Quiz Information - OB Exam

Woman with type 1 diabetes or type 2 diabetes can prevent problems during pregnancy by: A. Limiting weight gain during pregnancy B. Checking blood sugar often C. Healthy food and exercise D. All of the above

D. All of the above

What is an advantage of using the active method of managing the third stage of labour? A. As the oxytocic drug is given after the delivery of the placenta, complications with a second twin are avoided. B. Retained placenta is uncommon. C. An assistant is not needed. D. Blood loss during the third stage is reduced.

D. Blood loss during the third stage is reduced.

Which of the following complications may be indicated by continuous seepage of blood from the vagina of a PP client, when palpation of the uterus reveals a firm uterus 1 cm below the umbilicus? A. Uterine atony B. Urinary tract infection C. Retained placental fragments D. Cervical laceration

D. Cervical laceration

A client at 36 weeks gestation is scheduled for a routine ultrasound prior to amniocentesis. After teaching the client about the purpose of the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction? A. The ultrasound locates a pool of amniotic fluid. B. The ultrasound identifies blood flow through the umbilical cord. C. The ultrasound will help to locate the placenta. D. The test will determine where to insert the needle.

B. The ultrasound identifies blood flow through the umbilical cord.

On a mission trip to Mexico a 35 year old G6P4105 has been in active labor for 12 hours. To facilitate her delivery she is given Pitocin. Three hours later the FHT drop to 90 from a previous baseline of 120, tocometry reveals no contractions. Moderate vaginal bleeding is also noted, and a vertical abdominal scar. What has likely occurred? A. Placenta previa B. Uterine rupture C. Placental abruption D. Intraamniotic infection

B. Uterine rupture

Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurse / midwife would assess the client for signs and symptoms of which of the following? A.) Acne vulgaris B.) Hypertension C.) Anemia D.) Dysmenorrhea

B.) Hypertension

T/F: High blood sugar level in the mother does not affect the fetus' sugar level.

FALSE

How many chromosomes does a typical zygote have? 23 24 48 46

46

What hormone is heavily involved in the Physiology of the third stage of labour? A.) Progesterone B.) Oxytocin C.) Adrenaline D.) Testosterone

B.) Oxytocin

What week does Gastrulation occur? A.) Week 4 B.) Week 3 C.) Week 8 D.) Week 28

B.) Week 3

What are the three layers of the uterine wall called? A.) Myometrium, entrametrium, endometrium B.) Perimetrium, myometrium, endometrium C.) Endometrium, perimetrium, uterine lining D.) Myometrium, endometrium, myocardium

B.) Perimetrium, myometrium, endometrium

The nurse/midwife is counselling a couple who has sought information about conceiving. The couple ask the nurse to explain when ovulation usually occurs. In a 28 day cycle, when should ovulation normally occur? A. Day 14 B. Immediately after menstruation C. Immediately before menstruation D. Day 21

A. Day 14

A nurse/midwife is providing education to a patient who is to undergo a non stress test/cardiotocograph (CTG) for reduced foetal movement. Which of the following should the nurse/midwife include in her plan of care? A. Maintain client nil orally throughout the procedure B. Place client in a prone position C. Eat chocolate D. Instruct the client to press the provided foetal movement button every time movement is felt.

A. Maintain client nil orally throughout the procedure

Which measure would be least effective in preventing postpartum hemorrhage? A. Massage the fundus every hour for the first 24 hours following birth. B. Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered. C. Encourage the woman to void every 2 hours. D. Teach the woman the importance of rest and nutrition to enhance healing.

A. Massage the fundus every hour for the first 24 hours following birth.

Which of the following signs do not confirm the diagnosis that the placenta has separated? A. The fundus of the uterus moves from below to above the umbilicus B. Suprapubic pressure does not result in shortening of the umbilical cord when the uterus is pushed upwards C. Lengthening of the umbilical cord D. A sudden gush of blood runs out of the vagina

A. The fundus of the uterus moves from below to above the umbilicus

A 32-year-old homeless lady, G2P0100 who claims to be 32 weeks pregnant based on her last LMP presents to the ED with complaint of heavy vaginal bleeding. She has not received any prenatal care. She reports minimal cramping pain in her lower abdomen. Her uterus is soft and non-tender. Vital signs are stable. What is the next step in management? A. Transabdominal ultrasound. B. Sterile speculum exam C. Begin PCN G D. Digital pelvic exam E. IV fluids with observation

