OB Exam 1

When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find? A) Ambivalence B) Introversion C) Acceptance D) Emotional lability

A) Ambivalence

A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.) A) Amenorrhea B) Nausea C) Abdominal enlargement D) Braxton-Hicks contractions E) Fetal heart sounds

A) Amenorrhea B) Nausea

A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman's gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply. A) Hyperemic gums B) Increased peristalsis C) Complaints of bloating D) Heartburn E) Nausea

A) Hyperemic gums C) Complaints of bloating D) Heartburn E) Nausea

Assessment of a woman 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 D) Perineal phase of the second stage

A) Latent phase of the first stage

Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following? A) Linea nigra B) Striae gravidarum C) Melasma D) Vascular spiders

A) Linea nigra

Which of the following would indicate to the nurse that the placenta is separating? A) Uterus becomes globular B) Fetal head is at vaginal opening C) Umbilical cord shortens D) Mucous plug is expelled

A) Uterus becomes globular

The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse notes that the health care provider has documented the presence of Goodell's sign. The nurse determines that this sign is indicative of: A. A softening of the cervix B. The presence of fetal movement C. The presence of human chorionic gonadotropin in the urine D. A soft blowing sound that corresponds with the natural pulse that is heard while auscultating the uterus

A. A softening of the cervix

1. When obtaining a blood test for pregnancy, which hormone would the nurse expect the test to measure? A. Human chorionic gonadotropin (hCG) B. Human placental lactogen (hPL) C. Follicle-stimulating hormone (FSH) D. Luteinizing hormone (LH)

A. Human chorionic gonadotropin (hCG)

A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.) A. Presence of support partner B. View of birth as a stressor C. Low anxiety level D. Fear of loss of control E. Participation in a pregnancy exercise program

A. Presence of support partner C. Low anxiety level E. Participation in a pregnancy exercise program

During pregnancy, which of the following should the expectant mother reduce or avoid? A. Raw meat or uncooked shellfish B. Fresh, washed fruits and vegetables C. Whole grains and cereals D. Protein and iron from meat sources

A. Raw meat or uncooked shellfish

In a client's eight month of pregnancy, she reports feeling dizzy when she lies down flat on the back. Which of the following is the explanation for this? A. That feeling often occurs due to pressure of the gravid uterus on the vena cava B. That feeling occurs because during pregnancy because there is a 50% increase in blood volume C. That feeling occurs during pregnancy because of physiologic anemia due to a decrease in hemoglobin level D. That feeling occurs due to pressure of the presenting fetal part on the diaphram

A. That feeling often occurs due to pressure of the gravid uterus on the vena cava

GTPAL gravida term deliveries preterm deliveries abortions, and living children) for a pregnant woman is "2-0-1-1-1". What does this means? A. The woman was pregnant twice, gave birth at 35th week, and the baby survived. B. The woman was pregnant once and gave birth to twins at the 35th week of pregnancy, both survived C. The woman was pregnant once, gave birth at the 39th week, and the baby died D. The woman was pregnant once, gave birth at the 38th week, and the baby survived

A. The woman was pregnant twice, gave birth at 35th week, and the baby survived.

A woman telephones her health care provider and reports that her water just broke. Which suggestion by the nurse would be most appropriate? A) Call us back when you start having contractions. B) Come to the clinic or emergency department for an evaluation .C) Drink 3 to 4 glasses of water and lie down. D) Come in as soon as you feel the urge to push.

B) Come to the clinic or emergency department for an evaluation

A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which of the following would the nurse include in the discussion? (Select all that apply.) A) Keep weight gain to 15 lb B) Eat three meals with snacking C) Limit the use of salt in cooking D) Avoid using diuretics E) Participate in physical activity

B) Eat three meals with snacking D) Avoid using diuretics E) Participate in physical activity

A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the clients pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted? A) Platypelloid B) Gynecoid C) Android D) Anthropoid

B) Gynecoid

During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client? A) Ineffective tissue perfusion related to supine hypotensive syndrome B) Impaired gas exchange related to pulmonary congestion C) Activity intolerance related to increased metabolic requirements D) Anxiety related to fear of pregnancy outcome

