OB Exam 2 Lippincott Practice Questions
Which nursing action prevents a complication associated with the lithotomy position for the birth of the fetus? a. Placing a wedge under the hips b. Providing a paper bag c. Massaging the client's lower back d. Rubbing the client's legs
a
A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which equipment is most appropriate when auscultating fetal heart sounds at the 12th week? a. fetoscope b. tocodynometer c. Doppler d. stethoscope
c
The fetus of a nulliparous woman is in a shoulder presentation. The nurse would prepare the client for which type of birth? a. vacuum extraction b. forceps-assisted c. vaginal d. cesarean
d
A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus? a. ROA b. LOP c. LOA d. ROP
a
A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? a. Clear to straw-colored fluid b. Bloody fluid c. Cloudy white fluid d. Greenish fluid
a
The licensed practical nurse is evaluating the tracings on the fetal heart monitor. The nurse is concerned that there is a change in the tracings. What should the LPN do first? a. Assess and reposition the woman. b. Notify the registered nurse. c. Wait 2 minutes to review another tracing. d. Notify the health care provider.
a
While talking with a pregnant client who has undergone genetic testing, the client informs the nurse that the baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of a: a. trisomy numeric abnormality. b. chromosomal deletion. c. multifactorial inheritance. d. X-linked recessive inheritance.
a
A nurse is providing care to a woman during the third stage of labor. Which finding would alert the nurse that the placenta is separating? a. uterus becoming discoid shaped b. sudden gush of dark blood from the vagina c. boggy, soft uterus d. shortening of the umbilical cord
b
A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive? a. amniocentesis b. chorionic villus sampling c. ultrasound d. percutaneous umbilical cord sampling
c
A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes? a. 23 b. 44 c. 22 d. 46
d
A pregnant woman comes to the emergency department stating she thinks she is in labor. Which assessment finding concerning the pain will the nurse interpret as confirmation that this client is in true labor? a. Slows when the woman changes position b. Lasts about 20 to 25 seconds c. Occurs in an irregular pattern d. Radiates from the back to the front
d
A pregnant woman with a fetus in the cephalic presentation is in the latent phase of the first stage of labor. Her membranes rupture spontaneously. The fluid is green in color. Which action by the nurse would be appropriate? a. Check the maternal heart rate. b. Check the pH to ensure the fluid is amniotic fluid. c. Prepare to administer an antibiotic. d. Notify the health care provider about possible meconium.
d
A primigravida has been in labor for 18 hours and is finally moving into the second stage and is anxious to begin pushing. Which assessment should be prioritized at this time? a. evaluate maternal vital signs b. ensure empty urinary bladder c. evaluate fetal heart monitor d. ensure cervix fully dilated
d
Assessing a pregnant client in labor reveals that the client has not voided in the past 4 hours. What instruction will the nurse provide? a. "Even though you are sweating, you still need to urinate at least every hour." b. "You need to get up and walk around a bit so that your bladder can get filled more fully," c. "You need to give a urine specimen each time you urinate so we can check for infection." c. "It is important to try to urinate every 2 hours because you might not feel the urge."
d
A nurse is describing fetal growth to a group of newly pregnant clients. Place the structures below in the order from ovulation to term. 1. fetus 2. ovum 3. zygote 4. embryo
2, 3, 4, 1
The nurse is preparing a 38-year-old primigravid client for an amniocentesis. Which nursing consideration is appropriate regarding the testing process? a. Use an external fetal heart monitor during the test to ensure the fetus is not in distress.
a
Which cardinal movement of delivery is the nurse correct to document by station? a. Descent b. Internal rotation c. Extension c. Flexion
a
When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? a. passage of the mucous plug b. degree of thinning c. extent of opening to its widest diameter d. fetal presenting part
b
A client states, "I think my water broke! I felt this gush of fluid between my legs." The nurse tests the fluid with nitrazine paper and confirms membrane rupture if the swab turns: a. pink. b. olive green. c. yellow. d. blue.
d
Which complication occurs as a result of ineffective breathing patterns? a. flatus b. nausea c. hiccups d. hyperventilation
d
The fluid-filled, inner membrane sac surrounding the fetus is which structure? a. decidua b. endometrium c. amnion d. chorion
c
A G3 P2 with no apparent risk factors presents to the labor-and-delivery suite in early labor. She refuses the fetal monitor, stating she delivered her second baby at home without a monitor and everything went well. What is the nurse's best response? a. A few minutes on the monitor will ensure the baby is doing well and then the baby can then be monitored intermittently. b. Explain that you will have to call the physician and get an order to leave the fetal monitor off. c. Insist that the fetal monitor be used due to a lack of staff to adequately monitor her using any other method. d. Tell her that it is her decision, but that she will be placing herself and her baby at grave risk.
