Summary

This document contains a series of obstetrics questions and answers, focusing on pregnancy and labor.

Full Transcript

**1 - Question:** A pregnant client asks why her urine is checked every visit for protein, ketones, and glucose. The nurse explains that the purpose of the test is to monitor for the development of which conditions? 1. Diabetes, UTI & chronic HTN 2. Diabetes, chronic HTN & STDs 3. Diabetes, PI...

**1 - Question:** A pregnant client asks why her urine is checked every visit for protein, ketones, and glucose. The nurse explains that the purpose of the test is to monitor for the development of which conditions? 1. Diabetes, UTI & chronic HTN 2. Diabetes, chronic HTN & STDs 3. Diabetes, PIH, and dehydration (selected answer) 4. UTI, dehydration, and PIH 2- **Question 2:** When providing education on pre-conceptual considerations to a female patient and her spouse, the nurse knows that teratogens during the embryonic stage pose the greatest risk.   - **A.** Week 2-8 - **B.** Week 9-12 - **C.** Week 13-birth - **D.** Fertilization to the 2nd week - **E.** The 1st trimester **Question 3**The increased blood volume in pregnancy is responsible for which of the following? - **A.** Rise in BP - **B.** Physiologic anemia of pregnancy - **C.** Increase risk of DVT - **D.** Pregnancy-induced HTN **Question 4:** What biologic marker is secreted and is the basis for pregnancy tests? - **A.** Estradiol - **B.** Progesterone - **C.** Luteinizing hormone - **D.** Human chorionic gonadotropin **Question 5:** A laboring client is to be given an epidural for pain management in labor. Prior to the procedure, the physician orders a rapid intravenous infusion of 1500 cc of Lactated Ringer\'s solution. The nurse knows that the purpose of this treatment regime is to:   - **A.** Prevent dehydration, which may result from side effects of nausea and vomiting - **B.** Restore fluid and electrolyte imbalance that has occurred during the labor process - **C.** Replace blood volume lost during the labor process - **D.** Increase intravenous fluid volume to prevent hypotension **Question 6:** Which assessment is the best indication that a client is in true labor? - **A.** Bloody show/mucus - **B.** Membrane leak/positive - **C.** Vertex presentation at +1 station - **D.** Cervical change **Question 7 :** For which screening test to detect chromosomal anomalies would a nurse schedule a client for at 10 weeks gestation? - **A.** Amniocentesis - **B.** Chorionic villus sampling - **C.** Fasting glucose - **D.** Ultrasound **Question 8:** A client is a gravida 1 para 0, 42 weeks gestation in early labor. Her tracing indicates normal variability and variable decelerations. As her nurse, you are aware that the decelerations are probably caused by:   - **A.** Compression of the umbilical cord - **B.** Head compression - **C.** Uteroplacental insufficiency - **D.** Maternal hypotension **Question 9:** A pregnant client is complaining of morning sickness. The nurse advises her to: - **A.** Avoid fluids after 8:00 PM - **B.** Eat dry carbohydrates before arising - **C.** Eat high protein foods - **D.** Eat small, frequent meals **Question 10:** What is a positive sign of pregnancy? - **A.** Enlargement of the uterus and abdomen - **B.** Fetal heart tones, Ultrasound and fetal movement - **C.** Positive pregnancy test - **D.** Quickening **Question 11:** The nurse is assessing the mother\'s knowledge of the functions of the amniotic fluid. Her statement is correct when she states: **SELECT ALL THAT APPLY:** - **A.** The fluid is responsible for oxygen exchange - **B.** The fluid helps maintain environmental temperature - **C.** The fluid helps cushion the baby against harm - **D.** The fluid helps to keep the skin lubricated **Question 12:** The nurse prepares prescribed oxytocin, which is to be added to the client\'s IV when the placenta has been delivered. The nurse determines the placenta has separated and is about to be delivered when the:   - **A.** Abdominal wall relaxes noticeably and the cord shortens - **B.** Client complains of the urge to push and there is a gush of blood - **C.** Cord lengthens outside the vagina with a gush of blood - **D.** Uterus falls below the level of the symphysis pubis and gets firm **Question 13:** Which client problem would be considered a danger signal that a client should report immediately? - **A.** Chronic constipation - **B.** Early evening fatigue - **C.** Loss of appetite - **D.** Decreased fetal movement **Question 14 :** Identify the type of FHR deceleration observed in the provided fetal monitoring strip. - **A.** Early deceleration **Question 15:** A contraction stress test indicates the following late decelerations occurring in about 6 of the 8 contractions. The nurse documents these results as: - **A.