Policies And Procedures Update Quiz

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Policies And Procedures Update Quiz - Quiz

Dept. Of Ob/Gyn policies and procedures have been updated. Do you know what they are?


Questions and Answers
  • 1. 

    Policy: Triage of Obstetrical Patients Immediate notification by the nurse and evaluation by a physician of a patient in triage should occur if the patient presenting complaint is?

    • A.

      Heavy vaginal bleeding

    • B.

      Category 2-3 FHT

    • C.

      Respiratory distress or complaint of SOB or chest pain

    • D.

      SBP>160 or DBP> 110

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    All of these clinical situations require immediate attention in order to avoid patient injury or patient harm.

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  • 2. 

    Policy: Triage of Obstetrical Patients Patients with less urgent complaints should be seen in what following time period.

    • A.

      Within 10 minutes

    • B.

      Within 30 minutes

    • C.

      Within 1 hour

    • D.

      Whenever someone can come to see her

    Correct Answer
    B. Within 30 minutes
    Explanation
    Patients with less urgent complaints should be seen within 30 minutes. This means that although their complaints are not considered urgent, they still require attention within a reasonable time frame. This ensures that their needs are addressed in a timely manner and prevents any potential deterioration of their condition. It also reflects the importance of providing quality care to all patients, regardless of the urgency of their complaints.

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  • 3. 

    Policy: Code Crimson Activating Code Crimson will activate the massive transfusion protocol?  True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Only the obstetrician or anesthesiologist can activate the massive transfusion protocol.

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  • 4. 

    Policy: Code Crimson Code Crimson should be activated any time there is a potential or an identified massive hemorrhage in an obstetric patient, and any team member can activate the system.       True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Any team member can activate a Code Crimson

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  • 5. 

    Policy: OB Rapid Response Team - RRT Obstetric and post partum RRT is activated by calling essential team members through the ASCOM phone system. These team member include:

    • A.

      MFM In-House at ext 5491

    • B.

      Chief Resident of Obstetric Service at ext 5368

    • C.

      L&D Charge nurse at ext 0456

    • D.

      L&D CRNA at ext 0463

    • E.

      NICU Team at ext 7853

    • F.

      All of the above

    Correct Answer
    F. All of the above
    Explanation
    These are all key members of the RRT and need to be called to evaluate the patient.

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  • 6. 

    Policy: Oxytocin The infusion rate of oxytocin that is similar to spontaneous labor is?

    • A.

      4-6 mu/min

    • B.

      10-12 mu/min

    • C.

      20 mu/min

    • D.

      30 mu/min

    Correct Answer
    A. 4-6 mu/min
    Explanation
    The correct answer is 4-6 mu/min. Oxytocin is a hormone that is commonly used to induce or augment labor. The infusion rate of oxytocin that is similar to spontaneous labor is typically 4-6 mu/min. This rate helps to mimic the natural release of oxytocin during labor, promoting effective contractions and progression of labor. Higher infusion rates may lead to hyperstimulation of the uterus and potential complications. Therefore, it is important to closely monitor the patient's response and adjust the infusion rate accordingly.

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  • 7. 

    Policy: Oxytocin The maximum dose for oxytocin infusion at LVHN L&D is?

    • A.

      10 mu/min

    • B.

      20 mu/min

    • C.

      30 mu/min

    • D.

      40 mu/min

    Correct Answer
    B. 20 mu/min
    Explanation
    The correct answer is 20 mu/min. This is the maximum dose for oxytocin infusion at LVHN L&D. Oxytocin is commonly used in labor and delivery to induce or augment labor. It helps to stimulate contractions of the uterus. However, it is important to administer it at the appropriate dose to avoid complications such as uterine hyperstimulation or fetal distress. Therefore, the maximum dose of 20 mu/min is recommended to ensure safe and effective labor induction or augmentation.

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  • 8. 

    Policy: Oxytocin For tachysystole with FHR changes, all of the following should occur EXCEPT?

    • A.

      Place patient in lateral lie

    • B.

      Administer IV fluid bolus of 500 mls.

    • C.

      Increase oxytocin as to " push through" the tachysystole

    • D.

