PRACTICE EXAM NEWEST 2024
NURP 531 Exam 3
COMPLETE 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
During first prenatal visit, what labs do you draw? - answer>>>- blood type
- RH- Rh - mother would attack Rh + fetus, so RHOGAM needed within 72 hours
- antibody screen
- CBC- baseline RBC, HCT, HBG, WBC, and platelet
- Hep B surface antigen- immunity
- HIV screening/STI screening
- Rubella/varicella titers
- TORCH titers- toxoplasmosis, other/CT/GC, rubella, cytomegalovirus, herpes
- urinalysis with culture and sensitivity
- PAP smear if indicated- pregnant women can still get it done and spotting is normal is
normal afterwards
- obtain HA1C and fasting blood glucose if at risk
How do manage a missed and inevitable abortion? - answer>>>- support- give mother
time to process and grieve- can be up to 45 days; in professor's practice it is 14 days
- if patient is hemodynamically stable, then she can choose:
1) expectant management
2) medical abortion- cytotec- cervical softening and uterine contractions or misoprostol-
detaches pregnancy from uterine wall
3) surgical intervention- D&C
How do you dx hydatidiform mole? tx? - answer>>>- dx- UX- classic snow storm
pattern, no fetus detected, no yolk sac or fetal pole
- fluid filled vesicles in grapelike pattern
- obtain HCG level
, - tx- preferred method is D&C; consider hysterectomy if fertility preservation is not a
concern (tumor must be removed to avoid development of malignancy)
How do you screen for gestational diabetes? How does gestational diabetes get dx? -
answer>>>- 1 hr oral glucose tolerance test should be performed between 24-28 weeks
gestation
- 50 grams oral glucose given and then blood is taken in 1 hr
- if 1 hr test is over 130-140 mg/dL, pt will need to do 3 hr test
- 3 hr glucose tolerance test- fasting glucose taken and then 100g of oral glucose given
and blood is drawn each hour after for 3 hours
- dx- requires at least 2 of the following blood glucose values- fasting, 1 hr, 2 hr, 3 hr
How long does it take to expel products of conception? - answer>>>- 30% expel it within
7 days
- 60% within 14 days
- 75% within 45 days
- patients should monitor for any temp >/= 100.4, chills, saturation of more than 1
pad/hour, or passing large clots greater than golf ball/50 cent piece --> will need to get
D&C procedure
How long is postpartum period? What is puerperium - answer>>>- 6 weeks
- 1st 72 hours of postpartum is known as puerperium
How long is pregnancy? How is it calculated? - answer>>>- 9 calendar months; 40
weeks; 280 days
- measured from the last normal menstrual period (LNMP)
How much additional calories is needed for healthy pregnancy? What are other healthy
nutrition components? - answer>>>- only additional 300 cal needed
- appropriate and timely vitamin and mineral supplementation- avoid lunch meat, unless
steaming hot, avoid all unpasteurized dairy, avoid raw seafood
How often do serum beta HCG levels increase? - answer>>>- should double every 48-
72 hours
- should plateau during weeks 8-10 when HPL takes over
- should double:
- every 1.5 days through week 5
- every 2 days in week 6
- every 2-2.5 days in week 7
How should pregnant patient put on seatbelt? Is sexual activity allowed? - answer>>>-
seatbelt should be either on top or under belly; never across belly
, - sexual activity is okay unless there is premature rupture of membranes, risk of preterm
labor, hypertension, incompetent cervix or multiple pregnancy
If HCG is not doubling every 48-72 hours, what could be the problem? If HCG is higher
than doubling every 48-72 hours, what could be the problem? - answer>>>- not
doubling- loss of pregnancy?
- higher than doubling- multiple pregnancies
Is zofran recommended for morning sickness? risks? - answer>>>- not FDA approved
for morning sickness
- avoid in 1st trimester due to increased risk of heart defects and cardiac malformations
and cleft plate and palate malformations
physiologic dyspnea vs pathologic dyspnea - answer>>>- physiologic dyspnea- SOB,
but normal RR- pregnant women
- pathologic dyspnea- SOB and changes in RR like tachypnea- should NOT occur in
pregnant women
Risk factors of preeclampsia? maternal vs fetal complications? - answer>>>- nulliparity*
- extremes of age <20 or >35
- multiple gestations
- diabetes
- prexisting renal disease
- CHTN
- AA race
-molar pregnancy
- vascular or CT disease
- maternal complications- renal failure, liver failure, cerebral hemorrhage, DIC, abruptio
placentae, emergent operative delivery, death
- fetal complications- oligohydramnios, preterm delivery, IUGR, intrapartum fetal ditress,
stillbirth
s/sx of PE vs s/sx of DVT? tx? - answer>>>- s/sx of PE- dyspnea, palpitations, pleuritic
chest pain, hemoptysis, tachycardia tachypnea, hypotension, collapse
- s/sx of DVT- DVT in pregnancy usually proximal, unilateral leg pain/tenderness,
swelling in extremity, increase calf/thigh circumference, increased temperature,
prominent superficial veins, pitting edema
- tx- REFER TO ED/ER for anticoagulant tx and rest; obtain ux to confirm dx
T/F: any murmurs greater than 2/6 or ANY diastolic murmurs must be evaluated via
referral to cardiology - answer>>>true
T/F: avoid anything that increases core temperature like heating pads, hot tubs, and
ibuprofen - answer>>>true
NURP 531 Exam 3
COMPLETE 300 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW VERSION!!
