OB Quiz Questions

The nurse assesses a large-for-gestational-age infant admitted to the newborn observational unit with the diagnosis of hypoglycemia. What would best correlate with this diagnosis?

jitteriness

A woman with uterine prolapse is scheduled to undergo surgery. When providing preoperative teaching, the nurse reviews information about the type of surgery being planned. Based on the nurse's knowledge of the client's condition, the nurse would most likely include information about which surgery?

vaginal hysterectomy

A woman in active labor has just had her membranes ruptured to speed up labor. The nurse is concerned the woman is experiencing a prolapse of the umbilical cord when the nurse notices which pattern on the fetal heart monitor?

variable deceleration pattern

A client presents in the hospital at 32 weeks gestation for preterm contractions. The physician orders betamethasone IM to help with fetal lung maturity. The patient is ordered two doses of Betamethasone 24 hours apart. Order: Betamethasone 12 mg IM x1 now, dose to repeat in 24 hours. Dose on Hand: Betamethasone Vial 6 mg/ml How many ml of Betamethasone will the nurse administer in the initial injection?

2 mL

The physician orders for the nurse to start the patient on a magnesium sulfate infusion for preeclampsia. The physician orders a 4 g bolus to be followed by a 2 g/hour maintenance dose. The bolus order reads: administer magnesium sulfate IV infusion bolus 4g in 100ml of NS over 30 minutes. What will the nurse set the pump infusion rate at?

200 ml/hour

Which medication would the nurse anticipate administering to a woman with preterm rupture of membranes to help the fetus's lungs mature?

Betamethosone

A nurse is caring for a newborn who is at 34 weeks of gestation, weighs 1,550 g, and has nasal flaring, intercostal retractions, expiratory grunting, and mild cyanosis. The nurse should place the newborn in an incubator for which of the following reasons?

The newborn's temperature control mechanism is immature.

A client at 32 weeks' gestation is admitted to labor and delivery with vaginal bleeding and contractions. The physician orders a course of two steroid injections. The client asks why she needs steroids. What is the best explanation by the nurse?

The steroids speed up the development of the lungs

Which medication is used to suppress viral load of the HSV-2 infection?

acyclovir

After teaching a pregnant woman about the hormones produced by the placenta, the nurse determines that the teaching was successful when the woman identifies which hormone produced as being the basis for pregnancy tests?

human chorionic gonadotropin (hCG)

A young couple is preparing to leave the hospital and go home after the birth of their baby. While preparing their care plan, the nurse can demonstrate recognition of their cultural differences by asking:

"Do you have any treatment preferences you would like me to include in the care plan?"

A nurse in a prenatal clinic overhears a newly licensed nurse discussing conception with a client. Which of the following statements by the newly licensed nurse requires intervention by the nurse?

"Implantation occurs between 2 and 3 weeks after conception."

A physically abused pregnant woman reports to the nurse that her spouse has stopped hitting her and promises never to hurt her again. Which response by the nurse would be most appropriate?

"Remember, the cycle of violence often repeats itself."

A nurse is caring for a new mother who is concerned that her newborn's eyes cross. Which of the following statements is a therapeutic response by the nurse?

"This occurs because newborns lack muscle control to regulate eye movement."

A patient is being induced for severe preeclampsia. The provider orders magnesium sulfate to be initiated. The order is for an initial bolus of magnesium sulfate 4gm IV over 15 minutes. The available concentration is Magnesium sulfate 4gm in 100mL of NS. What will the infusion rate be?

400 mL/hr

A woman at 34 weeks' gestation arrives in triage with c/o severe abdominal pain, vaginal bleeding, and a history of chronic hypertension. The nurse recognizes that the patient may be experiencing.

Abruptio Placentae

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)

The nurse is monitoring a client in labor who has had a previous cesarean section and is trying a vaginal birth with an epidural. The nurse observes a sudden drop in blood pressure, increased heart rate, and deep variable deceleration on the fetal monitor. The client reports severe pain in the abdomen and shoulder. What should the nurse prepare to do?

