NSG-330-1 OB NCLEX Questions
A nurse is caring for a client who is in her first trimester of pregnancy and asks the nurse if she can continue to exercise during pregnancy. Which of the following responses by the nurse is appropriate? -"Activities that raise the body temperature, such as saunas and hot tubs, are safe until the third trimester." -"It is recommended that pregnant clients limit their exercise routine to stretching activities on a mat several times a week." -"Exercising during pregnancy is not recommended." -"Daily jogging for up to 30 minutes is fine throughout the pregnancy."
"Daily jogging for up to 30 minutes is fine throughout the pregnancy." (While weight-bearing exercises might become uncomfortable in the last trimester, they are generally not contraindicated, providing the client stays hydrated and avoids becoming overheated for extended periods.)
A nurse is providing teaching about expected gestational changes to a client who is at 12 weeks of gestation. Which of the following statements by the clients indicates a need for further teaching? -"I will use only nonprescription medications while pregnant." -"I will reduce my stress level." -"I will monitor my weight gain during the remaining months." -"I will tell my doctor before using home remedies for nausea."
"I will use only nonprescription medications while pregnant." (Both nonprescription and prescription medications can be harmful to the fetus. The client needs to understand the importance of disclosing all medications, supplements, and vitamins to the provider prior to use during pregnancy.)
A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks of this will continue until delivery. Which of the following responses should the nurse make? -"There is no way to predict how long it will last in each individual client." -"It occurs during the first trimester and near the end of the pregnancy." -"It's a minor inconvenience, which you should ignore." -"In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone."
"It occurs during the first trimester and near the end of the pregnancy." (Urinary frequency is due to increased bladder sensitivity during the first trimester and recurs near the end of the pregnancy as the enlarging uterus places pressure on the bladder.)
A nurse in a prenatal clinic is caring for a client who believes that she might be pregnant because she feels the baby moving. Which of the following statements should the nurse make? -"This is a possible sign of pregnancy." -"This is a presumptive sign of pregnancy." -"This is a positive sign of pregnancy." -"This is a probable sign of pregnancy."
"This is a presumptive sign of pregnancy." (Presumptive signs of pregnancy include physical changes that are apparent to the client, such as quickening.)
A nurse is caring for a client who is at 6 weeks of gestation with her first pregnancy and asks the nurse when she can expect to experience quickening. Which of the following responses should the nurse make? -"This will occur during the last trimester of pregnancy." -"This will happen by the end of the first trimester of pregnancy." -"This will happen once the uterus begins to rise out of the pelvis." -"This will occur between the fourth and fifth months of pregnancy."
"This will occur between the fourth and fifth months of pregnancy." (Quickening is defined as the first time the client is able to feel her fetus move. In a primigravida client, this usually occurs at 18 weeks of gestation or later. In a multigravida client, this can occur as early as 14 to 16 weeks.)
A nurse is caring for a client who has a major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless". Which of the following responses should the nurse make? -"It's not unusual for depressed people to feel that way." -"You've been feeling that your life has no meaning." -"Why do you feel you are worthless?" -"You have a great deal to live for."
"You've been feeling that your life has no meaning." (This open-ended statement uses the communication tool of empathy and addresses the client's feeling of worthlessness. This therapeutic response communicates to the client that the nurse was listening, and it will encourage the client to talk further about personal feelings.)
A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes the client's current status? -2-0-0-2-0 -4-0-1-2-2 -4-2-0-2-2 -3-0-2-0-2
4-0-1-2-2 (This response correctly describes the client's current status: pregnant currently and had 3 prior pregnancies (G); no term births (T); one pregnancy resulted in the preterm birth (P) of twins; two pregnancies ended in abortion (A); and she has two living children (L).)
A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients? -All of the clients -A client who has a history of preterm labor -A client who has been exposed to AIDS -A client who has mitral valve prolapse
All of the clients (MSAFP is a screening tool to detect open spinal and abdominal wall defects in the fetus. This maternal blood test is recommended for all pregnant woman.)
A nurse is caring for a client who is considering several methods of contraception. Which of the following methods of contraception should the nurse identify as being most reliable? -An intrauterine device (IUD) -An Oral contraceptive -A male condom -A diaphragm with spermicide
An intrauterine device (IUD) (An IUD is found to have a failure rate of less than 1 in 100 users, which makes it one of the most reliable methods of contraception.)
