OB Escape Room Study Guide Exam 4 (answered) 2021/2022
OB Escape Room Study Guide Exam 4 1. What’s the correct definition of “subinvolution of the uterus”? a. The uterus’s shape is not conducive to a vaginal delivery b. Failure of the uterus to involute as expected c. Success of the uterus in descending as expected d. The process of the uterus contracting in the postpartum period 2. Which of the following are reasons a woman might experience stronger uterine contractions in the postpartum period? (SATA). a. Multiple gestation b. Multigravida c. Breastfeeding d. Baby is large for gestation e. Polyhydramnios 3. The nurse is conducting discharge phone calls. A woman who vaginally delivered 4 days ago at term reports the following symptoms. Which would be most concerning & requires follow-up? a. Light-moderate bleeding b. Abdominal cramping c. Persistent headaches d. Puffy feet 4. The nurse conducts a routine postpartum check 30 minutes following a vaginal delivery. The nurse finds that the uterus is boggy, is displaced above & to the right of the umbilicus. What’s the nurse’s most appropriate response? a. Call the provider immediately b. Begin IV antibiotics c. Assist the patient to empty her bladder d. Conduct a fundal massage 5. The nurse is conducting a routine postpartum assessment. Upon assessment, the nurse finds that the woman is heavily bleeding. What’s the nurse’s TOP priority at this time? a. Call the provider immediately b. Begin a fluid bolus c. Assist the patient to empty her bladder d. Conducts a fundal massage 6. The provider wishes to assess FHR, fetal movement, fetal tone, & the Amniotic Fluid Index (AFI). Which of the following tests would the nurse anticipate? a. Biophysical Profile (BPP) b. Ultrasound c. Nonstress test d. Amniocentesis 7. A pregnant woman presents to the clinic with a history of Diabetes Mellitus. The nurse knows the mother & fetus are at greater risk for what? (SATA). a. Pre-term birth b. Polyhydramnios c. Fetal congenital anomalies d. Fetal hypoglycemia 8. The postpartum nurse is conducting a routine assessment of the mom & baby 24 hrs. after delivery. The nurse notes that the baby appears somewhat yellow in the skin & eyes. The mother reports the baby has a poor latch & suck when feeding & hasn’t had a bowel movement since delivery. What does the nurse suspect? a. Low blood sugar b. Hyperbilirubinemia (jaundice) c. Bowel obstruction d. Prematurity 9. There are 2 forms of jaundice: physiological & pathological. What’s the cause of physiological jaundice? a. Increased dead RBCs due to RhO incompatibilities b. Accumulation of bilirubin due to renal immaturity c. Accumulation of bilirubin due to liver immaturity d. Allergies to breastmilk 10. Pathological jaundice is when a disorder exacerbates the normal physiological conditions that lead to hyperbilirubinemia. Which is a true statement regarding pathological jaundice? a. Is benign & corrects itself b. Is always preventable c. Noted usually after day 3 of life d. Noted withing the first 24 hrs. of life 11. When a child has hyperbilirubinemia, the bilirubin may accumulate so much that it spills across the blood-brain barrier & cause seizures & other long-term effects. What’s this condition called? a. Kernicterus b. Extreme hyperbilirubinemia c. Excessive hyperbilirubinemia d. Brain jaundice 12. Because jaundice may not present itself until after discharge, what education should the nurse provide to the parents? (SATA). a. Ensure the baby feeds 8-12 times a day b. Notify provider if yellowing of skin or eyes is noted c. Notify provider if infant does not have a bowel movement within 24 hrs. d. Notify provider if infant does not wake to feed for 2 consecutive feeds 13. A newborn just had a circumcision. What does the nurse teach the parents regarding post- procedure care? (SATA). a. Scrub penis with baby wipes to ensure cleanliness with each diaper change b. Do not submerge infant in bath until healed c. Notify provider of redness, warmth, bleeding, or discharge d. Place petroleum jelly on gauze around the glans with each diaper change 14. A nurse comes to conduct a postpartum assessment on mom & baby. The baby is sucking on its hand & making sucking noises. The nurse also notes the baby opens her mouth & turns her head towards the nurse’s hand when the nurse