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MVU_NURS629_Exam_01_Study_Guide.

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Exam 1 Outline: Main Topics The goal of this test is to show you can identify what is normal and abnormal in your OB physical exams. Below is some of the information that you will be tested on. This list is not inclusive. You should be sure to read all study material in addition to material specific to any conditions listed here. You should know how to diagnose and treat these conditions. 1. What are the recommended office visits (interval) for a low-risk client throughout the pregnancy? ○ What is the recommended office visit interval during each trimester? 1. Up to 28 weeks – Every 4 Weeks 2. 28 to 36 weeks – Every 2 weeks 3. 36 weeks and on – Every week or more as necessary ○ What are appropriate findings for each trimester? 1. 1 st Trimester: week 1-12 1. Breast enlargement, darkening of areola, raise pink Montgomery’s tubercles, nausea, vomiting, and fatigue. Heart tones with Doppler. Positive pregnancy test. Also audible with ultrasound around 12 weeks. Chadwicks sign, Goodell’s sign. Neural tube development for the baby, rapid cell growth. Vital systems are beginning to form. 2. 2 nd Trimester: week 13-26 1. Surge in energy levels, mother will start having an enlarged abdomen from growing fetus, fetal movement, leg cramps, varicose veins, backaches, and nasal congestion. Gender and heart tones are assessed. Heart tones present around 14 weeks. 3. 3 rd Trimester: week 27-40. 1. Linea negra, pressure on lungs, bladder may be palpable, Braxton hicks contractions, back pains. Head engages into the pelvis ○ What are the normal, non-worrisome complaints during each trimester and what complaints would need to be evaluated further? 1. 1 st Trimester: 1. Increasing tenderness and size of breasts: Changes in breast or nipple size, shape, symmetry, as these s&s may indicate other condition. 2. Constipation: Should not include change in stool, fever, weight-loss, anorexia, periumbilical pain, fever, rectal bleeding, pus, or mucous. 3. Excessive salivation (ptyalism), bad taste in mouth: Refer client with dental disease. 4. Fatigue: Refer if psychosocial stress increases. Expected in 1st and 3rd trimester 5. Flatulence: Refer to a mental health care provider if symptoms of psychosocial stress are evident. 6. Headache: If headache is severe, change in vision, severe swelling of hands and feet, if painkillers don’t respond. 7. Hemorrhoids: Rectal lesions (condyloma acuminate cancerous lesion) 8. Nausea and vomiting: Weight loss, dehydration, ketonuria, and hypokalemia. 9. Urinary frequency and incontinence: Frequently repeated UTI’s 10. Varicosities of vulva and legs: Vascular disease, deep vein thrombosis, 2. 2 nd Trimester: 1. Backache: Refer if pain does not improve 2. Dyspnea: S&S of respiratory infection, PE, cardiac problems, or anemia. 3. Epistaxis: Nasal polyps and evidence of cocaine use 4. Leukorrhea: Green, watery or bloody stools, foul or fishy smelling odor, vaginal itching or discomfort, fever, flulike sx, abdominal pain, or bleeding after intercourse, dysuria or dyspareunia. 5. Ligament pain: Anorexia, flank pain, vomiting blood, low-grade fever, diarrhea, vomiting, or a tender lump in the groin that tends to worsen. 6. Muscle cramps in calf, thigh, or buttocks: Homan’s sign, no redness, tenderness, heat or swelling should be noted. 7. Pica: If eating dangerous items consult psychologist. (sign of iron deficiency). 8. Syncope: Substance abuse, sinus, hearing, or ear problems, numbness or tingling in digits around the mouth, melena, heart palpitations, SOB, anxiety/depression, nausea, vomiting. 3. 3 rd Trimester: 1. Braxton-hicks contractions: If labor is continuous, no vaginal bleeding, if contractions begin getting closer together. 2. Discomfort in the upper extremities: Recurrent hyperventilation warrants further investigation 3. Edema: Visual changes, headache, fatigue, nausea, vomiting, abdominal pain, decreased urine output. 4. Heartburn: SOB, chest pain, hypertension, palpitations, sweating, flulike sx, right shoulder pain. 5. Insomnia: Psychosocial stress, anxiety, s&s of suicide 6. Joint pain/ache: Signs of labor, signs of tick bites, symptoms of uti, redness of joints, intermittent claudication, stiffness, flulike symptoms, fever. ○ What OCP can be given to breastfeeding women? 1. Progestin-only pill (POP) also called the “mini-pill” ○ What immunizations can be given in pregnancy? 1. Flu 2. TDAP 3. Possible Hep B 4. Chickenpox (varicella) vaccine, measles, mumps and rubella (MMR) vaccine, shingles vaccine. ○ How to screen for gestational DM (See Assessment PPT) 1. 1 hour GTT (24-28 weeks). Drink 50g of glucose. If 1 hour BG is ≥130-140 proceed below 2. 3 hour GTT high carb died x2 days, then NPO after MN. FBS, then drink 100g of glucose 3. Gest diabetes is diagnosed with 1 hour (180), 2 hour (153). 4. Two Step - If the value meets or exceeds the thresholds below and is ≤ 200 mg administer a 100-g oral glucose tolerance test. 1. 50g oral glucose challenge – 140mg after 1 hour threshold 2. 100g oral glucose test – 1 hour (180), 2 hour (155), 3 hour (140). 5. One Step 1. Administer 75 g oral glucose – 1 hour (180), 2 hour (153). At risk if over 35, overweight, previous FBS 110-125, previous gest diabetes, previous infant 9lbs, previous unexplained stillbirth, family history of diabetes. ○ Treatment of mild PIH 1. Bed rest, lay on left side, methyldopa, labetalol. 1. Second line – verapamil nifedapine, hydralazine (bad hypertension), may use diuretics ○ s/s of mastitis 1. Subjective: Malaise, fever, chills. Also a tender, hot, red, painful area or lump in the breast. 2. Objective: Fever (often high), tachycardia. Warmth, redness and swelling of breasts. Breast distended with milk. Nipple may be cracked or abraded. ○ s/s of gestational HTN 1. Subjective: Headache, edema, weight gain, vision changes, nausea, vomiting, pain in upper right side of stomach, making small amounts of urine 2. Objective: elevated blood pressure, proteinuria, edema. ○ What should the fundal height be at various prenatal visits? 1. 6 weeks: Hegars (softening of lower uterine segment is present) 2. 12 weeks: The fundus is noted at the symphysis pubis 3. 16 weeks: the fundus is midway between the symphysis and the umbilicus 4. 20 weeks: uterine fundus can be palpated at the umbilicus and measures 20cm. 5. 36 weeks: the fundus is just below the xiphoid process and measures approximately 36cm in length

