OB BULLETS
1. Unlike Unlike false false labor, labor, true labor
. hen hen used used to desc describ ribe e the the
produces regular rhythmic
degree of fetal descent during
contractions, abdominal
labor, 3oating means the
discomfort, progressive descent
presenting part isn"t engaged in
of the fetus, bloody show, and
the pelvic inlet, but is freely
progressive progressive eacement and
movable )ballotable* above the
dilation of the cervix.
pelvic inlet.
2. To help a mother mother break break the the
4. hen hen used used to desc describ ribe e the the
suction of her breastfeeding breastfeeding
degree of fetal descent,
infant, the nurse should teach
engagement means when the
her to insert a !nger at the
largest diameter of the
corner of the infant"s mouth.
presenting part has passed
#. $dminist $dministerin ering g high high level levels s of oxygen to a premature neonate
through the pelvic inlet. 1(.
5etal etal sta stattion ion ind indic icat ates es the the
can cause blindness as a result
location of the presenting part in
of retrolental !broplasia.
relation to the ischial spine. -t"s
%. $mniotomy $mniotomy is arti!ci arti!cial al ruptur rupture e of the amniotic membranes. &. 'uring 'uring pregnanc pregnancy, y, weight weight gain
described as 61, 62, 6#, 6%, or 6& to indicate the number of centimeters above the level of
averages 2& to #( lb )11 to 1#.&
the ischial spine7 station 6& is at
kg*.
the pelvic inlet.
+. ubella ubella has a teratog teratogenic enic eect eect
11.. 11
5etal etal stat statio ion n al also is desc descri ribe bed d
on the fetus during the !rst
as 81, 82, 8#, 8%, or 8& to
trimester. -t produces
indicate the number of
abnormalities in up to %( of
centimeters it is below the level
cases without interrupting the
of the ischial spine7 station ( is
pregnancy.
at the level of the ischial spine.
/. -mmuni -mmunity ty to rube rubella lla can can be
12.
'uri uring tth he !r !rst s sttage of of
measured by a
labor, the sidelying position
hemagglutination inhibition test
usually provides the greatest g reatest
)rubella titer*. This test identi!es
degree of comfort, although the
exposure to rubella infection and
patient may assume any
determines determines susceptibility in
comfortable position.
pregnant women. -n a woman, a
1#.
'uri uring de delivery, if if th the
titer greater than 10 indicates
umbilical cord can"t be loosened
immunity.
and slipped from around the neonate"s neck, it should be
OB BULLETS
clamped with two clamps and
between 1+ and 14 weeks"
cut between the clamps.
gestation.
1%.
$n $p $pgar score of of / to to 1( 1(
indicates no immediate distress, % to + indicates moderate
2(.
Avul Avulat atiion ceases ases dur during ing
pregnancy. 21.
$ny $n y vag vagiinal nal ble bleed ediing dur during
distress, and ( to # indicates
pregnancy should be considered
severe distress.
a complication until proven
1&.. 1&
To eli elici citt 9or 9oro" o"s s re3 re3e ex, the the
nurse holds the neonate in both
otherwise. To To estimate the date of delivery delivery
hands and suddenly, but gently,
using :Bgele"s rule, the nurse
drops the neonate"s head
counts backward # months from
backward. :ormally, the
the !rst day of the last
neonate abducts and extends all
menstrual period and then adds
extremities extremities bilaterally and a nd
/ days to this date.
symmetrically, symmetrically, forms a ; shape
22.
$t 1 12 2 wee weeks ks"" g ges esta tati tion on,, the the
with the thumb and fore!nger,
fundus should be at the top of
and !rst adducts and a nd then 3exes
the symphysis pubis.
the extremities. 1+.
2#.
;ow"s mi milk sh should uldn"t b be e
given to infants younger than
hypertension )preeclampsia* is
age 1 because it has a low
an increase in blood pressure of
linoleic acid content and its
#(=1& mm >g over baseline or
protein is diCcult for infants to
blood pressure of 1%(=4& mm >g
digest.
on two occasions at least +
2%.
-f Daund aundiice is is sus suspe pec cted ted iin na
hours apart accompanied by
neonate, the nurse should
edema and albuminuria after 2(
examine the infant under natural
weeks" gestation.
window light. -f natural light is
1/.
unavailable, the nurse should
include ultrasound evidence,
examine the infant under a
fetal heart tones, and fetal
white light.
movement felt by the examiner
2&.
The The thr thre ee pha phase ses s of of a uter uteriine
)not usually present until %
contraction are increment, increment,
months" gestation
acme, and decrement. decrement.
1.. 1
?ood ?oodel ell" l"s s sign sign is sof softeni tening ng of
the cervix. 14.
@uick uicke ening ning,, a pr presu sump mpttive
sign of pregnancy, occurs
2+.
The in intensity of of a labor
contraction can be assessed by the indentability of the uterine wall at the contraction"s peak.
OB BULLETS
-ntensity is graded as mild
station 61 or lower, so that a
)uterine muscle is somewhat
small electrode can be attached.
tense*, moderate )uterine
#2.
5etal alcohol syndrome
muscle is moderately tense*, or
presents in the !rst 2% hours
strong )uterine muscle is
after birth and produces
boardlike*.
lethargy, seiHures, poor sucking
2/.
;hloasma, the mask of
pregnancy, is pigmentation of a circumscribed area of skin
re3ex, abdominal distention, and respiratory diCculty. ##.
Fariability is any change in
)usually over the bridge of the
the fetal heart rate )5>* from
nose and cheeks* that occurs in
its normal rate of 12( to 1+(
some pregnant women.
beats=minute. $cceleration is
2.
The gynecoid pelvis is most
ideal for delivery. Ather types include platypelloid )3at*,
increased 5>7 deceleration is decreased 5>. #%.
-n a neonate, the symptoms
anthropoid )apelike*, and
of heroin withdrawal may begin
android )malelike*.
several hours to % days after
24.
advised that there is no safe level of alcohol intake. #(.
The freEuency of uterine
contractions, which is measured in minutes, is the time from the
birth. #&.
-n a neonate, the symptoms
of methadone withdrawal may begin / days to several weeks after birth. #+.
