AWHONN PEOP Perinatal Final Review 2022
Swiss cheese is often used as the paradigm for explaining medical error. In this
model, the holes in the cheese represent
latent weaknesses
You are assigned to a patient who is at 38 weeks and 6 days gestation. She is
being admitted for an elective induction of labor because her husband is going
on an extended business trip in 2 days and he wants to be present for the
delivery. The hospital has no policy regarding elective induction, but you know
that the AWHONN "Go the Full 40" campaign doesn't support early elective
induction. You approach the physician with your concerns. He responds that he's
been doing this for 30 years and has never had a bad outcome from an elective
induction at this gestation.
This scenario is an example of
normalization of deviance
Which of the following has been noted among the top three root causes of
sentinel events for over 10 years?
Communication
A shared understanding of what is going on and what is likely to happen next is
known as
situational awareness
A patient safety event, unrelated to the natural course of the underlying illness,
that reaches a patient and results in death, permanent harm, or severe temporary
harm with intervention required to sustain life is an example of
a sentinel event
Which tool is used when an adverse event has occurred to identify variations in
performance that led to the outcome?
Root cause analysis
Yearly objectives developed by The Joint Commission that focus on problems in
healthcare safety are known as
National Patient Safety Goals
The Perinatal Care Core Measures include all of the following EXCEPT
use of the NICHD nomenclature for electronic fetal monitoring.
Authoritative statements of the duties that all registered nurses, regardless of
role, population, or specialty are expected to perform competently are defined
Standards of Care
Position statements are recommendations for
a pathway of action regarding a particular issue
In health care, an unplanned event that did NOT result in injury, illness, or
damage but had the potential to do so is referred to as a
near miss
All of the following are elements of good documentation EXCEPT
inclusion of nursing opinion as to causes of error
Mrs. Johnson is a primipara at 34 weeks gestation who has been admitted to your
unit with increasing blood pressures. You have a discussion with the physician
,about her reports of headache and blurred vision. What actions should surround
the documentation of this conversation in the medical record?
Document the date, time, person spoken to, and objective details of what was said in
the medical record.
Which of the following is NOT a component of the risk reduction strategy known
as closed loop communication?
Is only used in emergency patient care situations
You are a nurse on the mother/baby unit caring for a woman who is 12 hours
postpartum from an operative vaginal delivery with midline episiotomy. The
woman has severe rectal pain and reports inability to urinate. You suspect a
vaginal hematoma and call her physician to request an evaluation. The physician
does not respond. Under these circumstances it is appropriate to
institute the chain of communication
Team training is an effective risk management strategy because it
outlines effective communication tools and techniques
One of the leading causes of obstetric liability is
oxytocin administration leading to tachysystole
Which two medications frequently used in the perinatal setting are identified as
high-risk medications by the Institute for Safe Medication Practices (ISMP)?
Magnesium sulfate and oxytocin
Successful defense against malpractice claims is enhanced by which of the
following?
Following national professional standards
The innermost layer of the uterus is called the
endometrium
Fertilization occurs in the
fallopian tube
During the proliferative phase of the menstrual cycle, which is NOT true?
Menstruation occurs
The corpus luteum produces ___________ to prepare the uterus to nurture the
fertilized egg.
progesterone
In the early menstrual cycle phase, which gland sends a signal telling the ovaries
to prepare to release an egg?
Pituitary
After ovulation, the ovarian follicle produces
progesterone
Implantation of a fertilized ovum occurs ______ days after ovulation.
7-10
Average viability for male sperm within the female reproductive tract is
2-3 days
For a healthy, 30-year-old woman, the chance of conception is approximately __
per cycle.
20%
The best way for a woman with a regular menstrual cycle to predict ovulation is to
record the first day of the LMP and
,count backward 14 days
Which is NOT a characteristic of ovulation in the female?
Decreased basal body temperature
Infertility evaluation is recommended for women less than 35 years old who have
not conceived after ___ months.
6 (but I think question is incorrectly worded should be 12 months; >35 y/o is 6 months)
Starting at what age does female fertility decline?
32
Which is NOT a symptom of polycystic ovarian syndrome?
Painful periods
What is the best way to confirm the diagnosis of endometriosis?
Laparoscopy
At ovulation, the cervical mucus becomes clear and stretchy. This facilitates
sperm to pass through the cervical canal
Which of the following uterine abnormalities may be surgically corrected to
improve fertility?
All the above (Endometrial polyps, Myomas, Uterine septum)
Which test is the best predictor of a woman's ovarian reserve?
Antral follicle count
When is the best time of the menstrual cycle to perform hysterosalpingography?
Day 7-12
Standards for semen analysis have been designated to maintain consistency and
quality control by
World Health Organization
Pregnancy outcomes associated with ART include
all the above (early pregnancy loss,
multiple gestation pregnancy,
preterm birth)
Which is NOT true about ovarian hyperstimulation syndrome?
