OB Test 1 Study Questions

The fetal/neonatal lung substance that improves pulmonary compliance by decreasing alveolar surface tension is: Question 4 options: 1) Meconium 2) Prostaglandin 3) Surfactant 4) Phospholipid

3) Surfactant

A positive Coombs test on an Rh-negative pregnant woman means: Question 20 options: 1) The mother has autoantibodies against Rh-positive red blood cells (RBC) 2) The fetus has autoantibodies against maternal RBCs 3) The mother does not have Rh factor against fetal RBCs 4) The fetus does not have RBC antibodies

1) The mother has autoantibodies against Rh-positive red blood cells (RBC)

A multigravida who is at 28 weeks of gestation has a fundal height of 29 cm. Which of the following is the best recommendation for this patient? Question 14 options: 1) Advise the mother that her pregnancy is progressing well 2) Order an ultrasound of the uterus 3) Refer her to an obstetrician for an amniocentesis 4) Recommend bed rest with bathroom privileges

1) Advise the mother that her pregnancy is progressing well

The majority of serum alpha fetoprotein is produced by the Question 24 options: 1) Fetal liver 2) Mother's liver 3) Placenta 4) Fetal neural tube

1) Fetal liver

Which of the following tests would you recommend to patients to confirm the diagnosis of beta thalassemia or sickle cell anemia? Question 39 options: 1) Hemoglobin electrophoresis 2) Bone morrow biopsy 3) Peripheral smear 4) Reticulocyte count

1) Hemoglobin electrophoresis

The positive signs of pregnancy include Question 26 options: 1) Palpation of the fetus and auscultation of the fetal heart tones by the nurse 2) Palpation of the fetus and a positive quantitative serum pregnancy test 3) Fetal heart tones and a positive quantitative serum pregnancy test 4) Fetal heart tones and felling of movement of the baby by the mother

1) Palpation of the fetus and auscultation of the fetal heart tones by the nurse

Fetal TORCH infections can cause microcephaly, mental retardation, hepatosplenomegaly, and intrauterine growth retardation. The acronym TORCH stands for: Question 13 options: 1) Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes 2) Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster 3) Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities 4) Toxins, other infections, roseola, candidiasis, and head abnormalities

1) Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes

The biophysical profile evaluates fetal well-being by combining fetal heart rate monitoring with Question 6 options: 1) Ultrasonography examination of established fetal parameters 2) Fetal movement count 3) External monitoring of uterine contractions 4) Serum complete blood count (CBC)

1) Ultrasonography examination of established fetal parameters

A 30-year-old primigravida is diagnosed with a possible threatened abortion. The result of the urine pregnancy test is positive. Which of the following statements is true regarding a threated abortion? Question 17 options: 1) Vaginal bleeding and cramping are present, but the cervix remains closed 2) Vaginal bleeding and cramping are present along with a dilated cervix 3) The fetus and placenta are all expelled 4) The products of conception and the placenta remain inside the uterus along with a dilated cervix

1) Vaginal bleeding and cramping are present, but the cervix remains closed

The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply. 1. "The ductus arteriosus allows blood to bypass the fetal lungs." 2. "One vein carries oxygenated blood from the placenta to the fetus." 3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy." 4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." 5. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta"

1. "The ductus arteriosus allows blood to bypass the fetal lungs." 2. "One vein carries oxygenated blood from the placenta to the fetus." 4. "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." Rationale: The ductus arteriosus is a unique fetal circulation structure that allows the nonfunctioning lungs to receive only a minimal amount of oxygenated blood for tissue maintenance. Oxygenated blood is transported to the fetus by one umbilical vein. The normal fetal heart tone range is considered to be 110-160 beats/min. Arteries carry deoxygenated blood and waste products from the fetus, and the umbilical vein carries oxygenated blood and provides oxygen and nutrients to the fetus. Blood pumped by the embryo's heart leaves the embryo through two umbilical arteries.