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MVU_NURS629_Exam_01_Study_Guide.


NURS 629 Exam Study Guide

Test-taking skills for NURS 629
• This course pulls together content from previous courses such as
pathophysiology, pharmacology, and advanced health assessment.

• Use the materials provided such as content slides, text, readings, and assignments to help
you study, comprehend, and apply the content.

• In this course, you will think like a provider, determine how to diagnose based on history and
exam findings/symptoms, come up with differential diagnoses, and determine a treatment
plan, the best medication to order, lab work to order, and education to provide to the patient.

o When you study, think about these questions: “How I would make this diagnosis and
differentiate symptoms between disease processes? What lab work would I order?
What medication would I prescribe and what education would I provide to the
patient?”

• When taking the test, read each question carefully, then read the answers carefully (look
for patterns in the answers) to help rule out answer options.

o Take your time.

o Do NOT change your answer once you decide.


Exam 1 Information:
• Open from Day 2 at 8 a.m. until Day 3 at 7:59 a.m. CST

• Proctored exam—all students should already have information regarding proctored exams.

• 30 questions worth 30 points

• You will have 60 minutes to take this exam.

• Items on the exam are from Weeks 1–3, which includes information from course
recordings, assignments, readings, course text, and all other material covered.

, MVU_NURS629_Exam_01_Study_Guide.
Exam Review:
Remember this is merely an overview of what may be on the exam. Not everything that may be on the
exam is covered here.

Be sure to review guidelines for diseases and conditions and normal pregnancy care.

• Risk factors for disorders during pregnancy

• Presenting signs and symptoms

• Diagnostic testing

• Differential diagnosis

• Treatment regimens utilizing updated guidelines found in your course material for
common disorders and diseases seen in women’s health care

Review patient education, when to report back to the clinic, what to watch out for, pharmacology, and
other non-pharmacological modalities.