A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? (Select all that apply) -Fetal gender -Rh incompatibility -Neural Tube Defects -Anomalies in fetal chromosomes -Cephalopelvic Disproportion
Anomalies in fetal chromosomes (Examination of amniotic fluid yields data about genetic anomalies, such as hemophilia and inborn metabolic disorders.) Neural tube defects (Examination of alpha fetoprotein levels in amniotic fluid confirms the presence of a neural tube defect, such as spina bifida.) Fetal gender (Karyotyping of fetal cells obtained from amniotic fluid permits the identification of fetal gender, which is important if an X-linked disorder is suspected in a male fetus.)
A nurse is instructing a women who is contemplating pregnancy about nutritional needs. To reduce the risk of giving birth to a newborn who has a neutral tube defect, which of the following information should the nurse include in the teaching? -Increase intake of iron-rich foods. -Limit alcohol consumption. -Avoid foods containing aspartame. -Consume foods fortified with folic acid
Consume foods fortified with folic acid (Increased consumption of folic acid in the 3 months prior to conception, as well as throughout the pregnancy, reduces the incidence of neural tube defects in the developing fetus.)
A nurse is caring for a client who is to undergo a biophysical profile. The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? (Select all that apply) -Fetal breathing -Amniotic fluid volume -Fetal motion -Fetal gender -Fetal neck translucency
Fetal breathing (A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume.) Fetal motion (A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume.) Amniotic fluid volume (A biophysical profile is an assessment of fetal well-being and includes ultrasound evaluation of fetal breathing movements, gross fetal movements, and amniotic fluid volume.)
A nurse is providing preconception counseling for a client who is planning a pregnancy. Which of the following supplements should the nurse recommend to help prevent neural tube defects in the fetus? -Calcium -Iron -Vitamin C -Folic acid
Folic acid (Adequate amounts of folic acid before conception and during the first trimester of pregnancy are necessary for fetal neural tube development. This vitamin helps prevent spina bifida and other neurological disorders.)
An assistive personnel (AP) tells the nurse manager that she observed a nurse on the unit removing a small amount of morphine from syringes prior to administering the medication to clients. Which of the following actions should the nurse manager take first? -Approach the involved nurse to discuss the behavior. -Refer the nurse to the board of nursing diversion program. -Notify the risk manager. -Gather data about the nurse's work performance and attendance history.
Gather data about the nurse's work performance and attendance history. (The first action the nurse should take is to conduct an investigation and determine if the allegations are true.)
A nurse is caring for a client who is at 22 weeks of gestation and has been unable to control her gestational diabetes mellitus with diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications? -Repaglinide -Glipizide -Glyburide -Acarbose
Glyburide (With the exception of glyburide, clients who are pregnant do not take oral hypoglycemics because they cross the placenta and can injure the fetus. Approximately 20% of clients who have gestational diabetes mellitus will require insulin. Insulin lowers blood glucose levels without harming the fetus.)
A nurse is preparing an educational program for a group of newly licensed nurses about client confidentiality. The nurse should explain that nurses may share a client's protected health information with which of the following groups? -The facility's administrators -Health care team members caring for the client -The client's immediate family members -Clergy affiliated with the facility
Health care team members caring for the client (To coordinate safe and effective care delivery, the nurse may share details of a client's health status and treatment plan with others who are responsible for delivering client care. The Health Insurance Portability and Accountability Act (HIPAA) allows sharing of information necessary for treating clients.)
A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following should the infant receive? -Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months -Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days -Hepatitis B immune globulin and hepatitis B vaccine within 12 hr of birth -Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen
Hepatitis B immune globulin and hepatitis B vaccine within 12 hr of birth (A newborn whose mother is positive for the hepatitis B surface antigen should receive both the hepatitis B vaccine and the hepatitis B immune globulin within 12 hr of birth.)
A nurse in a clinic is assessing a client who is at 8 weeks of gestation and has hyperemesis gravid arum. Which of the following should the nurse expect? -History of migraines -Nulliparous -Oligohydramnios -History of gestational hypertension -Twin gestations
History of migraines (History of migraines is a risk factor for hyperemesis gravidarum, which typically occurs during the first 20 weeks of pregnancy.) Nulliparous (Hyperemesis gravidarum is more common in nulliparous women, beginning in the first trimester. Clinical manifestations can continue throughout the pregnancy in some women.) Twin gestations (Twin gestations are a risk factor for hyperemesis gravidarum and might be related to increasing hormone levels of estrogen, progesterone, and human chorionic gonadotropin (hCG).)