A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it can be determined . The nurse informs the client that she should be able to find out the sex at 12 weeks' gestation because of which factor? 1. The appearance of the fetal external genitalia 2. The beginning of differentiation in the fetal groin 3. The fetal testes are descended into the scrotal sac 4. The internal differences in males and females become apparent

1. The appearance of the fetal external genitalia

A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings. The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean section

1. A normal test result Rationale: Contraction stress test results may be interpreted as negative (normal), positive (abnormal), or equivocal. A negative test result indicates that no late decelerations occurred in the fetal heart rate, although the fetus was stressed by 3 contractions of at least 40 seconds' duration in a 10-minute period. Options 2, 3, and 4 are incorrect interpretations.

The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid. The student responds correctly by explaining which as characteristics of amniotic fluid? Select all that apply. 1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 3. Maintains the body temperature of the fetus 4. Can be used to measure fetal kidney function 5. Prevents large particles such as bacteria from passing to the fetus 6. Provides an exchange of nutrients and waste products between the mother and the fetus

1. Allows for fetal movement 2. Surrounds, cushions, and protects the fetus 4. Can be used to measure fetal kidney function Rationale: The amniotic fluid surrounds, cushions, and protects the fetus. It allows the fetus to move freely and maintains the body temperature of the fetus. In addition, the amniotic fluid contains urine from the fetus and can be used to assess fetal kidney function. The placenta prevents large particles such as bacteria from passing to the fetus and provides an exchange of nutrients and waste products between the mother and the fetus

.The nurse is performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. The nurse should assess for which probable signs of pregnancy? Select all that apply. 1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Positive pregnancy test 5. Fetal heart rate detected by a nonelectronic device 6. Outline of fetus via radiography or ultrasonography

1. Ballottement 2. Chadwick's sign 3. Uterine enlargement 4. Positive pregnancy test Rationale: The probable signs of pregnancy include uterine enlargement, Hegar's sign (compressibility and softening of the lower uterine segment that occurs at about week 6), Goodell's sign (softening of the cervix that occurs at the beginning of the second month), Chadwick's sign (violet coloration of the mucous membranes of the cervix, vagina, and vulva that occurs at about week 4), ballottement (rebounding of the fetus against the examiner's fingers on palpation), Braxton Hicks contractions, and a positive pregnancy test for the presence of human chorionic gonadotropin. Positive signs of pregnancy include fetal heart rate detected by electronic device (Doppler transducer) at 10 to 12 weeks and by nonelectronic device (fetoscope) at 20 weeks of gestation, active fetal movements palpable by the examiner, and an outline of the fetus by radiography or ultrasonography.

A second triple screen on a 35-year-old primigravida reveals abnormally low levels of the alpha fetoprotein and estriol and high levels of human chorionic gonadotropin. Which of the following interventions is the best choice for this patient? Question 11 options: 1) Order an ultrasound 2) Order a computed tomography (CT) scan of the abdomen 3) Order a 24-hour urine for protein clearance 4) Assess for a history of illicit drug or alcohol use

1. Order an ultrasound. The levels are abnormal during pregnancy. Ultrasound needed to further evaluate the fetus for down syndrome or fetal demise.

Human chorionic gonadotropin (hCG) is produced by the Question 23 options: 1) Placenta 2) Hypothalamus 3) Anterior pituitary 4) Ovaries

1. Placenta

When palpating a woman who is at 20 weeks of gestation, the uterine fundus should be palpated at what level? Question 29 options: 1) Just rising above the level of the pubic symphysis 2) Between the pubic symphysis and the umbilicus 3) At the level of the umbilicus 4) Above the level of the umbilicus

3) At the level of the umbilicus At 16 weeks gestation, the fundus of the uterus can be palpated at the midpoint between the umbilicus and the pubic symphysis. At 20 weeks gestation, the fundus can be palpable at the level of the umbilicus

Abruption placentae is most likely to occur in a woman with: Question 3 options: 1) Cardiac disease 2) Hyperthyroidism 3) Gestational hypertension 4) Cephalopelvic disproportion

3) Gestational hypertension ??

