practice questions

What does antepartum mean?

The period during pregnancy before birth.

How does implantation occur?

Enzymes from the conceptus erode the uterine decidua, allowing embedding.

When is the embryonic period?

Weeks 3–8 after conception.

Why are teratogens particularly harmful during weeks 3–8 after conception?

Major organ structures are forming; exposure can disrupt organ development.

What is progesterone's main role in pregnancy?

Maintains the uterine lining and reduces uterine contractility.

What is hPL's main effect?

Increases insulin resistance and nutrient availability to the fetus.

Which structure forms the fetal portion of the placenta?

Chorionic villi.

What are presumptive signs of pregnancy?

Subjective signs reported by the patient; they do not confirm pregnancy.

What are probable signs of pregnancy?

Objective findings that suggest pregnancy but do not confirm a viable intrauterine fetus.

What are positive signs of pregnancy?

Fetus visualized on ultrasound, fetal heart activity distinct from maternal pulse, or fetal movement palpated by an examiner.

What is Naegele's rule?

First day of LMP + 7 days − 3 months + 1 year, with calendar adjustment.

A patient is currently pregnant, had one term singleton, one 9-week loss, and living twins delivered at 34 weeks. What is GTPAL?

G4 T1 P1 A1 L3.

What is full term?

39 weeks 0 days to 40 weeks 6 days.

How often are routine prenatal visits through 28 weeks according to lecture?

Every 4 weeks.

What are key initial prenatal lab screens?

Blood type/Rh, antibody screen, CBC, urine and infection screening, and dating assessment.

What should the nurse assess at prenatal follow-up visits?

BP, weight, new symptoms/risks, ordered urine tests, fundal growth, FHR, movement, coping, and teaching needs.

What is the typical fetal heart rate baseline?

110–160 beats/min.

Where is the fundus at approximately 20 weeks?

Near the umbilicus.

What do Leopold maneuvers assess?

Fetal lie, presentation, and position through abdominal palpation.

Which prenatal symptoms require prompt reporting?

Bleeding, fluid leakage, severe headache, vision changes, severe abdominal/RUQ pain, fever, reduced fetal movement, or preterm labor symptoms.

Why does physiologic anemia occur during pregnancy?

Plasma volume increases more than RBC mass, diluting hemoglobin and hematocrit.

A pregnant patient becomes dizzy and hypotensive while supine. What is the FIRST nursing action?

Turn the patient laterally, then reassess BP and symptoms.

How do Braxton Hicks contractions differ from true/preterm labor?

Braxton Hicks are generally irregular and do not cause progressive cervical change.

Which symptoms suggest possible preterm labor?

Regular persistent contractions, pelvic pressure, backache, fluid leakage, or cervical change.

How should the nurse screen for intimate partner violence?

Privately, without the partner present, using a qualified interpreter if needed.

What is the FIRST priority when IPV is disclosed?

Assess immediate danger and safety.

How can the nurse provide culturally responsive prenatal care?

Ask about individual beliefs, food practices, modesty, family roles, and support preferences without assumptions.

What does TORCH stand for?

Toxoplasmosis; Other (including syphilis/hepatitis B); Rubella; Cytomegalovirus; Herpes.

What fetal/newborn risks are associated with maternal HIV according to lecture?

Transmission to infant, miscarriage, low birth weight, stillbirth, and preterm birth.

What is the primary treatment for HIV in pregnancy?

Antiretroviral therapy to reduce transmission risk.

What fetal/newborn problems can CMV cause?

Neurologic impairment, seizures, vision/hearing problems, dental abnormalities, and petechiae.

What causes gestational diabetes?

Placental hormones increase insulin resistance beyond the mother's ability to compensate with insulin production.

When is routine gestational diabetes screening performed?

Usually 24–28 weeks.

What follows an abnormal 50-g screen in the two-step approach?

Fasting 100-g 3-hour oral glucose tolerance test.

What newborn complications are associated with maternal GDM (Gestational Diabetes Mellitus)?

Hypoglycemia, respiratory distress, hypocalcemia, and hyperbilirubinemia.

What are nursing priorities for gestational diabetes?

Meal planning, glucose checks, prescribed activity/medication, hypoglycemia recognition, and fetal surveillance.

Why is a large infant of a diabetic mother at risk for hypoglycemia after birth?

Maternal glucose supply stops at delivery, but fetal insulin remains elevated.

What are the functions of amniotic fluid?

Cushions fetus, permits movement, supports lung development, and helps prevent cord compression.

How many vessels are in the normal umbilical cord?

Two arteries and one vein.

What AFI suggests oligohydramnios?

Less than 5 cm.

What is placenta previa?

Placenta located low near or covering the internal cervical os.

What is the classic bleeding pattern of placenta previa?

Painless bright red vaginal bleeding with a soft uterus.

What examination must be avoided until placenta previa is excluded?

Digital vaginal examination.

What is placental abruption?

Premature separation of the placenta.

What are classic signs of placental abruption?

Pain, tender/rigid uterus, frequent contractions, and bleeding that may be concealed.

What are the FIRST priorities in suspected abruption?

Urgent maternal stabilization and fetal monitoring; assess for hemorrhage/shock and prepare IV access and blood products as ordered.

What symptoms suggest ruptured ectopic pregnancy?

Shoulder-tip pain, syncope, tachycardia, and shock.

What is the priority for suspected ruptured ectopic pregnancy?

Emergency surgical evaluation and stabilization.

What is the guide's definition of preeclampsia?

New hypertension after 20 weeks with proteinuria; guide also lists severe organ findings.