-n a neonate, the cardinal
beginning of one contraction to
signs of narcotic withdrawal
the beginning of the next.
include coarse, 3apping tremors7
#1.
Fitamin G is administered to
sleepiness7 restlessness7
neonates to prevent
prolonged, persistent, high
hemorrhagic disorders because
pitched cry7 and irritability.
a neonate"s intestine can"t
#/.
The nurse should count a
synthesiHe vitamin G.
neonate"s respirations for 1 full
Iefore internal fetal monitoring
minute.
can be performed, a pregnant
#.
;hlorpromaHine )ThoraHine*
patient"s cervix must be dilated
is used to treat neonates who
at least 2 cm, the amniotic
are addicted to narcotics.
membranes must be ruptured, and the fetus"s presenting part )scalp or buttocks* must be at
#4.
The nurse should provide a
dark, Euiet environment for a
OB BULLETS
neonate who is experiencing
speci!cally, days 1% to &+ of
narcotic withdrawal.
gestation.
%(.
-n a premature neonate,
%/.
$fter birth, the neonate"s
signs of respiratory distress
umbilical cord is tied 1N )2.& cm*
include nostril 3aring, substernal
from the abdominal wall with a
retractions, and inspiratory
cotton cord, plastic clamp, or
grunting.
rubber band.
%1.
espiratory distress
%.
?ravida is the number of
syndrome )hyaline membrane
pregnancies a woman has had,
disease* develops in premature
regardless of outcome.
infants because their pulmonary
%4.
alveoli lack surfactant.
pregnancies that reached
henever an infant is being put
viability, regardless of whether
down to sleep, the parent or
the fetus was delivered alive or
caregiver should position the
stillborn. $ fetus is considered
infant on the back. )emember
viable at 2( weeks" gestation.
back to sleep.*
$n ectopic pregnancy is one that
%2.
The male sperm contributes
an J or a K chromosome7 the female ovum contributes an J chromosome. %#.
5ertiliHation produces a total
of %+ chromosomes, including an JK combination )male* or an JJ combination )female*. %%.
The percentage of water in a
neonate"s body is about / to (. %&.
To perform nasotracheal
implants abnormally, outside the uterus. &(.
The !rst stage of labor
begins with the onset of labor and ends with full cervical dilation at 1( cm. &1.
The second stage of labor
begins with full cervical dilation and ends with the neonate"s birth. &2.
The third stage of labor
begins after the neonate"s birth
suctioning in an infant, the nurse
and ends with expulsion of the
positions the infant with his neck
placenta.
slightly hyperextended in a
-n a fullterm neonate, skin
LsniCngM position, with his chin
creases appear over twothirds
up and his head tilted back
of the neonate"s feet.
slightly.
neonates have heel creases that
%+.
Arganogenesis occurs during
the !rst trimester of pregnancy,
cover less than twothirds of the feet.
OB BULLETS
&#.
The fourth stage of labor
+#.
'uring the transition phase
)postpartum stabiliHation* lasts
of the !rst stage of labor, the
up to % hours after the placenta
cervix is dilated to 1( cm and
is delivered. This time is needed
contractions usually occur 2 to #
to stabiliHe the mother"s physical
minutes apart and last for +(
and emotional state after the
seconds.
stress of childbirth. &%.
$t 2( weeks" gestation, the
+%.
$ nonstress test is considered
nonreactive )positive* if fewer
fundus is at the level of the
than two fetal heart rate
umbilicus.
accelerations of at least 1&
&&.
$t #+ weeks" gestation, the
fundus is at the lower border of the rib cage. &+.
$ premature neonate is one
beats=minute occur in 2( minutes. +&.
$ nonstress test is considered
reactive )negative* if two or
born before the end of the #/th
more fetal heart rate
week of gestation.
accelerations of 1& beats=minute
&/.
hypertension is a leading cause of maternal death in the United Otates. &.
$ habitual aborter is a
above baseline occur in 2( minutes. ++.
$ nonstress test is usually
performed to assess fetal well being in a pregnant patient with
woman who has had three or
a prolonged pregnancy )%2
more consecutive spontaneous
weeks or more*, diabetes, a
abortions.
history of poor pregnancy
&4.
Threatened abortion occurs
when bleeding is present without cervical dilation. +(.
$ complete abortion occurs
when all products of conception are expelled. +1.
>ydramnios
outcomes, or pregnancyinduced hypertension. +/.
$ pregnant woman should
drink at least eight oH glasses )about 2,((( ml* of water daily. +.
hen both breasts are used
for breastfeeding, the infant
)polyhydramnios* is excessive
usually doesn"t empty the
amniotic 3uid )more than 2,(((
second breast. Therefore, the
ml in the third trimester*.
second breast should be used
+2.
Otress, dehydration, and
fatigue may reduce a breast feeding mother"s milk supply.
!rst at the next feeding.
OB BULLETS
+4.
$ lowbirthweight neonate
//.
-n partial )incomplete or
weighs 2,&(( g )& lb oH* or less
marginal* placenta previa, the
at birth.
placenta covers only a portion of
/(.
$ verylowbirthweight
neonate weighs 1,&(( g )# lb & oH* or less at birth. /1.
the cervical os. /.
$bruptio placentae is
premature separation of a
hen teaching parents to
normally implanted placenta. -t
provide umbilical cord care, the
may be partial or complete, and
nurse should teach them to
usually causes abdominal pain,
clean the umbilical area with a
vaginal bleeding, and a
cotton ball saturated with
boardlike abdomen.
alcohol after every diaper
/4.
;utis marmorata is mottling
change to prevent infection and
or purple discoloration of the
promote drying.
skin. -t"s a transient vasomotor
/2.
Teenage mothers are more
response that occurs primarily in
likely to have lowbirthweight
the arms and legs of infants who
neonates because they seek
are exposed to cold.
prenatal care late in pregnancy
(.
The classic triad of symptoms
)as a result of denial* and are
of preeclampsia are
more likely than older mothers
hypertension, edema, and
to have nutritional de!ciencies.
proteinuria. $dditional
/#.
Pinea nigra, a dark line that
symptoms of severe
extends from the umbilicus to
preeclampsia include
the mons pubis, commonly
hyperre3exia, cerebral and
appears during pregnancy and
vision disturbances, and
disappears after pregnancy.
epigastric pain.
