Second trimester 9.7-14.8 g/dL
Third trimester 9.5-15 g/dL
Progestin-only contraceptives Correct Answer--No hormone free
interval
-Have minimal effects on coagulation factors, blood pressure, or lipid
levels
-Considered safer for women who have contraindications to estrogen
such as cardiovascular risk factors, migraine with aura, history of VTE
-Overall blood loss decreases over time, making progestin only methods
protective against iron-deficiency anemia
-Likely to improve menstrual symptoms and anemia
-Women who are sensitive to even low estrogen pills (nausea, breast
tenderness, HTN), may do well on progestin only pills
-Depo-Provera injection given IM or subQ every 13 weeks
Combined oral contraceptives (COCs) Correct Answer--Most contain 10
to 35 mcg of ethinyl estradiol
-Traditional cyclic schedule is 21-24 active COCs followed by 4-7 days
of inactive pills or no pills
Indications for Combined oral contraceptives (COCs) Correct Answer--
Women with dysmenorrhea and menorrhagia
, -Women who want to regulate menses
-Women who will use a daily method consistently
Benefits of COCs Correct Answer--Decreased blood loss and anemia
-Decreased menstrual cramps and pain with more predictable menses
-Can be used to manipulate the timing of menses
-Decreases risk of ovarian cancer and endometrial cancer
-Reduces risk of ectopic pregnancy
-Effective to treat acne, hirsutism, and other androgen excess/sensitivity
states
-Reduced vasomotor symptoms and effective contraception in
perimenopausal women
-Increased bone mineral density
-Decreased pain and frequency of sickle cell disease crises
Disadvantages of COC Correct Answer--Decreased libido and
anorgasmia is unusual, but possible
-Mood changes, depression, anxiety, irritability
-No protection against STDs or HIV
-Nausea/vomiting, especially in the first few cycles
-Breast tenderness or pain
-Headaches may increase
Signs of presumptive pregnancy Correct Answer--Amenorrhea
-Nausea & vomiting
-Breast enlargement
-Darkening of the areolas
-Breast tenderness
-Fatigue
-Slight increase in body temperature: Rise in temperature coincides with
luteal phase and is the result of increased progesterone
-"Quickening" Mother feels the baby's movements for the 1st time; starts
at 16 weeks
Signs of Probable pregnancy Correct Answer--Positive urine or blood
pregnancy test
-PREGNANCY TESTS ARE CONSIDERED PROBABLE BECAUSE
B-HCG ALSO PRESENTS IN MOLAR PREGNANCIES &
OVARIAN CANCER
-Goodell's sign: cervical softening (around 4 weeks)
-Chadwick's sign: Blueish coloration of the vagina and cervix (6 to 8
weeks)
-Enlarged uterus
Signs of positive pregnancy Correct Answer--Palpation of the fetus by
the health care provider
-Ultrasound and visualization of the fetus
,-Fetal Heart Tones (FHT) auscultated by the health care provider
Fundal height Correct Answer-Can provide valuable information on
assessing the gestational age of the fetus as well as to monitor fetal
growth.
Naegele's rule Correct Answer--The Estimated Due Date is calculated by
adding 7 days to the first day of the last menstrual period, subtracting 3
months and adding 1 year
-For example, if the patient's last menstrual period was on August 10,
2019, the EDD would be calculated as follows: LMP equals August 10,
2019 plus 7 days equals August 17, 2019, minus 3 months equals May
17, 2019 plus one year equals May 17, 2020.
Hematological changes during pregnancy Correct Answer--Blood
volume increases by 30 to 50%, or 1,100 to 1,600 mL and peaks at 30 to
34 weeks gestation
-The increase in blood volume improves blood flow to the vital organs
and protects against excessive blood loss during birth
-Fetal growth during pregnancy and newborn weight are correlated with
the degree of blood volume expansion
-Of the blood volume expansion during pregnancy, 75% is considered to
be plasma
-The blood volume changes result in hemodilution, which leads to a
state of physiologic anemia during pregnancy
,Hemoglobin changes during pregnancy Correct Answer-Normal Hgb
12-16 g/dL
First trimester: 11.6-13.9 g/dL
Second trimester 9.7-14.8 g/dL
Third trimester 9.5-15 g/dL
Progestin-only contraceptives Correct Answer--No hormone free
interval
-Have minimal effects on coagulation factors, blood pressure, or lipid
levels
-Considered safer for women who have contraindications to estrogen
such as cardiovascular risk factors, migraine with aura, history of VTE
-Overall blood loss decreases over time, making progestin only methods
protective against iron-deficiency anemia
-Likely to improve menstrual symptoms and anemia
-Women who are sensitive to even low estrogen pills (nausea, breast
tenderness, HTN), may do well on progestin only pills
-Depo-Provera injection given IM or subQ every 13 weeks
Combined oral contraceptives (COCs) Correct Answer--Most contain 10
to 35 mcg of ethinyl estradiol
-Traditional cyclic schedule is 21-24 active COCs followed by 4-7 days
of inactive pills or no pills
Indications for Combined oral contraceptives (COCs) Correct Answer--
Women with dysmenorrhea and menorrhagia
, -Women who want to regulate menses
-Women who will use a daily method consistently
Benefits of COCs Correct Answer--Decreased blood loss and anemia
-Decreased menstrual cramps and pain with more predictable menses
-Can be used to manipulate the timing of menses
-Decreases risk of ovarian cancer and endometrial cancer
-Reduces risk of ectopic pregnancy
-Effective to treat acne, hirsutism, and other androgen excess/sensitivity
states
-Reduced vasomotor symptoms and effective contraception in
perimenopausal women
-Increased bone mineral density
-Decreased pain and frequency of sickle cell disease crises
Disadvantages of COC Correct Answer--Decreased libido and
anorgasmia is unusual, but possible
-Mood changes, depression, anxiety, irritability
-No protection against STDs or HIV
-Nausea/vomiting, especially in the first few cycles
-Breast tenderness or pain
-Headaches may increase