** Suspicious - **B.** Positive - **C.** Negative - **D.** Unsatisfactory **Question 16:** Leopolds maneuvers are used to assess the fetal presentation, dilation, and station. - **A.** True - **B.** False 0.5 ml **Question 18:** In stage 1 of labor, during the active phase, the cervix dilates? - **A.** 1-3 cm - **B.** 4-7 cm - **C.** 7-10 cm - **D.** 10 cm **Question 19:** The nurse is teaching a prenatal class on false labor. The nurse tells the class that false labor most likely will inclutde which of the following? SELECT ALL THAT APPLY. - **A.** An increase in intensity and frequency of contractions - **B.** Pain in the abdomen that diminishes with movement - **C.** Progressive cervical changes - **D.** Contractions that go away with walking **Question 20:** A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Select all probable signs of pregnancy.   - **A.** Uterine enlargement   - **B.** Chadwick\'s sign - **C.** Positive pregnancy test - **D.** Fetal heart rate detected by Doppler device - **E.** Active fetal movement palpable by the examiner **Question 21:** A pregnant client who is due in 3 weeks tells the nurse she has shortness of breath occasionally. The nurse explains that this will decrease after the occurrence of:   - **A.** Contractions - **B.** Lactation - **C.** Lightening - **D.** Quickening **Question22:** A 30-year-old G1 PO has a normal maternal AFP level. These test results tell her that the fetus: - **A.** Will not have any congenital anomalies - **B.** Is of a viable gestational age - **C.** Most likely does not have a neural tube defect **Question 23:** Choose the correct answer that places the cardinal movements in the correct order: - **A.** flexion, engagement, internal rotation, descent, external rotation, restitution, expulsion - **B.** engagement, flexion, internal rotation, descent, external rotation, expulsion - **C.** engagement, descent, internal rotation, flexion, external rotation, restitution, expulsion - **D.** engagement, flexion, internal rotation, restitution, external rotation, expulsion **Question 24:** The order is for Pitocin to infuse at 6 milliunits (mu) per minute. The nurse adds 15 units of Pitocin to 250 mL of LR for labor induction. How many mL/hour will the pump be set at? - **A.** 1.5 mL/hour - **B.** 60 mL/hour - **C.** 15 mL/hour - **D.** 6 mL/hour **Question 25** A pregnant woman in for her first check-up and states she had a boy at 30 weeks that died of SIDS (Sudden infant death syndrome), a baby girl at 39 weeks, an ectopic pregnancy at 11 weeks, and a miscarriage at 22 weeks. Identify the parity using GTPAL - *- G51211* **Question 26:** Stage 1 of labor includes which phases in the correct order? - **A.** Transition, Latent, Active - **B.** Active, Latent, Transition - **C.** Active, Transition, Latent - **D.** Latent, Active, Transition **Question 27:** A menopausal woman has been instructed to take 1200 milligrams of calcium daily. She has 300 mg tablets. The client should take: - 4 tablets. **Question 28 Identify the cervix in the picture** **Question 30:** The nurse notes that when palpating the abdomen during a contraction, it is not firm in the abdominal wall. The intensity of this contraction would be termed: - **A.** Mild - **B.** Moderate - **C. Strong** - **D.slight** **Question 31:** An non-stress test is said to be reactive when which characteristic is true? - **A.** The fetus is asleep - **B.** Movement occurs only with acoustic stimulation - **C.** Two fetal heart accelerations 15 beats above baseline lasting 15 seconds long, the accelerations occur within 20 minutes - **D.** FHR varies approximately 10 bpm above baseline and lasts 15 seconds long, but there is no fetal movement **Question:** Infuse 800 mL of D5LR at 75 mL/hour. The drop factor is 10 gtt/mL. How many drops per minute will the nurse administer? - **A.** 12 gtt/min - **B.** 13 gtt/min - **C.** 15 gtt/min - **D.** 17 gtt/min **Question 34:** Which comment by a client who is pregnant indicates a need for further teaching? - **A.** \"I have been walking 2 miles every day for the last 3 years, and I plan to maintain my walking in pregnancy.\" - **B.** \"I never liked milk, but I have started adding more cheese and other dairy products to my diet instead.\" - **C.** \"I used to douche once a week prior to pregnancy, but now I have stopped.\" - **D.** \"My husband and I used to have wine every night for dinner, now we have wine once a week.\" **Question:** The client presents with a LMP of 2/27/2019. Calculate the EDD. Please write your answer in the following format: MM/DD/YYYY. **Answer:** To calculate the estimated due date (EDD), add 9 months and 7 days to the LMP. 2/27/2019 + 9 months + 7 days = **11/04/2019** **Question 35 :Which comment by a client who is pregnant indicates a need for further teaching?