How to have a good study habits 2

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How to have a good study habits 2

  1. 1. How to have a good study habits
  2. 2. Study effectively: 1. Use memory aids, pictures, pathogenesis, schematic diagrams and mnemonics. They will assist in drawing associations from other ideas with the use of visual aids. 2. Review class notes the next day . Very effective study habit to develop during school is to review the class notes the day after the class. Correlate the notes and the visual the instructor presented with the information in the textbook.
  3. 3. 3. Plan your study time when you are most receptive to learning. Don’t study the night before the exam, only 40% will retain the next day. Your favorite study mode: toxic cramming. 4. Set a schedule of your daily activities. For example, when you set aside 2 hours for review after the class everyday then 2 hours of facebook after. Have a time schedule to deal with personal activities, family activities and then your school activities. Please feel guilty if you did not study for 2 hours that evening.
  4. 4. 5. Set a study goal: a. Decide on a study method b. Divide the review materials into segments c. Prioritize the segments; review first the areas in which you feel you are deficient or weak. Leave those areas you are the most comfortable with & most knowledgeable about for last. d. Identify areas that will require additional review in your Nursing textbook. Read your books!
  5. 5. e. Establish a realistic schedule and follow it. Example: 8-5 classroom discussion. 5- 7 facebook/ friendster/ multiply/youtube or any internet gaming. regular study mode: 8-10 pm daily. f. Plan on achieving your study goal several days before the examinations.
  6. 6. Group study: 1. Limit the group to four to five people. 2. Group members should be mature & serious about studying. Don’t end up laughing and impersonating your funny lecturers. 3. The group should agree on the planned study schedule. 4. If the group makes you anxious or you do not feel it meets your study needs, do not continue to participate.
  7. 7. 5. Group study is very effective with the right mix of participants Decrease some anxiety-provoking situations before examinations: a) Be early b) Don’t cram your classmates in the room. c) Do something pleasant the evening before the examination. d) Anxiety is contagious. If those around are extremely anxious, avoid contact with them.
  8. 8. e) Settle your accounts a few days before so you will not worry about it the day of examination. f) If the other person finishes before you do, will it put increased pressure on you to hurry up and finish? Don’t mind the people around you. g) Make your meal before the test a light, healthy one. Avoid eating highly spiced or different foods. This is not the time for gastrointestinal upset.
  9. 9. h) Do not take study material to the examination site. Its too late to study. i) Don’t panic when you encounter very hard questions that increases your anxiety. Take a deep breath and close your eyes at the moment then return to the question. j) Bring your past success to bring positive energy and “vibes” to your exam. YOU WILL PASS! I KNOW YOU CAN DO IT.
  10. 10. MIDTERM EXAMINATIONS
  11. 11.  Situation: Jent, a 32 year old primigravida at 39- 40 weeks AOG is admitted to the Labor Room due to hypo gastric and lumbo-sacral pains. IE reveals a fully dilated, fully effaced cervix, BOW, Station O. 1. The nurse inspects the amniotic fluid of Jent. Which of the following characteristics of the amniotic fluid confirm the diagnosis of fetal distress? A. Mucus-tinged c. Greenish B. Colorless d. Pinkish
  12. 12. 2. The nurse knows that Jent needs NO further instruction on monitoring fetal movement. Which of the following remarks of Jent influence the nurse to think so? a. “My baby is in good status, I felt her move twice for an hour.” b. “The last time my baby move was an hour ago.” c. “Maybe my baby is asleep. I have not felt her movement since an hour ago.” d. “My baby is very active, she move about 5 times per hour.”