/%.
-mplantation in the uterus
1.
Artolani"s sign )an audible
occurs + to 1( days after ovum
click or palpable Derk that occurs
fertiliHation.
with thigh abduction* con!rms
/&.
low implantation of the placenta so that it encroaches on or covers the cervical os. /+.
-n complete )total* placenta
previa, the placenta completely covers the cervical os.
congenital hip dislocation in a neonate. 2.
The !rst immuniHation for a
neonate is the hepatitis I vaccine, which is administered in the nursery shortly after birth. #.
-f a patient misses a
menstrual period while taking an
OB BULLETS
oral contraceptive exactly as
4(.
'rugs used to treat
prescribed, she should continue
withdrawal symptoms in
taking the contraceptive.
neonates include phenobarbital
%.
-f a patient misses two
)Puminal*, camphorated opium
consecutive menstrual periods
tincture )paregoric*, and
while taking an oral
diaHepam )Falium*.
contraceptive, she should
41.
-nfants with 'own syndrome
discontinue the contraceptive
typically have marked
and take a pregnancy test.
hypotonia, 3oppiness, slanted
&.
-f a patient who is taking an
eyes, excess skin on the back of
oral contraceptive misses a
the neck, 3attened bridge of the
dose, she should take the pill as
nose, 3at facial features,
soon as she remembers or take
spadelike hands, short and
two at the next scheduled
broad feet, small male genitalia,
interval and continue with the
absence of 9oro"s re3ex, and a
normal schedule.
simian crease on the hands.
+.
-f a patient who is taking an
42.
The failure rate of a
oral contraceptive misses two
contraceptive is determined by
consecutive doses, she should
the experience of 1(( women
double the dose for 2 days and
for 1 year. -t"s expressed as
then resume her normal
pregnancies per 1(( woman
schedule. Ohe also should use an
years.
additional birth control method for 1 week. /.
Qclampsia is the occurrence
of seiHures that aren"t caused by a cerebral disorder in a patient
4#.
The narrowest diameter of
the pelvic inlet is the anteroposterior )diagonal conDugate*. 4%.
The chorion is the outermost
who has pregnancyinduced
extraembryonic membrane that
hypertension.
gives rise to the placenta.
.
-n placenta previa, bleeding
is painless and seldom fatal on the !rst occasion, but it
4&.
The corpus luteum secretes
large Euantities of progesterone. 4+.
5rom the th week of
becomes heavier with each
gestation through delivery, the
subseEuent episode.
developing cells are known as a
4.
Treatment for abruptio
placentae is usually immediate cesarean delivery.
fetus. 4/.
-n an incomplete abortion,
the fetus is expelled, but parts of
OB BULLETS
the placenta and membrane remain in the uterus. 4.
The circumference of a
neonate"s head is normally 2 to # cm greater than the circumference of the chest. 44.
$fter administering
1(&. The neonatal period extends from birth to day 2. -t"s also called the !rst % weeks or !rst month of life. 1(+. $ woman who is breast feeding should rub a mild emollient cream or a few drops
magnesium sulfate to a
of breast milk )or colostrum* on
pregnant patient for
the nipples after each feeding.
hypertension or preterm labor,
Ohe should let the breasts air
the nurse should monitor the
dry to prevent them from
respiratory rate and deep
cracking.
tendon re3exes. 1((. 'uring the !rst hour after
1(/. Ireastfeeding mothers should increase their 3uid intake
birth )the period of reactivity*,
to 2R to # Et )2,&(( to #,((( ml*
the neonate is alert and awake.
daily.
1(1. hen a pregnant patient has
1(. $fter feeding an infant with a
undiagnosed vaginal bleeding,
cleft lip or palate, the nurse
vaginal examination should be
should rinse the infant"s mouth
avoided until ultrasonography
with sterile water.
rules out placenta previa. 1(2. $fter delivery, the !rst
1(4. The nurse instills erythromycin in a neonate"s
nursing action is to establish the
eyes primarily to prevent
neonate"s airway.
blindness caused by gonorrhea
1(#. :ursing interventions for a patient with placenta previa
or chlamydia. 11(. >uman immunode!ciency
include positioning the patient
virus )>-F* has been cultured in
on her left side for maximum
breast milk and can be
fetal perfusion, monitoring fetal
transmitted by an >-Fpositive
heart tones, and administering
mother who breastfeeds her
-.F. 3uids and oxygen, as
infant.
ordered. 1(%. The speci!c gravity of a
111. $ fever in the !rst 2% hours postpartum is most likely caused
neonate"s urine is 1.((# to
by dehydration rather than
1.(#(. $ lower speci!c gravity
infection.
suggests overhydration7 a higher one suggests dehydration.
112.
OB BULLETS
skin temperature of at least
true conDugate of 1(.& cm
4/.+S 5 )#+.%S ;* should receive
enables the fetal head )usually
care in an incubator )-solette* or
1( cm* to pass.
a radiant warmer. -n a radiant
12(. The smallest outlet
warmer, a heatsensitive probe
measurement of the pelvis is the
taped to the neonate"s skin
intertuberous diameter, which is
activates the heater unit
the transverse diameter
automatically to maintain the
between the ischial tuberosities.
desired temperature. 11#. 'uring labor, the resting
121. Qlectronic fetal monitoring is used to assess fetal wellbeing
phase between contractions is at
during labor. -f compromised
least #( seconds.
fetal status is suspected, fetal
11%. Pochia rubra is the vaginal
blood p> may be evaluated by
discharge of almost pure blood
obtaining a scalp sample.
that occurs during the !rst few
122. -n an emergency delivery,
days after childbirth. 11&. Pochia serosa is the serous
enough pressure should be applied to the emerging fetus"s
vaginal discharge that occurs %
head to guide the descent and
to / days after childbirth.
prevent a rapid change in
11+. Pochia alba is the vaginal discharge of decreased blood and increased leukocytes that"s
pressure within the molded fetal skull. 12#. $fter delivery, a multiparous
the !nal stage of lochia. -t
woman is more susceptible to
occurs / to 1( days after
bleeding than a primiparous
childbirth.
