OB Inpatient Certification Practice Questions and answers

OB Inpatient Certification Practice Questions After delivery, progesterone levels fall causing what acid/base change? Correct Answer: Increase pco2 With what disorder would AFP be elevated? Correct Answer: Esophageal atresia, neural tube defects Women with a history of GDM have increased risk of diabetes at what rate? Correct Answer: Onset within 20 years in 35-60% Glucose screen is done when? Correct Answer: 24-28 weeks If a mother has Insulin dependent diabetes during pregnancy, what electrolyte imbalance is the neonate at risk for? Correct Answer: Magnesium deficiency In which trimester is new onset of GHTN most common? Correct Answer: 3rd trimester In a pregnancy complicated by hypertension, what is a sign of deteriorating status? Correct Answer: Increased serum creatinine What difference can be expected between manual and electronic diastolic BP? Correct Answer: Manual are 5-7 mm HG higher On admission to L&D , a woman has 2+ reflexes. After IV mag, DTRs are absent. What is your immediate nursing intervention? Correct Answer: Stop mag and notify provider With no apparent HSV lesions what is the recommendation? Correct Answer: Oral acyclovir 4 weeks prior to delivery +IgG antibodies in PP period? Correct Answer: The recurrence is unlikely, no further action is required. (IgG chronic, IgM is active) The most common rheumatic valvular lesion in pregnancy is? Correct Answer: Mitral stenosis Cardiac defect with most complications in labor? Correct Answer: Mitral stenosis Methamphetamines are expected to last? Correct Answer: 7-24 hrs What is recommended L/S ratio? Correct Answer: 2:1 - lungs are probably mature 3:1 - indicative of maturity What causes a sinusoidal FHR tracing? Correct Answer: Fetal anemia What is the parenteral analgesic with most rapid peak effect? Correct Answer: Fentanyl What neonatal complication is increased with cesarean delivery? Correct Answer: Respiratory morbidity A woman who has a c/s is more likely to be re-hospitalized with what pp complication? Correct Answer: Wound infection During the postpartum period, low levels of placental lactogen, estrogen, cortisol, growth hormone and insulinase result in? Correct Answer: Lower glucose levels Due to the catabolic process of involution postpartum, which lab value is expected to be elevated postpartum? Correct Answer: BUN Avg weight loss with delivery? Correct Answer: 12 lbs Where would you expect to palpate fundus 24h pp? Correct Answer: 1cm below umbilicus What is the term for lochia appearing 3-10 days pp and pink or brown in colora Correct Answer: Lochia serosa The process of involution that allows for healing of the placental site preventing scarring is? Correct Answer: Exfoliation True or false 2500cc urine 2 days pp is a normal physiologic response to delivery Correct Answer: True If pp woman's fundus is deviated from midline first RN intervention is? Correct Answer: Empty bladder Why is UTI common in 1st few weeks pp? Correct Answer: Dilated ureters and renal pelvis By which pp day has circulating blood volume diminished secondary to diuresis, returning to prepregnancy volume? Correct Answer: Day 5 What intervention can increase physiological jaundice? Correct Answer: Delayed cord clamping A woman is 12 days pp and has WBC of 25,000. This indicates? Correct Answer: Expected range What is the antidote for Coumadin? Correct Answer: Vitamin k What is antidote to MAg? Correct Answer: Calcium glucinate What med for malignant hyperthermia? Correct Answer: Dantrolene sodium Uterotonic med contraindicated for elevated BP? Correct Answer: Methergine Following delivery, insulin requirements I'd diabetic woman.... Correct Answer: Decrease rapidly Rhinitis and nasal stuffiness increase in pregnancy are due to? Correct Answer: Estrogen A newly delivered postpartum woman received terbutaline and corticosteroids during labor is at risk for what potential drug interaction? Correct Answer: Hyperglycemia Antidote for heparin? Correct Answer: Protamine sulfate Two IV anti hypertensives that may be used to treat severe maternal hypertension? Correct Answer: Hydralazine, labatelol Severe BP values Correct Answer: Over 160 sbp or over 110 dbp Another name for hydralazine? Correct Answer: Apresoline Another name for labatelol? Correct Answer: Trandate, normodyne At 12 hrs pp a breastfeeding mom is 180/114, what does the RN anticipate the provider will order? Correct Answer: Labatelol A common side effect of pitocin is? Correct Answer: Anti diuretic effect/water intoxication CDC requirement for a TDAP for a pt who had tetanus shot two years ago? Correct Answer: Administer prior to d/c. All pts should have booster in pregnancy Pp woman has order for rubella vaccine and Rh immune globulin. The nurse knows they should be given? Correct Answer: At the same time Unsensitized Rh- mom whose baby is Rh+ should? Correct Answer: Receive 300 mcg of rhogham within 72hrs of delivery A pp woman has large hemorrhoid. She may be instructed to? Correct Answer: Gently attempt to push back into rectum After birth pains usually last? Correct Answer: 2-3 days A woman readmitted for wound infection shows signs of sleep disturbance, irritability, agitation and confusion. The nurse suspects? Correct Answer: Post partum psychosis What is the chance of pregnancy when using the lactational amenorrhea method (LAM) at 12 months? Correct Answer: Can approach 7%