  13. 13.  Situation: Celine is pregnant for the second time. Since she is breastfeeding her first baby, she has menstruated. She reports having noticed tingling breast tenderness and feels nauseated in the morning. 3. If Celine is not menstruating after her first child, what sign will help her estimate her gestational age? A. Quickening c. Abdominal girth B. First time heart sound was using Doppler d. Lightening
  14. 14. 4. Celine is given instruction to notify the nurse if she notices any of the following signals, Except: A.Tight finger rings, puffy eyelids B. Severe, persistent headache C. Vaginal bleeding D. Nausea and vomiting in the first
  15. 15. 5. The first action of the nurse upon admission is to: a. Take the fetal heart tone b. Notify the obstetrician c. Determine cervical dilatation d. Inspect the color, amount and odor of the amniotic fluid
  16. 16. 6. A woman is having a prenatal visit at 18 weeks gestation. Why is it important to ask her about fetal movement? a. Absence of fetal movement at this time suggests that the pregnancy is more advanced than her dates indicated. b. Denial of fetal movement at this stage in pregnancy may indicate that the woman is not accepting her pregnancy. c. If she has started feeling the movement, the fetal heartbeat will be checked with the use of a fetoscope to confirm that the fetus is living. d. Fetal movement is the first felt by the mother about this time and provides a marker for a approximate gestational age.
  17. 17. Situation: Annabelle, an 18-year-old primigravida at 39-40 weeks gestation is admitted to the hospital in active labor. Her cervical dilatation is 7cms. 90% effaced station 0 and positive for bag of water(BOW). 7. Soon after, Annabelle is admitted; she had a bloody mucoid vaginal discharge. Which of the following is the BEST action of the nurse? a. Call the obstetrician b. Perform IE to determine the cervical dilatation c. Prepare for a double set-up procedure d. Check if there is a rupture of the bag of water
  18. 18. 8. She starts to have intolerable pain during contractions. Which of the following breathing techniques will be MOST effective during this phase? A. Pursed lip breathing B. Deep chest breathing c. Pant, pant, blow d. Slow chest breathing
  19. 19.  9. Her cervical dilatation is now 10cm. 100% effaced and station + 1. Her BOW ruptured spontaneously to clear amniotic fluids. Which of the following actions of the nurse is PRIORITY? A. Check the FHT B. Start an intravenous fluid line c. Notify the obstetrician d. Transfer Annabelle to the delivery table.
  20. 20. 10. The obstetrician is still scrubbing when Annabelle shouts. “The baby is coming!” Which of the following actions should the nurse perform? A. Tell her to push when she has the urge B. Urge her to do shallow breathing C. Instruct her to pant-blow D. Administer oxygen per mask
  21. 21. 11. Annabelle delivered a live baby girl. She remarks, “She looks just like me when I was a baby!” Which of the following is an interpretation of this statement? A. Potential post-partum depression B. Maternal-infant boding c. Disappointment of the gender of the babY d. Rejection of her baby
  22. 22.  Situation: Rachel Osorio, 24 years old, full term primigravida, is admitted to the Labor Room. IE findings 3-4cms. Dilated; 70% effaced; station-2; breech presentation. 12. Which of the following statements BEST describes what a station-2 means? The presenting part of the fetus is; a. Two cms. above the ischial spines b. Two cms. below the sacral prominence c. At the level of the ischial spines d. Two cms. above the symphysis pubis
  23. 23. 13. What type of breech presentation does the fetus assume when the legs are extended and lie against the abdomen and chest? a. Single footing c. Frank b. Complete d. Double footing
  24. 24. 14. In breech presentation, where can the fetal heart sounds be usually heard at its loudest? a. Above the symphysis pubis b. Slightly above the umbilicus c. At the level of the symphysis d. Below the umbilicus
  25. 25. 15. What method of delivery will the nurse anticipate to prepare considering the status of Mrs. Osorio? a. Low mid forceps delivery b. Breech extraction c. Normal spontaneous delivery d. Cesarean section
  26. 26. 16. Artificial rupture of the membrane is done. Which of the following nursing diagnosis is PRIORITY? a. High risk for infection related to rupture of membranes b. Potential for injury related to prolapse of cord c. Alteration if comfort related to increasing strength of uterine contractions d. Anxiety related to unfamiliar procedure