Prepare the client for a cesarean birth

A nurse is caring for 3 couplets. The nurse recognizes which newborn as a priority assessment

Respiration rate of 72

The nurse should carefully screen a client who insists on using only oral contraceptive pills (OCPs) for which contraindication?

deep vein thrombosis

A nurse working in the newborn nursery hears an innocent murmur on auscultation of a 24-hour-old infant's chest. The nurse recognizes this as most likely the result of which condition?

delayed fetal shunt closure

A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize?

depressed deep tendon reflexes

A client is giving birth when shoulder dystocia occurs in the fetus. The nurse recognizes that which condition in the client is likely to increase the risk for shoulder dystocia?

diabetes

Which assessment finding will alert the nurse to be on the lookout for possible placental abruption (abruptio placentae) during labor?

gestational hypertension

The nurse should carefully monitor which neonate for hyperbilirubinemia?

neonate with ABO incompatibility

When describing the structures involved in fetal circulation to a pregnant woman, the nurse describes which structure as the opening between the right and left atrium?

ovale

A patient is at 22 weeks' gestation is preparing to have her fundal height measured. Given the patient's stage of gestation and following McDonald's rule, what result does the nurse expect?

22 cm

The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame?

24 to 28 weeks

A client is admitted to antepartum for hydration. The physician orders IV hydration. Order: 1000ml of Lactated Ringers to infuse over 4 hours. What will the nurse set the infusion rate at (ml/hr)?

250 mL/hr

The nurse is caring for a group of clients in labor and delivery. Which client is at greatest risk for placental abruption (abruptio placentae)?

28 y.o G1 at 30 weeks' gestation with a blood pressure of 150/94 and history of cigarette smoking

The nurse is monitoring several postpartum women for potential complications related to the birthing process. Which assessment should a nurse prioritize on an hourly basis?

Pad count

A nurse is caring for a patient that is 32 weeks' gestation with a placenta previa. The nurse starts to assess the patient. Which of the following assessments does the nurse recognize as consistent with a placenta previa?

Painless bright red vaginal bleeding

A nurse is assisting with the care of a newborn who has a myelomeningocele. Which of the following actions by the nurse is appropriate?

Place the newborn in a prone-kneeling position

A nurse is caring for a client who is at 40 weeks gestation and is in active labor. The client has 6 cm of cervical dilation and 100% cervical effacement. The nurse obtains the client's blood pressure while the patient is lying on their back. The blood pressure reading is 82/52 mm Hg. Which of the following nursing interventions should the nurse perform?

Assist the client to turn onto her side.

A patient is experiencing a post-partum hemorrhage 1 hour post-delivery. The nurse notes uterine atony. What interventions will be the priority for the nurse to perform? (Select all that apply)

Fundal Message IV Oxytocin Empty bladder IM methergine

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

Which assessment on the third postpartum day would indicate to the nurse that a woman is experiencing uterine subinvolution?

Her uterus is one finger width above the level of the umbilicus.

In an infant who has hypothermia, what would be the most appropriate nursing diagnosis?

Impaired tissue perfusion

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?

Instill a prophylactic agent in the eyes of the newborn.

The father of a 2-week-old infant presents to the clinic with his disheveled wife for a postpartum visit. He reports his wife is acting differently, is extremely talkative and energetic, sleeping only 1 or 2 hours at a time (if at all), not eating, and appears to be totally neglecting the infant. The nurse should suspect the client is exhibiting signs and symptoms of which disorder?

Postpartum psychosis

A patient arrives at their first prenatal appointment and states that their last menstrual period was April 1st. Using Naegel's Rule, what would be the correct estimated date of delivery?

January 8

A nurse is providing education to the parents of a newborn regarding care of the umbilical cord. Which statement should the nurse include in their education?

Keep the cord dry and observe for signs of infection

A patient delivered 12 hours ago and is on magnesium sulfate for preeclampsia. The nurse notes that the patient has had 2 consecutive severe range blood pressures 15 minutes apart. Which drugs are considered the first line antihypertensives for the pregnant patient (select all that apply)

Labetalol Hydralazine Nifedipine

The nurse assesses the client who is 1 hour postpartum and discovers a heavy, steady trickle of bright red blood from the vagina in the presence of a firm fundus. Which potential cause should the nurse question and report to the RN or primary care provider?

