OB Inpatient Certification Test
The [_____] is considered the pathogenic focus for all manifestations of pre-e Correct Answer: Placenta
(Regarding Pre-e): Increased sensitivity to Angiotensin II leads to [-------] and [------] Correct Answer:
Vascular damage & arteriolar vasoconstriction and systemic vasospasm
A [---------] measurement is recommended for all pregnant women with HTN Correct Answer: 24-hr
urinary protein measurement
Thrombocytopenia is present when platelets are low: [-------], and severe: [------] Correct Answer: Low
platelets: less than 100,000/mm3, severe platelets: less than 50,000/mm3
In severe pre-e, urine output decreases to less than [---]ml in 24hrs Correct Answer: 400ml
(Regarding pre-e): Arteriolar vasospasms damage the [-----] layer of small blood vessels, causing lesions
--> [-----] accumulate at lesions sites and fibrin network forms--> RBCs are forced through the network
under high pressure, resulting in [------] Correct Answer: Arteriolar vasospasms damage the endothelial
layer..... platelets accumulate at lesions..... resulting in hemolysis
With regards to HELLP, Hemolysis can be identified by looking for (4): Correct Answer:
1) falling hematocrit
2) hyperbilirubinemia (>1.2mg/dl)
3) Increased LDH
4) Jaundice including sclerae
With regards to HELLP, Elevated Liver Enzymes can be identified by looking for (5): Correct Answer:
1) Increased LDH
2) Increased AST/ALT
3) Feeling Malaise
4) Viral-like symptoms
5) RUQ pain
With regards to HELLP, Low Platelets can be identified by looking for (2): Correct Answer:
1) falling platelet count (low: <100,000, severe: <50,000)
2) Abnormal coagulation and fibrinolytic values
You do not need to diagnose [-------] in order to diagnose HELLP Correct Answer: Preeclampsia
The definitive treatment of for preeclampsia is .... Correct Answer: delivery
The primary goals of management of pre-e are: (4) Correct Answer:
1) Prevent convulsions through use of Mag Sulfate
2) Ensure adequate kidney functions
, 3) Monitor fetal status continuously for signs of uteroplacental insufficiency
4) To stabilize the women so vaginal/cesarean birth can be accomplished
A women with preeclampsia might experience a reduced plasma volume, and a [--------] diet can worsen
the situation Correct Answer: a salt-restricted diet
In nursing management of a women with preeclampsia, BPs should be ..... Correct Answer: taken in the
same position on the left arm, horizontal with the heart
In nursing management of a women with preeclampsia, oliguria is [-------] and is an [-----] sign Correct
Answer: oliguria is output less than 30ml/hr for 2hrs.... and is an ominous sign
In nursing management of a women with preeclampsia, limit fluid administration to no more than [-----]
or [--]ml/kr/hr Correct Answer: no more than 150ml/hr, or 1ml/kg/hr
Magnesium sulfate is given for [-------] therapy, it is note given to treat [------] Correct Answer:
Magnesium sulfate is given for anticonvulsant therapy, not to treat hypertension
The therapeutic range of magnesium sulfate is between [-------] Correct Answer: between 4 to 7 mEq/L
The antidote to Magnesium toxicity is [-----] Correct Answer: Calcium gluconate
Current recommendations for antihypertensive therapy include these 3 medications: Correct Answer:
1) Hydralazine (Apresoline- arteriolar dilator)
2) Labetalol (Adrenergic blocker)
3) Nifedipine (Calcium entry blocker)
The preeclamptic women maintained on therapeutic levels of Mag Sulfate is at risk for [-------] after
delivery, this is of great concern because she is already experiencing reduced [----] and [-----] Correct
Answer: At risk for postpartum hemorrhage after delivery... she is already experiencing reduced blood
volume and hemoconcentration
HTN during the last 20weeks of pregnancy or in the first 24hrs postpartum without other signs of
preeclampsia Correct Answer: Transient Hypertension
A term sometimes used to designate expectant women who have elevated BP after 20 weeks but
without accompanying proteinuria Correct Answer: Gestational Hypertension
A subset of preeclampsia Correct Answer: HELLP syndrome
Sometimes seen in normotensive women within the first hours after delivery but with a subsequent
return to baseline BP levels within 24 hrs. Correct Answer: Transient Hypertension
The development of a BP higher than 140/90 mmHG or higher after the 20th week of pregnancy and
accompanied by proteunuria Correct Answer: Preeclampsia
Occurs before the 20th week of gestation in the presence of pathologic changes in the placenta Correct