woman because her uterine
11/. ;olostrum, the precursor of milk, is the !rst secretion from the breasts after delivery. 11. The length of the uterus
muscles may be overstretched and may not contract eCciently. 12%. :eonates who are delivered by cesarean birth have a higher
increases from 2RM )+.# cm*
incidence of respiratory distress
before pregnancy to 12RM )#2
syndrome.
cm* at term. 114. To estimate the true
12&. The nurse should suggest ambulation to a postpartum
conDugate )the smallest inlet
patient who has gas pain and
measurement of the pelvis*,
3atulence.
deduct 1.& cm from the diagonal conDugate )usually 12 cm*. $
OB BULLETS
12+. 9assaging the uterus helps
1#&. $ mother should allow her
to stimulate contractions after
infant to breastfeed until the
the placenta is delivered.
infant is satis!ed. The time may
12/. hen providing phototherapy
vary from & to 2( minutes.
to a neonate, the nurse should
1#+. :itraHine paper is used to
cover the neonate"s eyes and
test the p> of vaginal discharge
genital area.
to determine the presence of
12. The narcotic antagonist naloxone ):arcan* may be given
amniotic 3uid. 1#/. $ pregnant patient normally
to a neonate to correct
gains 2 to & lb )1 to 2.& kg*
respiratory depression caused
during the !rst trimester and
by narcotic administration to the
slightly less than 1 lb )(.& kg*
mother during labor.
per week during the last two
124. -n a neonate, symptoms of
trimesters.
respiratory distress syndrome
1#. :eonatal Daundice in the !rst
include expiratory grunting or
2% hours after birth is known as
whining, sandpaper breath
pathological Daundice and is a
sounds, and seesaw retractions.
sign of erythroblastosis fetalis.
1#(. ;erebral palsy presents as
1#4. $ classic dierence between
asymmetrical movement,
abruptio placentae and placenta
irritability, and excessive, feeble
previa is the degree of pain.
crying in a long, thin infant.
$bruptio placentae causes pain,
1#1. The nurse should assess a
whereas placenta previa causes
breechbirth neonate for hydrocephalus, hematomas,
painless bleeding. 1%(. Iecause a maDor role of the
fractures, and other anomalies
placenta is to function as a fetal
caused by birth trauma.
lung, any condition that
1#2. hen a patient is admitted to
interrupts normal blood 3ow to
the unit in active labor, the
or from the placenta increases
nurse"s !rst action is to listen for
fetal partial pressure of arterial
fetal heart tones.
carbon dioxide and decreases
1##. -n a neonate, long, brittle !ngernails are a sign of postmaturity. 1#%. 'esEuamation )skin peeling* is common in postmature neonates.
fetal p>. 1%1.
OB BULLETS
agent used to prevent and treat
1%4. >ighsodium foods can cause
postpartum hemorrhage caused
3uid retention, especially in
by uterine atony or
pregnant patients.
subinvolution. 1%#. $s emergency treatment for excessive uterine bleeding, (.2 mg of methylergonovine
1&(. $ pregnant patient can avoid constipation and hemorrhoids by adding !ber to her diet. 1&1. -f a fetus has late
)9ethergine* is inDected -.F. over
decelerations )a sign of fetal
1 minute while the patient"s
hypoxia*, the nurse should
blood pressure and uterine
instruct the mother to lie on her
contractions are monitored.
left side and then administer
1%%. Iraxton >icks contractions
to 1( P of oxygen per minute by
are usually felt in the abdomen
mask or cannula. The nurse
and don"t cause cervical change.
should notify the physician. The
True labor contractions are felt in
sidelying position removes
the front of the abdomen and
pressure on the inferior vena
back and lead to progressive
cava.
cervical dilation and eacement. 1%&. The average birth weight of neonates born to mothers who smoke is + oH )1/( g* less than
1&2. Axytocin )
that of neonates born to
body until about 2( weeks"
nonsmoking mothers.
gestation. Then it begins to
1%+. ;uldoscopy is visualiHation of the pelvic organs through the posterior vaginal fornix. 1%/. The nurse should teach a
disappear from the face, trunk, arms, and legs, in that order. 1&%. -n a neonate, hypoglycemia causes temperature instability,
pregnant vegetarian to obtain
hypotonia, Ditteriness, and
protein from alternative sources,
seiHures.
such as nuts, soybeans, and
postmature, smallfor
legumes.
gestationalage, and largefor
1%. The nurse should instruct a
gestationalage neonates are
pregnant patient to take only
susceptible to this disorder.
prescribed prenatal vitamins
1&&. :eonates typically need to
because overthecounter high
consume &( to && cal per pound
potency vitamins may harm the
of body weight daily.
fetus.
OB BULLETS
1&+. Iecause oxytocin )
neonate to help her come to terms with the death. 1+%. 9olding is the process by
must be administered under
which the fetal head changes
close observation to help
shape to facilitate movement
prevent maternal and fetal
through the birth canal.
distress. 1&/. 'uring fetal heart rate
1+&. -f a woman receives a spinal block before delivery, the nurse
monitoring, variable
should monitor the patient"s
decelerations indicate
blood pressure closely.
compression or prolapse of the umbilical cord. 1&. ;ytomegalovirus is the
1++. -f a woman suddenly becomes hypotensive during labor, the nurse should increase
leading cause of congenital viral
the infusion rate of -.F. 3uids as
infection.
prescribed.
1&4. Tocolytic therapy is indicated
1+/. The best techniEue for
in premature labor, but
assessing Daundice in a neonate
contraindicated in fetal death,
is to blanch the tip of the nose
fetal distress, or severe
or the area Dust above the
hemorrhage.
umbilicus.
1+(. Through ultrasonography, the
1+. 'uring fetal heart
biophysical pro!le assesses fetal
monitoring, early deceleration is
wellbeing by measuring fetal
caused by compression of the
breathing movements, gross
head during labor.
body movements, fetal tone,
1+4. $fter the placenta is
reactive fetal heart rate
delivered, the nurse may add
)nonstress test*, and Eualitative
oxytocin )
amniotic 3uid volume.
patient"s -.F. solution, as
1+1. $ neonate whose mother has
prescribed, to promote
diabetes should be assessed for
postpartum involution of the
hyperinsulinism.
uterus and stimulate lactation.