Laceration

A nurse is caring for a newborn. Which of the following actions by the newborn indicates readiness to feed? (Select all that apply)

Lip smacking Attempting to place their hands in their mouth Head turning toward the breast

Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be born. Stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia?

McRoberts maneuver

The nurse is caring for several families in the prenatal obstetrics office setting. Which is most important for the nurse?

Understanding and accepting the various types of family units, such as lesbian, gay and transgender

A pregnant client diagnosed with hyperemesis gravidarum. The nurse is reviewing the patient's lab results. Which of the following findings is a manifestation of hyperemesis?

Urine ketones present

A 47-year-old woman was just diagnosed with a cancer of her reproductive tract. The public health nurse is aiding in counseling. Which nursing interventions would be supportive in counseling this woman? Select all that apply.

Use sincere, basic communication techniques. Validate the client's feelings and provide realistic hope. Give postoperative care and instructions when prescribed.

The nursing instructor is leading a discussion exploring the various conditions that can result in postpartum hemorrhage. The instructor determines the session is successful when the students correctly choose which condition is most frequently the cause of postpartum hemorrhage?

Uterine atony

A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?

Uteroplacental insufficiency

A nurse in the clinic is providing education to a patient that is 24 weeks gestation. The nurse is reviewing complications that should be reported promptly to the provider. Which of the following complications is the priority that should be included in the nurses teaching?

Vaginal Bleeding

A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?

Variable decelerations are due to umbilical cord compression.

A mother asks the nurse why her newborn is getting a Vitamin K injection in the birth room. The nurse explains that the injection is necessary because:

Vitamin K is needed for coagulation, and the newborn does not produce vitamin K in the few days following birth.

Which statement is false regarding screening for intimate partner violence in women?

Women tend to fit a profile for intimate partner violence, and victims tend to share similar physical characteristics.

A nurse in the emergency department is admitting a client who is at 40 weeks of gestation, has ruptured membranes, and the nurse observes the newborn's head is crowning. The client tells the nurse she wants to push. Which of the following statements should the nurse make?

"You should try to pant as the delivery proceeds."

A patient in labor experiences tachysystole which results in a 4-minute-long prolonged deceleration. The provider orders Terbutaline 250mcg SQ x 1 now to relax the uterus. The available dose is Terbutaline 1mg/mL. How many milliliters will the nurse administer?

0.25 mL

The patient is comes into the OB clinic with complaints of severe nausea and vomiting. Order: Promethazine 12.5 mg IV Available: Promethazine 50 mg/mL vial How many mL of promethazine does the nurse administer?

0.25 ml

The nurse has an order to administer the Hepatitis B vaccination to a 12 hour old newborn. The order is to administer 10mcg x1 IM. The available dose is 20mcg per 1mL. How many milliliters will the nurse administer? (Please include the unit of measurement)

0.5 mL

The nurse is ready to administer the newborn their Vitamin K injection. The order is for Vitamin K 1mg IM one time now. Dose on hand: Vitamin K 2mg/mL How many milliliters will the nurse administer?

0.5 mL

A patient is experiencing nausea due to her pregnancy and has been prescribed Zofran. Order: Zofran 8 mg PO Q8H Available: Zofran in 100 ml bottle labeled 4 mg/5 ml How many ml will the patient need to for each dose?

10 ml

The patient is GBS positive and has an order for Penicillin 2.5 million units in 50 mL of NS to infuse over 30 min q4h while in labor The nurse hangs the antibiotic and sets the pump to what rate? (please include units)

100 mL/hr

A nurse is caring for a client who is at 39 weeks of gestation and is in active labor. The nurse locates the fetal heart tones above the client's umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

Breech

A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor?

Changes in the cervix

The nurse is caring for a patient who has been ruptured for over 24 hours. The nurse notes the fetal heart rate is increasing and is now 165, the patient is tachycardic and has a temperature of 38.0. The nurse suspects what condition?

