OB Class study guide for exam 1
Exam 1 Blue Print: Topic LOOK AT YOUR OBJECTIVES!!!!!!
Approximate # of test questions
Preconception/Prenatal Care
Conception & Fetal Development
Prenatal Testing
Maternal Adaptation in Pregnancy
Maternal-Fetal Nutrition
Nursing Care/Patient Teaching of the Pregnant Family
Sexually Transmitted Infections
Psychosocial – Intimate Partner Violence
Fetal Assessment (Electronic Fetal Monitoring)
Substance Abuse
Math Question
Questions directly from prep sheets (listed above)
Total
Ms. Hoolapa really does go by the objectives with these!
As I answered these questions, I saw that some books don9t say what the answer is plainly.
For these areas, the lead teacher, Brenda Hoolapa, covers the relevant material verbally in her
lecture videos. I cannot recommend highly enough listening to them all at least once, and more
if you can! (We change textbooks from time-to-time, and so, while most content is pretty
,standard, sometimes some info is different or not addressed as well as in another book. Never
be afraid to look up the info from a reputable professional health care website as a starting
strategy, if you don9t know the answer and the book seems to give only a partial answer.)
Preconception/Prenatal Care
1. Know the female menstrual cycle, including length, hormones, and events leading to
ovulation.
Normal 28 days. Estrogen & Progesterone.
Ovarian cycle- developing oocyte in ovaries
Follicular cell swells and maturation begins
Mature follicle (Graafian follicle)
-Follicular phase: follicles form mature egg (day 1 of cycle through approx
day 14) Hypothalamus initiated- GNRH -> increases estrogen levels -> pituitary releases FSH ->
ovary releases 5-20 immature ovum -> anterior pituitary releases LH to mature the follicle
-Ovulation: the surge in LH when the follicle bursts and releases the
mature oocyte (Day 14)
-Luteal phase
2. Where and when does fertilization take place?
Outer third ampulla of fallopian tube
After ovulation, during luteal proliferative or secretory phase. If not fertilized then
menstruation occurs in endometrial cycle.
3. How many veins and arteries does the umbilical cord have?
2 Umbilical arteries carry blood away from the fetus to the placenta
1 Umbilical vein carries blood from the placenta to the fetus
4. What are possible, presumptive, and positive signs of pregnancy?
Subjective-Presumptive: things mom feels. Nausea, amenorrhea, urinary
frequency, breast tenderness
Objective-Probable: related S&S- but could be something else. Softening of the
uterus, coloration changes, pregnancy tests.
, DIagnostic-Positive: visualizing fetus on ultrasound, palpating for fetal
movement, and hearing fetal heartbeat
BOX 11.1
SIGNS AND SYMPTOMS OF PREGNANCY
Presumptive Probable Positive
Fatigue (12 wks) Braxton Hicks contractions Ultrasound verification of embryo or f
(16–28 wks) (4–6 wks)
Breast tenderness (3–4 wks)
Positive pregnancy test (4– Fetal movement felt by experienced
Nausea and vomiting (4–14 w wks) clinician (20 wks)
Amenorrhea (4 wks) Abdominal enlargement (14 Auscultation of fetal heart tones via
wks) Doppler (10–12 wks)
Urinary frequency (6–12 wks)
Ballottement (16–28 wks)
Hyperpigmentation of the ski
(16 wks) Goodell’s sign (5 wks)
Fetal movements (quickening Chadwick’s sign (6–8 wks)
16–20 wks)
Hegar’s sign (6–12 wks)
Uterine enlargement (7–12 wk
Breast enlargement (6 wks)
5. What is quickening and does it feel to pregnant women?
First fetal movements, feels like a fluttering
Between 13-20 weeks. With multipara women will feel quickening earlier.
6. What is lightening and how does it feel?
Fundal height drops, fetal head drops into pelvis after 36 weeks. Urinary
frequency returns.
Breathing is easier, decrease in gastric reflux. May complain of increased pelvic
pressure, leg cramping, dependent edema in lower legs, and lower back discomfort. Increase in
vaginal discharge.
, 7. How often are prenatal clinical visits scheduled in each trimester?
Q4 weeks for first 28 weeks
Q2 weeks until 36 weeks
Weekly until birth
8. If a mother is diabetic, why is it important for her to get her blood glucose levels under
control before she gets pregnant?
There are increased risks to the fetus- macrosomia (excessive fetal growth), birth
trauma, electrolyte imbalances, neonatal hypoglycemia, urinary and vaginal infections,
hydramnios, ketoacidosis, hypoglyemia, hyperglycemia, pre-eclampsia.
Conception & Fetal Development
1. What is the psychosocial role and task of the mother in each trimester of pregnancy?
Phase 1: I am pregnant. Views the child as part of self. Introspection
Phase 2: i am going to have a baby. Growing awareness of the baby as a separate
being enhanced by quickening. Hearing FHT and ultrasound visualization. Period of
introspection moving to acceptance, partner may feel left out. Other children may be more
demanding.
Phase 3: I am going to be a mother. Mother speculates about characteristics of the baby,
family members interact with baby. Preparing for safe passage of the baby.
2. Where is the level of the fundus at 12, 20, 30, and 40 weeks of pregnancy? (Using
landmarks from the mother abdomen, and how many cm?)
12: 12-14 fundus will be palpated above symphysis pubis
20: fundal height 20cm above symphysis pubis (approx umbilicus)
30: from 20-38 weeks distance from symphysis pubis is reflective of gestational age +/- 2
weeks
40: approx 38-40 weeks head begins to drop into pelvis and fundal height decreases.
3. Use Nagele9s rule to calculate a due date4this is on nearly every OB test you will take!
-LNMP/LMP (first day of last normal menses) ie 08/20/2019
-Subtract 3 months 05/20/2019
Exam 1 Blue Print: Topic LOOK AT YOUR OBJECTIVES!!!!!!