1+2. -n a patient with
1/(.
preeclampsia, epigastric pain is
nonfood items, such as dirt,
a late symptom and reEuires
crayons, chalk, glue, starch, or
immediate medical intervention.
hair. -t may occur during
1+#. $fter a stillbirth, the mother should be allowed to hold the
pregnancy and can endanger the fetus.
OB BULLETS
1/1. $ pregnant patient should
anomalies noted, and the risks
take folic acid because this
clearly outweigh the potential
nutrient is reEuired for rapid cell
bene!ts.
division. 1/2. $ woman who is taking
1/+. $ patient with a ruptured ectopic pregnancy commonly
clomiphene );lomid* to induce
has sharp pain in the lower
ovulation should be informed of
abdomen, with spotting and
the possibility of multiple births
cramping. Ohe may have
with this drug.
abdominal rigidity7 rapid,
1/#. -f needed, cervical suturing is usually done between 1% and 1 weeks" gestation to reinforce an
shallow respirations7 tachycardia7 and shock. 1//. $ patient with a ruptured
incompetent cervix and maintain
ectopic pregnancy commonly
pregnancy. The suturing is
has sharp pain in the lower
typically removed by #& weeks"
abdomen, with spotting and
gestation.
cramping. Ohe may have
'uring the !rst trimester, a
abdominal rigidity7 rapid,
pregnant woman should avoid
shallow respirations7
all drugs unless doing so would
tachycardia7 and shock.
adversely aect her health. 1/%. 9ost drugs that a breast
1/. The mechanics of delivery are engagement, descent and
feeding mother takes appear in
3exion, internal rotation,
breast milk.
extension, external rotation,
1/&. The 5ood and 'rug $dministration has established
restitution, and expulsion. 1/4. $ probable sign of
the following !ve categories of
pregnancy, 9c'onald"s sign is
drugs based on their potential
characteriHed by an ease in
for causing birth defects0 $, no
3exing the body of the uterus
evidence of risk7 I, no risk found
against the cervix.
in animals, but no studies have been done in women7 ;, animal studies have shown an adverse
1(. $menorrhea is a probable sign of pregnancy. 11. $ pregnant woman"s partner
eect, but the drug may be
should avoid introducing air into
bene!cial to women despite the
the vagina during oral sex
potential risk7 ', evidence of
because of the possibility of air
risk, but its bene!ts may
embolism.
outweigh its risks7 and J, fetal
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12. The presence of human chorionic gonadotropin in the blood or urine is a probable sign
14(. Otrabismus is a normal !nding in a neonate. 141. $ postpartum patient may
of pregnancy.
resume sexual intercourse after
adiography isn"t usually used in
the perineal or uterine wounds
a pregnant woman because it
heal )usually within % weeks
may harm the developing fetus.
after delivery*.
-f radiography is essential, it
142. $ pregnant sta member
should be performed only after
shouldn"t be assigned to work
#+ weeks" gestation.
with a patient who has
1#. $ pregnant patient who has
cytomegalovirus infection
had rupture of the membranes
because the virus can be
or who is experiencing vaginal
transmitted to the fetus.
bleeding shouldn"t engage in sexual intercourse. 1%. 9ilia may occur as pinpoint spots over a neonate"s nose. 1&. The duration of a contraction is timed from the moment that the uterine muscle begins to
14#. 5etal demise is death of the fetus after viability. 14%. espiratory distress syndrome develops in premature neonates because their alveoli lack surfactant. 14&. The most common method of
tense to the moment that it
inducing labor after arti!cial
reaches full relaxation. -t"s
rupture of the membranes is
measured in seconds.
oxytocin )
1+. The union of a male and a
14+. $fter the amniotic
female gamete produces a
membranes rupture, the initial
Hygote, which divides into the
nursing action is to assess the
fertiliHed ovum.
fetal heart rate.
1/. The !rst menstrual 3ow is
14/. The most common reasons
called menarche and may be
for cesarean birth are
anovulatory )infertile*.
malpresentation, fetal distress,
1. OpermatoHoa )or their
cephalopelvic disproportion,
fragments* remain in the vagina
pregnancyinduced
for /2 hours after sexual
hypertension, previous cesarean
intercourse.
birth, and inadeEuate progress
14.
in labor. 14. $mniocentesis increases the risk of spontaneous abortion,
OB BULLETS
trauma to the fetus or placenta,
maternal antibodies attached to
premature labor, infection, and
red blood cells in the neonate.
h sensitiHation of the fetus. 144. $fter amniocentesis,
2(+. :ausea and vomiting during the !rst trimester of pregnancy
abdominal cramping or
are caused by rising levels of the
spontaneous vaginal bleeding
hormone human chorionic
may indicate complications.
gonadotropin.
2((. To prevent her from
2(/. Iefore discharging a patient
developing h antibodies, an h
who has had an abortion, the
negative primigravida should
nurse should instruct her to
receive ho)'* immune globulin
report bright red clots, bleeding
)ho?$9* after delivering an h
that lasts longer than / days, or
positive neonate.
signs of infection, such as a
2(1. -f a pregnant patient"s test
temperature of greater than
results are negative for glucose
1((S 5 )#/.S ;*, foulsmelling
but positive for acetone, the
vaginal discharge, severe
nurse should assess the
uterine cramping, nausea, or
patient"s diet for inadeEuate
vomiting.
caloric intake. 2(2. -f a pregnant patient"s test
2(. hen informed that a patient"s amniotic membrane
results are negative for glucose
has broken, the nurse should
but positive for acetone, the
check fetal heart tones and then
nurse should assess the
maternal vital signs.
patient"s diet for inadeEuate caloric intake. 2(#. ubella infection in a pregnant patient, especially during the !rst trimester, can
2(4. The duration of pregnancy averages 2( days, %( weeks, 4 calendar months, or 1( lunar months. 21(. The initial weight loss for a
lead to spontaneous abortion or
healthy neonate is & to 1( of
stillbirth as well as fetal cardiac
birth weight.
and other birth defects. 2(%. $ pregnant patient should take an iron supplement to help prevent anemia. 2(&. 'irect antiglobulin )direct ;oombs"* test is used to detect
211. The normal hemoglobin value in neonates is 1/ to 2( g=dl. 212. ;rowning is the appearance of the fetus"s head when its largest diameter is encircled by the vulvovaginal ring.
