OB Exam 2
Which cardinal movement allows the fetus to travel through the birth canal most efficiently? a. external rotation b. extension c. engagement d. flexion
d. flexion
A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn? a. bicuspid valve stenosis b. hypertension c. clubbed fingers and toes d. microcephaly
d. microcephaly
A pregnant woman diagnosed with cardiac disease 4 years ago is told that her pregnancy is a high-risk pregnancy. The nurse then explains that the danger occurs primarily because of the increase in circulatory volume. The nurse informs the client that the most dangerous time for her is when? a. in weeks 28 to 32 b. in weeks 20 to 28 c. in weeks 8 to 12 d. in weeks 12 to 20
a. in weeks 28 to 32
When providing education to a prenatal care class for teenagers, the nurse states that infants born to teenage mothers are more likely to have which outcome? a. low-birth-weight b. genetic problems c. lower mortality rates d. postdate birth
a. low-birth-weight
A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? a. limiting sodium intake b. assessing for cardiac decompensation c. inspecting the extremities for edema d. ensuring that the client consumes a high fiber diet
b. assessing for cardiac decompensation
A nurse is caring for a client who is in labor. For which fetal response should the nurse monitor? a. increase in fetal breathing movements b. decrease in circulation and perfusion to the fetus c. increase in fetal oxygen pressure d. decrease in arterial carbon dioxide pressure
b. decrease in circulation and perfusion to the fetus
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 lie c. fetal presentation d. fetal position
b. fetal lie
A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? a. elevated liver enzymes b. onset of seizure activity c. diminished or absent reflexes d. serum magnesium level of 6.5 mEq/L
c. diminished or absent reflexes
Cytomegalovirus infection can result in different congenital anomalies. It can also be transmitted via different routes. When discussing this infection with a pregnant woman, the nurse integrates understanding that permanent fetal disability can occur with which type of transmission of CMV? a. after birth transmission b. during birth transmission c. in utero transmission d. with any transmission
c. in utero transmission
The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? a. monitor the mass with transvaginal ultrasound b. determine the size of the mass c. monitor the FHR d. monitor the client's vital signs and bleeding
d. monitor the client's vital signs and bleeding
Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? a. shoulders b. brow c. buttocks d. occiput
d. occiput
A nurse sees a pregnant client at the clinic. The client is close to her due date. During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility? a. increased risk of infection b. potential placenta previa c. potential rapid birth of fetus d. increased risk of breech presentation
a. increased risk of infection
A woman with no previous history of heart disease begins to have symptoms of myocardial failure a few weeks before the birth of her first child. Findings include shortness of breath, chest pain, and edema, with her heart also showing enlargement. The nurse suspects which condition? a. peripartum cardiomyopathy b. pulmonary valve stenosis c. left-sided heart failure d. mitral stenosis
a. peripartum cardiomyopathy
The nurse is monitoring a client who is in active labor. The nurse will carefully monitor which phase of the involuntary uterine contraction to ensure the fetus is progressing adequately? a. acme b. relaxation c. decrement d. increment
b. relaxation
A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station? a. 0 b. +2 c. -2 d. +4
c. -2
A nurse is admitting a client who presents in active labor at 41 weeks' gestation. The nurse prepares for the possibility of a cesarean delivery after noting the client has which type of pelvis documented? a. platypelloid b. gynecoid c. android d. anthropoid
c. android
The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage). When asked why this happened, which reason should the nurse share as a common cause?
chromosomal abnormality
A pregnant client is admitted to a maternity clinic for birth. The client wishes to adopt the kneeling position during labor. The nurse knows that which of the following is an advantage of adopting a kneeling position during labor? a. It helps the woman in labor to save energy. b. It facilitates vaginal examinations. c. It facilitates external belt adjustment. d. It helps to rotate the fetus in a posterior position.
d. It helps to rotate the fetus in a posterior position.
A nursing instructor identifies which factor as increasing the chances of infection when coupled with prolonged labor?
premature rupture of membranes (PROM)
A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer?
"the antibodies may be those transferred across the placenta; the baby may not develop AIDS."
The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action? a. Eat a sustaining-carbohydrate snack. b. Add a bolus of long-acting insulin. c. Inject a bolus of insulin. d. Eat a high-carbohydrate snack.
a. Eat a sustaining-carbohydrate snack.