  27. 27. 17. Upon admission, FHT is noted to be 110 beats per minute over RLQ. Which of the following actions should be immediately done by the nurse? a. Place her on left lateral position b. Monitor FHT every 15 minutes c. Call the obstetrician d. Administer oxygen inhalation
  28. 28. 18. Which of the following BEST describes a threatened abortion? a. A likely expulsion of the fetus and placenta before the 10th week of gestation b. Prolonged retention of a fetus who died during the first half of pregnancy c. A sudden gush of fluid accompanied by bleeding and pain during early pregnancy d. Any vaginal discharge or bleeding which appears during the first half of pregnancy
  29. 29.  19. What will be the immediate nursing action be done? a. Start an IVF infusion b. Notify her obstetrician c. Request for CBC, blood typing and cross matching d. Place her in a complete bed rest 20. After D and C is done, Melissa should be observed for: a. Hemorrhage and infection b. Depression c. Dehydration and hemorrhage d. Dehydration
  30. 30. 21. The client asked how she would recognize a true labor. What are the characteristics of the uterine contractions in a true labor? a. Regular with increasing frequency of duration b. Regular and remain constant in frequency c. Occasional and irregular in duration d. Regular with diminishing frequency and duration
  31. 31. 22. A woman is hospitalized for the treatment of severe preeclampsia. Which of the following represents an unusual finding for this condition? a. Convulsions b. blood pressure 160/100 mmHg c. protenuria d. generalized edema
  32. 32. 23. A woman is admitted with severe preeclampsia. What type of room should the nurse select for this woman? a. a room next to the elevator b. the room farthest from the nursing station c. the quietest room on the floor d. the labor suite
  33. 33. 24. A woman is discharged after treatment for hydatidiform mole. The nurse should include which of the following in the discharge teaching plan? a. Do not become pregnant for at least one year b. Have blood pressure checked weekly for six months c. Avoid smoking for one year d. An amniocentesis can detect a recurrence of this disorder in the future
  34. 34. 25. A woman 30 weeks gestation is being discharge to home care with a diagnosis of placenta previa. The nurse knows that the client understands her home care when the client states: a. “As I get closer to my due date I will have to remain in bed” b. “I can continue with my office job because its mostly sitting” c. “My husband won’t be too happy with this “no sex” order” d. “I’m disappointed that I will need a cesarean section”
  35. 35. 26. After a prenatal check up and class on health behaviors during pregnancy, the nurse can evaluate that learning has occurred when a client states. a. “Alcohol in the first trimester of pregnancy is very dangerous, later its OK.” b. “Drinking alcohol during pregnancy is the most preventable cause of mental retardation” c. “Alcohol is bad during pregnancy, but a little with breastfeeding helps with breastfeeding” d. “Problems for the baby usually only occur with heavy drinking of alcohol” 
  36. 36. 27. The nurse is caring for a 20 year old primigravida who has been in the first stage of labor for about 8 hours. What assessment findings would indicate the client is progressing to the 2nd stage of labor? a. uterine contraction about 10 minutes apart, cervical dilatation at 6cm. b. cervical effacement at 100% dilatation at 10cm. c. scant to moderate blood mucus showing, station +2 d. fetal station at -2 and fetal hearth rate noted at level of the umbilicus
  37. 37. 28. The nurse is assessing a client 12 hours after a prolonged labor and delivery. What assessment data would cause the nurse the most concern? a. oral temperature of 98 degree Fahrenheit. b. Moderate amount of dark red vaginal discharge c. Episiotomy area bruised with small amount of dark bloody drainage d. Uterine fundus palpated to the right of the umbilicus
  38. 38. 29. The nurse is caring for a client in labor. How are frequency of contractions timed? a. End of one to the beginning of the next b. Beginning of one to the end of the next c. End of one to the end of the next d. Beginning of one to the beginning of the next
  39. 39. 30. A client is 38 weeks pregnant and is admitted with bright red vaginal bleeding. She complains of abdominal discomfort, but she is not having contractions. After assessing the client’s vital signs and the FHR. What is the most important information to obtain? a. The amount of cervical dilatation that is present. b. The exact location of her abdominal discomfort. c. The station of the presenting part. d. At what time the client last ate.