OB BULLETS
21#. $ multipara is a woman who
higher in these infants than in
has had two or more
those born to nondiabetic
pregnancies that progressed to
women.
viability, regardless of whether the ospring were alive at birth. 21%. -n a pregnant patient,
214. Okeletal system abnormalities and ventricular septal defects are the most
preeclampsia may progress to
common disorders of infants
eclampsia, which is
who are born to diabetic women.
characteriHed by seiHures and may lead to coma. 21&. The $pgar score is used to
The incidence of congenital malformation is three times higher in these infants than in
assess the neonate"s vital
those born to nondiabetic
functions. -t"s obtained at 1
women.
minute and & minutes after
22(. The patient with
delivery. The score is based on
preeclampsia usually has
respiratory eort, heart rate,
puCness around the eyes or
muscle tone, re3ex irritability,
edema in the hands )for
and color.
example, L- can"t put my
21+. Iecause of the antiinsulin eects of placental hormones,
wedding ring on.M*. 221. Gegel exercises reEuire
insulin reEuirements increase
contraction and relaxation of the
during the third trimester.
perineal muscles. These
21/. ?estational age can be
exercises help strengthen pelvic
estimated by ultrasound
muscles and improve urine
measurement of maternal
control in postpartum patients.
abdominal circumference, fetal
222. Oymptoms of postpartum
femur length, and fetal head
depression range from mild
siHe. These measurements are
postpartum blues to intense,
most accurate between 12 and
suicidal, depressive psychosis.
1 weeks" gestation. 21. Okeletal system
22#. The preterm neonate may reEuire gavage feedings
abnormalities and ventricular
because of a weak sucking
septal defects are the most
re3ex, uncoordinated sucking, or
common disorders of infants
respiratory distress.
who are born to diabetic women. The incidence of congenital malformation is three times
22%. $crocyanosis )blueness and coolness of the arms and legs* is normal in neonates because of
OB BULLETS
their immature peripheral circulatory system. 22&. To prevent ophthalmia neonatorum )a severe eye infection caused by maternal
2#2. -f the neonate is stable, the mother should be allowed to breastfeed within the neonate"s !rst hour of life. 2##. The nurse should check the
gonorrhea*, the nurse may
neonate"s temperature every 1
administer one of three drugs,
to 2 hours until it"s maintained
as prescribed, in the neonate"s
within normal limits.
eyes0 tetracycline, silver nitrate,
$t birth, a neonate normally
or erythromycin.
weighs & to 4 lb )2 to % kg*,
:eonatal testing for
measures 1N to 22N )%&.& to &+
phenylketonuria is mandatory in
cm* in length, has a head
most states.
circumference of 1#RM to 1%N
22+. The nurse should place the neonate in a #(degree Trendelenburg position to facilitate mucus drainage. 22/. The nurse may suction the
)#% to #&.& cm*, and has a chest circumference that"s 1N )2.& cm* less than the head circumference. 2#%. -n the neonate, temperature
neonate"s nose and mouth as
normally ranges from 4S to 44S
needed with a bulb syringe or
5 )#+./S to #/.2S ;*, apical pulse
suction trap.
rate averages 12( to 1+(
22. To prevent heat loss, the nurse should place the neonate under a radiant warmer during
beats=minute, and respirations are %( to +( breaths=minute. 2#&. The diamondshaped anterior
suctioning and initial delivery
fontanel usually closes between
room care, and then wrap the
ages 12 and 1 months. The
neonate in a warmed blanket for
triangular posterior fontanel
transport to the nursery.
usually closes by age 2 months.
224. The umbilical cord normally has two arteries and one vein. 2#(. hen providing care, the nurse should expose only one part of an infant"s body at a time. 2#1. Pightening is settling of the
2#+. -n the neonate, a straight spine is normal. $ tuft of hair over the spine is an abnormal !nding. 2#/.
fetal head into the brim of the
before labor induction with
pelvis.
oxytocin )
OB BULLETS
2#. Oupernumerary nipples are occasionally seen on neonates. They usually appear along a line that runs from each axilla,
2%%. 9ongolian spots are common in nonwhite infants and usually disappear by age 2 to # years. 2%&. Fernix caseosa is a
through the normal nipple area,
cheeselike substance that
and to the groin.
covers and protects the fetus"s
2#4. 9econium is a material that
skin in utero. -t may be rubbed
collects in the fetus"s intestines
into the neonate"s skin or
and forms the neonate"s !rst
washed away in one or two
feces, which are black and tarry.
baths.
2%(. The presence of meconium in
2%+. ;aput succedaneum is
the amniotic 3uid during labor
edema that develops in and
indicates possible fetal distress
under the fetal scalp during
and the need to evaluate the
labor and delivery. -t resolves
neonate for meconium
spontaneously and presents no
aspiration.
danger to the neonate. The
2%1. To assess a neonate"s rooting re3ex, the nurse touches a !nger to the cheek or the corner
edema doesn"t cross the suture line. 2%/. :evus 3ammeus, or port
of the mouth. :ormally, the
wine stain, is a diuse pink to
neonate turns his head toward
dark bluish red lesion on a
the stimulus, opens his mouth,
neonate"s face or neck.
and searches for the stimulus. 2%2. >arleEuin sign is present
2%. The ?uthrie test )a screening test for phenylketonuria* is most
when a neonate who is lying on
reliable if it"s done between the
his side appears red on the
second and sixth days after birth
dependent side and pale on the
and is performed after the
upper side.
neonate has ingested protein.
2%#. 9ongolian spots can range
2%4. To assess coordination of
from brown to blue. Their color
sucking and swallowing, the
depends on how close
nurse should observe the
melanocytes are to the surface
neonate"s !rst breastfeeding or
of the skin. They most
sterile water bottlefeeding.
commonly appear as patches
2&(. To establish a milk supply
across the sacrum, buttocks,
pattern, the mother should
and legs.
breastfeed her infant at least every % hours. 'uring the !rst
OB BULLETS
month, she should breastfeed
2&/. ;ommon complications of
to 12 times daily )demand
early pregnancy )up to 2(
feeding*.
weeks" gestation* include fetal
2&1. To avoid contact with blood and other body 3uids, the nurse should wear gloves when
loss and serious threats to maternal health. 2&. 5etal embodiment is a
handling the neonate until after
maternal developmental task
the !rst bath is given.
that occurs in the second
2&2. -f a breastfed infant is
trimester. 'uring this stage, the
content, has good skin turgor,
mother may complain that she
an adeEuate number of wet
never gets to sleep because the
diapers, and normal weight gain,
fetus always gives her a thump
the mother"s milk supply is
when she tries.
assumed to be adeEuate.