a
A client in her third trimester comes to the clinic for an evaluation. Assessment reveals that the cervix is thinning. The client says, "I know my cervix needs to dilate, but why does it get thinner?" Which response by the nurse would be appropriate? a. "You need the cervix to thin so it can stretch more easily." b. "Cervical thinning is a sign that you are in true labor."
a
A group of nursing students are analyzing the fetal circulation. After the session, the students correctly point out which fetal structure contains the highest concentration of oxygen? a. umbilical vein b. ductus arteriosus c. pulmonary vein d. umbilical artery
a
A nurse is discussing the importance of good nutrition to a young pregnant client. The nurse would point out that the growing fetus is getting nutrition from the mother via which structure? a. placenta b. chorion c. amniotic fluid
a
The nurse is caring for a client whose fetus is noted to be in the position shown. For which fetal lie would the nurse provide client teaching? a. oblique b. transverse c. longitudinal
c
A woman at 15 weeks' gestation is about to undergo amniocentesis. Which nursing intervention should be made first? a. Place the client in supine position. b. Have the client void. c. Observe the fetal heart rate monitor. d. Obtain a signed consent form.
d
A nurse is performing a vaginal examination of a woman in the early stages of labor. The woman has been at 2 cm dilated for the past 2 hours, but effacement has progressed steadily. Which statement by the nurse would best encourage the client regarding her progress? a. "You are still 2 cm dilated, but the cervix is thinning out nicely." b. Don't mention anything to the client yet; wait for further dilation (dilatation) to occur. c. "You haven't dilated any further, but hang in there; it will happen eventually." d. "There has been no further dilation (dilatation); effacement is progressing."
a
A nurse is providing care to a pregnant client in labor. Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation? a. frank b. complete c. footling
a
A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as: crowning. a. -2 station. b. 0 station. c. +2 station.
a
A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone? a. maintains the endometrial lining of the uterus during pregnancy b. regulates maternal glucose, protein, and fat levels c. contributes to mammary gland development d. ensures the corpus luteum of the ovary continues to produce estrogen
a
Assessment for surfactant level via lecithin/sphingomyelin (L/S) ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to: a. prevent alveoli from collapsing on expiration. b. encourage immunologic competence of lung tissue. c. increase lung resistance on inspiration. d. promote maturation of lung alveoli.
a
Assessment of a client in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in: a. latent phase of the first stage b. active phase of the first stage c. transition phase of the first stage.
a
During which time is the nurse correct to document the end of the third stage of labor? a. At the time of placental delivery b. Following fetal birth c. When pushing begins d. When the mother is moved to the postpartum unit
a
Prenatal testing is used to assess for genetic risks and to identify genetic disorders. In explaining to a couple about an elevated maternal serum alpha-fetoprotein screening test result, the nurse would discuss the need for: a. more definitive evaluations to conclude anything. b. a more specific determination of the acid-base status. c. special care needed for a Down syndrome infant. d. immediate termination of the pregnancy based on results.
a
The nurse identifies from a client's prenatal record that she has a documented gynecoid pelvis. Upon the client entering the labor and delivery department, which nursing action is best? a. Take no extra measures; prepare for a standard labor. b. Notify the client's support person that the labor is typically long. c. Prepare for vital signs and fetal monitoring hourly. d. Anticipate this client is a one-to-one registered nursing assignment.
a
The nurse is analyzing the readout on the EFM and determines the FHR pattern is normal based on which recording? a. Acceleration of at least 15 bpm for 15 seconds b. Increase in variability by 27 bpm c. Deceleration followed by acceleration of 15 bpm d. Decrease in variability for 15 seconds
a
The nurse is assisting a client in labor and delivery and notes the placenta is now delivered. What will the nurse document? a. completion of the third stage of labor b. completion of the fourth stage of labor c. transition phase d. attachment phase
a
The nurse is preparing a 38-year-old primigravid client for an amniocentesis. Which nursing consideration is appropriate regarding the testing process? a. Use an external fetal heart monitor during the test to ensure the fetus is not in distress. b. Monitor the client's vital signs during the test and hourly afterward for 8 hours. c. Instruct the client that minor bleeding and cramping are common. d. Instruct the client not to empty their bladder before the test.