Not an assisted reproductive technologies (ART) risk
The MOST common form of ART for a woman with cervical factor infertility is
intrauterine insemination (IUI)
Which of the following is TRUE about IVF?
Involves ovarian stimulation
Which of the following is TRUE about GIFT?
Requires laparoscopy
Preconception care includes maximizing health
all of the above (between pregnancies, during pregnancies, and throughout life)
Anticipatory guidance is an important part of preconception and interconception
care because the following percentage of all pregnancies in the United States are
unintended.
45%
Healthcare providers should strive to provide preconception and interconception
care to all women of childbearing age, which is generally considered to be
15-44 years of age
Interconception care should be provided to a woman
, postpartum until she can no longer become pregnant
Which of the following birth outcomes may be improved by preconception and
interconception care?
All of the above (Infant mortality, Preterm birth, Birth defects)
Cultural sensitivity means that the healthcare provider is
alert and considerate of others' views
Increasing maternal and paternal age have been shown to influence the risk of
genetic abnormalities
Women over the age of 35 have an increased risk of
all of the above (cesarean birth, miscarriage and stillbirth, pregnancy-related
complications)
Access to care may be limited by all factors except lack of
contraception
A tool used to screen for IPV is
RADAR
The first "a" in RADAR stands for
ask directly, in a kind, nonjudgmental way
Nadia has arrived for a routine annual physical examination. She does not
maintain eye contact and provides only brief responses to questions during the
physical assessment systems review. Upon physical examination, you notice
bruises on her breasts, upper thighs, and genitals. Nadia begins to cry and states
that her husband beats her. Your first action should be to
assess Nadia's safety and ask if she has a safety plan
Folic acid supplementation prior to and during pregnancy has been shown to
reduce the risk of neural tube defects by at least
85%
Some foods are considered unsafe during pregnancy, and women may choose to
avoid them during the preconception period. Undercooked meat and unwashed
fruits and vegetables may expose women to which organism?
Toxoplasma gondii
Methylmercury may be found in certain fishes and can adversely affect which
fetal system?
Neurologic
In nonpregnant women, obesity is defined as a body mass index (BMI) over
30
Obese women (BMI ≥30) should gain how many pounds during pregnancy?
11-20
Women who are underweight may have difficulty conceiving due to which of the
following conditions?
Oligo-ovulation
Obesity can result in
all of the above (ovulatory dysfunction,
altered oocyte and endometrial functions, lower birth rates)
Smoking increases the risk of
increase in spontaneous abortion
Swiss cheese is often used as the paradigm for explaining medical error. In this
model, the holes in the cheese represent
latent weaknesses
You are assigned to a patient who is at 38 weeks and 6 days gestation. She is
being admitted for an elective induction of labor because her husband is going
on an extended business trip in 2 days and he wants to be present for the
delivery. The hospital has no policy regarding elective induction, but you know
that the AWHONN "Go the Full 40" campaign doesn't support early elective
induction. You approach the physician with your concerns. He responds that he's
been doing this for 30 years and has never had a bad outcome from an elective
induction at this gestation.
This scenario is an example of
normalization of deviance
Which of the following has been noted among the top three root causes of
sentinel events for over 10 years?
Communication
A shared understanding of what is going on and what is likely to happen next is
known as
situational awareness
A patient safety event, unrelated to the natural course of the underlying illness,
that reaches a patient and results in death, permanent harm, or severe temporary
harm with intervention required to sustain life is an example of
a sentinel event
Which tool is used when an adverse event has occurred to identify variations in
performance that led to the outcome?
Root cause analysis
Yearly objectives developed by The Joint Commission that focus on problems in
healthcare safety are known as
National Patient Safety Goals
The Perinatal Care Core Measures include all of the following EXCEPT
use of the NICHD nomenclature for electronic fetal monitoring.
Authoritative statements of the duties that all registered nurses, regardless of
role, population, or specialty are expected to perform competently are defined
Standards of Care
Position statements are recommendations for
a pathway of action regarding a particular issue
In health care, an unplanned event that did NOT result in injury, illness, or
damage but had the potential to do so is referred to as a
near miss
All of the following are elements of good documentation EXCEPT
inclusion of nursing opinion as to causes of error
Mrs. Johnson is a primipara at 34 weeks gestation who has been admitted to your
unit with increasing blood pressures. You have a discussion with the physician
,about her reports of headache and blurred vision. What actions should surround
the documentation of this conversation in the medical record?
Document the date, time, person spoken to, and objective details of what was said in
the medical record.
Which of the following is NOT a component of the risk reduction strategy known
as closed loop communication?