Chorioamnionitis

The nurse is caring for a patient who has a condition where the bladder bulges into the vagina. This is know as a

Cystocele

A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what is the priority nursing action?

Dry the skin.

A nurse is updating the plan of care for a newborn who is undergoing phototherapy. Which of the following actions should the nurse include in the plan?

Encourage the newborn to breastfeed every 2 hrs

A woman is 2 weeks postpartum when she calls the clinic and tells the nurse that she has a fever of 101°F (38.3°C). She reports abdominal pain and a "bad smell" to her lochia. The nurse recognizes that these symptoms are associated with which condition?

Endometritis

Following the birth, the nurse notices that the newborn has not been dried completely. This will place the infant at risk for what type of heat loss?

Evaporation

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal?

Prevent maternal seizures

A nurse in the labor and delivery unit is caring for a client who is undergoing external fetal monitoring. The nurse observes that the fetal heart rate begins to slow after the start of a contraction and the lowest rate occurs after the peak of the contraction. Which of the following actions should the nurse take first? Select all that apply

Reposition patient IV bolus Turn off oxytocin

A post-partum patient that was diagnosed with preeclampsia continues to be on magnesium sulfate for 24 hours post-delivery. What assessments are priority nursing assessments for this patient? (Select all that apply)

Respiratory Status Reflexes Urinary Output

A nurse is preparing to administer oxygen to a newborn who was born at 30 weeks of gestation. Which of the following actions should the nurse take?

Response: Titrate the oxygen to keep the newborn's oxygen saturation above 95%. Correct answer: Administer warm, humidified oxygen to the newborn.

A nurse is conducting a class on gestational diabetes for a group of pregnant women who are at risk for the condition. The nurse determines that additional teaching is needed when the class identifies which complication may be a result of gestational diabetes?

SGA (small for gestational age)

A pregnant client asks the nurse about what she can do to avoid complications of pregnancy and best ensure a positive outcome for her baby. The nurse would recommend which action?

Seek prenatal care as soon as she knows she is pregnant.

An adolescent client asks the nurse about how the ovaries work. The nurse would include which information in her reply?

Storage of ova and maturation of them is one of the main functions of the ovaries.

While reviewing the medical record of a client, the nurse notes that the client is para 2. What does the nurse know from this information?

The client has had 2 pregnancies greater than 20 weeks

A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?

The lowermost portion of the fetus is at the level of the ischial spines.

When describing birth during the 18th century, which description would be most accurate regarding maternal care during pregnancy and birth?

The majority of births occurred in the home with female midwives in attendance.

The nurse is caring for a preeclamptic patient. There is concern that the patient may be developing HELLP syndrome. Which components are involved in HELLP.

Thrombocytopenia Hemolysis Elevated ALT/AST

A patient is inquiring about medicinal pain management in labor. The nurse informs the patient that their options may include IV morphine, IV fentanyl, or an epidural. The patient askes which method is safest for the baby, the nurse replies that IV pain medications will cross the placental barrier but the epidural medication will not.

True

Physiological jaundice is common and is generally seen day 3-4 in the newborn and is related to an immature liver and feeding, while pathological jaundice is seen within the first 24 hours and is related to a pathology.

True

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned, and she has no real family support. The nurse's most therapeutic response would be to:

encourage her to identify someone that she can talk to and share the pregnancy experience.

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

expiratory grunting

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives?

hepatitis B

A woman comes to the clinic for a routine checkup. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus?

human papillomavirus

A pregnant woman with chronic hypertension comes to the clinic for evaluation. The last several blood pressure readings have been gradually increasing. On today's visit her blood pressure is 166/100 mm Hg. The health care provider prescribes an antihypertensive agent. The nurse anticipates which agent as likely to be prescribed?

labetalol

A nurse is conducting a health promotion program, encouraging lifestyle changes to help clients prevent various benign and treatable conditions. Which suggestions would the nurse most likely include? Select all that apply.

low-fat diet regular exercise high vegetable-fruit diet adequate fluid intake

A pregnant client is diagnosed with severe preeclampsia and is to receive medication therapy to prevent eclampsia. Which medication does the nurse anticipate being prescribed?

magnesium sulfate