You note the following result on a routine urinalysis of a 37-year-old primigravida who is at 30 weeks of gestation. Leukocyte = trace, nitrite = negative, protein = 2+, blood = negative. Her weight has increased by 5 lbs during the past week. Which of the following is most likely? Question 25 options: 1) HELLP syndrome 2) Pregnancy-induced hypertension (preeclampsia) 3) Eclampsia of pregnancy 4) Primary hypertension

2) Pregnancy-induced hypertension (preeclampsia)

All of the following vaccines are contraindicated in pregnancy except? Question 37 options: 1) Influenza 2) Mumps 3) Varicella 4) Rubella

1. influenza

Rank these test in order from least invasive (1) to most invasive (4) ____ Amniocentesis at 20 weeks ____ Non-stress testing in 3rd trimester ____ Chorionic Villus Sampling in 1st trimester ____ Alfa-fetoprotein (Quad Screen) at 15-21 weeks

1. non-stress testing in third trimester 2. alfa-fetoprotein (quad screen) at 15-21 weeks 3. Chorionic villus sampling in 1st trimester 4. amniocentesis at 20 weeks

Jane a young primigravida, reports to you that she is starting to feel the baby's movements in her uterus. This is considered to be which of the following? Question 33 options: 1) Presumptive sign 2) Probable sign 3) Positive sign 4) Possible sign

2) Probable sign

Hagar's sign is considered a: Question 28 options: 1) Positive sign of pregnancy 2) Probably sign of pregnancy 3) Presumptive sign in pregnancy 4) Problem in pregnancy

2) Probably sign of pregnancy Softening of the uterine isthmus

Chadwick's sign is characterized by: Question 27 options: 1) Softening of the cervix 2) Blue coloration of the cervix and vagina 3) Softening of the uterine isthmus 4) Nausea and vomiting during the first trimester of pregnancy

2) Blue coloration of the cervix and vagina

Obesity during pregnancy is associated with an increased risk of Question 5 options: 1) Fetuses that are small-for-gestational-age 2) Cesarean birth 3) Rapid postpartum weight loss 4) Hypoglycemia

2) Cesarean birth

A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus is located at which of the following areas? Question 18 options: 1) Between the umbilicus and the suprapubic bone 2) Just rising above the suprapubic bone. 3) Between the suprapubic bone and the xiphoid process 4) Between the umbilicus and the xiphoid process

2) Just rising above the suprapubic bone.

A major risk factor for Down syndrome infants is: Question 40 options: 1) Maternal age younger than 16 years of age 2) Maternal age older than 35 years 3) A positive family history of Down syndrome 4) A positive family history of genetic disease

2) Maternal age older than 35 years

A 38-year-old multigravida who is at 32 weeks of gestation calls the office complaining of bright red vaginal bleeding. There is no watery discharge. She complains that her uterus feels hard and is very painful. Which of the following conditions is most likely? Question 32 options: 1) Placenta previa 2) Placenta abruptio 3) A molar pregnancy 4) An ectopic pregnancy

2) Placenta abruptio

Which of the following conditions is a possible complication of severe eclampsia? Question 38 options: 1) Placenta previa 2) Placenta abruptio 3) Erythroblastosis fetalis 4) Uterine rupture

2) Placenta abruptio

A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse should determine whether this method of family planning would be most appropriate? 1. "Did you ever had surgery?" 2. "Do you plan to have any other children?" 3. "Do either of you have diabetes mellitus?" 4. "Do either of you have problems with high blood pressure?"

2. "Do you plan to have any other children?" Rationale: Sterilization is a method of contraception for couples who have completed their families. It should be considered a permanent end to fertility because reversal surgery is not always successful. The nurse would ask the couple about their plans for having children in the future. Options 1, 3, and 4 are unrelated to this procedure. Test-Taking Strategy: Note the strategic

The nurse in a health care clinic is instructing a pregnant client how to perform "kick counts." Which statement by the client indicates a need for further instruction? 1. "I will record the number of movements or kicks." 2. "I need to lie flat on my back to perform the procedure." 3. "If I count fewer than 10 kicks in a 2-hour period, I term-32should count the kicks again over the next 2 hours." 4. "I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."