A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize? a. "I have trouble getting comfortable in bed." b. "I sometimes get a bit wheezy." c. "Certain substances make me sneeze." d. "I sometimes get a feeling of euphoria."
b. "I sometimes get a bit wheezy."
Which nursing action is a priority when the fetus is at the +4 station? a. Have a tocometer and a client gown ready. b. Have a blue bulb suction and an infant warmer ready. c. Prepare for an immediate cesarean birth. d. Provide lubricating jelly and an internal monitor.
b. Have a blue bulb suction and an infant warmer ready.
The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which? a. The fetus is floating high in the pelvis. b. The client is fully effaced. c. The fetus is in the true pelvis and engaged. d. The fetus has descended down the birth canal.
c. The fetus is in the true pelvis and engaged.
During which time is the nurse correct to document the end of the third stage of labor? a. When the mother is moved to the postpartum unit b. When pushing begins c. At the time of placental delivery d. Following fetal birth
c. At the time of placental delivery
Which is the most important nursing assessment of the mother during the fourth stage of labor? a. Blood pressure b. Heart rate c. The mother's psyche d. Hemorrhage
d. Hemorrhage
The client is being rushed into the labor and delivery unit. At which station would the nurse document the fetus immediately prior to birth? a. 0 b. -5 c. +1 d. +4
d. +4
A woman at 26 weeks' gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client's return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test? a. 100 mg/dl (5.55 mmol/L) b. 130 mg/dL (7.21 mmol/L) c. 114 mg/dL (6.33 mmol/L) d. 146 mg/dL (8.10 mmol/L)
d. 146 mg/dL (8.10 mmol/L)
The first stage of labor is often a time of introspection. In light of this, which information would guide the nurse's plan of care? a. A woman should be left entirely alone during this period. b. A woman will rarely speak or laugh during this period. c. No nursing care is needed to be done during this time. d. A woman may spend time thinking about what is happening to her.
d. A woman may spend time thinking about what is happening to her.
There are four essential components of labor. The first is the passageway. It is composed of the bony pelvis and soft tissues. What is one component of the passageway? a. Cervix b. Perineum c. Uterus d. False pelvis
a. Cervix
A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? SATA a. increase in gastric emptying and pH b. increase in blood pressure c. slight decrease in body temperature d. increase in respiratory rate e. increase in heart rate
b, d, e
The nurse is caring for a pregnant woman with diabetes mellitus. Which potential fetal complications should the nurse monitor the client for as she presents for her scheduled visits? SATA a. respiratory disorder b. congenital malformations c. fetus with juvenile diabetes d. smaller than gestational age baby e. macrosomia
a, b, e
A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this disease make her infant at risk for? a. chickenpox b. deafness c. neonatal laryngeal papillomas d. blindness
d. blindness
A nurse is assessing a newborn and suspects that newborn may have been exposed to alcohol during gestation. The nurse suspect this based on which newborn findings? SATA a. limb abnormality b. small head circumference c. thin upper lip d. macrocephaly e. large inset eyes
a, b, c
A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? SATA a. obesity b. hypertension c. maternal age less than 18 years d. previous large-for-gestational-age (LGA) infant e. genitourinary tract abnormalities
a, b, d
What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? a. stressing the positive benefits of a healthy lifestyle b. stressing the increased use of Vitamin D supplements c. stressing regular walks and exercise d. stressing the avoidance of dairy products
a. stressing the positive benefits of a healthy lifestyle
A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and convey to the RN or health care provider? a. initial BP 140/85 mm Hg; current BP 130/80 mm Hg b. initial BP 100/70 mm Hg; current BP 140/90 mm Hg
b. initial BP 100/70 mm Hg; current BP 140/90 mm Hg
Which change in insulin is most likely to occur in a woman during pregnancy? a. enhanced secretion from normal b. less effective than normal c. unavailable because it is used by the fetus d. not released because of pressure on the pancreas
b. less effective than normal
The nurse is providing care to a neonate whose mother has heroin use disorder. The nurse suspects that the neonate is experiencing neonatal abstinence syndrome based on which finding? a. hypotonicity b. sneezing c. easy consolability d. vigorous sucking
b. sneezing
Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor? a. Braxton Hicks contractions cause "ripening" of the cervix. b. Braxton Hicks contractions do not last long enough to be true labor. c. Braxton Hicks contractions get closer together with activity. d. Braxton Hicks contractions usually decrease in intensity with walking.
d. Braxton Hicks contractions usually decrease in intensity with walking.