  40. 40. 31. The pelvic examination reveals the fetus to be at -1 station. What information does this indicate to the nurse about the presenting part of the fetus? a. Is visible on the perineum. b. Has not yet entered the inlet of pelvis. c. Is above large to fit through the opening into the true pelvis. d. Is too large to fit through the opening into the true pelvis.
  41. 41. 32. During the first stage of labor, the cervix becomes thin and distinct from the body of the uterus. What is the term the nurse would use to describe this observation?  a. Dilation b. Attitude  c. Effacement d. Transition
  42. 42. 33. The nurse is checking a laboring client. Her assessment reveals the head at +3 station. What will the nurse do? a. Prepare for the delivery of the infant. b. Begin administration of oxygen at 6L/min. c. Determine if contractions are increasing d. Determine the FHR
  43. 43.  34. A multigravida client comes to the emergency room complaining of abdominal pain. She is at 30 weeks gestation. On assessment, the nurse observes complete dilatation and effacement of the cervix with the perineal area bulging. What is your nursing action? a. prepare the client for an emergency cesarean delivery. b. Place even gentle pressure on infant’s head and support it through the birth canal. c. Have the client hold her legs together and take her to the labor and delivery unit. d. Have the client take two deep breaths and push hard with next contraction.
  44. 44.  35. A woman who is gravida 1 is in the active phase of stage 1 labor. The fetal position is LOA. When her membranes rupture the nurse should expect to see? a. a large amount of bloody fluid. b. a moderate amount of clear to straw-colored fluid. c. a small amount of greenish fluid. d. A small amount of the umbilical cord.
  45. 45.  36. The nurse is caring for a woman in stage 1 labor. The fetal position is LOA. When her membranes rupture the nurse’s first action should be to: a. notify the physician b. measure the amount of fluid c. count the fetal heart rate d. perform a vaginal examination 
  46. 46.  37. A woman had a mediolateral episiotomy performed at delivery. The primary purpose of the episiotomy is to? a. allow forceps to be applied b. enlarge the vaginal opening c. eliminate the possibility of lacerations d. eliminate the need for cesarean birth
  47. 47.  38. A woman is admitted to the hospital in labor. Vaginal examination reveals that she is 8cm. dilated. At this point in her labor, which of the following statements would the nurse expect her to make? a. “I can’t decide what to name my baby” b. “It feels good to push with each contraction” c. “Take your hand off my stomach when I have a contraction!” d. “This isn’t as bad as I expected”
  48. 48.  39. The nurse is talking with a woman who is 36 weeks gestation during a prenatal visit. Which statement indicates that the woman understands the onset of labor? a. “I need to go to the hospital as soon as the contractions become painful.” b. “If I experience bright red vaginal bleeding I know that I am about to deliver.” c. I need to go to the hospital when I am having regular contractions and bloody show.” d. “My labor will not start until my membranes rupture and gush fluid.”
  49. 49.  40. Using Leopold’s maneuvers to determine fetal position, the nurse finds that the fetus is in a vertex position with the back on the left side. Where is the best place for the nurse to listen for fetal heart tones? a. in the right upper quadrant of the mother’s abdomen. b. In the left upper quadrant of the mother’s abdomen. c. In the right lower upper quadrant of the mother’s abdomen. d. In the left lower upper quadrant of the mother’s abdomen.
  50. 50.  41. A woman arrives at the CEH ER in active labor. On examination, the cervix is 5 cm. dilated membranes intact and bulging and the presenting part at -1 station. The woman asks if she can go for a walk. What is the best response for the nurse to give? a. “I think it would be best for you to remain in bed at this time because of the risk of cord prolapsed.” b. “It’s time for you to walk, but please stay nearby. If you feel a gush of fluid, I will need to check you and your baby.” c. “It will be best time for you to walk because that will assist the natural body to bring the baby down the birth canal” d. “I would be glad to get you a bean bag chair or rocker instead
  51. 51.  42. A woman who is in active labor at 4 cm. dilated, 100% effaced and 0 station is ambulating and experienced a gush of fluid. What is the most appropriate initial action for the nurse to take? a. Send a specimen of the amniotic fluid to the laboratory for analysis. b. Have the woman return to her room and place her in Trendelenburg position to prevent cord prolapsed. c. Have the woman return to her room so that you can assess fetal status including auscultation of fetal heart for one full minute. d. Call the woman’s physician because a cesarean delivery will require.