2&4. FisualiHation in pregnancy is
2&#. -n the supine position, a
a process in which the mother
pregnant patient"s enlarged
imagines what the child she"s
uterus impairs venous return
carrying is like and becomes
from the lower half of the body
acEuainted with it.
to the heart, resulting in supine
2+(. >emodilution of pregnancy is
hypotensive syndrome, or
the increase in blood volume
inferior vena cava syndrome.
that occurs during pregnancy.
2&%. Tocolytic agents used to treat
The increased volume consists
preterm labor include
of plasma and causes an
terbutaline )Irethine*, ritodrine
imbalance between the ratio of
)Kutopar*, and magnesium
red blood cells to plasma and a
sulfate.
resultant decrease in
2&&. $ pregnant woman who has hyperemesis gravidarum may
hematocrit. 2+1. 9ean arterial pressure of
reEuire hospitaliHation to treat
greater than 1(( mm >g after
dehydration and starvation.
2( weeks of pregnancy is
2&+. 'iaphragmatic hernia is one
considered hypertension.
of the most urgent neonatal
2+2. The treatment for supine
surgical emergencies. Iy
hypotension syndrome )a
compressing and displacing the
condition that sometimes occurs
lungs and heart, this disorder
in pregnancy* is to have the
can cause respiratory distress
patient lie on her left side.
shortly after birth.
OB BULLETS
2+#. $ contributing factor in dependent edema in the pregnant patient is the increase
regulatory, and respiratory systems. 2/(. Abstetric data can be
of femoral venous pressure from
described by using the 5=T<$P
1( mm >g )normal* to 1 mm
system0
>g )high*.
5=T0 5ullterm delivery at #
2+%. >yperpigmentation of the
weeks or longer
pregnant patient"s face, formerly
<0
called chloasma and now
and #/ weeks
referred to as melasma, fades
$0 $bortion or loss of fetus
after delivery.
before 2( weeks
2+&. The hormone relaxin, which
P0 :umber of children living )if a
is secreted !rst by the corpus
child has died, further
luteum and later by the
explanation is needed to clarify
placenta, relaxes the connective
the discrepancy in numbers*.
tissue and cartilage of the
2/1.
symphysis pubis and the
number of infants delivered,
sacroiliac Doint to facilitate
only the number of deliveries.
passage of the fetus during delivery. 2++.
2/2. omen who are carrying more than one fetus should be encouraged to gain #& to %& lb
integrity of the pregnancy by
)1&.& to 2(.& kg* during
inhibiting uterine motility.
pregnancy.
2+/. Padin"s sign, an early
2/#. The recommended amount of
indication of pregnancy, causes
iron supplement for the
softening of a spot on the
pregnant patient is #( to +( mg
anterior portion of the uterus,
daily.
Dust above the uterocervical Duncture. 2+. 'uring pregnancy, the
2/%. 'rinking six alcoholic beverages a day or a single episode of binge drinking in the
abdominal line from the
!rst trimester can cause fetal
symphysis pubis to the
alcohol syndrome.
umbilicus changes from linea
;horionic villus sampling is
alba to linea nigra.
performed at to 12 weeks of
2+4. -n neonates, cold stress aects the circulatory,
pregnancy for early identi!cation of genetic defects.
OB BULLETS
2/&. -n percutaneous umbilical blood sampling, a blood sample is obtained from the umbilical
21. The maDor cause of uterine atony is a full bladder. 22. -f the mother wishes to
cord to detect anemia, genetic
breastfeed, the neonate should
defects, and blood
be nursed as soon as possible
incompatibility as well as to
after delivery.
assess the need for blood transfusions. 2/+. The period between
2#. $ smacking sound, milk dripping from the side of the mouth, and sucking noises all
contractions is referred to as the
indicate improper placement of
interval, or resting phase. 'uring
the infant"s mouth over the
this phase, the uterus and
nipple.
placenta !ll with blood and allow
2%. Iefore feeding is initiated, an
for the exchange of oxygen,
infant should be burped to expel
carbon dioxide, and nutrients.
air from the stomach.
2//. -n a patient who has
2&. 9ost authorities strongly
hypertonic contractions, the
encourage the continuation of
uterus doesn"t have an
breastfeeding on both the
opportunity to relax and there is
aected and the unaected
no interval between
breast of patients with mastitis.
contractions. $s a result, the
2+. :eonates are nearsighted
fetus may experience hypoxia or
and focus on items that are held
rapid delivery may occur.
1(N to 12N )2& to #(.& cm* away.
2/. Two Eualities of the
2/. -n a neonate, lowset ears are
myometrium are elasticity,
associated with chromosomal
which allows it to stretch yet
abnormalities such as 'own
maintain its tone, and
syndrome.
contractility, which allows it to
2. 9econium is usually passed
shorten and lengthen in a
in the !rst 2% hours7 however,
synchroniHed pattern.
passage may take up to /2
2/4. 'uring crowning, the presenting part of the fetus
hours. 24. Ioys who are born with
remains visible during the
hypospadias shouldn"t be
interval between contractions.
circumcised at birth because the
2(. Uterine atony is failure of the uterus to remain !rmly contracted.
foreskin may be needed for constructive surgery.
OB BULLETS
24(. -n the neonate, the normal blood glucose level is %& to 4( mg=dl. 241. >epatitis I vaccine is usually given within % hours of birth.