B) Impaired gas exchange related to pulmonary congestion

A client's last menstrual period was April 11. Using Nagele's rule, her expected date of birth (EDB) would be: A) January 4 B) January 18 C) January 25 D) February 24

B) January 18

A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping and lower back pain. The nurse determines that which of the following has most likely occurred? A) Cervical dilation B) Lightening C) Bloody show D) Braxton- Hicks contractions

B) Lightening

A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following? A) Excess folic acid, which could increase the risk for neural tube defects B) Mercury, which could harm the developing fetus if eaten in large amounts C) Lactose, which leads to abdominal discomfort, gas, and diarrhea D) Low-quality protein that does not meet the woman's requirements

B) Mercury, which could harm the developing fetus if eaten in large amounts

Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following? A) Quickening B) Pica C) Ballottement D) Linea nigra

B) Pica

A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis, based on whichassessment finding? A) Fever B) Vaginal itching C) Urinary frequency D) Incontinence

B) Vaginal itching

When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics? A)Extent of opening to its widest diameter B)Degree of thinning C)Passage of the mucous plug D)Fetal presenting part

B)Degree of thinning

A nurse is collecting data during an admission assessment of a patient who is pregnant with twins. The patient has a healthy 5-year-old child that was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. How would the nurse document the GTPAL for this patient? A. 3,2,0,0,1 B.2,1,0,0,1 C.1,1,1,0,1 D. 2,0,0,0,1

B. 2,1,0,0,1

What does the umbilical cord contain: A.Contains one large vein (CO2) and two small arteries (O2) B. Contains one large vein (O2) and two small arteries (CO2) C. Contains two large vein (O2) and one small artery (CO2) D. Contains two large vein (CO2) and one small artery () O2

B. Contains one large vein (O2) and two small arteries (CO2)

A nurse is collecting data from an admission assessment of a client who is pregnant with twins. The client also has an 8-year old child. The nurse would document which gravid (G) and para (P) status on this client? A. G1P1 B. G2P1 C. G2P2 D.G3P2

B. G2P1

The tendency of maternal mortality in the U.S is: A. Constantly declining B. Increasing, especially in vulnerable populations C. Increasing among white women D. Not clear since statistics are not accurate

B. Increasing, especially in vulnerable populations

Which of the following is true regarding the physiologic changes a woman may expect during her pregnancy? A. Gastric emptying and large bowel motility are increased in pregnancy B. Plasma volume increases around 50% during the pregnancy C. Cholasma is present in the abdomen D. The urinary frequency during the third trimester decreases

B. Plasma volume increases around 50% during the pregnancy

Which time-based description of a stage of development in pregnancy is accurate? A. Viability- period from the beginning of the pregnancy to 20 weeks B. Term- pregnancy from the beginning of week 37 of gestation to week 42 C. Preterm-pregnancy from 10 to 18 weeks D. Postdate- pregnancy that extends beyond 38 weeks

B. Term- pregnancy from the beginning of week 37 of gestation to week 42

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? A.Less audible heart sounds (S1, S2) B.Increased pulse rate C.Increased blood pressured D. Decreased red blood cell (RBC) production

B.Increased pulse rate

A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful? A) "I'll sit in a window seat so I can focus on the sky to help relax me." B) "I won't drink too much fluid so I don't have to urinate so often." C) "I'll get up and walk around the airplane about every 2 hours." D) "I'll do some upper arm stretches while sitting in my seat."

C) "I'll get up and walk around the airplane about every 2 hours."

