1. Late in pregnancy, a pa ent o en develops supine hypotension because of
a. par al occlusion of the vena cava and aorta.
b. decreased peripheral collateral circula on.
c. increased blood flow to the placenta. -correct answers A
because of par al occlusion of the vena cava and aorta from the weight of the uterus. This
impedes venous return from the lower extremi es although increased collateral circula on
during pregnancy helps to compensate. Remaining in the supine posi on for long periods of
me could decrease fetal oxygena on as well. The lateral recumbent posi on relieves the
pressure on the vena cava and aorta, allowing the blood pressure to increase and symptoms to
decrease.
The nurse must educate the new mother that a contraindica on to breast feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infec on with HIV/AIDS. -correct answers C
Some maternal contraindica ons to breas eeding include:
-Infec on with HIV/AIDS
-Use of an retroviral medica ons
-Ac ve TB not treated
-Infec on with human T-cell lymphotropic virus
-Illicit drug use
-Use of chemotherapeu c agents
-Radia on therapy (may require only interrup on during treatment)
-Use of other medica ons that pass into the breast milk and may harm the child
,-Presence of herpes on the breast
-Presence of varicella lesions on the breast (may resume a er lesions crust)
The ini al postpartal interven on indicated for a so boggy uterus is to
a. apply an ice compress.
b. massage the fundus un l firm.
c. apply a warm compress. -correct answers B
...with the dominant hand while suppor ng the inferior uterus with the non-dominant hand to
prevent trauma. If the fundus does not contract with massage, then further evalua on is
indicated to determine if placental fragments remain. A er the fundus becomes contracted, the
nurse should push firmly downward on the fundus to expel clots that may have pooled.
With the vibroacous c s mula on test, s mulus with an ar ficial larynx or other device is
applied to the maternal abdomen for
a. 1 to 3 seconds.
b. 5 to 10 seconds.
c. 1 to 2 minutes. -correct answers A
Usually, s mulus is applied for 1-2 seconds and repeated up to 3 mes with me extending to 3
seconds in order to s mulate fetal movement. A posi ve or reac ve finding is an increased fetal
heart rate of 15 bpm or more for at least 15 seconds; however, a nonreac ve result does not
always indicate fetal abnormality but indicates the need for further tes ng.
Absence of the Moro reflex on one side only in a neonate may indicate
a. fractured scapula.
b. cerebral palsy.
c. fractured clavicle. -correct answers C
a fractured clavicle or brachial plexus injury. Damage to the central nervous system, such as may
occur with cerebral palsy, o en results in bilateral absence of the reflex. The Moro reflex is
elicited by allowing the infant's head and trunk to fall slightly backward when the infant is
,raised. A posi ve Moro reflex includes immediate extension and abduc on of the arms(and
some mes the legs) with fingers fanning and forming a C-shape with a return of the limbs to the
flexed states
In a mul parous woman, what is the lowest Bishop score that predicts labor induc on will be
successful?
a. 5
b. 7
c. 9 -correct answers A
In a mul parous woman, the Bishop score that predicts that labor induc on will be successful is
5 or more while it is a 9 or more for a nulliparous woman. The Bishop score is a ra ng system to
determine readiness for induc on based on scores of 0-3 in four different measures: dila on
(cm), effacement (percentage), sta on (cm), and cervical consistency (firm, medium, so ), and
cervical posi on (posterior, mid posi on, anterior). The fi h measure, cervical posi on, is
scored only 0-2.
When cervical lacera on occur during delivery, they are most common at what posi on?
a. 3 and 9 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock -correct answers A
Cervical lacera ons are most o en iden fied with vaginal retractors when bleeding is persistent
a er delivery. The lacera ons are sutured with absorbable sutures, so no further treatment is
usually indicated. Minor lacera ons o en occur during delivery, but they usually require no
treatment. Tears are more common a er forceps assisted and vacuum assisted deliveries than
normal vaginal births
If using fetal pulse oximetry, what is normal oxygen satura on?
a. 30% to 65%
b. 65% to 90%
c. 90% to 100% -correct answers A
, because of the fetus's high hemoglobin and hematocrit. A value below 30% may be associated
with hypoxia and metabolic acidosis. For fetal pulse oximetry, which may be used to determine
whether immediate interven on is needed for non-reassuring fetal heart rate, a special single-
use sensor is placed internally along the fetal cheek, temple, or forehead. However, fetal pulse
oximetry has not been found to reduce overall rates of Caesarean.
A decrease of fetal heart rate of at least 15 bpm for at least 10 minutes is classified as
a. recurrent decelera on.
b. prolonged decelera on.
c. baseline change. -correct answers C
If it persists more than 2 minutes but less than 10 minutes, it is classified as a prolonged
decelera on. Recurrent decelera ons are classified as occurring with half or more of uterine
contrac ons in a 20 minute period. Intermi ent decelera ons occur with fewer than half of
uterine contrac ons in a 20 minute period.
With suspected fetal hypoxia, a cord blood gas specimen is obtained during delivery by
a. withdrawing blood from the vein/artery before the cord is clamped or cut and before
placental expulsion.
b. placing one clamp and withdrawing blood above the clamp before cu ng the cord.
c. double clamping a 10 to 20 cm segment, cu ng it out, and then withdrawing blood from the
segment. -correct answers C
The segment can be placed on ice temporarily as cord blood gas can be accurately assessed for
60 minutes. An arterial sample is preferred over venous, but paired sampling is recommended.
A pH of 7.24 or less is associated with neurological compromise. A base excess of 12 mmol/L or
more is predic ve of motor or cogni ve impairment.