• Think back to the case studies and how you gave your rationale using updated
guidelines and diagnostic criteria.

**Please refer to the Exam Outline for additional items that may be covered on the exam.

**Remember that this outline is not exhaustive and that all material covered in Weeks 1–3 can be on
the exam.


Exam 1 Outline: Main Topics
The goal of this test is to show you can identify what is normal and abnormal in your OB physical exams.
Below is some of the information that you will be tested on. This list is not inclusive. You should be sure
to read all study material in addition to material specific to any conditions listed here. You should know
how to diagnose and treat these conditions.

1. What are the recommended office visits (interval) for a low-risk client throughout
the pregnancy?
○ What is the recommended office visit interval during each trimester?
1. Up to 28 weeks – Every 4 Weeks
2. 28 to 36 weeks – Every 2 weeks
3. 36 weeks and on – Every week or more as necessary
○ What are appropriate findings for each trimester?
1. 1st Trimester: week 1-12
1. Breast enlargement, darkening of areola, raise pink Montgomery’s
tubercles, nausea, vomiting, and fatigue. Heart tones with Doppler.
Positive pregnancy test. Also audible with ultrasound around 12
weeks. Chadwicks sign, Goodell’s sign. Neural tube development for
the baby, rapid cell growth. Vital systems are beginning to form.

, MVU_NURS629_Exam_01_Study_Guide.
2. 2nd Trimester: week 13-26
1. Surge in energy levels, mother will start having an enlarged abdomen
from growing fetus, fetal movement, leg cramps, varicose veins,
backaches, and nasal congestion. Gender and heart tones are
assessed. Heart tones present around 14 weeks.
rd
3. 3 Trimester: week 27-40.
1. Linea negra, pressure on lungs, bladder may be palpable, Braxton
hicks contractions, back pains. Head engages into the pelvis
○ What are the normal, non-worrisome complaints during each trimester and
what complaints would need to be evaluated further?
1. 1st Trimester:
1. Increasing tenderness and size of breasts: Changes in breast or
nipple size, shape, symmetry, as these s&s may indicate other
condition.
2. Constipation: Should not include change in stool, fever, weight-
loss, anorexia, periumbilical pain, fever, rectal bleeding, pus, or
mucous.
3. Excessive salivation (ptyalism), bad taste in mouth: Refer client
with dental disease.
4. Fatigue: Refer if psychosocial stress increases. Expected in 1st and
3rd trimester
5. Flatulence: Refer to a mental health care provider if symptoms
of psychosocial stress are evident.
6. Headache: If headache is severe, change in vision, severe swelling
of hands and feet, if painkillers don’t respond.
7. Hemorrhoids: Rectal lesions (condyloma acuminate cancerous lesion)
8. Nausea and vomiting: Weight loss, dehydration, ketonuria,
and hypokalemia.
9. Urinary frequency and incontinence: Frequently repeated UTI’s
10. Varicosities of vulva and legs: Vascular disease, deep vein thrombosis,
nd
2. 2 Trimester:
1. Backache: Refer if pain does not improve
2. Dyspnea: S&S of respiratory infection, PE, cardiac problems, or anemia.
3. Epistaxis: Nasal polyps and evidence of cocaine use
4. Leukorrhea: Green, watery or bloody stools, foul or fishy smelling
odor, vaginal itching or discomfort, fever, flulike sx, abdominal pain, or
bleeding after intercourse, dysuria or dyspareunia.
5. Ligament pain: Anorexia, flank pain, vomiting blood, low-grade fever,
diarrhea, vomiting, or a tender lump in the groin that tends to
worsen.
6. Muscle cramps in calf, thigh, or buttocks: Homan’s sign, no
redness, tenderness, heat or swelling should be noted.
7. Pica: If eating dangerous items consult psychologist. (sign of
iron deficiency).
8. Syncope: Substance abuse, sinus, hearing, or ear problems, numbness
or tingling in digits around the mouth, melena, heart palpitations,
SOB, anxiety/depression, nausea, vomiting.
3. 3rd Trimester:
1. Braxton-hicks contractions: If labor is continuous, no vaginal bleeding,
if contractions begin getting closer together.

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