A. Transabdominal ultrasound.

It is recommended that pregnancy be allowed to continue in the presence of preterm rupture of the membranes (unless there are contraindications) until the duration of pregnancy reaches: A.) 37 weeks B.) 40 weeks C.) 34 weeks D.) 32 weeks

A.) 37 weeks

Alpha fetoprotein is A.) A substance present in the blood of a pregnant women B.) A substance present in the pregnant women's urine C.) A test that scans for genetic abnormalities D.) A substance found in the blood that shows the body has used used all available carbohydrate

A.) A substance present in the blood of a pregnant women

Which methods of birth control needs a prescription? A.) All of the above B.) Cervical cap C.) Diaphragm D.) Contraceptive patch E.) Birth control pill

A.) All of the above

A patient with preterm rupture of the membranes, who is allowed to continue with her pregnancy, must: A.) Be admitted to hospital for complete bed rest B.) Have an examination at least twice daily for signs of clinical chorioamnionitis C.) Have daily white cell counts D.) Be seen at the antenatal clinic at least weekly, as she has a high-risk pregnancy

A.) Be admitted to hospital for complete bed rest

Which of the following is the most common injury to the baby in the case of shoulder dystocia? A.) Brachial Plexus injury B.) Death C.) Hypoxic Ischaemic Brain injury D.) Humerus & Clavicle Fractures

A.) Brachial Plexus injury

A 37 week pregnant patient is admitted with severe preeclampsia. The patient begins to experiences a tonic-clonic seizure. Which of the following would the nurse AVOID during the seizure? A.) Holding down the patient's head to prevent injury B.) Staying with the patient and activating the emergency response team C.) Timing the seizure D.) Providing 8 to 10 L of oxygen

A.) Holding down the patient's head to prevent injury

If labor does not begin within 6 to 12 hours after premature rupture of membranes (PROM), there is an increased risk of: A.) Infection in the uterus or fetus B.) Birth defects C.) Prolonged labor D.) Delayed labor

A.) Infection in the uterus or fetus

What is morning sickness? A.) Mild nausea sometimes accompanied by vomiting B.) Severe nauseas and vomiting C._ A condition in pregnancy lasting the entire length of the pregnancy D.) All of these answers

A.) Mild nausea sometimes accompanied by vomiting

A nurse / midwife should be aware that pre-term is defined as between... A.) None of the above B.) 20 weeks and 37 weeks gestation C.) 28 weeks and 27 weeks gestation D.) 24 weeks and 40 weeks gestation

A.) None of the above

Which patients are at the highest risk of preterm labour? A.) Patients with a history of preterm labour in a previous pregnancy B.) Patients living in low socio-economic circumstances C.) Patients who book early in pregnancy D.) Multigravidas

A.) Patients with a history of preterm labour in a previous pregnancy

The obs nurse/midwife responsible for the antenatal care ask the pregnant woman her LMP. The LMP is critical to determine which of the following? A.) The gestational period B.) The day the woman conceived C.) The month when the menstrual period will resume again post delivery. D.) The specific date which this woman is going to have her baby

A.) The gestational period

What are the four parts of the uterine tubes called? A.) fimbriae, infundibulum, ampulla, isthmus B.) fimbriae, infundibulum, broad ligament, uterus C.) isthmus, ampulla, outer cortex, inner cortex D.) infundibulum, ampulla, isthmus, outer cortex

A.) fimbriae, infundibulum, ampulla, isthmus

When administering magnesium sulphate to a client with pre-eclampsia, the nurse/midwife understand that this drug is given to A.) reduce blood pressure. B.) prevent seizures. C.) increase diuresis. D.) speed up the process of labour.

B.) prevent seizures.