The nurse is leading a discussion with a group of pregnant women who have diabetes. The nurse should point out which situation can potentially occur during their pregnancy? a. Postterm birth b. Hypotension of pregnancy c. Small-for-gestational-age (SGA) infant d. Polyhydramnios
d. Polyhydramnios
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. providing clear information about procedures d. allowing the woman time to be alone
d. allowing the woman time to be alone
A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? a. sexual development of the client b. whether sex was consensual c. options for birth control in the future d. knowledge of child development
d. knowledge of child development
Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? a. Maternal request for pain medication b. Fetal heart rate in relation to contractions c. The station in which the fetus is located d. Maternal heart rate and blood pressure
b. Fetal heart rate in relation to contractions
A G4P3 client with a history of controlled asthma is upset her initial prenatal appointment is taking too long, making her late for another appointment. What is the nurse's best response when the client insists she knows how to handle her asthma and needs to leave? a. Schedule an appointment for her to return to discuss her asthma management. b. Note in the chart that the woman was not counseled about her asthma. c. Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications. d. Remind her to continue taking asthma medications, to monitor peak flow daily, and to monitor the baby's kicks in the second and third trimesters.
c. Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications.
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 130/86 mm Hg; week 20 - 138/88 mm Hg; week 24 - 136/82 mm Hg; and week 28 - 138/88 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? a. stage 2 b. hypertensive crisis c. stage 1 d. elevated
c. stage 1
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make NEXT?
palpate the fundus and check the fetal heart rate
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the PRIORITY for this woman on admission? a. performing a vaginal examination to assess the extent of bleeding b. assessing fetal heart tones by use of an external monitor c. assessing fetal heart tones by use of an internal monitor d. inform the client she can remain ambulatory
b. assessing fetal heart tones by use of an external monitor
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. LOP b. LOA c. ROA d. ROP
c. ROA
A nurse is teaching a group of pregnant women about the signs that labor is approaching. When describing these signs, which sign would the nurse explain as being essential for effacement and dilation (dilatation) to occur? a. lightening b. Braxton Hicks contractions c. cervical ripening and softening d. bloody show
c. cervical ripening and softening
The nurse is monitoring a client who is in labor and notes the client is happy, cheerful, and "ready to see the baby." The nurse interprets this to mean the client is in which stage or phase of labor? a. stage 2 b. stage 3 c. transition stage d. latent phase
d. latent phase
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth? a. the viral load b. amniocentesis results at 34 weeks' gestation c. prophylactic antiretroviral therapy (ART) to the infant at birth d. the mother's age
a. the viral load
A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that:
as long as she receives Rho(D) immune globulin, there is no limit
The nurse is assessing a 35-year-old woman at 22 weeks' gestation who has had recent laboratory work. The nurse notes fasting blood glucose 146 mg/dl (8.10 mmol/L), hemoglobin 13 g/dl (130 g/L), and hematocrit 37% (0.37). Based on these results, which instruction should the nurse prioritize? a. Include iron-enriched foods in the diet. b. The signs and symptoms of urinary tract infection c. Check blood sugar levels daily. d. Take daily iron supplements.
c. Check blood sugar levels daily.
A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance? a. a full meal b. water c. milk d. orange juice
d. orange juice
Assessment of a woman in labor reveals that the scapula of the fetus is the presenting part. The nurse interprets this finding as indicating which fetal presentation? a. breech b. vertex c. cephalic d. shoulder
d. shoulder
The nurse is documenting the length of time in the second stage of labor. Which data will the nurse use to complete the documentation? a. Effacement time and time when contractions are regular b. Complete cervical dilation (dilatation) and time of fetal birth c. Time of mucus plug expulsion and full cervical dilation d. Admission time and time of fetal birth
b. Complete cervical dilation (dilatation) and time of fetal birth
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. dilation b. effacement c. crowning d. molding
b. effacement
A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority? a. administration of immunoglobulins b. consumption of a low-fat diet c. avoidance of infection d. constipation prevention
c. avoidance of infection