2. "I need to lie flat on my back to perform the procedure." Rationale: The client should sit or lie quietly on her side to perform kick counts. Lying flat on the back is not necessary to perform this procedure, can cause discomfort, and presents a risk of vena cava (supine hypotensive) syndrome. The client is instructed to place her hands on the largest part of the abdomen and concentrate on the fetal movements. The client records the number of movements felt during a specified time period. The client needs to notify the health care provider (HCP) if she feels fewer than 10 kicks over two consecutive 2-hour intervals or as instructed by the HCP.

The nursing instructor asks the students to describe fetal circulation , specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus? 1. "It connects the pulmonary artery to the aorta." 2. "It is an opening between the right and left atria. 3. "It connects the umbilical vein to the inferior vena cava." 4. "It connects the umbilical artery to the inferior vena cava."

3. "It connects the umbilical vein to the inferior vena cava."

A 55-year-old male client confides in the nurse that he is concerned about his sexual function. What is the nurse's best response? 1. "How often do you have sexual relations?" 2. "Please share with me more about your concerns." 3. "You are still young and have nothing to be concerned about." 4. "You should not have a decline in testosterone until you are in your 80s."

2. "Please share with me more about your concerns." Rationale: The nurse needs to establish trust when discussing sexual relationships with men. The nurse should open the conversation with broad statements to determine the true nature of the client's concerns. The frequency of intercourse is not a relevant first question to establish trust. Testosterone declines with the aging process.

A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client? 1. "Come to the clinic immediately." 2. "The vaginal discharge may be bothersome, but is a normal occurrence." 3. "Report to the emergency department at the maternity center immediately." 4. "Use tampons if the discharge is bothersome, but be sure to change the tampons every 2 hours."

2. "The vaginal discharge may be bothersome, but is a normal occurrence." Rationale: Leukorrhea begins during the first trimester. Many clients notice a thin, colorless or yellow vaginal discharge throughout pregnancy. Some clients become distressed about this condition, but it does not require that the client report tothe health care clinic or emergency department immediately. If vaginal discharge is profuse, the client may use panty liners, but she should not wear tampons because of the risk of infection. If the client uses panty liners, she should change them frequently.

The nurse should make which statement to a pregnant client found to have a gynecoid pelvis? 1. "Your type of pelvis has a narrow pubic arch." 2. "Your type of pelvis is the most favorable for labor and birth." 3. "Your type of pelvis is a wide pelvis, but it has a short diameter." 4. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal delivery."

2. "Your type of pelvis is the most favorable for labor and birth." Rationale: A gynecoid pelvis is a normal female pelvis and is the most favorable for successful labor and birth. An android pelvis (resembling a male pelvis) would be unfavorable for labor because of the narrow pelvic planes. An anthropoid pelvis has an outlet that is adequate, with a normal or moderately narrow pubic arch. Aplatypelloid pelvis (flat pelvis) has a wide transverse diameter, but the anter

A client at 30-weeks gestation and is complaining of pressure over the pubic area. She is admitted for observation. She is contracting irregularly and demonstrates underlying uterine irritability. Vaginal examination reveals that her cervix is closed, thick, and high. Based on this data, which intervention should the nurse implement first? Question 1 options: 1) Provide oral hydration 2) Have a complete blood count (CBC) drawn 3) Obtain a specimen for urine analysis 4) Place the client on strict bedrest

3) Obtain a specimen for urine analysis

Oxytocin is stored in which portion of the brain? Question 8 options: 1) Medulla oblongata 2) Hypothalamus 3) Posterior pituitary gland 4) Occipital lobe

3) Posterior pituitary gland Oxytocin is produced in the hypothalamus and stored in the Posterior pituitary gland

A 35-year-old primigravida who is at 20 weeks of gestation is expecting twins. What would you expect her alpha fetoprotein (AFP) values to be? Question 12 options: 1) Normal 2) Higher than normal 3) Lower than normal 4) None of the above

2. Higher than normal. High levels are seen in multiple gestations due to the growing liver in each fetus.

A client arrives at the clinic for the first prenatal assessment. She tells the nurse that the first day of her last normal menstrual period was October 19, 2018. Using Na¨gele's rule, which expected date of delivery should the nurse document in the client's chart? 1. July 12, 2019 2. July 26, 2019 3. August 12, 2019 4. August 26, 2019

2. July 26, 2019 Rationale: Accurate use of Na¨gele's rule requires that the woman have a regular 28-day menstrual cycle. Subtract 3 months and add 7 days to the first day of the last menstrual period, and then add 1 year to that date: first day of the last menstrual period, October 19, 2018; subtract 3 months, July 19, 2018; add 7 days, July 26, 2018; add 1 year, July 26, 2019.

