NURS 242 Final UPDATED ACTUAL Exam
Questions and CORRECT Answers
Identify the different antepartum conditions that place a mother at high risk - CORRECT
ANSWER - hyperemesis gravidarum, hypertensive disorders, multiple gestation,
gestational diabetes, placenta previa, abruptio plaventae, substance abuse, infections
Describe hyperemesis gravidarum - CORRECT ANSWER - severe nausea, vomiting,
diarrhea, weight loss, electrolyte disturbances related to rapid rise in hormone levels
mild- dietary changes, rest, antacids
severe- hospitalization (IV fluids and nutrition); tube feeding; medications such as antiemetics
and/or steroids; alternate therapies
experience weeks 4-6 with peak weeks 9-13; relief weeks 14-20
Describe gestational hypertension - CORRECT ANSWER - new onset elevations of BP
after 20 weeks gestation, often near term in the absence of accompanying proteinuria
management: monitor fetal movement daily, twice weekly BP checks, weekly liver enzymes,
platelet count, and proteinuria checks, ultrasound to monitor for IGUR, biophysical profile and
umbilical artery doppler study
after 37 weeks gestation, delivery recommended
Describe preeclampsia - CORRECT ANSWER - new onset of hypertension after 20 weeks
gestation with proteinuria and multiorgan involvement (kidneys, liver, and blood vessels)
Describe preeclampsia with proteinuria versus without preeclampsia - CORRECT
ANSWER - proteinuria: diagnosed when 24 hour urine test equals or exceeds 300 mg or
the ratio of measured protein to creatinine in a single voided urine measures or exceeds 3.0
without proteinuria: diagnosed when new onset thrombocytopenia, impaired liver function, renal
insufficiency, pulmonary edema, visual disturbances, cerebral distrubances (headache, facial
edema, periorbital edema, dizziness)
, What is the indicator that preeclampsia is developing into eclampsia? - CORRECT
ANSWER - epigastric pain/liver pain
How do we prevent preeclampsia? - CORRECT ANSWER - low dose aspirin (60-80mg)
beginning in the late first trimester
for women with medical history of early onset preeclampsia and preterm delivery at less than 34
weeks of gestation or preeclampsia in more than one prior pregnancy
Describe mild vs severe management of preeclampsia - CORRECT ANSWER - mild (less
than 37 weeks): instruct women to report severe headaches, visual changes, epigastric pain, and
SOB; go to twice weekly non stress test and if nonreactive, BPP recommended; monitor
maternal BP twice weekly; monitor CBC, liver enzymes, and creatinine levels once weekly;
delivery is best cure for preeclampsia
severe: delivery ASAP post maternal stabilization; corticosteroids, magnesium sulfate, and
antihypertensives (labetalol, hydralazine, nifedipine); monitor FHR and symptoms with
ultrasound and laboratory tests
What is magnesium sulfate used for in preeclampsia? - CORRECT ANSWER - to prevent
seizures because it is a CNS depressant and smooth muscle relaxer
Identify nursing management for preeclampsia - CORRECT ANSWER - assess epigastric
pain or right upper quadrant pain; assess weight daily; complete 24 hour urine test; evaluate lab
values; prepare NST and BPP; I/O; education; encourage left lateral recumbent position when
resting; report deterioration in maternal or fetal status to provider
Describe eclampsia - CORRECT ANSWER - new onset grand mal seizures in a woman
with preeclampsia severe headaches and hyperreflexia which are usually premonitory events
leads to HELLP syndrome (hemolysis, elevated liver function tests, and low platelet count);
manage HELLP syndrome with delivery and steroids
What are multiple gestation women at risk for? - CORRECT ANSWER -
Questions and CORRECT Answers
Identify the different antepartum conditions that place a mother at high risk - CORRECT
ANSWER - hyperemesis gravidarum, hypertensive disorders, multiple gestation,
gestational diabetes, placenta previa, abruptio plaventae, substance abuse, infections
Describe hyperemesis gravidarum - CORRECT ANSWER - severe nausea, vomiting,
diarrhea, weight loss, electrolyte disturbances related to rapid rise in hormone levels
mild- dietary changes, rest, antacids
severe- hospitalization (IV fluids and nutrition); tube feeding; medications such as antiemetics
and/or steroids; alternate therapies
experience weeks 4-6 with peak weeks 9-13; relief weeks 14-20
Describe gestational hypertension - CORRECT ANSWER - new onset elevations of BP
after 20 weeks gestation, often near term in the absence of accompanying proteinuria
management: monitor fetal movement daily, twice weekly BP checks, weekly liver enzymes,
platelet count, and proteinuria checks, ultrasound to monitor for IGUR, biophysical profile and
umbilical artery doppler study
after 37 weeks gestation, delivery recommended
Describe preeclampsia - CORRECT ANSWER - new onset of hypertension after 20 weeks
gestation with proteinuria and multiorgan involvement (kidneys, liver, and blood vessels)
Describe preeclampsia with proteinuria versus without preeclampsia - CORRECT
ANSWER - proteinuria: diagnosed when 24 hour urine test equals or exceeds 300 mg or
the ratio of measured protein to creatinine in a single voided urine measures or exceeds 3.0
without proteinuria: diagnosed when new onset thrombocytopenia, impaired liver function, renal
insufficiency, pulmonary edema, visual disturbances, cerebral distrubances (headache, facial
edema, periorbital edema, dizziness)
, What is the indicator that preeclampsia is developing into eclampsia? - CORRECT
ANSWER - epigastric pain/liver pain
How do we prevent preeclampsia? - CORRECT ANSWER - low dose aspirin (60-80mg)
beginning in the late first trimester
for women with medical history of early onset preeclampsia and preterm delivery at less than 34
weeks of gestation or preeclampsia in more than one prior pregnancy
Describe mild vs severe management of preeclampsia - CORRECT ANSWER - mild (less
than 37 weeks): instruct women to report severe headaches, visual changes, epigastric pain, and
SOB; go to twice weekly non stress test and if nonreactive, BPP recommended; monitor
maternal BP twice weekly; monitor CBC, liver enzymes, and creatinine levels once weekly;
delivery is best cure for preeclampsia
severe: delivery ASAP post maternal stabilization; corticosteroids, magnesium sulfate, and
antihypertensives (labetalol, hydralazine, nifedipine); monitor FHR and symptoms with
ultrasound and laboratory tests
What is magnesium sulfate used for in preeclampsia? - CORRECT ANSWER - to prevent
seizures because it is a CNS depressant and smooth muscle relaxer
Identify nursing management for preeclampsia - CORRECT ANSWER - assess epigastric
pain or right upper quadrant pain; assess weight daily; complete 24 hour urine test; evaluate lab
values; prepare NST and BPP; I/O; education; encourage left lateral recumbent position when
resting; report deterioration in maternal or fetal status to provider
Describe eclampsia - CORRECT ANSWER - new onset grand mal seizures in a woman
with preeclampsia severe headaches and hyperreflexia which are usually premonitory events
leads to HELLP syndrome (hemolysis, elevated liver function tests, and low platelet count);
manage HELLP syndrome with delivery and steroids
What are multiple gestation women at risk for? - CORRECT ANSWER -