  52. 52. 43. A woman is completely dilated and at +2 station. Her contractions are strong and last 50-60 seconds. Based on this information, the nurse should know that the client is in which stage of labor. a. First stage b. Second stage b. c. Third stage d. Fourth stage
  53. 53.  44. A woman’s cervix is completely dilated with the head at -2 station. The head has not descended in the past hour. What is the most appropriate initial assessment for the nurse to make? a. Asses to determine of the client’s bladder are distended. b. Send the client for X-rays to determine fetal size. c. Notify the surgical team so that an operative procedure should be done. d. Assess fetal status, including fetal heart tones.
  54. 54.  45. A woman who has been in labor for 6 hours is now 9 cm. dilated and has intense contractions every 1 to 2 minutes. She is anxious and feels the need to bear down with her contractions. What is the best action for the nurse to take? a. Allow her to push so that delivery can be expedited. b. Encourage panting breathing through contractions to prevent pushing. c. Reposition her in a squatting position to make her more comfortable. d. Provide back rubs during contractions to distract her. a.
  55. 55.  46. A woman is scheduled for a cesarean section delivery due to a transverse fetal lie. What is the best way for the nurse to evaluate that she understands the procedure? a. Ask her about the help she will have at home after delivery. b. Give her a diagram of the body and ask the scheduled surgery. c. Ask her to tell you what she knows about the scheduled surgery. d. Provide her with a booklet explaining cesarean deliveries when she arrives at the hospital.
  56. 56.  47. A client is being admitted to the OBW unit for Hypovolemia secondary to hyperemesis gravidarum. Which of the following factors predisposes to the development of this condition? a. trophoblastic disease b. low levels of human chorionic gonadotropin c. malnourished or underweight d. maternal age older than 35 years
  57. 57.  48. A client at 14 weeks gestation is scheduled for an intentional abortion. The nurse should explain to the client that the method used for the abortion will most likely be a: a. vacuum extraction b. partial birth abortion c. saline induction d. menstrual extraction
  58. 58.  49. The nurse in a family clinic is assessing a client who is at 30 weeks gestation. The nurse hears a fetal heart rate (FHR) of 88 beats per minute. What should the nurse do next? a. notify the physician immediately b. assess the client’s radial pulse c. recognize that the rate is within the normal units and document the rate d. permit the mother to hear the heartbeat
  59. 59.  50. A pregnant client is scheduled to have an ultrasound to determine the growth of the fetus. To prepare the client for this diagnostic test, the nurse should instruct the client to: a. drink large volume of water before the test b. void before the procedure c. lie on her right side during the test d. remain NPO for 8 hours before the test
  60. 60.  51. The nurse is caring for a client after suction curettage for gestational trophoblastic disease. When planning discharge instructions, the nurse should instruct the client to: a. consider having hysterectomy in the next year b. avoid pregnancy for at least 1 year c. have her blood tested for HCG every 2 hours d. try to become pregnant as soon as possible
  61. 61.  52. A multipara client who is pregnant with her fourth child visits the prenatal clinic at 35 weeks gestation and tells the nurse that her “hands and face are swollen”. The nurse should assess: a. marked hyporeflexia b. gestational diabetes c. pregnancy-induced hypertension d. chronic hypertension
  62. 62.  53. A pregnant client at 36 weeks gestation is admitted to the emergency room of CEH after an automobile accident. The client is conscious. The nurse should assess the client for which of the following complications? a. incompetent cervix b. placenta previa c. still birth d. placenta separation
  63. 63.  54. During the initial history assessment of a pregnant client, the nurse determines that the client has a history of abruptio placenta with her last pregnancy. Based on this information the nurse should expect to find which of the following in her evaluation of this client? a. anemia b. Stillbirth c. hypertension d. multiparity