A rubella titer result of a 1-day postpartum client is less than 1:8, and a rubella virus vaccine is prescribed to be administered before discharge. The nurse provides which information to the client about the vaccine? Select all that apply. 1. Breast-feeding needs to be stopped for 3 months. 2. Pregnancy needs to be avoided for 1 to 3 months. 3. The vaccine is administered by the subcutaneous route. 4. Exposure to immunosuppressed individuals needs to be avoided. 5. A hypersensitivity reaction can occur if the client has an allergy to eggs. 6. The area of the injection needs to be covered with a sterile gauze for 1 week

2. Pregnancy needs to be avoided for 1 to 3 months. 3. The vaccine is administered by the subcutaneous route. 4. Exposure to immunosuppressed individuals needs to be avoided. 5. A hypersensitivity reaction can occur if the client has an allergy to eggs. Rationale: Rubella vaccine is administered to women who have not had rubella or women who are not serologically immune. The vaccine may be administered in the immediate postpartum period to prevent the possibility of contracting rubella in future pregnancies. The live attenuated rubella virus is not communicable in breast milk; breast-feeding does not need to be stopped. The client is counseled not to become pregnant for 1 to 3 months after immunization or as specified by the health care provider because of a possible risk to a fetus from the live virus vaccine; the client must be using effective birth control at the time of the immunization. The client should avoid contact with immunosuppressed individuals because of their low immunity toward live viruses and because the virus is shed in the urine and other body fluids. The vaccine is administered by the subcutaneous route. A hypersensitivity reaction can occur if the client has an allergy to eggs because the vaccine is made from duck eggs. There is no useful or necessary reason for covering the area of the injection with a sterile gauze.

A 28-year-old multipara who is at 32 weeks gestation presents to your office complaining of a sudden onset of small amounts of bright red vaginal bleeding. She has had several episodes and appears anxious. On exam, her uterus is soft to palpation. Which of the following is most likely? Question 16 options: 1) Placenta abruptio 2) Placenta previa 3) Acute cervicitis 4) Molar pregnancy (hydatidiform mole)

2. Placenta previa. Placenta implants abnormally, partially, or wholly in the lower segment of the uterus or over the internal os.

The nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 weeks and tells the nurse that she does not have a history of any type of abortion or fetal demise. Using GTPAL, what should the nurse document in the client's chart? 1. G¼3, T¼2, P¼0, A¼0, L¼1 2. G¼ 2. T¼1, P¼0, A¼0, L¼1 3. G¼1, T¼1, P¼1, A¼0, L¼1 4. G¼2, T¼0, P¼0, A¼0, L¼1

2. T¼1, P¼0, A¼0, L¼1 Rationale: Pregnancy outcomes can be described with the acronym GTPAL. G is gravidity, the number of pregnancies; T is term births, the number born at term (longer than 37 weeks); P is preterm births, the number born before 37 weeks of gestation; A is abortions or miscarriages, the number of abortions or miscarriages (included in gravida if before 20 weeks of gestation; included in parity [number of births] if past 20 weeks of gestation); and L is the number of current living children. A woman who is pregnant with twins and has a child has a gravida of 2. Because the child was delivered at 38 weeks, the number of term births is 1, and the number of preterm births is 0. The number of abortions is 0, and the number of living children is 1

Physiologic anemia of pregnancy is due to: Question 35 options: 1) An increase in the cardiac output at the end of the second trimester 2) A physiologic decrease in the production of RBCs in pregnant women 3) An increase of up to 50% of the plasma volume in pregnant women 4) An increase in the need for dietary iron in pregnancy

3) An increase of up to 50% of the plasma volume in pregnant women

Which of the following findings is most likely in young primigravidas with pregnancy-induced hypertension? Question 10 options: 1) Abdominal cramping and constipation 2) Edema of the face and the upper extremities 3) Shortness of breath 4) Dysuria and frequency

2. edema of face and upper extremities. Other symptoms include weight gain, blurred vision, elevated blood pressure, proteinuria and headaches.