When elici ng the scarf sign in a neonate, the infant's elbow crosses the midline of the chest,
probably indica ng a
a. preterm infant.
b. term infant.
a. par al occlusion of the vena cava and aorta.
b. decreased peripheral collateral circula on.
c. increased blood flow to the placenta. -correct answers A
because of par al occlusion of the vena cava and aorta from the weight of the uterus. This
impedes venous return from the lower extremi es although increased collateral circula on
during pregnancy helps to compensate. Remaining in the supine posi on for long periods of
me could decrease fetal oxygena on as well. The lateral recumbent posi on relieves the
pressure on the vena cava and aorta, allowing the blood pressure to increase and symptoms to
decrease.
The nurse must educate the new mother that a contraindica on to breast feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infec on with HIV/AIDS. -correct answers C
Some maternal contraindica ons to breas eeding include:
-Infec on with HIV/AIDS
-Use of an retroviral medica ons
-Ac ve TB not treated
-Infec on with human T-cell lymphotropic virus
-Illicit drug use
-Use of chemotherapeu c agents
-Radia on therapy (may require only interrup on during treatment)
-Use of other medica ons that pass into the breast milk and may harm the child
,-Presence of herpes on the breast
-Presence of varicella lesions on the breast (may resume a er lesions crust)
The ini al postpartal interven on indicated for a so boggy uterus is to
a. apply an ice compress.
b. massage the fundus un l firm.
c. apply a warm compress. -correct answers B
...with the dominant hand while suppor ng the inferior uterus with the non-dominant hand to
prevent trauma. If the fundus does not contract with massage, then further evalua on is
indicated to determine if placental fragments remain. A er the fundus becomes contracted, the
nurse should push firmly downward on the fundus to expel clots that may have pooled.
With the vibroacous c s mula on test, s mulus with an ar ficial larynx or other device is
applied to the maternal abdomen for
a. 1 to 3 seconds.
b. 5 to 10 seconds.
c. 1 to 2 minutes. -correct answers A
Usually, s mulus is applied for 1-2 seconds and repeated up to 3 mes with me extending to 3
seconds in order to s mulate fetal movement. A posi ve or reac ve finding is an increased fetal
heart rate of 15 bpm or more for at least 15 seconds; however, a nonreac ve result does not
always indicate fetal abnormality but indicates the need for further tes ng.
Absence of the Moro reflex on one side only in a neonate may indicate
a. fractured scapula.
b. cerebral palsy.
c. fractured clavicle. -correct answers C
a fractured clavicle or brachial plexus injury. Damage to the central nervous system, such as may
occur with cerebral palsy, o en results in bilateral absence of the reflex. The Moro reflex is
elicited by allowing the infant's head and trunk to fall slightly backward when the infant is
,raised. A posi ve Moro reflex includes immediate extension and abduc on of the arms(and
some mes the legs) with fingers fanning and forming a C-shape with a return of the limbs to the
flexed states
In a mul parous woman, what is the lowest Bishop score that predicts labor induc on will be
successful?
a. 5
b. 7
c. 9 -correct answers A
In a mul parous woman, the Bishop score that predicts that labor induc on will be successful is
5 or more while it is a 9 or more for a nulliparous woman. The Bishop score is a ra ng system to
determine readiness for induc on based on scores of 0-3 in four different measures: dila on
(cm), effacement (percentage), sta on (cm), and cervical consistency (firm, medium, so ), and
cervical posi on (posterior, mid posi on, anterior). The fi h measure, cervical posi on, is
scored only 0-2.
When cervical lacera on occur during delivery, they are most common at what posi on?
a. 3 and 9 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock -correct answers A
Cervical lacera ons are most o en iden fied with vaginal retractors when bleeding is persistent
a er delivery. The lacera ons are sutured with absorbable sutures, so no further treatment is
usually indicated. Minor lacera ons o en occur during delivery, but they usually require no
treatment. Tears are more common a er forceps assisted and vacuum assisted deliveries than
normal vaginal births
If using fetal pulse oximetry, what is normal oxygen satura on?
a. 30% to 65%
b. 65% to 90%
c. 90% to 100% -correct answers A
, because of the fetus's high hemoglobin and hematocrit. A value below 30% may be associated
with hypoxia and metabolic acidosis. For fetal pulse oximetry, which may be used to determine
whether immediate interven on is needed for non-reassuring fetal heart rate, a special single-
use sensor is placed internally along the fetal cheek, temple, or forehead. However, fetal pulse
oximetry has not been found to reduce overall rates of Caesarean.
A decrease of fetal heart rate of at least 15 bpm for at least 10 minutes is classified as
a. recurrent decelera on.
b. prolonged decelera on.
c. baseline change. -correct answers C
If it persists more than 2 minutes but less than 10 minutes, it is classified as a prolonged
decelera on. Recurrent decelera ons are classified as occurring with half or more of uterine
contrac ons in a 20 minute period. Intermi ent decelera ons occur with fewer than half of
uterine contrac ons in a 20 minute period.
With suspected fetal hypoxia, a cord blood gas specimen is obtained during delivery by
a. withdrawing blood from the vein/artery before the cord is clamped or cut and before
placental expulsion.
b. placing one clamp and withdrawing blood above the clamp before cu ng the cord.
c. double clamping a 10 to 20 cm segment, cu ng it out, and then withdrawing blood from the
segment. -correct answers C
The segment can be placed on ice temporarily as cord blood gas can be accurately assessed for
60 minutes. An arterial sample is preferred over venous, but paired sampling is recommended.
A pH of 7.24 or less is associated with neurological compromise. A base excess of 12 mmol/L or
more is predic ve of motor or cogni ve impairment.
When elici ng the scarf sign in a neonate, the infant's elbow crosses the midline of the chest,
probably indica ng a
a. preterm infant.
b. term infant.