Answer: Preeclampsia
The [_____] is considered the pathogenic focus for all manifestations of pre-e Correct Answer: Placenta
(Regarding Pre-e): Increased sensitivity to Angiotensin II leads to [-------] and [------] Correct Answer:
Vascular damage & arteriolar vasoconstriction and systemic vasospasm
A [---------] measurement is recommended for all pregnant women with HTN Correct Answer: 24-hr
urinary protein measurement
Thrombocytopenia is present when platelets are low: [-------], and severe: [------] Correct Answer: Low
platelets: less than 100,000/mm3, severe platelets: less than 50,000/mm3
In severe pre-e, urine output decreases to less than [---]ml in 24hrs Correct Answer: 400ml
(Regarding pre-e): Arteriolar vasospasms damage the [-----] layer of small blood vessels, causing lesions
--> [-----] accumulate at lesions sites and fibrin network forms--> RBCs are forced through the network
under high pressure, resulting in [------] Correct Answer: Arteriolar vasospasms damage the endothelial
layer..... platelets accumulate at lesions..... resulting in hemolysis
With regards to HELLP, Hemolysis can be identified by looking for (4): Correct Answer:
1) falling hematocrit
2) hyperbilirubinemia (>1.2mg/dl)
3) Increased LDH
4) Jaundice including sclerae
With regards to HELLP, Elevated Liver Enzymes can be identified by looking for (5): Correct Answer:
1) Increased LDH
2) Increased AST/ALT
3) Feeling Malaise
4) Viral-like symptoms
5) RUQ pain
With regards to HELLP, Low Platelets can be identified by looking for (2): Correct Answer:
1) falling platelet count (low: <100,000, severe: <50,000)
2) Abnormal coagulation and fibrinolytic values
You do not need to diagnose [-------] in order to diagnose HELLP Correct Answer: Preeclampsia
The definitive treatment of for preeclampsia is .... Correct Answer: delivery
The primary goals of management of pre-e are: (4) Correct Answer:
1) Prevent convulsions through use of Mag Sulfate
2) Ensure adequate kidney functions
, 3) Monitor fetal status continuously for signs of uteroplacental insufficiency
4) To stabilize the women so vaginal/cesarean birth can be accomplished
A women with preeclampsia might experience a reduced plasma volume, and a [--------] diet can worsen
the situation Correct Answer: a salt-restricted diet
In nursing management of a women with preeclampsia, BPs should be ..... Correct Answer: taken in the
same position on the left arm, horizontal with the heart
In nursing management of a women with preeclampsia, oliguria is [-------] and is an [-----] sign Correct
Answer: oliguria is output less than 30ml/hr for 2hrs.... and is an ominous sign
In nursing management of a women with preeclampsia, limit fluid administration to no more than [-----]
or [--]ml/kr/hr Correct Answer: no more than 150ml/hr, or 1ml/kg/hr
Magnesium sulfate is given for [-------] therapy, it is note given to treat [------] Correct Answer:
Magnesium sulfate is given for anticonvulsant therapy, not to treat hypertension
The therapeutic range of magnesium sulfate is between [-------] Correct Answer: between 4 to 7 mEq/L
The antidote to Magnesium toxicity is [-----] Correct Answer: Calcium gluconate
Current recommendations for antihypertensive therapy include these 3 medications: Correct Answer:
1) Hydralazine (Apresoline- arteriolar dilator)
2) Labetalol (Adrenergic blocker)
3) Nifedipine (Calcium entry blocker)
The preeclamptic women maintained on therapeutic levels of Mag Sulfate is at risk for [-------] after
delivery, this is of great concern because she is already experiencing reduced [----] and [-----] Correct
Answer: At risk for postpartum hemorrhage after delivery... she is already experiencing reduced blood
volume and hemoconcentration
HTN during the last 20weeks of pregnancy or in the first 24hrs postpartum without other signs of
preeclampsia Correct Answer: Transient Hypertension
A term sometimes used to designate expectant women who have elevated BP after 20 weeks but
without accompanying proteinuria Correct Answer: Gestational Hypertension
A subset of preeclampsia Correct Answer: HELLP syndrome
Sometimes seen in normotensive women within the first hours after delivery but with a subsequent
return to baseline BP levels within 24 hrs. Correct Answer: Transient Hypertension
The development of a BP higher than 140/90 mmHG or higher after the 20th week of pregnancy and
accompanied by proteunuria Correct Answer: Preeclampsia
Occurs before the 20th week of gestation in the presence of pathologic changes in the placenta Correct
Answer: Preeclampsia