Which is the risk factor for gestational diabetes? A. Body mass index of more than 30 B. Family history of diabetes C. Age more than 25 years D. All of the above

D. All of the above

A nurse/midwife is educating a client who has pre-eclampsia and has been prescribed a 24hr urine collection test. The nurse/midwife should tell the client that the purpose of the test is to identify which of the following? A.) pH B.) Protein C.) Glucose D.) Crystals

B.) Protein

From the Blastocyst, two layers appear, the trophoblast and the embryoblast. What does the trophoblast become? A.) Limb buds B.) The fetal placenta (the chorion) C.) The cardiovascular system D.) The embryo

B.) The fetal placenta (the chorion)

When is the Embryonic period? A.) Week 0 - 14 B.) Week 3 - Week 8 C.) Week 3 - 28 D.) Week 0 - 40

B.) Week 3 - Week 8

A 22-year-old female G1 at 17 weeks presents to Triage reporting spotting after sex with her husband. She is worried she may be having a miscarage. Doppler confirms FHT, and speculum exam reveals a closed cervix with bright red margins noted on the transformation zone. What is the likely cause of bleeding? A. Placental abruption B. Ectropion C. Complete AB D. Inevitable AB

B. Ectropion

Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta? A. Premature rupture of membranes B. Excessive vaginal bleeding C. Tetanic uterine contractions D. Rigid, board-like abdomen

B. Excessive vaginal bleeding

A 34-year-old G3P2 at 37 weeks presents to OB triage with painful bright red vaginal bleeding. She reports tripping and landing on her buttocks nearly 1 hour ago. Physical exam reveals a tender and firm uterus. Emergency US reveals FHT in the 100's with a posterior placenta. VS= BP 100/60 HR= 112 R=18= T=98.2. What is the most likely diagnosis? A. Placenta accrete B. Placental abruption C. Vasa previa D. Normal labor E. Uterine rupture

B. Placental abruption

During her first prenatal visit, a woman asks why she is being screened for syphilis. Which of the following is the best response by the healthcare provider? A.) "If you test positive you may need to be admitted to the hospital for care." B.) "Syphilis can be transferred from you to your baby through the placenta." C.) "We must report all cases of syphilis to the health department." D.) "If you have the infection, the safest time to treat you is during the first trimester."

B.) "Syphilis can be transferred from you to your baby through the placenta."

What are symptoms of hyperemesis gravidarum? A.)Dehydration B.) All answers are correct C.) Weight loss of 5% or greater of pre-pregnancy weight D.) Severe nausea and vomiting that disrupts daily activities and affects less than 3% of all pregnancies

B.) All answers are correct

If a patient presents with preterm labour, the first step in the management is to: A.) Do a sterile speculum examination to see whether liquor is draining from the cervix. B.) Do a vaginal examination to evaluate cervical dilatation and effacement. C._ Do an abdominal examination to evaluate the frequency and duration of uterine contractions. D.) Estimate the gestational age as accurately as possible and rule out fetal distress.

B.) Do a vaginal examination to evaluate cervical dilatation and effacement.

Cord prolapse - which of the following are true? A.) Occurs in 1 in 5000 deliveries. B.) Initial management is to elevate the presenting part to prevent cord compression, followed by expedited delivery. C.) Cord prolapse occurs when the cord is felt through intact membranes. D.) More than half occur at artificial amniotomy. E.) Is a common cause of intrapartum stillbirth. F.) Risk factors include preterm labour, breech presentation, abnormal lie and twin pregnancy.

B.) Initial management is to elevate the presenting part to prevent cord compression, followed by expedited delivery. D.) More than half occur at artificial amniotomy. F.) Risk factors include preterm labour, breech presentation, abnormal lie and twin pregnancy.

A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? A. Platelet infusion. B. Immediate caesarean delivery. C. Activity limited to bed rest. D. Labor induction with oxytocin.

C. Activity limited to bed rest.

A patient presents in labor at term. Clinical pelvimetry is performed. She has an oval-shaped pelvis with the anteroposterior (AP) diameter at the pelvic inlet greater than the transverse diameter. The baby is occiput posterior. The patient most likely has what kind of pelvis? A. A gynecoid pelvis B. A platypelloid pelvis C. An anthropoid pelvis D. An android pelvis E. An androgenous pelvis

C. An anthropoid pelvis

Passive management of the third stage of labour includes: A. Giving an oxytocic drug and then waiting for the signs of placental separation B. Giving an oxytocic drug when the signs of placental separation appear so that the placenta can be spontaneously delivered C. Waiting for the signs of placental separation when the patient is then asked to bear down and spontaneously deliver the placenta D. Pulling down steadily on the umbilical cord and pushing the uterus up when the patient has a contraction

C. Waiting for the signs of placental separation when the patient is then asked to bear down and spontaneously deliver the placenta

A nurse / midwife should know that routine antenatal booking bloods screen for... A.) Human Immunodeficiency Virus (HIV) B.) Hepatitis B & C C.) All of the above D.) Syphilis

