OB FINAL Exam- Fall 2020
Which diagnostic test is used to confirm a suspected diagnosis of breast cancer? A. MRI B. Mammogram C. Needle biopsy D. Ultrasound
ANS: C
Which of the following findings is indicative of the HELLP syndrome, which sometimes complicates severe pre-eclampsia? A. Edema of the face, hands, and feet B. Elevated Blood pressure C. Thrombocytopenia D. Seizures
ANS: C
A client who is a gravida 2, para 1 is admitted in the active phase of labor. She tells the nurse, "I don't remember anything about my last birth. I want to see and enjoy the birth this time. I can deal with the contractions; I just need some relief down below when the baby is coming out." The anesthesia which would best help the client achieve her goal during labor would be: A. general anesthesia. B. a spinal. C. a systemic analgesic. D. a pudendal.
ANS: D
An appropriate question to ask a client with painful menstruation to differentiate primary from secondary dysmenorrhea: A. "Have you had a recent personal crisis or change in your lifestyle?" B. "Does your pain become worse with activity or overexertion?" C. "Is your pain relived by non-steroidal anti-inflammatory drugs?" D. "When in your menstrual history did the pain with your period begin?"
ANS: D
Indicate the rationale for a nonstress test with a postterm client. A. To assess fetal response to uterine stimulation. B. To evaluate fetal response to acoustic stimulation. C. To evaluate uterine relaxation response. D. To assess the well-being of the fetus.
ANS: D
The nurse assesses the fetal monitor and sees the following strip. What action by the nurse is most appropriate? (STRIP SHOWN) A. Apply a fetal scalp electrode. B. Reposition the woman. C. Administer oxygen by nasal cannula. D. Record this reassuring pattern.
ANS: D
The nurse is caring for a patient pregnant with twins. Which statement indicates that the patient needs additional information? A. "If I have one boy and one girl, I will know they came from two eggs." B. "It is rare for both twins to be within the same amniotic sac." C. "Because both of my twins are boys, I know that they are identical." D. "If my twins came from one fertilized egg that split, they are identical."
ANS: D
When providing a woman recovering from primary herpes with information regarding the recurrence of herpes infection of the genital tract, the nurse would tell her which of the following? A. Little can be done to control the recurrence of infection. B. Cortisone based ointments should be used to decrease discomfort. C. Fever and flu-like symptoms will precede each recurrent infection. D. Tingling and burning often occur before the appearance of vesicles.
ANS: D
Which statement correctly describes the nurse's responsibility related to electronic monitoring? A. Teach the woman and her support person about the monitoring equipment, and discuss any questions they have. B. Report abnormal findings to the physician before initiating corrective actions C. Document the frequency, duration, and intensity of contractions measured by the external device. D. Inform the support person that the nurse will be responsible for all comfort measures when the electronic equipment is in place.
ANS: A
Which woman is mot likely to have osteoporosis? A. A 55 year old woman with a sedentary lifestyle B. A 50 year old woman receiving estrogen therapy C. A 60 year old woman who takes supplemental calcium D. A 65 year old woman who walks 2 miles a day
ANS: A
While evaluating a patient for osteoporosis, the nurse should be aware of what risk factor? A. Cigarette smoking B. African-American race C. Obesity D. Low protein diet
ANS: A
A 26 year old woman has just been diagnosed with fibrocystic changes in her breasts. Which of the following nursing diagnoses would be a priority for this woman? A. Acute pain related to cyclical enlargement of breast cysts or lumps B. Anxiety related to anticipated surgery to remove cysts from breasts. C. Risk of infection related to altered integrity of the areola associated with accumulation of thick, sticky discharge from nipples. D. Fear related to high risk of breast cancer.
ANS: A
A 36 week gestation gravid patient lies flat on her back. Which of the following maternal signs/symptoms would the nurse expect to observe? A. Dizziness B. Hypertension C. Chloasma D. Rales
ANS: A
A newborn has meconium aspiration at birth. The nurse notes increasing respiratory distress. What action takes priority? A. Obtain an oxygen saturation B. Notify the provider at once C. Stimulate the baby to increase respirations. D. Prepare to institute ECMO
ANS: A
A nurse is conducting a clinic visit with a prenatal client with heart disease. The nurse carefully assesses the client's vital signs, weight, fluid and nutritional status to detect complications caused by: A. the increase in circulating blood volume. B. fetal cardiomegaly. C. hypertrophy and increased contractility of the heart. D. Rh incompatibility.