What BP qualifies as severe-range in the chapter?

Systolic at least 160 OR diastolic at least 110 mmHg.

Which medication prevents/treats eclamptic seizures?

Magnesium sulfate.

A patient with preeclampsia has a seizure. What should the nurse do FIRST?

Call for help, protect from injury, position laterally when possible, and support airway/breathing.

What does HELLP stand for?

Hemolysis, Elevated Liver enzymes, Low Platelets.

A patient on magnesium has absent reflexes and depressed respirations. What is the FIRST action?

Stop/hold magnesium, call for urgent help, and support airway/breathing.

What is the antidote for magnesium toxicity?

Calcium gluconate.

What can high maternal AFP indicate?

Open neural tube/abdominal wall defect, incorrect dating, or multiple gestation.

When is chorionic villus sampling (CVS) commonly performed?

10–13 weeks.

When is amniocentesis typically performed?

15 weeks or later.

What makes an NST reactive at 32 weeks or later?

At least two FHR accelerations of at least 15 bpm lasting at least 15 seconds within 20 minutes.

What are the five components of a biophysical profile (BPP)?

NST, fetal breathing, movement, tone, and amniotic fluid.

What does BPP 8–10 generally mean?

Reassuring when amniotic fluid is normal.

What is a positive CST?

Late decelerations with at least 50% of contractions.

What is the purpose of RhoGAM?

Prevents anti-D antibody production in an unsensitized Rh-negative mother.

When is routine RhoGAM given according to the guide?

At 28 weeks and within 72 hours after delivery of an Rh-positive infant.

Which vaccines are listed as safe in the lecture?

Tdap, hepatitis A, hepatitis B, influenza, and COVID vaccines.

Which vaccines are listed as unsafe during pregnancy?

Live MMR and varicella vaccines.

What folic acid intake does the lecture recommend before conception/early pregnancy?

At least 400 mcg (0.4 mg) daily; higher-risk doses are prescribed.

What daily iron intake is listed during pregnancy?

27 mg/day; lecture also lists a 30-mg supplement.

Which foods/exposures does the lecture say to avoid during pregnancy?

Alcohol, raw/rare meat, raw shellfish/eggs, unwashed produce, high-mercury fish, unpasteurized soft cheeses, and deli meats.

How does physiologic anemia differ from iron-deficiency anemia?

Physiologic anemia is dilution from plasma expansion; iron-deficiency anemia reflects insufficient iron stores.

What distinguishes hyperemesis gravidarum from usual morning sickness?

Severe vomiting with poor intake, weight loss, dehydration, and possible electrolyte/acid-base disturbances or ketosis.

What treatment options are listed for hyperemesis?

IV replacement, antiemetics, and in selected cases TPN; assess nutritional deficiency including thiamine.

What findings show hyperemesis treatment is working?

Better intake and urine output, stable vitals/weight/electrolytes, and improved hydration.

What newborn complications can maternal GBS cause?

Neonatal sepsis and meningitis.

When does the lecture say GBS screening occurs?

35–37 weeks by vaginal/rectal culture.

What GBS intrapartum penicillin G loading dose does the guide list?

5 million units IVPB.

What GBS intrapartum penicillin G maintenance dose does the guide list?

2.5 million units every 4 hours until delivery.

What is preterm labor?

Regular contractions with cervical change after 20 weeks but before 37 weeks.

What warning symptoms suggest preterm labor?

Pelvic pressure, low backache, cramps, discharge change, and fluid leakage.

What is fetal fibronectin used for?

Assessing short-term birth risk in selected symptomatic patients.

Why is betamethasone given in threatened preterm birth?

Promotes fetal surfactant production and lung maturity.

What betamethasone dose/interval does the lecture list?

12 mg IM for two doses, 12–24 hours apart.

What is cognitive learning?

Knowledge learning; use discussion and teach-back.

What is psychomotor learning?

Skill learning; use demonstration, practice, and return demonstration.

What is affective learning?

Beliefs and attitudes; explore concerns and reassess readiness.

What is primary prevention? Give a pregnancy example.

Preventing illness; folic acid to reduce neural tube defects.

What is secondary prevention? Give a pregnancy example.

Early detection; gestational diabetes screening.

What is tertiary prevention? Give a pregnancy example.

Limiting complications of existing disease; diabetes management.

What is primordial prevention? Give an example.

Changing population conditions before risks develop; safer activity environments.

What does sensitivity measure?

Ability to identify people who have disease; low sensitivity misses cases.

What does specificity measure?

Ability to identify people without disease; low specificity produces false positives.

What is reliability?

Consistency of a measurement.

What is validity?

Accuracy of what is being measured.

What does the Health Belief Model emphasize?

Perceived risk/severity, benefits/barriers, and confidence affecting action.

What does Pender's model emphasize?

Wellness, experiences, and support.

What does Orem's model emphasize?

Self-care ability and deficits.

What does Maslow's hierarchy imply for nursing education?

Meet basic needs before higher-level learning.

A pregnant patient has severe headache, visual changes, and hypertension. What should the nurse suspect and do?

Suspect severe preeclampsia; urgently assess/escalate, confirm BP per protocol, assess neuro/lungs, obtain labs and fetal monitoring, and prepare ordered treatment.

How do classic previa and abruption cues differ?

Previa: painless bright red bleeding/soft uterus. Abruption: painful tender/rigid uterus with possible concealed bleeding.

How should a nurse evaluate whether an intervention worked?

Reassess the relevant cue: BP, respirations/reflexes, urine output, bleeding, glucose, hydration, fetal status, or demonstrated learning.