24. To obtain an estriol level, urine is collected for 2% hours. 244. $n estriol level is used to assess fetal wellbeing and maternal renal functioning as
242. >epatitis I immune globulin
well as to monitor a pregnancy
is usually given within 12 hours
that"s complicated by diabetes.
of birth. 24#. >QPP< )hemolysis, elevated liver enHymes, and low platelets* syndrome is an unusual
#((. $ pregnant patient with vaginal bleeding shouldn"t have a pelvic examination. #(1. -n the early stages of
variation of pregnancyinduced
pregnancy, the !nding of
hypertension.
glucose in the urine may be
24%. 9aternal serum alpha
related to the increased
fetoprotein is detectable at /
shunting of glucose to the
weeks of gestation and peaks in
developing placenta, without a
the third trimester. >igh levels
corresponding increase in the
detected between the 1+th and
reabsorption capability of the
1th weeks are associated with
kidneys.
neural tube defects. Pow levels
#(2. $ patient who has premature
are associated with 'own
rupture of the membranes is at
syndrome.
signi!cant risk for infection if
24&. $n arrest of descent occurs when the fetus doesn"t descend
labor doesn"t begin within 2% hours.
through the pelvic cavity during
#(#. -nfants of diabetic mothers
labor. -t"s commonly associated
are susceptible to macrosomia
with cephalopelvic disproportion,
as a result of increased insulin
and cesarean delivery may be
production in the fetus.
reEuired. 24+. $ late sign of preeclampsia is
#(%. To prevent heat loss in the neonate, the nurse should bathe
epigastric pain as a result of
one part of his body at a time
severe liver edema.
and keep the rest of the body
24/. -n the patient with preeclampsia, blood pressure
covered. #(&. $ patient who has a cesarean
returns to normal during the
delivery is at greater risk for
puerperal period.
infection than the patient who gives birth vaginally.
OB BULLETS
#(+. The occurrence of thrush in the neonate is probably caused by contact with the organism
paleness, turn the patient on her left side. #1&. -f the ovum is fertiliHed by a
during delivery through the birth
spermatoHoon carrying a K
canal.
chromosome, a male Hygote is
#(/. The nurse should keep the sac of meningomyelocele moist with normal saline solution. #(. -f fundal height is at least 2
formed. #1+. -mplantation occurs when the cellular walls of the blastocyte implants itself in the
cm less than expected, the
endometrium, usually / to 4
cause may be growth
days after fertiliHation.
retardation, missed abortion,
#1/. -mplantation occurs when the
transverse lie, or false
cellular walls of the blastocyte
pregnancy.
implants itself in the
#(4. 5undal height that exceeds expectations by more than 2 cm may be caused by multiple
endometrium, usually / to 4 days after fertiliHation. #1. >eart development in the
gestation, polyhydramnios,
embryo begins at 2 to % weeks
uterine myomata, or a large
and is complete by the end of
baby.
the embryonic stage.
#1(. $ maDor developmental task for a woman during the !rst trimester of pregnancy is accepting the pregnancy. #11. Unlike formula, breast milk oers the bene!t of maternal antibodies. #12. Opontaneous rupture of the membranes increases the risk of a prolapsed umbilical cord. #1#. $ clinical manifestation of a prolapsed umbilical cord is variable decelerations. #1%. 'uring labor, to relieve supine hypotension manifested by nausea and vomiting and
#14. 9ethergine stimulates uterine contractions. #2(. The administration of folic acid during the early stages of gestation may prevent neural tube defects. #21. ith advanced maternal age, a common genetic problem is 'own syndrome. #22. ith early maternal age, cephalopelvic disproportion commonly occurs. #2#. -n the early postpartum period, the fundus should be midline at the umbilicus. #2%. $ rubella vaccine shouldn"t be given to a pregnant woman.
OB BULLETS
The vaccine can be administered after delivery, but the patient should be instructed to avoid
be ordered at 1& to 1/ weeks" gestation. ##%. To avoid puncturing the
becoming pregnant for #
placenta, a vaginal examination
months.
shouldn"t be performed on a
#2&. $ 1+yearold girl who is pregnant is at risk for having a lowbirthweight neonate. #2+. The mother"s h factor
pregnant patient who is bleeding. ##&. $ patient who has postpartum hemorrhage caused
should be determined before an
by uterine atony should be given
amniocentesis is performed.
oxytocin as prescribed.
#2/. 9aternal hypotension is a complication of spinal block. #2. $fter delivery, if the fundus is
##+. Paceration of the vagina, cervix, or perineum produces bright red bleeding that often
boggy and deviated to the right
comes in spurts. The bleeding is
side, the patient should empty
continuous, even when the
her bladder.
fundus is !rm.
#24. Iefore providing a specimen
##/. >ot compresses can help to
for a sperm count, the patient
relieve breast tenderness after
should avoid eDaculation for %
breastfeeding.
to /2 hours. ##(. The hormone human
##. The fundus of a postpartum patient is massaged to stimulate
chorionic gonadotropin is a
contraction of the uterus and
marker for pregnancy.
prevent hemorrhage.
##1.
##4. $ mother who has a positive
during the last trimester of
human immunode!ciency virus
pregnancy may indicate
test result shouldn"t breastfeed
placenta previa.
her infant.
##2. 'uring the transition phase of labor, the woman usually is irritable and restless. ###. Iecause women with
#%(. 'inoprostone );ervidil* is used to ripen the cervix. #%1. Ireastfeeding of a premature neonate born at #2
diabetes have a higher
weeks" gestation can be
incidence of birth anomalies
accomplished if the mother
than women without diabetes,
expresses milk and feeds the
an alphafetoprotein level may
neonate by gavage.
OB BULLETS
#%2. -f a pregnant patient"s rubella
#%+. The nurse must place
titer is less than 10, she should
identi!cation bands on both the
be immuniHed after delivery.
mother and the neonate before
#%#. The administration of oxytocin )
they leave the delivery room. #%/. Qrythromycin is given at birth
the contractions are 4( seconds
to prevent ophthalmia
or longer.
neonatorum.
#%%. 5or an extramural delivery
#%.
)one that takes place outside of
to prevent or relieve backache
a normal delivery center*, the
during pregnancy.
priorities for care of the neonate
#%4. Iefore performing a Peopold
include maintaining a patent
maneuver, the nurse should ask
airway, supporting eorts to
the patient to empty her
breathe, monitoring vital signs,
bladder.
and maintaining adeEuate body temperature.
#&(. $ccording to the Unang Kakap program )Qssential
#%&. Oubinvolution may occur if
:ewborn ;are*, the cord should
the bladder is distended after
not be clamped until pulsations
delivery.
have stopped )that"s about 1# minutes*.