A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate which of the following? A) 14 weeks' gestation B) 20 weeks' gestation C) 28 weeks' gestation D) 36 weeks' gestation

C) 28 weeks' gestation

A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3 B) 3 1 2 2 3 C) 4 1 1 1 3 D) 4 2 1 3 1

C) 4 1 1 1 3

A client who is 6 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 10-year-old twins who were born at 33 weeks gestation, a 3-year old son born at 40 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as: A) 3 2 1 0 3 B) 3 1 2 2 3 C) 4 1 1 1 3 D) 4 2 1 3 1

C) 4 1 1 1 3

A woman is at 20 weeks' gestation. The nurse would expect to find the fundus at which of the following? A) Just above the symphysis pubis B) Mid-way between the pubis and umbilicus C) At the level of the umbilicus D) Mid-way between the umbilicus and xiphoid process

C) At the level of the umbilicus

During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as: A) Hegar's sign B) Goodell's sign C) Chadwick's sign D) Ortolani's sign

C) Chadwick's sign

When preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following? A) Shower with an antiseptic scrub. B) Swallow the preprocedure sedative. C) Empty her bladder. D) Lie on her left side

C) Empty her bladder.

A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures which of the following? A) Platelet level B) Rh status C) Immunity to German measles D) Red blood cell count

C) Immunity to German measles

Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? A) Ligament tightening B) Decreased swayback C) Increased lordosis D) Joint contraction

C) Increased lordosis

A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy? A) Absence of menstrual period B) Abdominal enlargement C) Palpable fetal movement D) Morning sickness

C) Palpable fetal movement

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? A) I'm feeling contractions mostly in my back. B) My contractions are about 6 minutes apart and regular. C) The contractions slow down when I walk around. D) If I try to talk to my partner during a contraction, I cant.

C) The contractions slow down when I walk around.

A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings asindicating: A) Latent phase of the first stage of labor B) Active phase of the first stage of labor C) Transition phase of the first stage of labor D) Pelvic phase of the second stage of labor

C) Transition phase of the first stage of labor

A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitatethe progress of labor? A) Supine B) Lithotomy C) Upright D) Kneechest

C) Upright

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: A. +2 station B. 0 station C. 2 station D. Crowning

C. 2 station

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 pH to ensure the fluid is amniotic fluid B. Prepare tp administer an antibiotic C. Notify the health care provider about possible meconium D. Check the maternal heart rate

C. Notify the health care provider about possible meconium

Sally comes in for her 1st prenatal examination. This is her 1st child. She asks you (the nurse), "How does my baby get air to breathe inside my uterus?" The BEST response to Sally is which of the following? A. The baby's lungs works in utero to exchange oxygen and carbon dioxide B. The baby absorbs oxygen from your blood system C. The placenta provides oxygen to the baby and excretes carbon dioxide in your bloodstream D. The placenta delivers oxygen-rich blood through the umbilical artery to the baby's abdomen

C. The placenta provides oxygen to the baby and excretes carbon dioxide in your bloodstream

A father and mother are carriers of Tay sach disease their two year old daughter has the condition the couple tells the nurse that they are having a second baby because their daughter has Tay-each disease, and they are certain this baby will not be affected. Which response by the nurse is most appropriate? A. "Good planning. You need to take advantage of the odds that are in your favor" B."You are both carriers; therefore, each baby has 50% chance of being affected" C. You are both carriers; therefore, each baby has 25% chance of being affected D. The ultrasound indicates a boy, and boys are not affected by Tay-Sachs

C. You are both carriers; therefore, each baby has 25% chance of being affected

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. Boggy, soft uterus B. Uterus becoming discoid shaped C. sudden gush of dark blood from the vagina D. Shortening of the umbilical cord

C. sudden gush of dark blood from the vagina

A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered? A. Butorphanol B. Fentanyl C.Naloxone D. Promethazine

C.Naloxone

A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as: A) +4 B) +2 C) 0 D) -2

D) -2

The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy? A) 35 to 40 pounds B) 25 to 35 pounds C) 28 to 40 pounds D) 15 to 25 pounds

D) 15 to 25 pounds

When assessing a woman at follow-up prenatal visits, the nurse would anticipate which of the following to be performed? A) Hemoglobin and hematocrit B) Urine for culture C) Fetal ultrasound D) Fundal height measurement

D) Fundal height measurement

The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation? A) Estrogen B) Progesterone C) Follicle-stimulating hormone D) Luteinizing hormone

D) Luteinizing hormone

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction? A) Heart rate increase from 76 bpm to 90 bpm B) Blood pressure rise from 110/60 mm Hg to 120/74 C) White blood cell count of 12,000 cells/mm3 D) Respiratory rate of 10 breaths /minute

D) Respiratory rate of 10 breaths /minute

A woman who is 8 months pregnant asks the nurse, "Does my baby have any antibodies to fight infection?" What is the most appropriate response by the nurse? A. "Your baby has all the immunoglobulins necessary: immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA)." B. "Your baby won't receive any antibodies until he is born and you breastfeed him." C. "Your baby does not have any antibodies to fight infection." D. "Your baby has IgG and IgM."