ANS: A
During which weeks of gestation is the embryo/fetus most vulnerable to teratogens? A. 2 - 8 B. 9 - 12 C. 21 - 28 D. 13 - 20
ANS: A
Which of the following nursing interventions will promote comfort for a client with a small hematoma of the perineal area? (Select 3 that apply). A. Encourage sitz baths at least twice a day. B. Obtain an order for an indwelling catheter C. Apply warm packs to the perineal area for the first 24 to 48 hours. D. Apply ice to the perineal area for the first 24 to 48 hours. E. Use a topical antiseptic cream or spray on the perineal area
ANS: A, B, D
A client 39 weeks gestation, calls the labor unit stating, "I think my water broke." The nurse tells the client to come to the labor unit for assessment. What two tests would the nurse perfrom to determine the presence of amniotic fluid? (Select all that apply). A. Fern test B. CST C. Nitrazine D. A biophysical profile E. An NST
ANS: A, C
A woman, G1P0000, is 40 weeks gestation. Her Bishop score is 4. Which of the following complementary therapies do midwives frequently recommend to clients in similar situations? (Select all that apply) A. Ingestion of castor oil B. Aromatherapy C. Aerobic exercise D. Breast stimulation E. Sexual intercourse
ANS: A, D, E
A client is to have a hysterosalpingogram. In this procedure, the physician will be able to determine which of the following? A. If the cervix is incompetent B. Whether or not the fallopian tubes are obstructed. C. Whether or not the ovaries are maturing properly. D. If the endometrium is fully vascularized.
ANS: B
A defining parameter for preeclampsia is that it occurs: A. During the first trimester B. After the 20th week of pregnancy C. In the last four weeks of pregnancy D. Prior to the 20th week of pregnancy
ANS: B
The nurse counseling a 30 year old woman regarding effective measures to use to relieve the discomfort associated with dysmenorrhea could suggest which of the following? (Select 3 answers). A. Decrease intake of fruits, especially peaches and watermelon. B. Use back massage and heat application to abdomen to enhance relaxation and circulation. C. Add vegetables such as asparagus the diet. D. Limit intake of salty and fatty foods. E. Avoid exercise completely during this time.
ANS: B, C, D
The client is 36 weeks' gestation. The nurse understands that the pregnancy is progressing normally when she sees which of the following physiologic changes documented on the client's prenatal record? (Select all that apply.) A. The cervix is firm and purplish-blue in color. B. The joints of the pelvis have relaxed. C. Hair loss is decreased, with thickening of the hair. D. Gastric emptying time is prolonged, and the client complains of gas and bloating. E. The uterine fundus is at a height of 36 cm above the pubic symphysis.
ANS: B, D, E
A 26-week-gestation woman is diagnosed with severe preeclampsia with HELLP syndrome. The nurse assesses for which of the following signs/symptoms? A. high serum protein B. bloody stools C. epigastric pain D. low serum creatinine
ANS: C
A laboring woman has been given an injection of epidural anesthesia. Which assessment by the nurse takes priority? A. Intravenous infusion rate B. Contraction pattern C. Maternal blood pressure D. Urinary output
ANS: C
A physician diagnoses a total abruptio placenta, explains the situation to the client and leaves to arrange from an emergency cesarean delivery. The client's eyes are filled with tears. Which of the following actions should the nurse do first? A. Take the client's hand and reassure her. B. Begin to gather equipment needed to prepare for cesarean birth. C. Ask the physician to come back and reassure the client. D. Ask the client if she has a family member the nurse can contact.
ANS: B
A pregnant client presents with gestational hypertension. Which of the following is the primary adverse effect of this disorder that results in risk to the fetus? A. Increased urinary output B. Uteroplacental insufficiency C. Pulmonary edema D. Enlargement of the liver
ANS: B
Which statement by the patient indicates that she understands breast self-examination? A. "I will examine both breasts in four different positions." B. "I only need to examine the outer upper position of my breast because that's the only area breast cancer occurs." C. "I will use the palm of my hand to perform the examination." D. "I will perform breast self-examination 1 week after my menstrual period."