C.) All of the above

Braxton Hicks contractions: A.) Are regular B.) Are associated with cervical dilatation C.) Are sometimes uncomfortable but are not painful D.) Increase in duration and frequency

C.) Are sometimes uncomfortable but are not painful

A patient who is gravida 8 presents with a missed period of 7 weeks. P.V. bleeding. Cervical excitation, lower abdominal pain, fainting 2 times yesterday. Your diagnosis is: A.) Abortion B.) Pancreatitis C.) Ectopic pregnancy D.) None of these

C.) Ectopic pregnancy

The most effective maneuver to resolve shoulder dystocia is A.) McRobert's B.) McRoberts maneuver C.) McRoberts D.) McRoberts position

C.) McRoberts

Which statement is TRUE regarding abruptio placenta? A.) Fetal distress is not common in this condition as it is in placenta previa B.) A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening C.) Nursing interventions for this condition includes measuring the fundal height D.) This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical opening

C.) Nursing interventions for this condition includes measuring the fundal height

A woman who has had a hysterectomy and bilateral salpingo-oophorectomy, has had what structures removed? A.) Ovaries on one side, uterus, cervix B.) Both ovaries, both uterine tubes C.) Uterus, cervix, both uterine tubes, both ovaries D.) Uterus, cervix

C.) Uterus, cervix, both uterine tubes, both ovaries

If gestational diabetes is left untreated in the mother, how does it affect the baby? A. Respiratory distress syndrome in the newborn B. High birth weight C. Hypoglycemia in the newborn D. All of the above

D. All of the above

A multigravida comes in your unit and complains of not feeling well since last week but its on and off. The nurse/midwife would accurately describe multigravida to mean A.) A woman giving birth for the first time B.) A woman who has given birth at least once before C.) A woman pregnant for the first time D.) A woman who has been pregnant before

D.) A woman who has been pregnant before

Which of the following options are the warning signs of a shoulder dystocia case? A.) Slow progress in labor B..) Turtle neck sign C.) More painful labor D.) All of the above

D.) All of the above

Overt prolapse (protruding from the vagina) occurs with ruptured membranes and is more common with which of the following? A.) Multifetal pregnancy B.) Fetopelvic disproportion C.)Vertex presentation D.) Breech presentation

D.) Breech presentation

A nurse is caring for a client who will undergo medical management for an ectopic pregnancy. Which treatment would the nurse anticipate? A.) Methotrexate B.) Plan B pill C.) Folic acid D.) Laparotomy

D.) Laparotomy

Preterm rupture of the membranes is defined as: A.) Membranes that have ruptured before the onset of labour at any gestational age B.) Membranes that have ruptured at term, and not been followed by the onset of labour within 24 hours C.) Membranes that rupture before the second stage of labour D.) Membranes that have ruptured before 37 weeks of gestation, in the absence of contractions

D.) Membranes that have ruptured before 37 weeks of gestation, in the absence of contractions

What are the three parts of the broad ligament called? A.) Meometrium, mesosalpinx, endometrium B.) Mesovarium, mesosalpinx, myometrium C.) Mesovarium, myometrium, perimetrium D.) Mesovarium, mesosalpinx, mesometrium

D.) Mesovarium, mesosalpinx, mesometrium

A client tell the nurse / midwife that they plan on using the natural method of family planning. The nurse / midwife is aware that the success of the method depends on... A.) Frequency of intercourse B.) Range of the client's temperature C.) Age of the client D.) Regularity of the menses

D.) Regularity of the menses

In occult umbilical cord prolapse (contained within the uterus), the umbilical cord is often compressed by a shoulder or the head. A fetal heart rate pattern that suggests cord compression and progression to hypoxemia may be the only clue. Which of the following characterizes that heart rate pattern? A.) Episodic accelerations B.) Moderate C.) Fibrillation D.) Severe variable decelerations

D.) Severe variable decelerations

Pelvic examination is performed in a 34-year-old P0101 at 34 weeks' gestation who is in labor. The patient is noted to be 6 cm dilated, and completely effaced with the fetal nose and mouth palpable. The chin is pointing toward the maternal left hip This is an example of which of the following? A. Brow presentation B. Occiput transverse position C. Transverse lie D. Vertex presentation E. Mentum transverse position

E. Mentum transverse position

T/F: Gestational diabetes usually gets back to normal after pregnancy.

TRUE