a
The nurse is reporting a maternal serum alpha-fetoprotein (MSAFP) level of 2.5 MoM on shift hand-off. The oncoming nurse would be correct to initiate a teaching plan related to the fetus being at higher risk for which condition? a. Down syndrome b. Tay-Sachs disease c. Edwards syndrome d. Hemophilia A
a
Which intervention would be least effective in caring for a woman who is in the transition phase of labor? a. encouraging the woman to ambulate b. providing one-to-one support c. having the client breathe with contractions d. urging her to focus on one contraction at a time
a
While in utero, a fetus swallows many substances that are deposited in the fetal intestinal system as meconium. What problem can arise from this occurrence? a. If the fetus becomes stressed, the meconium is released into the amniotic fluid, placing the fetus at risk for pneumonia. b. Meconium-stained fluids cause an increased risk of jaundice. c. The fetus can become constipated following birth. d. Abdominal distension occurs and infection can set in.
a
A multigravida client admitted in active labor has progressed well and the client and fetus have remained in good condition. Which action should the nurse prioritize if the client suddenly shouts out, "The baby is coming!"? a. Contact the primary care provider. b. Inspect the perineum. c. Time the contractions. d. Auscultate the fetal heart tones.
b
A multigravida client at 39 weeks' gestation has been in labor for 8 hours without much change. The last vaginal exam revealed cervix 8 cm dilated and 0 station. Which is the best response if the client asks the nurse how far the fetus has advanced in the past half hour? a. "Checking your cervix will not speed up labor; let's wait." b. "Once your labor signs change, we can find out." c. "I can arrange for a cervix check, if you want." d. "The health care provider will have to check you. I'll call him."
b
A nurse is preparing a pregnant client for a nonstress test. To obtain the most accurate rhythm strip tracings, in which position is it best to place the client? a. supine b. semi-Fowler c. high Fowler d. client's left side
b
A pregnant client asks the nurse how the fetus breathes if it is floating in the amniotic fluid. The best explanation by the nurse is: a. the fetus breathes by receiving blood from the maternal circulation. b. the fetus receives oxygen through the umbilical vein. c. the fetus receives oxygen through the umbilical artery. d. the fetus breathes by exchanging gases in the lungs.
b
A pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse? a. "Amniotic fluid keeps the fetus from moving freely inside it to prevent injury." b. "Amniotic fluid cushions your baby to prevent injury." c. "Amniotic fluid provides fetal blood circulation." d. "Amniotic fluid supplies the food your baby needs to grow."
b
A woman is confused after finding out the ultrasound results predict a different due date for the birth of her baby. Which factor should the nurse point out is most likely the reason for the miscalculation of the fetal age? a. not seeking prenatal care in the beginning b. mistaking implantation bleeding for last menstrual period (LMP) c. amount of weight gain of mother in early weeks of pregnancy d. an error in math when calculating
b
Assessment of a pregnant client reveals that she has been having frequent contractions. Which question would be helpful to ask next? a. "When were the first contractions felt?" b. "Are the contractions increasing in frequency and intensity?" c. "Can you rate the pain on a scale of 1 to 10?" d. "Can you feel your abdominal muscles tighten?"
b
At what time is the laboring client encouraged to push? a. When the nurse wants the client to push b. When the cervix is fully dilated c. When the health care provider has arrived d. When the fetal head can be seen
b
The nurse cares for a pregnant client in labor and determines the fetus is in the right occiput anterior (ROA) position. Which action by the nurse is best? a. Auscultate fetal heart rate (FHR) in the left upper quadrant. b. Continue to monitor the progress of labor. c. Prepare the client for cesarean birth of the fetus. d. Educate the client this fetal position may result in a longer labor.
b
The nurse is caring for a woman at her first prenatal appointment. The woman reports her last menstrual period was August 1. The woman would like to begin her maternity leave at the beginning of the month of her due date. Which month would the nurse advise the woman to submit for her leave to begin? a. April b. May c. June d. July
b
The nurse is conducting a presentation for a young adult community group about fetal development and pregnancy. The nurse determines that the teaching was successful when the group identifies that the sex of offspring is determined at which time? a. during meiosis cell division b. at fertilization c. when the morula forms d. during oogenesis
b
The nurse is reviewing the results of a woman's maternal serum alpha fetoprotein (AFP) blood test. The results are positive, in the high range. Which action will the nurse complete next? a. Notify the woman of the results of the test. b. Notify the primary health care provider of the results. c. Place the results in the client's medical records. d. Obtain instructions on how to lower the blood levels.