touches her cheek. The baby begins to cry as the nurse completes the assessment. What does the nurse tell the mom regarding the baby’s actions? a. The baby needs a diaper change b. These are normal infant cues c. The baby is not getting enough to eat d. The baby needs a pacifier 15. The triage nurse takes a phone call from a woman who delivered at the hospital a week ago. The woman reports having a fever, a red spot on her chest that’s in the shape of a pie wedge, & it’s warm & tender when she touches it. What does the nurse suspect? a. Sepsis b. Postpartum psychosis c. Mastitis d. Poor breastfeeding latch 16. A woman who just delivered her first baby is unsure about initiating breastfeeding. The postpartum nurse knows which of the following are legitimate contraindications for NOT breastfeeding? (SATA). a. Mom is HIV positive b. Mom is unsure & lacks confidence c. Mom is currently undergoing chemotherapy treatments d. Mom is using street drugs 17. A new mom wishes to bottle/formula feed her newborn baby. What education should the nurse provide? (SATA). a. Once prepared, the formula should be refrigerated & used within 24 hrs. b. Unused formula should be discarded c. Burp child only at the end of the feed d. Prop bottle on blankets if desired 18. A nurse is checking up on a new mother who delivered a few weeks ago. The mom is angry, states she’s having difficulty eating, & cries a lot. The nurse identifies this as: a. Lack of social support b. Emotional immaturity of the mother c. Postpartum psychosis d. Postpartum blues 19. The nurse is assessing a 5-day old infant. The infant is hypotonic, lethargic, & has a poor latch & suck. What does the nurse suspect? a. Cardiac defect b. Hyperbilirubinemia c. Milk allergy d. Normal sleep pattern 20. A pregnant woman is at 34 weeks gestation. She comes to the clinic complaining of headaches, right-sided epigastric pain, & puffiness. What does the nurse anticipate? a. Preeclampsia b. Hypertension c. Dehydration d. Normal complaints of pregnancy 21. A woman is seen in OB triage. Her lab results show hemolysis, elevated ALT & AST, & platelets of 90,000. What does these lab results indicate? a. Normal changes in pregnancy b. Kidney disfunction c. Preeclampsia d. HELLP syndrome 22. A woman is being assessed for a potential diagnosis of HELLP syndrome. The nurse knows which of the following are potential effects of HELLP? (SATA). a. Post-date delivery b. Placental abruption c. Kidney failure d. Maternal & fetal demise 23. A pregnant woman is seen in the clinic who has chronic uncontrolled hypertension. The nurse knows which of the following are potential risks for the baby? (SATA). a. Prematurity b. Post-date delivery c. Macrosomia d. Intrauterine growth restriction (IUGR) 24. A pregnant woman has had chronic hypertension & in her most recent clinic visit, her BP was 160/100. The mother is currently at 36 weeks gestation. What does the nurse know about these assessments and the patient's history? (SATA). a. The fetus is at high risk of seizures b. Imminent delivery is expected, as near to term as possible c. The fetus is at risk for IUGR & prematurity d. The mother should receive betamethasone 25. A woman with preeclampsia has been admitted for induction of labor. She’s 36 weeks pregnant & is on Pitocin & magnesium sulfate. What’s true regarding this woman’s plan of care? (SATA). a. Pitocin stimulates contractions & magnesium is a muscle relaxer, so these 2 medications compete & the labor may be longer b. With a potentially long labor, plus being on magnesium sulfate (a muscle relaxer), the woman is at increased risk for PPH c. Since the woman is on magnesium, her BPs do not need to be monitored as closely d. Seizure pads should be placed on the bed 26. Which of the following are included in the diagnosis of HELLP syndrome? (SATA). a. Hemolysis of RBCs b. High serum ALT & AST levels c. Serum platelets below 100,000 d. Hemorrhage 27. A woman presents in the clinic after a positive home pregnancy test. Her history shows diabetes, but the patient states she can’t afford the medication & hasn’t been monitoring her blood sugar levels. With mom being an uncontrolled pre-gestational diabetic, what are the risk factors for the fetus? (SATA). a. Congenital anomalies b. Fetal birth injury due to macrosomia c. Hypoglycemia