** *- My husband and I used to have wine every night for dinner, now we have wine once a week* **Question 36 :** The nurse instructs the client to begin pushing with her contractions: - **A.** At the beginning of the 2nd stage - **B.** During the transition part of the 3rd stage - **C.** During the 3rd stage - **D.** At the end of the 1st stage **Question 37** When assessing a client who has just begun experiencing labor pains, you explain that the frequency of her contractions is determined by: - **A.** Beginning of one contraction to the end of the next one - **B.** Beginning of one contraction to the beginning of the next one - **C.** End of one contraction to the beginning of the next one - **D.** Peak of one contraction to the peak of the next one **Question 38:** A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of Goodell\'s sign. The nurse determines this sign indicates:   - **A.** A softening of the cervix - **B.** A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus   - **C.** The presence of Chadwick\'s sign   - **D.** The presence of ballottement **Question 39:** A pregnant client complains of morning sickness. Which assessment finding may indicate a possible developing complication?   - **A.** Ketones in the urine - **B.** Trace glucose in the urine - **C.** Fetal heart rate (FHR) 155 - **D.** Maternal pulse 90 **Question 40:** You auscultate the FHR and determine a rate of 152. Which action is appropriate? - **A.** Immediately report FHR to the physician - **B.** Inform the client that the rate is normal - **C.** Reassess the FHR in 5 minutes - **D.** Take the client\'s temperature **Question 41**Please identify the 3-letter code to identify the position of the baby in the picture below. - **A.** ROA - **B.** RSA - **C.** LOA - D.LSP **Question 42:** A client presents to L&D for evaluation. Upon placing her on the EFM, you find the FHR t o be consistently 170 to 180 bpm. What should the nurse do first? - **A.** Apply oxygen at 10 L/min by face mask - **B.** Increase IV fluids - **C.** Prepare for a cesarean section - **D.** Take the mother\'s temperature **Question 43:** The nurse is caring for a client in labor. Which assessment finding indicates to the nurse that the client is beginning the second stage of labor?   - **A.** The contractions are regular - **B.** The membranes have ruptured - **C.** The cervix is completely dilated - **D.** The client starts to expel clear vaginal fluid **Question 44** What approach would be best for the nurse to use when assessing for ruptured membranes in a laboring patient? - **A.** Perform a vaginal exam with sterile gloves - **B.** Test a vaginal sample of fluid with Nitrazine paper - **C.** Obtain a vaginal sample of fluid and test for ferning - **D.** Test the vaginal fluid with AmnioSure **Question 45:** A patient has requested an epidural. What are the nursing responsibilities prior to the procedure? Select all that apply: - **A.** IV fluids (bolus 400 cc) - **B.** Assess WBCs - **C.** Assess contractions - **D.** Assess PT/PTT **Question 46:** A pregnant client is 36 weeks' gestation and is complaining of heartburn. What would be the most helpful nursing intervention? - **A.** Avoid fruits and vegetables high in acid content - **B.** Eat smaller and more frequent meals - **C.** Rest after each meal - **D.** Take an antacid tablet before each meal **Question 47:** The nurse is auscultating FHRs in a patient who is 37 weeks pregnant. While in a supine position, the patient states \"I feel lightheaded, dizzy, and nauseous.\" Which of the following nursing actions is appropriate? - **A.** Change position, preferably to the left side - **B.** Place a wedge or pillow under the patient\'s right hip - **C.** Prepare for administration of RBCs - **D.** Administer supplemental oxygen - **E.** Help the patient turn on her right side **Question 48:** Which couple would be at potential risk for developing problems with the Rh factor? - **A.** Both parents are Rh negative - **B.** Both parents are Rh positive - **C.** The mother is Rh negative, the father is Rh positive   - **D.** The mother is Rh positive and the father is Rh negative **Question 49:** Which maternal test needs to be addressed in a client having an amniocentesis? - **A.** Blood type - **B.** Rh factor - **C.** HCG - **D.** Rubella titer **Question 50:** While providing an education to a prenatal class, the nurse instructs first-time mothers and fathers during the first trimester to include information that the father may experience which of the following as normal during the pregnancy? - **A.** No changes, only the mother has changed during pregnancy - **B.** Physical symptoms similar to the mother - **C.** Feeling distant from the mother - **D.** All of the above

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