  64. 64.  55. A pregnant client’s ultrasound evaluation has determined that she is pregnant with twins. The nurse explains to the client that she will need more frequent prenatal visits to assess for: a. pregnancy-induced hypertension b. gestational diabetes c. fetal anomalies d. hemolytic disease
  65. 65.  56. A client is receiving an intravenous infusion of magnesium sulfate for severe pregnancy-induced hypertension. Which of the following should the nurse anticipate giving for magnesium sulfate toxicity? a. RhoGAM b. Hydralazine (Apresoline) c. calcium lactate d. calcium gluconate
  66. 66.  57. A pregnant client at 6 weeks gestation visits the clinic and tells the nurse that she has mild spotting and a few “cramps”. Vaginal examination reveals no cervical dilation. The client is most likely experiencing a type of abortion termed.  a. inevitable b. threatened c. therapeutic d. missed
  67. 67.  58. At 36 weeks gestation, a client visits the emergency room and complains of a sudden gush of bright red, painless, vaginal bleeding. Based on this information, the nurse assess that the client might be experiencing which of the following complications? a. abruption placenta b. incompetent cervix c. placenta previa d. placenta accreta
  68. 68.  59. A pregnant client is diagnosed with hydramnios at 35 weeks gestation. The nurse should be aware that the presence of hydramnios might be indicating that the fetus has the potential for? a. renal dysfunction b. gastrointestinal malformation c. fetal growth retardation d. cardiac anomalies
  69. 69.  60. A client is admitted to the hospital with a diagnosis of ruptured ectopic pregnancy. Which of the following actions should the nurse perform first? a. ask the client to sign a surgery consent b. prepare to administer antibiotic c. assess the amount of vaginal bleeding d. draw blood for typing and cross matching
  70. 70.  61. A 40 year old client visits the clinic and a pregnancy of 8 weeks is confirmed. The nurse should instruct the client that more frequent prenatal visits will be necessary because pregnant women of her age are at greater risk for? a. pregnancy-induced hypertension b. multiple pregnancies c. uterine rupture d. birth defects
  71. 71.  62. A pregnant client at term and in labor tells that she used amphetamines during her pregnancy. After the birth, the nurse should assess the newborn for: a. hyperbilirubinemia b. intrauterine growth retardation c. meconium aspiration syndrome d. cardiac anomalies
  72. 72.  63. A pregnant client tests, positive for cocaine use. The nurse should instruct the client that one of the long-term neonatal effects of this drug is a. tremulousness b. continual crying c. muscle rigidity d. learning defects
  73. 73.  64. a pregnant client at term and in labor tells the nurse that she used cocaine during her pregnancy. After birth, the nurse should assess the newborn for complication except: a. low birth weight b. fetal alcohol syndrome c. microcephally d. decrease fetal oxygenation
  74. 74.  65. The nurse is caring a nullipara in active labor cervical dilation is 4 cm. The nurse should explain to the client that she is in which of the following stages of labor? a. latent stage of labor b. first stage of the active phase of labor c. second stage of the active phase of labor d. third stage of labor
  75. 75.  66. After birth of a healthy newborn, the nurse knows that one of the signs that the placenta is ready to deliver is: a. shortening of the umbilical cord b. a sudden gush of vaginal blood c. a change in the shape of the uterus to an oval shape d. an increase in the amount of amniotic fluid
  76. 76.  67. During labor a client’s amniotic membranes rupture. Meconium is present in the amniotic fluid, which is a normal finding in which of the following situations? a. breech presentation b. preterm labor c. prolonged latent phase d. cephalopelvic disproportion
  77. 77. 68.The degree of flexion that the fetus assumes or the relationship of the fetal parts to one another is termed fetal:  a. lie b. presentation  c. attitude d. position 69.The nurse is caring for a client at term who is in active labor. The nurse should explain to the client that the setting of the presenting part of the fetus into the pelvis at the level of the maternal ischial spines is termed: a. engagement b. descent c. lightening d. station