ANS: D
One of the major factors that differentiates eclampsia from preeclampsia is: A. Convulsions B. Generalized edema C. Oliguria D. Retinal edema
ANS: A
The best time to teach nonpharmacologic pain control methods to an unprepared laboring woman is during which phase? A. Latent phase B. Active phase C. Second stage D. Transition phase
ANS: A
The client's vaginal exam reveals: 3 cm dilated, 80% effaced, vertex at a -1 station. The woman is talkative and appears excited. The nurse determines the client to be in which stage and phase of labor? A. First stage, latent phase B. Third stage, transition stage C. Second stage, latent stage D. First stage, active phase
ANS: A
The nurse notes a pattern of late decelerations on the fetal monitor. The most appropriate action is to A. give the woman oxygen by face mask. B. continue observation of this reassuring pattern. C. notify the physician or nurse-midwife. D. place the woman in a Trendelenburg position.
ANS: A
The nurse provides education regarding breast care should explain to the woman that fibrocystic changes in the breasts are A. lumpiness with pain and tenderness found in breasts of healthy women. B. a pre-malignant disorder characterized by lumps found in the breast tissue. C. lumpiness accompanied by tenderness after menses. D. a disease of the milk ducts and glands in the breasts.
ANS: A
The test most often used to diagnose placenta previa is: A. ultrasound B. vibroacoustic stimulation test C. contraction stress test D. nonstress test
ANS: A
What information about caffeine in pregnancy does the nurse provide the prenatal class with? A. It causes vasoconstriction, which could keep the fetus from growing. B. Severe diuresis can leave you at risk for dehydration during pregnancy. C. Caffeine depresses your heart's ability to pump and function. D. It stays in your body twice as long as when you are not pregnant.
ANS: A
Which nursing intervention is necessary before a second trimester transabdominal ultrasound? A. Instruct the woman to drink 1 to 2 quarts of water. B. Perform an abdominal prep. C. Place the woman NPO for 12 hours D. Administer a soapsuds enema.
ANS: A
A client who is breastfeeding has mastitis. The client should be taught to do which of the following? A. Limit the amount of time that the infant nurses on each breast. B. Completely empty each breast at each feeding or with a pump C. Wear a tight fitting bra or breast binder until lactation has ceased. D. Nurse the infant only on the unaffected breast until resolved.
ANS: B
A vaginal exam is performed on a multiparous woman who is in labor. The results of the exam were documented as 6 cm dilated, 75% effaced, +1 station, and LOA. Which of the following would be an accurate interpretation of this data? A. Presentation is cephalic. B. Station is 2 cm above the ischial spines. C. Lie is transverse. D. Woman is in the latnet phase of the first stage of labor.
ANS: A
A woman is scheduled for an ultrasound and is asking the nurse questions about this test. Which statement by the nurse regarding ultrasonography during pregnancy is most accurate? A. Ultrasonography is not harmful to the fetus. B. Ultrasonography is not a component of biophysical profile testing. C. Ultrasonography is only utilized as an adjunct to more invasive tests. D. Ultrasonography uses infrared technology to create an image.
ANS: A
A primigravida at 10 weeks of gestation reports mild uterine cramping and slight vaginal spotting without passage of tissue. When she is examined, no cervical dilation is noted. The nurse caring for this woman would: A. Prepare the woman for dilatation and currettage. B. Anticipate that the woman will be sent home and placed on bedrest with instructions to avoid stress. C. Tell the woman that the doctor will most likely perform a cerclage to help her maintain her pregnancy. D. Notify a grief counselor to assist the woman with the imminent loss of her fetus.
ANS: B
A woman is determined to be Group B streptococcus (GBS) positive at the onset of her labor. The nurse should prepare this woman for which of the following? A. Cesarean birth B. IV antibiotics during labor C. Application of acyclovir to her labial lesions D. Transplacental infection of her newborn with GBS
ANS: B
An NST in which two or more fetal heart rate (FHR) accelerations of 15 beats per minute (bpm) or more occur with fetal movement in a 20-minute period is termed A. nonreactive B. reactive C. negative D. positive
ANS: B
Methotrexate is recommended as part of the treatment plan for which of the following obstetric complications? A. Missed abortion B. Unruptured ectopic pregnancy C. Abruptio placentae D. Complete hydatidiform mole
ANS: B
Vaginal examinations are contraindicated for women with 3rd trimester bleeding for which of the following reasons? A. It is undesirable to stimulate labor. B. A low-lying placenta may be dislodged and bleeding may occur. C. When cervical dilation is 10 centimeters. D. There is a danger of rupturing the membranes.
