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AWHONN POEP FINAL EXAM
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AWHONN POEP FINAL EXAM
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AWHONN POEP FINAL EXAMSwiss cheese is often used as the paradigm for explaining medical error. In this model,
the holes in the cheese represent - Answers -latent weakness
Implantation of the embryo outside the uterus is called - Answers -ectopic pregnancy
Full term newborns that are asymptomatic & born to a woman who was pretreated for
GBS with penicillin may be observed in the normal newborn nursery. A limited
diagnostic evaluation & antibiotic therapy is indicated in which of the following
circumstances? - Answers -rupture of membranes occurred 18 hours prior to birth
You are assigned to a patient who is at 38 weeks and 6 days gestation. She is being
admitted for an elective induction of labor because her husband is going on an
extended business trip in 2 days and he wants to be present for the delivery. The
hospital has no policy regarding elective induction, but you know that the AWHONN "Go
the Full 40" campaign doesn't support early elective induction. You approach the
physician with your concerns. He responds that he's been doing this for 30 years and
has never had a bad outcome from an elective induction at this gestation. - Answers -
normalization of deviance
A shared understanding of what is going on & what is likely to happen next is known as
- Answers -situational awareness
A patient safety event, unrelated to the natural course of the underlying illness, that
reaches a patient and results in death, permanent harm, or severe temporary harm with
intervention required to sustain life is an example of - Answers -sentinel event
Which of the following is a contraindication for magnesium sulfate administration? -
Answers -nifedipine
Amniotic band syndrome is associated with what complication in pregnancy? - Answers
-rupture of membranes
Risk factors for placenta previa include - Answers -previous uterine surgery, smoking,
and hypertension.
Classic signs of placenta previa are - Answers -painless bright red bleeding
Clinical signs of velamentous insertion of the cord include - Answers -FHR bradycardia
Mrs. Jordan has arrived to the unit for a labor evaluation. She is 39 weeks pregnant and
is complaining of continuous abdominal pain and "port wine" vaginal bleeding. She is
having high frequency, low amplitude contractions and the fetal heart pattern shows
minimal variability. You suspect that Mrs. Jordan may have a - Answers -placental
abruption
,Couvelaire uterus is associated with what condition? - Answers -placental abruption
You are caring for Mrs. Henderson, G2 P2 had a vaginal birth three hours ago. The
nursing student obtained Mrs Henderson's vital signs and reported the following: heart
rate of 124 bpm, respirations 24, temperature of 97.8°F, and blood pressure 92/62. The
nursing student also commented that Mrs. Henderson appeared "agitated." Given the
vital sign assessment that you received from the nursing student, what should you
consider? - Answers -Mrs Henderson may be experiencing a postpartum hemorrhage
and will need immediate further examination.
Which of the following complications may predispose a pregnant woman to
disseminated intravascular coagulopathy (DIC). (Select all that apply.) - Answers -
concealed placental abruption, intrauterine fetal demise, preeclampsia
An ova that is fertilized by one sperm and then divides into two zygotes results in -
Answers -monozygotic gestation.
Because of the decreased lower esophageal sphincter tone of pregnancy and
increasing mechanical pressure due to the rapidly growing uterus in the women
pregnant with multiples, she is at risk for - Answers -gastroesophageal reflux.
Which feature is recommended when monitoring twin gestations to differentiate
between fetal heart rates and maternal heart rate? - Answers -maternal pulse oximetry
Karen, G1P0, 34 weeks gestation with twins presents to the OB triage with complaints
of severe itching on her hands and feet. Your first suspicion is that Karen may have -
Answers -intrahepatic cholestasis.
The MOST common postpartum complication for mothers with higher-order multiples is
- Answers -postpartum hemorrhage
Roberta, a 29 year-old, G3P2, arrives in the OB triage. Her significant other Jose
reported Roberta's complaints of severe heartburn. He shared that the pain started after
they had lunch. You noticed Roberta was not speaking for herself. What would your
next course of action be? - Answers -Ask Roberta what her preferred spoken language
is and provide an interpreter as needed.
Tammy, a 32 year-old, G2P1 with chronic hypertension, is being seen in the OB triage
with complaints of an unrelieved headache after taking acetaminophen. The provider
order labs including uric acid. The uric acid result was 4.5-6.0 mg/dL. - Answers -tammy
may have superimposed preeclampsia
Proteinuria may indicate worsening underlying renal disease or preeclampsia when 24-
hour urine levels exceed - Answers -300 mg/dL
, Treating hypertension with vasodilating agents during pregnancy may be associated
with - Answers -decreased uteroplacental blood flow.
Sandy, a new nurse to the L&D unit, asks you why the provider ordered a 24-hour urine
for protein when you have the supplies needed on the unit to perform a urine dip stick
for protein. Your best response is? - Answers -There is potential for a high false-positive
when performing a urine dipstick for protein.
You are caring for Tish, a 32 year-old G4P3 who was admitted to the antepartum unit
with gestational hypertension. Antihypertensive therapy was initiated four hours ago.
Tish current vital signs are BP 144/92 mm Hg, heart rate 122 bpm, respirations 22 bpm,
temperature 98.9°F. Given Tish's current vital signs, what could potentially be
happening? - Answers -Because of the tachycardia, Tish may be experiencing
decreased cardiac output and pulmonary edema.
Mona, a 22 year-old, G2P1 with a history of asthma, was admitted to the antepartum
unit with preeclampsia. The provider ordered Labetalol 10mg IV. What is your next
course of action? - Answers -Notify the provider that Mona has a history of asthma and
request a different antihypertensive.
An acquired condition in pregnancy where the heart muscle becomes enlarged, thick, or
rigid leading to a decrease in contractility is called - Answers -Peripartum
cardiomyopathy.
Olivia, a 32 year-old, G3P2 with a history of cardiac disease, is being admitted for labor.
Given her history, what is the recommended method of pain control? - Answers -
regional anesthesia
Mrs. Barnes is 14 weeks pregnant and presents with a history of atrial fibrillation in
conjunction with mitral valve stenosis. Her primary care provider has determined that
she should be treated with anticoagulant therapy throughout her pregnancy. Which
anticoagulant is superior in preventing clot formation but is also a known teratogen and
should not be used during organogenesis? - Answers -Warfarin
Jing is a 36-year-old multiparous woman who presents for a routine prenatal visit says
she has pain in her right lower leg. Her calf is inflamed and warm to touch. A
noninvasive diagnostic tool that may be used in pregnancy to determine whether Jing
has deep vein thrombosis is - Answers -compression ultrasonography
You are caring for a mother/baby couplet. Approximately 40 hours ago, Melinda, a 32-
year-old primiparous woman, had an urgent cesarean birth after a prolonged second
stage of labor during which she had a Category-III abnormal fetal heart tracing. Melinda
has been weepy and has not wanted to get out of bed. She describes symptoms of
dyspnea and chest pain. Her vital signs are blood pressure of 84/56 while lying down,
pulse of 122 beats per minute, and respirations of 26 breaths per minute. Melinda is
displaying symptoms of - Answers -pulmonary embolism
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