Is only used in emergency patient care situations
You are a nurse on the mother/baby unit caring for a woman who is 12 hours
postpartum from an operative vaginal delivery with midline episiotomy. The
woman has severe rectal pain and reports inability to urinate. You suspect a
vaginal hematoma and call her physician to request an evaluation. The physician
does not respond. Under these circumstances it is appropriate to
institute the chain of communication
Team training is an effective risk management strategy because it
outlines effective communication tools and techniques
One of the leading causes of obstetric liability is
oxytocin administration leading to tachysystole
Which two medications frequently used in the perinatal setting are identified as
high-risk medications by the Institute for Safe Medication Practices (ISMP)?
Magnesium sulfate and oxytocin
Successful defense against malpractice claims is enhanced by which of the
following?
Following national professional standards
The innermost layer of the uterus is called the
endometrium
Fertilization occurs in the
fallopian tube
During the proliferative phase of the menstrual cycle, which is NOT true?
Menstruation occurs
The corpus luteum produces ___________ to prepare the uterus to nurture the
fertilized egg.
progesterone
In the early menstrual cycle phase, which gland sends a signal telling the ovaries
to prepare to release an egg?
Pituitary
After ovulation, the ovarian follicle produces
progesterone
Implantation of a fertilized ovum occurs ______ days after ovulation.
7-10
Average viability for male sperm within the female reproductive tract is
2-3 days
For a healthy, 30-year-old woman, the chance of conception is approximately __
per cycle.
20%
The best way for a woman with a regular menstrual cycle to predict ovulation is to
record the first day of the LMP and
,count backward 14 days
Which is NOT a characteristic of ovulation in the female?
Decreased basal body temperature
Infertility evaluation is recommended for women less than 35 years old who have
not conceived after ___ months.
6 (but I think question is incorrectly worded should be 12 months; >35 y/o is 6 months)
Starting at what age does female fertility decline?
32
Which is NOT a symptom of polycystic ovarian syndrome?
Painful periods
What is the best way to confirm the diagnosis of endometriosis?
Laparoscopy
At ovulation, the cervical mucus becomes clear and stretchy. This facilitates
sperm to pass through the cervical canal
Which of the following uterine abnormalities may be surgically corrected to
improve fertility?
All the above (Endometrial polyps, Myomas, Uterine septum)
Which test is the best predictor of a woman's ovarian reserve?
Antral follicle count
When is the best time of the menstrual cycle to perform hysterosalpingography?
Day 7-12
Standards for semen analysis have been designated to maintain consistency and
quality control by
World Health Organization
Pregnancy outcomes associated with ART include
all the above (early pregnancy loss,
multiple gestation pregnancy,
preterm birth)
Which is NOT true about ovarian hyperstimulation syndrome?
Not an assisted reproductive technologies (ART) risk
The MOST common form of ART for a woman with cervical factor infertility is
intrauterine insemination (IUI)
Which of the following is TRUE about IVF?
Involves ovarian stimulation
Which of the following is TRUE about GIFT?
Requires laparoscopy
Preconception care includes maximizing health
all of the above (between pregnancies, during pregnancies, and throughout life)
Anticipatory guidance is an important part of preconception and interconception
care because the following percentage of all pregnancies in the United States are
unintended.
45%
Healthcare providers should strive to provide preconception and interconception
care to all women of childbearing age, which is generally considered to be
15-44 years of age
Interconception care should be provided to a woman
, postpartum until she can no longer become pregnant
Which of the following birth outcomes may be improved by preconception and
interconception care?
All of the above (Infant mortality, Preterm birth, Birth defects)
Cultural sensitivity means that the healthcare provider is
alert and considerate of others' views
Increasing maternal and paternal age have been shown to influence the risk of
genetic abnormalities
Women over the age of 35 have an increased risk of
all of the above (cesarean birth, miscarriage and stillbirth, pregnancy-related
complications)
Access to care may be limited by all factors except lack of
contraception
A tool used to screen for IPV is
RADAR
The first "a" in RADAR stands for
ask directly, in a kind, nonjudgmental way
Nadia has arrived for a routine annual physical examination. She does not
maintain eye contact and provides only brief responses to questions during the
physical assessment systems review. Upon physical examination, you notice
bruises on her breasts, upper thighs, and genitals. Nadia begins to cry and states
that her husband beats her. Your first action should be to
assess Nadia's safety and ask if she has a safety plan
Folic acid supplementation prior to and during pregnancy has been shown to
reduce the risk of neural tube defects by at least
85%
Some foods are considered unsafe during pregnancy, and women may choose to
avoid them during the preconception period. Undercooked meat and unwashed
fruits and vegetables may expose women to which organism?
Toxoplasma gondii
Methylmercury may be found in certain fishes and can adversely affect which
fetal system?
Neurologic
In nonpregnant women, obesity is defined as a body mass index (BMI) over
30
Obese women (BMI ≥30) should gain how many pounds during pregnancy?
11-20
Women who are underweight may have difficulty conceiving due to which of the
following conditions?
Oligo-ovulation
Obesity can result in
all of the above (ovulatory dysfunction,
altered oocyte and endometrial functions, lower birth rates)
Smoking increases the risk of
increase in spontaneous abortion