Approximate # of test questions
Preconception/Prenatal Care
Conception & Fetal Development
Prenatal Testing
Maternal Adaptation in Pregnancy
Maternal-Fetal Nutrition
Nursing Care/Patient Teaching of the Pregnant Family
Sexually Transmitted Infections
Psychosocial – Intimate Partner Violence
Fetal Assessment (Electronic Fetal Monitoring)
Substance Abuse
Math Question
Questions directly from prep sheets (listed above)
Total
Ms. Hoolapa really does go by the objectives with these!
As I answered these questions, I saw that some books don9t say what the answer is plainly.
For these areas, the lead teacher, Brenda Hoolapa, covers the relevant material verbally in her
lecture videos. I cannot recommend highly enough listening to them all at least once, and more
if you can! (We change textbooks from time-to-time, and so, while most content is pretty
,standard, sometimes some info is different or not addressed as well as in another book. Never
be afraid to look up the info from a reputable professional health care website as a starting
strategy, if you don9t know the answer and the book seems to give only a partial answer.)
Preconception/Prenatal Care
1. Know the female menstrual cycle, including length, hormones, and events leading to
ovulation.
Normal 28 days. Estrogen & Progesterone.
Ovarian cycle- developing oocyte in ovaries
Follicular cell swells and maturation begins
Mature follicle (Graafian follicle)
-Follicular phase: follicles form mature egg (day 1 of cycle through approx
day 14) Hypothalamus initiated- GNRH -> increases estrogen levels -> pituitary releases FSH ->
ovary releases 5-20 immature ovum -> anterior pituitary releases LH to mature the follicle
-Ovulation: the surge in LH when the follicle bursts and releases the
mature oocyte (Day 14)
-Luteal phase
2. Where and when does fertilization take place?
Outer third ampulla of fallopian tube
After ovulation, during luteal proliferative or secretory phase. If not fertilized then
menstruation occurs in endometrial cycle.
3. How many veins and arteries does the umbilical cord have?
2 Umbilical arteries carry blood away from the fetus to the placenta
1 Umbilical vein carries blood from the placenta to the fetus
4. What are possible, presumptive, and positive signs of pregnancy?
Subjective-Presumptive: things mom feels. Nausea, amenorrhea, urinary
frequency, breast tenderness
Objective-Probable: related S&S- but could be something else. Softening of the
uterus, coloration changes, pregnancy tests.
, DIagnostic-Positive: visualizing fetus on ultrasound, palpating for fetal
movement, and hearing fetal heartbeat
BOX 11.1
SIGNS AND SYMPTOMS OF PREGNANCY
Presumptive Probable Positive
Fatigue (12 wks) Braxton Hicks contractions Ultrasound verification of embryo or f
(16–28 wks) (4–6 wks)
Breast tenderness (3–4 wks)
Positive pregnancy test (4– Fetal movement felt by experienced
Nausea and vomiting (4–14 w wks) clinician (20 wks)
Amenorrhea (4 wks) Abdominal enlargement (14 Auscultation of fetal heart tones via
wks) Doppler (10–12 wks)
Urinary frequency (6–12 wks)
Ballottement (16–28 wks)
Hyperpigmentation of the ski
(16 wks) Goodell’s sign (5 wks)
Fetal movements (quickening Chadwick’s sign (6–8 wks)
16–20 wks)
Hegar’s sign (6–12 wks)
Uterine enlargement (7–12 wk
Breast enlargement (6 wks)
5. What is quickening and does it feel to pregnant women?
First fetal movements, feels like a fluttering
Between 13-20 weeks. With multipara women will feel quickening earlier.
6. What is lightening and how does it feel?
Fundal height drops, fetal head drops into pelvis after 36 weeks. Urinary
frequency returns.
Breathing is easier, decrease in gastric reflux. May complain of increased pelvic
pressure, leg cramping, dependent edema in lower legs, and lower back discomfort. Increase in
vaginal discharge.
, 7. How often are prenatal clinical visits scheduled in each trimester?
Q4 weeks for first 28 weeks
Q2 weeks until 36 weeks
Weekly until birth
8. If a mother is diabetic, why is it important for her to get her blood glucose levels under
control before she gets pregnant?
There are increased risks to the fetus- macrosomia (excessive fetal growth), birth
trauma, electrolyte imbalances, neonatal hypoglycemia, urinary and vaginal infections,
hydramnios, ketoacidosis, hypoglyemia, hyperglycemia, pre-eclampsia.
Conception & Fetal Development
1. What is the psychosocial role and task of the mother in each trimester of pregnancy?
Phase 1: I am pregnant. Views the child as part of self. Introspection
Phase 2: i am going to have a baby. Growing awareness of the baby as a separate
being enhanced by quickening. Hearing FHT and ultrasound visualization. Period of
introspection moving to acceptance, partner may feel left out. Other children may be more
demanding.
Phase 3: I am going to be a mother. Mother speculates about characteristics of the baby,
family members interact with baby. Preparing for safe passage of the baby.
2. Where is the level of the fundus at 12, 20, 30, and 40 weeks of pregnancy? (Using
landmarks from the mother abdomen, and how many cm?)
12: 12-14 fundus will be palpated above symphysis pubis
20: fundal height 20cm above symphysis pubis (approx umbilicus)
30: from 20-38 weeks distance from symphysis pubis is reflective of gestational age +/- 2
weeks
40: approx 38-40 weeks head begins to drop into pelvis and fundal height decreases.
3. Use Nagele9s rule to calculate a due date4this is on nearly every OB test you will take!
-LNMP/LMP (first day of last normal menses) ie 08/20/2019
-Subtract 3 months 05/20/2019