      Notify the obstetrical provider responsible for the patient

    Correct Answer
    C. Increase oxytocin as to " push through" the tachysystole
    Explanation
    Always turn Oxytocin off when tachysystole is encountered.

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  • 9. 

    General Principles Policies and CPG'S are meant to be guidelines. Clinical situations may exist where deviation from the policy/CPG may be clinically appropriate. In these situtations, the clinician must document the rationale for this management.  True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    In the event of policy or CPG conflicts with a clinical situation and a deviation from the signed documents occurs, a comprehensive note /document needs to be written in the medical record as to the reason for the deviation. Be clear as to your thoughts of why the deviation is necessary,

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  • 10. 

    Policy: HIV Assessment Protocol Rescreening for HIV is done at 36 weeks or in labor for women who ?

    • A.

      Declined initial testing

    • B.

      Choose to be rescreened

    • C.

      Have risk factors for HIV infection

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    The correct answer is "All of the above." This means that women who declined initial testing, choose to be rescreened, or have risk factors for HIV infection should be rescreened for HIV at 36 weeks or in labor. This policy ensures that all women who fall into any of these categories are given the opportunity to be tested for HIV, which is important for the prevention and management of the infection.

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  • 11. 

    Policy: HIV Assessment Protocol Patients who present for admission to PNU or L&D should be offered which test?

    • A.

      Routine HIV testing

    • B.

      Rapid HIV testing

    • C.

      ELISA

    • D.

      Western blot

    Correct Answer
    B. Rapid HIV testing
    Explanation
    Patients with unknown HIV, those who choose rescreening, or those with risk factors for HIV infection need a RAPID HIV test in labor so that the results are available prior to delivery and that she can receive intrapartum AZT treatment if postive.

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  • 12. 

    General Knowledge/ Practice :Surgical Prep A level 1 c-section has been called due to cord prolapse. What type of abdominal prep should the circulating nurse do?

    • A.

      Chloraprep and let it dry as usual

    • B.

      Scrub abdomen with betadine solution

    • C.

      Pour betadine over abdomen, "splash and dash"

    • D.

      Chloraprep and wipe off

    Correct Answer
    B. Scrub abdomen with betadine solution
    Explanation
    The correct answer is to scrub the abdomen with betadine solution. This is because a level 1 c-section is a surgical procedure that requires a thorough cleaning of the abdomen to minimize the risk of infection. Scrubbing the abdomen with betadine solution helps to remove any bacteria or contaminants from the skin surface, ensuring a clean surgical field. This method is more effective than simply pouring betadine over the abdomen or using chloraprep, as scrubbing helps to physically remove dirt and bacteria from the skin.

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  • 13. 

    Policy: Cesarean Delivery Level Recommendations A level 3 c-section has been called for your patient. As the bedside nurse, your responsibility is to?

    • A.

      Keep track of the time

    • B.

      Monitor mother and fetus for clinical changes

    • C.

      Notify physician of any changes in maternal or fetal status

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    As the bedside nurse, your responsibility during a level 3 c-section is to keep track of the time, monitor the mother and fetus for any clinical changes, and notify the physician of any changes in maternal or fetal status. This is because during a c-section, it is crucial to closely monitor the well-being of both the mother and the fetus, as well as keep track of the time to ensure the procedure is progressing smoothly and timely. Therefore, all of the options mentioned are part of the nurse's responsibilities during a level 3 c-section.

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  • 14. 

    Policy: Use and Administration of Terbutaline Sulfate Terbutaline can be used in the following clinical situation EXCEPT?

    • A.

      Prior to external cephalic version

    • B.

      Preterm contractions

    • C.

      Uterine tachysystole

    • D.

      All of the above

    Correct Answer
    B. Preterm contractions
    Explanation
    Terbutaline is not used for PRETERM contractions.

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  • 15. 

    Policy: Use and Administration of Terbutaline Sulfate Following administration of terbutaline, how long should a patient be monitored closely (continuous fetal monitoring, frequent blood pressure, pulse oximetry)?

    • A.

      5 minutes

    • B.

      15 minutes

    • C.

      30 minutes

    • D.