  78. 78.  70. The nurse is caring for a multipara client in active labor at 39 weeks gestation. To assess the frequency of the contractions, the nurse should assess the length of time from the a. end of one contraction to the end of the next contraction b. beginning of one contraction to the end of the same contraction c. beginning of one contraction to the beginning of the next contraction d. peak of one contraction to the peak of the next contraction
  79. 79.  71. Passage of the fetus through the birth canal involves various position changes by the fetus- termed cardinal movements of labor. The first cardinal movements is: a. descent b. internal rotation c. engagement d. extension 72. The nurse is caring for a primigravida client in active labor. The nurse should encourage the client to void every 2 hours because full bladder can result in: a. uterine rupture b. delayed fetal descent c. prolonged contractions d. urinary tract infections
  80. 80.  73. A pregnant client visits the emergency room at CEH because she thinks she is in labor. The nurse should explain to the client that true labor can be differentiated from false labor by contractions that: a. are often irregular b. are felt abdominally c. achieve cervical dilation d. may disappear with ambulation
  81. 81.  74. The nurse is caring for a primigravida in active labor whose cervix is 10cm. dilated and who has been pushing for 45 minutes. The nurse should explain to the client that one advantage of an episiotomy is: a. greater diameter for the fetal head b. increased perineal tearing c. decreased blood loss d. advanced to 3rd labor
  82. 82.  75. The nurse is caring for a client in active labor who will have a forceps birth. Immediately after the forceps are applied, the nurse should assess the: a. client’s ability to push b. fetal presenting part c. client’s blood pressure d. fetal heart rate
  83. 83.  76. A multipara has been diagnosed with gestational diabetes. The nurse would expect that the client would be managed initially by which of the following therapies? a. oral hypoglycemic drugs b. oral hypoglycemic and insulin c. diet d. insulin
  84. 84. 77. What drug that is similar to natural hormone that is being given to pregnant client for induction of labor? a. oxytocin b. progesterone c. magnesium sulfate d. estriol 78. On fetal circulation, blood that enters the pulmonary artery will go to lungs to supply oxygen but will shunt to descending aorta passing a special structure called: a. foramen ovale b. ductus venosus c. ductus arteriosus d. umbilical arteries
  85. 85.  79. Pathogenesis of RH incompatibility include the following except: a. accidental break in placental villi results in fetal blood entering the maternal blood stream b. occurs when the mother is RH positive and the fetus is RH negative c. maternal and fetal blood are mixed up, causing the mother to produced antibodies that will attack the fetus d. maternal bloodstream will destroy the fetal red blood cells and can result to fetal anemia
  86. 86.  80. Heart structure that connects that right and left atrium before and closes (at times open) after birth. a. inferior vena cava b. aorta, descending c. pulmonary arteries d. foramen ovale
  87. 87.  81. TORCH syndrome, to include Rubella is one of the teratogenic infections that cause fetal complication. Health teachings for mothers planning to get pregnant include the following except: a. Rubella immunization 3 month before pregnancy b. Avoid contact with children with rashes while pregnant c. Have intravenous Zovirax IV to women during pregnancy d. Infants born with rubella must be isolates from other newborn
  88. 88. 82. Teratogenic drugs that includes alcohol, coffee, tea and cola which of this has a non- stimulant effect to mother and fetus? a. cola b. tea c. coffee d. alcohol 83. A type of presentation that the hips are flexed but the knees are extended to rest on chest making the buttocks alone as the presenting part. a. Compound b. Frank breech c. incomplete breech d. transverse lie
  89. 89.  84. A type of presentation that the presenting part is usually iliac crest, hand or an elbow. a. Shoulder presentation c. compound presentation b. Vertex presentation d. single footling  85. Identify the most common fetal position in most pregnancies (Left occiput anterior) 