A nurse is preparing to administer an injection of RhO (D) immunoglobulin. The nurse should understand that the purpose of this injection is to prevent which of the following newborn complications? -Hydrops fettles -Billiary atresia -Transient clotting difficulties -Hypobilirubemia
Hydrops fetalis (Hydrops fetalis is the most severe form of Rh incompatibility and can be prevented by the administration of Rho (D) immunoglobulin.)
A nurse receives a client care assignment from the charge nurse that he believes is unfair. The nurse voices his concern to the charge nurse. The nurse is using which level of communication at this time? -Interpersonal -Public -Interpersonal -Transpersonal
Interpersonal (Interpersonal communication is face-to-face interaction with another person. It results in an exchange of ideas, problem solving, expression of feelings, decision-making and personal growth.)
A nurse in a provider's office is caring for a client who is at 36 weeks of gestation scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse? -"It assists in identifying the location of the placenta and fetus." -"This is a screening tool for spina bifida." -"This will determine if there is more than one fetus." -"It is useful for estimating fetal age."
It assists in identifying the location of the placenta and fetus." (Identifying the positions of the fetus, placenta, and amniotic fluid pockets immediately prior to the amniocentesis increases the safety of this test by assisting with correct placement of the needle.)
A nurse is caring for a client who is at 18 weeks gestation. The client tells the nurse that she felt fluttering movements in her abdomen 3 days ago. The nurse should interpret this finding as which of the following? -Lightening -Quickening -Ballottement -Chloasma
Quickening (Clients describe quickening as a fluttering sensation, which can be felt as early as the 14th week of gestation. It reflects fetal movement.)
A nurse in a prenatal clinic is caring for a client. Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long, smooth surface on the client's right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones? -Right Upper -Right Lower -Left Lower -Left Upper
Right Upper (Fetal heart tones are best auscultated directly over the location of the fetal back, which, in this breech presentation, would be in the right upper quadrant.)
A nurse is caring for a client during the first trimester of pregnancy. After reviewing the client's blood work, the nurse notices she does not have immunity to rubella. Which of the following times should the nurse understand is recommended for rubella immunization? -Immediately -In the third trimester -During her next attempt to get pregnant -Shortly after giving birth
Shortly after giving birth (The rubella immunization should be offered to the client following birth, preferably prior to discharge from the hospital. This prevents the client from contracting rubella during the current or subsequent pregnancies, which would put her fetus at risk for rubella syndrome.)
A nurse is caring for a client who is at 36 weeks of gestation and is on the antepartum unit for continuous close observation. The client confides to the nurse that she doesn't think she will ever be a mother and begins to cry. Which of the following responses should the nurse make? -Gently change the subject to something more positive. -Sit quietly with the client and follow her cues. -Reassure the client that the provider will use advanced medical technology to detect any problems with her pregnancy. -Suggest that the client discuss her fears with her provider.
Sit quietly with the client and follow her cues. (This demonstrates using silence and active listening, therapeutic techniques that offer support and acceptance and encourage further communication.)
A nurse in a pediatric clinic is caring for a client who is postpartum and asks the nurse what to do when the newborn cries persistently. Which of the following strategies should the nurse suggest? (Select all that apply) -Take the newborn for a ride in the car. -Carry the newborn in a front or back pack. -Allow the newborn to continue crying. -Keep the newborn in the center of a large crib. -Swaddle the newborn in a receiving blanket.
Take the newborn for a ride in the car (Movement and rhythmic noise are soothing to newborns.) Carry the newborn in a front or back pack (Carrying the newborn in a front or back carrier provides the comfort of close contact and gentle movement that is soothing to newborns.) Swaddle the newborn in a receiving blanket (Swaddling simulates the intrauterine environment, position-wise, and provides security to the newborn.)
A nurse is reinforcing teaching about contraceptive methods with a client. Which of the following should the nurse recognize as a contradiction for diaphragm use? -The client is 42 years old. -The client has a 3-month-old infant. -The client smokes cigarettes. -The client has pelvic relaxation.
The client has pelvic relaxation. (Pelvic relaxation and large cystocele are contraindications for diaphragm use.)
A nurse is assessing a newborn who has Trisomy 21 (Down's syndrome) Which of the following are common characteristics? (Select all that apply) -Low birth weight -Transverse palmar creases -Muscular hypertonicity -Protruding tongue -Large ears
Transverse palmar creases zx(A common characteristic of newborns who have Trisomy 21 is transverse palmar creases.) Protruding tongue (A common characteristic of newborns who have Trisomy 21 is protruding tongue.)
