NUR 504 Exam 1 Review Questions and
Complete Solutions
RN role ✅responsible for broadly, monitoring fetal status (baby's HR, etc), monitoring
maternal status (complications in labor, what they are, what they look like, what to do,
correcting them), monitoring labor progression (don't want to be in labor for long, want it
to progress, make sure it isn't stalling, measuring opening of cervix as we go along,
monitoring contractions, frequency, strength, duration), administering most medications
(but not anastetics, like epidurals, but giving antiemetics, antibiotics, fluids (all NPO),
monitoring fluid status, communicating with advanced practitioner (may not even be
there, we are their eyes and ears till they do come in, it is possible that you will be only
practitioner until they are fully dilated), support, education.
Advanced practitioner (Nurse midwife- CNM), OBGYN (Obstetrician-Gynecologist
certified MD) role ✅OBGYN: anything related to typical pregnancy and delivery.
Nurse Midwife: Has RN degree but also specialized graduate degree for 2 years. Some
restrictions, state dependent on practice acts, like not can't do c-section, care for high
risk pregnancies (crazy uncontrolled diabetes, triplets), but if everything is fine PT may
never need to see Dr. Every CNM needs to practice with physician as a backup in case
PT needs c-section etc.
Lay midwifes: Not certified, more like apprenticeship, not allowed to deliver in hospitals,
help people deliver at home.
Doula role ✅Support person that you can pay for that is very knowledgeable in
pregnancy and birth. Haven't gone through formal education, bachelors, masters
degrees. May have done some training courses. Not there in hospitals, hired for the
patient. Insurance doesn't cover it. Call when you are delivering, meet you in hospital,
they are advocate for you.
AWHON- (Association of Women's Health, Obstetric, and Neonatal Nurses)
ACOG- (American College of Obstetricians and Gynecologists- Physician group)
✅These are associations that deal this specific population. One is nursing association,
one is physicians. Both groups try to figure out info on patient population, do a lot of
research, literature study, put out info related to that to improve health outcomes of
these patient populations. Both of these are well lead and very influential. Advocate for
new laws if needed. Might see influence in hospital setting with social inductions
(induction of labor, starting at week 37 used to be, not due to medical reasons), but
research was done that found that 39-40 week babies did better than 38-37 weeks,
more respiratory problems, longer hospitalizations. These groups made position
statements that said no one should be induced before 39 weeks, and because these
groups are great, hospitals started making policies following this.
,NICU levels of care ✅We don't have specific levels of care for maternal side but have
it for NICU. NICU levels can be from 1-4. Neonatal is first 28 days.
Level 1: lowest level, can basically provide full term (at 37 weeks or greater) who are
well, no medical issues, complications. If someone delivers near term they can stabilize
then transport them.
Level 2: Take care of babies who are 32 weeks or greater, and those who are
moderately ill but with issues they expect to resolve fairly quickly. Examples are B-
North, Mercy, Christ.
Level 3: Take care of babies less than 32 weeks or of any gestations with complex
medical illness. Can do fairly full range of medical care, ventilator support, pediatric sub-
specialties (Neonatology, Pediatric anesthesiologists). Examples are GoodSam, UC,
Saint Elizabeth.
Level 4: highest level, highest acuity. This can deal with complex surgeries. If baby
needs surgery they will be shipped to Children's (only level 4 in the area). Often
delivered at separate hospital and transferred over.
neonatal mortality ✅If die within first 28 days
infant mortality ✅If die within first year
maternal mortality ✅if anything related to pregnancy or delivery exacerbated death,
this is change and is why we have seen maternal deaths increase, because of
recording. US has highest maternal death rate of developed countries, but spends the
most on health care, and only developing nation that is getting worse rather than better.
Obesity, diabetes, hypertension may be the cause.
EDC- Estimated Date of Confinement, (confinement is end of pregnancy).
EDD- Estimated Date of Delivery.
EDB- Estimated Date of Birth. ✅These are acronyms for due dates. Synonymous,
used interchangeably.
Abortion ✅when a pregnancy ends before 20 weeks gestation. This encompasses
SAB and EAB (spontaneous(miscarriage) and elective). If baby is less than 500g it is
also considered an abortion if age of fetus is not known.
Term pregnancy ✅as a broad category it is a period of time starting at 37 weeks up to
42 weeks.
Early term: 37-39
Full term: 39-41
Late term: 41-42
, Preterm labor ✅this is less than 37 weeks but at least 20 weeks (before 20 is an
abortion).
Postterm labor ✅this starts at 42 weeks and later. We don't like this because pracenta
only made to last 42 weeks. Usually induce them before this.
Stillborn (interuterine fetal demise) IUFD ✅Layman's term is stillbirth but medical term
is UFD (intrauterine fetal demise), when a baby is born not alive (but has to be after 20
weeks, because 20 weeks is abortion).
prenatal/antepartum period ✅Before labor, from start of conception up until they go
into labor.
Intrpartum ✅Once a woman goes into labor, from when labor starts up until products of
conception are delivered (baby and then placenta).
Postpartum ✅After products of conception are delivered until body goes back to
homeostasis (internal structures, blood values go back to normal). Every woman will be
different, average time frame is about 6 weeks. From when baby is born to about 6
weeks after.
Trimester/weeks gestation ✅Deals with antepartum part, prenatal.
First trimester- First 13 weeks.
Second trimester- Weeks 14 through 26.
Third trimester- Weeks 27 to 40 (due date).
Gravida ✅simply how many times a woman has been pregnant, no matter what has
happened with pregnancies.
Nulligravida- Woman who has never been pregnant.
Primigravida- Pregnant once.
Multigravida- Pregnant more than once, 2 or more times.
Para ✅How many births the woman has had after 20 weeks. (Before 20 weeks it is
considered an abortion). Doesn't matter if infant is born dead or alive as long as it is
after 20 weeks. Consider multiples one birthing experience.
Nullipara- Never delivered after 20 weeks. Possible that person had miscarriage but not
delivered before.
Primipara- Delivered once after 20 weeks.
Multipara- Delivered more than once after 20 weeks.