  90. 90. 86. Monitoring for true labor would include: I – cervical dilation II – regular intervals III – intensity remains unchanged IV – pain starts at the lumbar area to abdomen a. I, III & IV b. I, II only c. II, IV & I d. I & III only
  91. 91.  87. A woman is on active labor for 2 hours and she is on 6-7 cm dilatation. She ask for candy during relaxation. What is your best response? a. Mother should maintain on NPO for possible operation. b. Candies are contraindicated during labor since this will impede breathing techniques c. Candies and lollipops are recommended for carbohydrates fluid intake during labor d. Inform mother of the possibility of choking as the labor progresses
  92. 92.  Identify the following presentations on the illustrations presented: 88. Right occiput posterior 89. Left sacrum posterior 90. Right occiput posterior 91. Left occiput transverse 92. Mechanism by which fetus nestles into the pelvis. a. Engagement c. Descent b. Expulsion d. Flexion
  93. 93.  93. Rotation of the fetus into the pelvis, to the occiput anterior position while continuously descending.  Internal rotation c. Descent  External rotation d. Flexion  94. process of the fetal head's nodding forward toward the fetal chest. a. Internal rotation c. Descent b. External rotation d. Flexion
  94. 94.  95. process that the fetal head undergoes as it begins its journey through the pelvis a. Internal rotation c. Descent b. External rotation d. Flexion  96. birth of the entire body a. Engagement c. Descent b. Expulsion d. Flexion
  95. 95. 97. The shoulders externally rotate after the head emerges and restitution occurs, so that the shoulders are in the anteroposterior diameter of the pelvis. a. Internal rotation c. Descent b. External rotation d. Flexion 98. Stage of labor & delivery from the complete dilatation of the cervix to the birth of the baby. a. 1st Stage c. 2nd stage b. 3rd stage d. 4th stage
  96. 96. 99. stage of cervical dilatation a.1st Stage c. 2nd stage b. 3rd stage d. 4th stage 100. from the delivery of the placenta up to 1st 4 hours after delivery. a. 1st Stage c. 2nd stage b. 3rd stage d. 4th stage
  97. 97. “…..the last few miles of a journey are always tough, but if you keep going you’ll see that the last few steps are the most fulfilling…..”
  98. 98. Next topic: pre final sept.11,2009  Fetal distress  Prolapsed umbilical cord  causes  contributing factors  sign/symptoms  nursing care  Problems with the passageway  Abnormal size or shape of the pelvis  Cephalopelvic disproportion  Shoulder dystocia
  99. 99.  Problems with the powers  Dystocia or difficult labor  hypertonic uterine dysfunction  hypotonic uterine dysfunction  abnormal progress in labor  retraction rings  premature labor  precipitate labor and birth  uterine prolapsed  uterine rupture
  100. 100. Nursing Care of the Postpartal client assessment (  Important guidelines:  a. Breast (engorgement)  b. Uterus (contraction, position,size)  c. Bladder (distention)  d. Bowel (positive for bowel sounds or elimination)  e. Lochia (color, amount, consistency, number of pads consumed)  f. Episiotomy (condition of wound healing, signs of infection)  g. Homan’s sign (presence or absence)  h. Emotions (presence or absence of depression, coping mechanism)  - vital signs  - signs of complications such as hemorrhage, infections)
  101. 101. Postpartal hemorrhage  Early postpartal hemorrhage  Late postpartal hemorrhage (subinvolution) Postpartal Puerperial infection  Endometriosis  Wound infection  UTI  Hepatitis etc  Thromboembolic disorders  Postpartal psychiatric disorder
  102. 102.  Immediate Care of the Newborn  Assessment  APGAR Scoring  Vital signs  Physical assessment  assessment for deformities  anthropometric measurements (head, chest, and abdominal circumferences, weight and length)  management of establishing respiration  maintaining optimum temperature  identification of newborn  prevention of infection and injury
  103. 103.  Immunization  Newborn screening  Promotion of adequate nutrition  Observation of passage meconium  Newborn reflexes
  104. 104. Nursing care of clients with specific Health problems related to Reproduction and Sexuality

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