D. "Your baby has IgG and IgM."

2. During a clinic visit, a pregnant client at 30 weeks gestation tells the nurse, "I've had some mild cramps that are pretty irregular. What does this mean?" The cramps are probably: A. The beginning of labor in the very early stages B. An ominous finding indicating that the client is about to have a miscarriage C. Related to over hydration of the woman D. Braxton Hicks contractions, which occur throughout pregnancy

D. Braxton Hicks contractions, which occur throughout pregnancy

Which of the following hormones is identified as being the basis for pregnancy tests? A. Human placental lactose (hPL) B. Estrogen (estriol) C. Progesterone (progestin) D. Human chorionic gonadotropin (hCG)

D. Human chorionic gonadotropin (hCG)

Which of the following answers best describes the stage of pregnancy in which maternal circulation and fetal umbilical cord circulation are exchanged? A. 12 weeks of gestation B. Conception C. Third trimester D. Maternal and fetal blood circulation are never exchanged

D. Maternal and fetal blood circulation are never exchanged

7. Which of the following fish should be limited in a pregnant woman's diet because of the high mercury content? A. Salmon B. Cod C. Shrimp D. Sword fish

D. Sword fish

A client's last menstrual period was April 20. Using Nagele's rule, her expected date of birth (EBD would be:) A. January 4 B. March 20 C. January 25 D. February 24 E. January 27

E. January 27

The diagnosis of pregnancy is based on which POSITIVE sign(s) of pregnancy? A. Identification of fetal heartbeat (Doppler or ultrasound) B. Palpation of the umbilical cord C. Visualization of the fetus (ultrasound) D. Verification of fetal movement E. a,c,d

E. a,c,d A. Identification of fetal heartbeat (Doppler or ultrasound) C. Visualization of the fetus (ultrasound) D. Verification of fetal movement

Which of the following are PROBABLE signs of pregnancy? A. positive pregnancy test B. ultrasound visualization of the fetus C. Auscultation of a fetal heartbeat D. Ballottement E. Absence of menstruation F. Goodell's sign G. A,D,F

G. A,D,F Answers: A. positive pregnancy test D. Ballottement F. Goodell's sign

What types of laboratory testing are needed for a pregnant woman who has her PREGNANCY CONFIRMED with an ultrasounds and does not have a history of chronic diseases or cardiac issues? A. Blood type and Rh factor B. Cardiac evaluation C. Urinalysis D. Hemoglobin and hematocrit levels E. VDRL and HIV Test F. hCG in urine G. a,c,d,e

G. a,c,d,e A. Blood type and Rh factor C. Urinalysis D. Hemoglobin and hematocrit levels E. VDRL and HIV Test

A client with a 28-day cycle reports that she ovulated on May 10. When would the nurse expect the client's next menses to begin? a. May 24 b. May 26 c. May 30 d. June 1

a. May 24

6. A laboring woman is admitted to the labor and birth suite at 6-cm dilation. She would be in which phase of the first stage of labor? a. Latent b. Active c. Transition d. Early

b. Active

Down syndrome results from the: a. Absence of one chromosome in position 21 b. Presence of an extra chromosome in position 21 c. Absence of both chromosomes in position 21 d. Crossing over of the chromosomes in position 21

b. Presence of an extra chromosome in position 21

5. A pregnant client's LMP was on August 10. Using Nagele's rule, the nurse calculates that her EDD will be which of the following? a. June 23 b. July 10 c. July 30 d. May 17

d. May 17