During first prenatal visit, what labs do you draw? - answer>>>- blood type
- RH- Rh - mother would attack Rh + fetus, so RHOGAM needed within 72 hours
- antibody screen
- CBC- baseline RBC, HCT, HBG, WBC, and platelet
- Hep B surface antigen- immunity
- HIV screening/STI screening
- Rubella/varicella titers
- TORCH titers- toxoplasmosis, other/CT/GC, rubella, cytomegalovirus, herpes
- urinalysis with culture and sensitivity
- PAP smear if indicated- pregnant women can still get it done and spotting is normal is
normal afterwards
- obtain HA1C and fasting blood glucose if at risk
How do manage a missed and inevitable abortion? - answer>>>- support- give mother
time to process and grieve- can be up to 45 days; in professor's practice it is 14 days
- if patient is hemodynamically stable, then she can choose:
1) expectant management
2) medical abortion- cytotec- cervical softening and uterine contractions or misoprostol-
detaches pregnancy from uterine wall
3) surgical intervention- D&C
How do you dx hydatidiform mole? tx? - answer>>>- dx- UX- classic snow storm
pattern, no fetus detected, no yolk sac or fetal pole
- fluid filled vesicles in grapelike pattern
- obtain HCG level
, - tx- preferred method is D&C; consider hysterectomy if fertility preservation is not a
concern (tumor must be removed to avoid development of malignancy)
How do you screen for gestational diabetes? How does gestational diabetes get dx? -
answer>>>- 1 hr oral glucose tolerance test should be performed between 24-28 weeks
gestation
- 50 grams oral glucose given and then blood is taken in 1 hr
- if 1 hr test is over 130-140 mg/dL, pt will need to do 3 hr test
- 3 hr glucose tolerance test- fasting glucose taken and then 100g of oral glucose given
and blood is drawn each hour after for 3 hours
- dx- requires at least 2 of the following blood glucose values- fasting, 1 hr, 2 hr, 3 hr
How long does it take to expel products of conception? - answer>>>- 30% expel it within
7 days
- 60% within 14 days
- 75% within 45 days
- patients should monitor for any temp >/= 100.4, chills, saturation of more than 1
pad/hour, or passing large clots greater than golf ball/50 cent piece --> will need to get
D&C procedure
How long is postpartum period? What is puerperium - answer>>>- 6 weeks
- 1st 72 hours of postpartum is known as puerperium
How long is pregnancy? How is it calculated? - answer>>>- 9 calendar months; 40
weeks; 280 days
- measured from the last normal menstrual period (LNMP)
How much additional calories is needed for healthy pregnancy? What are other healthy
nutrition components? - answer>>>- only additional 300 cal needed
- appropriate and timely vitamin and mineral supplementation- avoid lunch meat, unless
steaming hot, avoid all unpasteurized dairy, avoid raw seafood
How often do serum beta HCG levels increase? - answer>>>- should double every 48-
72 hours
- should plateau during weeks 8-10 when HPL takes over
- should double:
- every 1.5 days through week 5
- every 2 days in week 6
- every 2-2.5 days in week 7
How should pregnant patient put on seatbelt? Is sexual activity allowed? - answer>>>-
seatbelt should be either on top or under belly; never across belly
, - sexual activity is okay unless there is premature rupture of membranes, risk of preterm
labor, hypertension, incompetent cervix or multiple pregnancy
If HCG is not doubling every 48-72 hours, what could be the problem? If HCG is higher
than doubling every 48-72 hours, what could be the problem? - answer>>>- not
doubling- loss of pregnancy?
- higher than doubling- multiple pregnancies
Is zofran recommended for morning sickness? risks? - answer>>>- not FDA approved
for morning sickness
- avoid in 1st trimester due to increased risk of heart defects and cardiac malformations
and cleft plate and palate malformations
physiologic dyspnea vs pathologic dyspnea - answer>>>- physiologic dyspnea- SOB,
but normal RR- pregnant women
- pathologic dyspnea- SOB and changes in RR like tachypnea- should NOT occur in
pregnant women
Risk factors of preeclampsia? maternal vs fetal complications? - answer>>>- nulliparity*
- extremes of age <20 or >35
- multiple gestations
- diabetes
- prexisting renal disease
- CHTN
- AA race
-molar pregnancy
- vascular or CT disease
- maternal complications- renal failure, liver failure, cerebral hemorrhage, DIC, abruptio
placentae, emergent operative delivery, death
- fetal complications- oligohydramnios, preterm delivery, IUGR, intrapartum fetal ditress,
stillbirth
s/sx of PE vs s/sx of DVT? tx? - answer>>>- s/sx of PE- dyspnea, palpitations, pleuritic
chest pain, hemoptysis, tachycardia tachypnea, hypotension, collapse
- s/sx of DVT- DVT in pregnancy usually proximal, unilateral leg pain/tenderness,
swelling in extremity, increase calf/thigh circumference, increased temperature,
prominent superficial veins, pitting edema
- tx- REFER TO ED/ER for anticoagulant tx and rest; obtain ux to confirm dx
T/F: any murmurs greater than 2/6 or ANY diastolic murmurs must be evaluated via
referral to cardiology - answer>>>true
T/F: avoid anything that increases core temperature like heating pads, hot tubs, and
ibuprofen - answer>>>true