b
The nurse is teaching a primigravida who does not speak the dominant language. The nurse will teach about the most common type of fetal presentation. Which presentation will the nurse prepare? a. footling presentation drawing a hand-prepared diagram b. cephalic presentation using preprinted materials in the client's language c. occiput presentation using a PowerPoint presentation d. breech presentation using a picture
b
When describing the characteristics of the amniotic fluid to a pregnant woman, the nurse would include which information? a. It limits fetal movement in utero. b. The amount gradually fluctuates during pregnancy. c. It is composed primarily of organic substances. d. It is usually an acidic fluid.
b
After teaching a class on the stages of fetal development, the nurse determines that the teaching was successful when the group identifies which stages? Select all that apply. a. umbilical b. placental c. embryonic d. pre-embryonic e. fetal
b, d, e
A woman at 38 weeks' gestation is in labor and oxytocin is prescribed to augment her labor. When preparing to administer this medication, what action by the nurse would be appropriate? a. Give the medication as an intramuscular injection using the Z-track technique. b. Give the medication orally every hour for the first 4 hours. c. Administer the medication piggybacked into a primary IV line using a pump. d. Assist with insertion of a central venous access device for administration.
c
A woman comes in for her annual gynecological examination and informs the nurse that she is going to try and become pregnant. She asks the nurse when the best time in the month is to become pregnant. What is the best response by the nurse? a. "5 days after your menstrual cycle is to begin." b. "The day after your menstrual cycle ends." c. "3 days before until 2 days after ovulation." d. "2 weeks before and 2 weeks after ovulation."
c
The nurse is caring for a client who is a primigravida. Which statement is best to improve the client's psyche? a. "You will be pushing very soon." b. "Your second pregnancy will be easier." c. "You are doing a great job" d. "You will be finished soon."
c
A client at 38 weeks' gestation is diagnosed with placental insufficiency. Which prescription from the health care provider will the nurse anticipate? a. Administer one dose of betamethasone. b. Discharge the client home with daily nonstress testing. c. Prepare the client for an induction of labor. d. Assess the client's blood pressure every 2 hours.
c
A client calls the prenatal clinic and tells the nurse, "I think I am in labor." The nurse determines that the client is in true labor based on which client statement? a. "I feel the tightening primarily in the front of my belly." b. "I will have a strong one and then the next one will be weaker." c. "I feel pressure in my vagina when I have the contraction." d. "The contractions lessen after I drink a large glass of water."
c
A client is confused concerning her fertile period each month. The nurse would educate the client by providing which information? a. The female fertility period is from Day 12 to Day 21 of her menstrual cycle. b. Fertilization can occur only if intercourse occurs on the day of ovulation. c. The window of opportunity for conception is from 3 days before to 2 days following ovulation. d. Since a sperm can only live 12 to 24 hours after ejaculation, fertility is limited to 1 day before to 1 day after ovulation.
c
A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention? a. Obtain assistance to check for a compressed umbilical cord. b. Document the finding. c. Help the woman change positions. d. Prepare the woman for an emergency cesarean birth.
c
A multigravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? a. The end of the first trimester b. The end of the third trimester c. The end of the second trimester d. The end of the fourth trimester
c
A nurse is conducting an in-service program for staff nurses working in the labor and birth unit. The nurse is discussing ways to promote a positive birth outcome for the woman in labor. The nurse determines that additional teaching is necessary when the group identifies which measure? a. promoting the woman's feelings of control b. encouraging the woman to use relaxation techniques c. allowing the woman time to be alone d. providing clear information about procedures
c
A pregnant client is undergoing an amniocentesis in her third trimester and is worried why she is undergoing this procedure. Which statement by the nurse would best alleviate this client's anxieties? a. "This procedure is not very dangerous and you should not worry about it." b. "The doctor can explain everything to you when we are done with the procedure." c. "We want to be sure your baby's lungs are mature and this measures the development of the baby's lungs. d. "We are concerned that your baby may have some genetic disorder."
c
The obstetrician is examining a woman who is in early labor to determine the positioning of the fetus. The nurse knows that which of the following fetal attitudes would be the most advantageous for birth? a. fetus in partial extension with brow presenting to birth canal b. fetus in complete extension with back arched c. head flexed forward so much that the chin touches the sternum d. chin in moderately flexed military position
c
The student nurse is preparing to assess the fetal heart rate (FHR) and has determined that the fetal back is located toward the client's left side, the small parts toward the right side, and there is a vertex (occiput) presentation. The nurse should initially begin auscultation of the fetal heart rate in the mother's: a. left upper quadrant. b. right upper quadrant. c. left lower quadrant. d. right lower quadrant.