      60 minutes

    Correct Answer
    C. 30 minutes
    Explanation
    After administration of terbutaline, it is recommended to closely monitor the patient for 30 minutes. This includes continuous fetal monitoring, frequent blood pressure checks, and pulse oximetry. This monitoring period allows healthcare professionals to closely observe any potential side effects or adverse reactions that may occur after taking terbutaline. Monitoring for this duration ensures the safety and well-being of the patient.

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  • 16. 

    Policy: Fetal Monitoring During Administration of Regional Anesthesia/ Analgesia The goals of the fetal monitoring during administration of anesthesia/analgesia policy are to ensure which of the following?

    • A.

      The fetal heart rate is traced at all times

    • B.

      Continuous awareness of fetal well being and encourage members of the team to seek additional assistance to ensure fetal well being.

    • C.

      Prolong the anesthesia/analgesia administration

    • D.

      All of the above

    Correct Answer
    B. Continuous awareness of fetal well being and encourage members of the team to seek additional assistance to ensure fetal well being.
    Explanation
    The correct answer is "Continuous awareness of fetal well being and encourage members of the team to seek additional assistance to ensure fetal well being." This policy aims to monitor the fetal heart rate continuously and ensure the well-being of the fetus during the administration of anesthesia/analgesia. It emphasizes the importance of maintaining awareness and seeking additional assistance if necessary to ensure the safety and well-being of the fetus. The policy does not mention prolonging the administration of anesthesia/analgesia as a goal.

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  • 17. 

    Fetal Monitoring During Administration of Regional Anesthesia/ Analgesia: When preparing a patient for a scheduled cesarean delivery, when should external fetal monitoring be applied and when discontinued?

    • A.

      Only a "heart rate check" after the spinal is placed. These patients do not need continuous monitoring.

    • B.

      As soon as the patient is placed in the supine position/just prior to the surgical prep

    • C.

      As soon as the paitent is placed in the supine position/ after the time out.

    • D.

      All of the above

    Correct Answer
    B. As soon as the patient is placed in the supine position/just prior to the surgical prep
    Explanation
    External fetal monitoring should be applied as soon as the patient is placed in the supine position or just prior to the surgical prep. This allows for continuous monitoring of the fetal heart rate during the administration of regional anesthesia/analgesia. Continuous monitoring is important to ensure the well-being of the fetus and to detect any potential complications that may arise during the procedure.

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  • 18. 

    Policy: Fetal Monitoring During Administration of Regional Anesthesia/ Analgesia When preparing a patient for a cesarean delivery, when should internal fetal monitoring be discontinued?

    • A.

      Whenever possible once the patient is in the Operating room.

    • B.

      Before the surgical skin prep

    • C.

      After the surgical skin prep, just prior to draping

    • D.

      After the "Time Out"

    Correct Answer
    C. After the surgical skin prep, just prior to draping
    Explanation
    Internal fetal monitoring involves the insertion of a probe into the uterus to directly monitor the baby's heart rate. During a cesarean delivery, it is important to have accurate and continuous monitoring of the baby's heart rate to ensure their well-being. However, the probe can interfere with the surgical procedure and increase the risk of infection. Therefore, it is recommended to discontinue internal fetal monitoring after the surgical skin prep, just prior to draping, to minimize these risks and allow for a safe and sterile surgical environment.

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  • 19. 

    Policy: CPN Can you place your patient into the CPN system prior to the patients arrival?          True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    False, you can only place the patient into CPN once they are on the clinical unit.

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  • 20. 

     When you cannot reconcile your fetal monitor strip in CPN a pink/red sticker must be placed on the paper strip and sent to medical records.  True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    All strips that are not able to be reconciled require a pink/red sticker and they MUST be sent to medical records for inclusion into the legal record.

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  • 21. 

    Policy: Fetal Monitor Strip Compliance Does the obstetrical nurse need to verify that the fetal monitor strip has been archived correctly at the beginning and end of their shift during shift report.  True or False?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    It is extremely important that fetal monitor strips be archived correctly by the nurse.

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  • 22. 

    Policy:  Abortion ( Induced Termination of Pregnancy or Delivery) Following the signing of an elective termination consent, how long must you wait until you are able to perform the procedure?

    • A.