ANS: B
When completing the admission history for an 18 year old client at 39 weeks gestation, the client states she has been leaking water from her vagina for 2 days. The nurse knows the client is at risk for A. placental abruption B. infection C. cord prolapse D. malpresentation
ANS: B
A client at 32 weeks gestation is admitted to the unit because she is having contractions. Her vaginal exam indicates she is dilated 1 cm and experiencing contractions every 5 to 10 minutes. She states she feels a little pelvic pressure and the contractions are not painful. Which of the following tests should the nurse expect to be ordered? A. Biophysical profile testing B. Amniotic fluid volume index C. Testing for fetal fibronectin D. Testing for meconium in the amniotic fluid
ANS: C
A client who is a gravida 2, para 1 is admitted in the active phase of labor. She tells the nurse, "I don't remember anything about my last birth. I want to see and enjoy the birth this time. I can deal with the contractions; I just need some relief down below when the baby is coming out." The anesthesia which would best help the client achieve her goal during labor would be: A. general anesthesia. B. a spinal. C. a pudendal block. D. a systemic analgesic.
ANS: C
At birth of a neonate, a placenta percreta is noted. The nurse should be alert for the possibility that the woman will need: A. Oxygen by nasal cannula B. Intravenous oxytocin C. A hysterectomy D. Prophylactic antibiotics
ANS: C
During transition, a woman becomes anxious and develops a deep and rapid respiratory pattern. She complains of dizziness and lightheadedness. The nurse's NEST response would be to: A. Turn the woman onto her side. B. Encourage the woman to continue this breathing pattern until the dizziness passes. C. Help the woman breathe into her cupped hands. D. Administer a sedative to help the woman.
ANS: C
The client has come to the prenatal clinic complaining of repeated nausea and vomiting. The nurse would look to which of the following as providing the best information about client hydration status? A. Hemoglobin B. Platelet count C. Urine specific gravity D. IgG level
ANS: C
The nurse anticipates the assessment of a normal episiotomy immediately post delivery is most likely to reveal which of the following by the nurse? A. Edema that makes the tissue look shiny. B. Gaping between the sutures. C. slight bruising. D. Pus coming from the incision.
ANS: C
The nurse is preparing to assess the fetal heart rate (FHR) and has determined that the fetal back is located toward the patient's left side, the small part toward the right side, and there is a vertex presentation. The nurse should initially begin auscultating the heart rate in the mother's: A. right lower quadrant B. right upper quadrant C. left lower quadrant D. left upper quadrant
ANS: C
The physician has ordered Pitocin immediately after a delivery. If the drug is effective it will: A. decrease blood pressure. B. decrease uterine contractions. C. produce a contracted uterus. D. produce a soft uterus.
ANS: C
What is the cause of epigastric pain that sometime occurs with severe preeclampsia? A. Increased gastric acidity B. Internal bleeding C. Hepatic ischemia and liver distention D. Renal damage
ANS: C
When presenting information about fetal development to a group of high school girls, one of the girls asks the nurse to explain the functions of the amniotic fluid. The nurse's response should be, "The amniotic fluid cushions the embryo/fetus against mechanical injury, controls the embryo's temperature, and A. allows freedom of movement so the embryo/fetus can change positions." B. provides for fetal respiration and metabolism." C. creates adherence to the amnion." D. provides a means of nutrient exchange for the embryo/fetus."
ANS: C
The student nurse is working with a laboring woman. What action by the student requires the registered nurse to intervene? A. Providing safety while the woman labors while standing B. Assisting the woman to a sitting position C. Turning the woman to a side-lying position D. Placing the woman in a supine position
ANS: D
Which of the following is the earliest indication of hypovolemia caused by hemorrhage in the postpartum client? A. Pale, cool, clammy skin, and pale mucous membranes B. Altered mental status and level of consciousness C. Increasing pulse and decreasing respiratory rate D. Increasing pulse and decreasing blood pressure
ANS: D