c
What term is used to describe the position of the fetal long axis in relation to the long axis of the mother? a. Fetal attitude b. Fetal presentation c. Fetal lie d. Fetal position
c
Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? a. The station in which the fetus is located b. Fetal heart rate in relation to contractions c. Maternal heart rate and blood pressure d. Maternal request for pain medication
c
Which is the most important nursing assessment of the mother during the fourth stage of labor? a. Heart rate b. The mother's psyche c. Hemorrhage d. Blood pressure
c
A client is to have an amniocentesis with ultrasound. What does the nurse explain to the client that amniocentesis can determine? Select all that apply. a. what type of facial features the fetus will have b. what the eye color of the baby will be c. whether the fetal lungs are mature enough to support respiration outside of the womb d. the amniotic fluid can be used for genetic testing how much the fetus will weigh at birth
c, d
A pregnant client asks the nurse about the estimated date of delivery/birth, because the client is in a wedding and wants to know if the infant will be born before the wedding date. The client reports that the last normal menstrual period was on August 1. The wedding is May 1. Using Naegele rule to determine the estimated date of delivery/birth, which response is accurate? a. You will just pass your due date so chances are that the infant will be born. b. The infant will be 4 weeks old when the wedding occurs. c. There is no problem, you still have several weeks until you reach your estimated date of delivery. d. It is going to be close but you may still be pregnant at the wedding.
d
A pregnant woman asks the nurse about medications taken during pregnancy and if they cross the placental barrier. What response by the nurse is appropriate? a. "Yes, all medications cross the placental barrier." b. "Medications taken orally typically do not cross the placental barrier because of the gastric absorption." c. "Medications taken during the first trimester are typically safe." d. "Some medications cross the placental barrier, so be sure to discuss medications with your provider."
d
The client calls the health care facility stating that they are in labor. The nurse would urge the client to come to the facility if the client reports which symptom? a. contractions noted in the front of the abdomen that stop when the client walks b. pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds c. increased energy level with alternating strong and weak contractions d. moderately strong contractions every 4 minutes, lasting about 1 minute
d
The nurse is admitting a client in early labor and notes: FHR 120 bpm, blood pressure 126/84 mm Hg, temperature 98.8°F (37.1°C), contractions every 4 to 5 minutes lasting 30 seconds, and greenish-color fluid in the vaginal vault. Which finding should the nurse prioritize? a. Possible maternal infection b. Irregular contractions c. Fetal heart rate s. Green-colored fluid in the vagina
d
The nurse is assigned four clients in the labor and birthing unit. Which client does the nurse assess last during assessment rounds? a. client who is experiencing variable decelerations on the fetal monitor b. client at 34 weeks' gestation with a cervical dilation (dilatation) of 6 cm c. client who is newly admitted experiencing contractions every 4 minutes d. client at 37 weeks' gestation who is having an irregular pattern of contractions
d
The nurse is meeting with a young couple who desire to get pregnant to teach them how to determine the best times for intercourse. During which time frame should the nurse encourage them to engage in intercourse to increase their chances of getting pregnant? a. 3 days before or the day of ovulation b. 1 day before ovulation to 2 days after ovulation c. 2 days before to 1 day after ovulation d. 3 days before to 2 days after ovulation
d
The school nurse is presenting a lecture to adolescents to teach them how conception occurs. Which statement by the nurse would accurately describe this process? a. "At the time of conception, the ovum determines the sex of the baby." b. "Conception usually occurs when the ovum is in the outer third of the fallopian tube." c. "Human life begins with the union of two cells: the zygote and the sperm." d. "The ovum carries the Y chromosome, and the sperm carries an X or Y chromosome."
d
When teaching a group of nursing students about the stages of labor, the nurse explains that softening, thinning, and shortening of the cervical canal occur during the first stage of labor. Which term is the nurse referring to in the explanation? a. crowning b. dilation (dilatation) c. molding d. effacement
d
When the client in the transition phase of labor experiences dizziness and tingling in the fingers and around the mouth from hyperventilation, the client is anticipated to be in: a. respiratory acidosis. b. metabolic acidosis. c. metabolic alkalosis. d. respiratory alkalosis.
d