      12 hours

    • B.

      24 hours

    • C.

      36 hours

    • D.

      48 hours

    Correct Answer
    B. 24 hours
    Explanation
    Pennsylvania Abortion Control Act states that when performing an elective termination the patient must sign no less than 24 hours prior to the procedure. This ensures that the patient has had enough time to proceed or cancel the procedure.

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  • 23. 

    Policy: Abortion ( Induced Termination of Pregnancy or Delivery) You have the right to make any staff member participate in the performance of an elective termination. True or False

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Any health care member has the right to refuse to participate in the performance of an elective termination. An employee is protected under the Right Of Conscience.

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  • 24. 

    Policy: Abortion ( Induced Termination of Pregnancy or Delivery) An elective termination of pregnancy can be performed at LVHN when the gestational age is greater than 24 weeks? True or False 

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Elective terminations CANNOT be performed after 24 weeks gestation at LVHN.

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  • 25. 

    Policy: Gestational Carrier Is early notification of a gestational carrier important for the hospital obstetric team to be aware of? Yes or No

    • A.

      Yes

    • B.

      No

    Correct Answer
    A. Yes
    Explanation
    There are a number of processes both legal and procedural that are required prior to the admission of the gestational carrier. It is important that all of the necessary legal documents are in order. Early notification provides the gestational carrier and the intended parents to have an enjoyable birth.

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  • 26. 

    Policy:  Gestational Carrier What are the required documents that a gestational carrier needs?

    • A.

      Consent to Treatment

    • B.

      Intended parent acknowledgement

    • C.

      Gestational Carrier - Maternity Acknowledgment

    • D.

      Court order or no court order present prior to discharge

    • E.

      All of the above

    Correct Answer
    E. All of the above
    Explanation
    All of these documents are a requirement and discharge of the newborn will not occur if the consents are not completed.

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  • 27. 

    Policy: Care of the Obstetrical Patient who Refuses Blood or Blood Products for Religious or Other Reasons When should you identify that a patient refuses to accept blood or blood products?

    • A.

      1st Obstetrical Vist

    • B.

      28 week visit

    • C.

      36 week visit

    • D.

      On admission to Labor & Delivery

    Correct Answer
    A. 1st Obstetrical Vist
    Explanation
    The first obstetrical visit the patient needs to be identified in the event the pregnancy terminates or continues. It is extremely important to identify what products the patient will accept.

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  • 28. 

    Policy: Care of the Obstetrical Patient who Refuses Blood or Blood Products for Religious or Other Reasons What consultations are advised if the patient's prenatal hemoglobin is less than 11?

    • A.

      MFM

    • B.

      Anesthsia

    • C.

      Hematology

    • D.

      All of the Above

    Correct Answer
    D. All of the Above
    Explanation
    Timely consultation with MFM, Anesthesia and Hematology should take place early in the pregnancy in order to optimize the hemoglobin.

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  • 29. 

    Policy: Care of the Obstetrical Patient who Refuses Blood or Blood Products for Religious or Other Reasons Blood/ Blood Product Acceptance/ Refusal Form should be completed as soon as possible during the antenatal care as some patients may desire a religious consultation for advice. True or False

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Many patients with religious objections to blood/ blood products desire to discuss with their religious leaders what is acceptable if faced with a clinical situation where volume expansion is needed.

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  • 30. 

    Policy:  Placental Examination/ Requisition What is required in completing the revised Placental Examination/ Requisition?

    • A.

      Check off only a maternal indicator

    • B.

      Have the nurse fill out the form and guess which indicator

    • C.

      Document relevant summary of prenatal care, and L&D delivery and choose an appropriate clinical indicator.

    • D.

      Complete the form for all deliveries

    Correct Answer
    C. Document relevant summary of prenatal care, and L&D delivery and choose an appropriate clinical indicator.
    Explanation
    It is important that a relevant summary of prenatal care, and the labor and delivery events be included. In addition, the clinical factors i.e. maternal, fetal, or placental for why review is needed assists the pathologist when examining the placenta.

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  • Current Version
  • Mar 15, 2023
    Quiz Edited by
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  • Apr 15, 2014
    Quiz Created by
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