d. Respiratory distress syndrome 28. Which of the following statements are TRUE regarding diabetes & pregnancy? (SATA). a. Maternal insulin crosses the placenta b. Maternal glucose crosses the placenta c. Pregnancy creates a diabetogenic effect to support glucose stores to the fetus d. Dietary & insulin needs remain the same as before pregnancy 29. A nurse is taking the history of a pregnant woman in the clinic. Which of the following places the woman at greatest risk for developing gestational diabetes? a. Diagnosis of type 2 diabetes b. Underweight c. Previous delivery of a macrosomic or large for gestation (LGA) baby d. Mother is 23 years old 30. The nurse is taking care of a woman following a cesarean section delivery. The nurse knows the woman is at greater risk for what complications? (SATA). a. Hemorrhage b. Wound dehiscence c. UTI d. DVT or PE 31. The nurse is taking care of an obese laboring patient. The nurse knows this patient is at greater for what complications throughout pregnancy & during the birthing process? (SATA). a. Infection b. High BP c. C-section delivery d. DVT or PE 32. Which is the MOST correct definition of cephalopelvic disproportion (CPD)? a. The mother is unable to adequately push the fetus through the birth canal b. Only refers to the large shape of the baby being unable to fit through the maternal pelvis c. The maternal pelvis is inadequately shaped to fit the baby through d. A condition in which size, shape, or position of the fetal head prevents it from passing through the lateral aspect of the maternal pelvis or when the maternal pelvis is of a size or shape that prevents the decent of the fetus through the pelvis 33. Balloon catheters & laminaria are used for what? a. Mechanical or physical ripening of the cervix b. Internal pressure of the uterus to treat postpartum hemorrhage c. Soothing mechanisms for the newborn d. Prevents preterm delivery 34. Which of the following are risk factors for preterm labor? (SATA). a. Infections: genitourinary & periodontal b. Infections: viral c. Multiple gestations (twins, etc.) d. Low pre-pregnancy birth weight 35. In the immediate postpartum period, uterine infection (chorioamnionitis) & uterine atony are the main cause of what? a. Maternal fevers b. Profuse bleeding c. Uterine inversion d. Vaginal hematomas 36. Which of the following patients is at greatest risk for experiencing early postpartum hemorrhage (PPH)? a. A woman in preterm labor with twins b. A woman is being prepared for an emergency c-section due to fetal intolerance of labor c. A woman with high blood pressures & epigastric pain, on magnesium sulfate & induced with Pitocin d. A G3P2 woman, last baby was large for gestation 37. A patient is experiencing early postpartum hemorrhage immediately following delivery. Which medications does the nurse anticipate the provider might order? (SATA). a. Pitocin b. Methergine c. Magnesium sulfate d. Misoprostol (Cytotec) 38. A nurse is reviewing the test results for a post-term pregnant patient. Which result is most concerning? a. Biophysical profile 5/10 & nonreactive b. Nonstress test reactive c. Mom’s WBCs 12,000 d. Mom’s platelets are 115,000 39. A nurse is assisting a woman to push in the final stages of labor. The delivering provider indicates a shoulder dystocia. What nursing actions are appropriate? (SATA). a. Lay the head of the bed flat b. Call staff members to assist c. Pull mom’s knees to chest d. Empty patient’s bladder e. Tell mom to keep pushing as long & hard as she can 40. A nurse is caring for a newborn who has hyperbilirubinemia & is receiving phototherapy. What should the nurse include in the plan of care for this patient? (SATA). a. Eye patches should be worn while under phototherapy b. Infant should only be in a diaper to promote maximum exposure to lights c. Frequent position changes d. Temperature monitoring e. Monitor I&Os closely
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nu 402
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ob escape room study guide exam 4
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what’s the correct definition of “subinvolution of the uterus”
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which of the following are reasons a woman might experience stronger uterine contractions in th