Which of the following is contraindicated in the care of pregnant women with placenta previa? Question 34 options: 1) Echocardiogram 2) Intravaginal ultrasound 3) Abdominal ultrasound 4) Pelvic ultrasound

2. intravaginal ultrasound

Folic acid supplementation is recommended for women who are planning pregnancy in order to: Question 21 options: 1) Prevent renal agenesis 2) Prevent anencephaly 3) Prevent kidney defects 4) Prevent heart defects

2. to prevent Neural tube defects such as spina bifida or anencephaly

A 25-year-old woman's last menstrual period was 6 weeks ago. She is complaining of nausea with vomiting in the morning and fatigue. Her breasts feel bloated. The nurse suspects she may be pregnant. Her symptoms would be considered: Question 31 options: 1) Positive signs of pregnancy 2) Probably signs of pregnancy 3) Presumptive signs of pregnancy 4) Possible signs of pregnancy

3) Presumptive signs of pregnancy

The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse's best response? 1. "It promotes the fertilized ovum's chances of survival." 2. "It promotes the fertilized ovum's exposure to estrogen and progesterone." 3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus." 4. "It promotes the fertilized ovum's exposure to luteinizing hormone and FSH"

3. "It promotes the fertilized ovum's normal implantation in the top portion of the uterus." Rationale: The tubal isthmus remains contracted until 3 days after conception to allow the fertilized ovum to develop within the tube. This initial growth of the fertilized ovum promotes its normal implantation in the fundal portion of the uterine corpus. Estrogen is a hormone produced by the ovarian follicles, corpus luteum, adrenal cortex, and placenta during pregnancy. Progesterone is a hormone secreted by the corpus luteum of the ovary, adrenal glands, and placenta during pregnancy. Luteinizing hormone and follicle-stimulating hormone are excreted by the anterior pituitary gland. The survival of the fertilized ovum does not depend on it staying in the fallopian tube for 3 days.

The nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide? 1. Strict bed rest is required after the procedure. 2. Hospitalization is necessary for 24 hours after the procedure. 3. An informed consent needs to be signed before the procedure. 4. A fever is expected after the procedure because of the trauma to the abdomen.

3. An informed consent needs to be signed before the procedure. Rationale: Because amniocentesis is an invasive procedure, informed consent needs to be obtained before the procedure. After the procedure, the client is instructed to rest, but may resume light activity after the cramping subsides. The client is instructed to keep the puncture site clean and to report any complications, such as chills, fever, bleeding, leakage of fluid at the needle insertion site, decreased fetal movement, uterine contractions, or cramping. Amniocentesis is an outpatient procedure and may be done in the health care provider's office or in a special prenatal testing unit. Hospitalization is not necessary after the procedure

A pregnant client is seen for a regular prenatal visit and tells the nurse that she is experiencing irregular contractions. The nurse determines that she is experiencing Braxton Hicks contractions. On the basis of this finding, which nursing action is appropriate? 1. Contact the health care provider. 2. Instruct the client to maintain bed rest for the remainder of the pregnancy. 3. Inform the client that these contractions are common and may occur throughout the pregnancy. 4. Call the maternity unit and inform them that the client will be admitted in a preterm labor condition.

3. Inform the client that these contractions are common and may occur throughout the pregnancy. Rationale: Braxton Hicks contractions are irregular, painless contractions that may occur intermittently throughout pregnancy. Because Braxton Hicks contractions may occur and are normal in some pregnant women during pregnancy, there is no reason to notify the health care provider. This client is not in preterm labor and, therefore, does not need to be placed on bed rest or be admitted to the hospital to be monitored.

Which purposes of placental functioning should the nurse include in a prenatal class? Select all that apply. 1. It cushions and protects the baby. 2. It maintains the temperature of the baby. 3. It is the way the baby gets food and oxygen. 4. It prevents all antibodies and viruses from passing to the baby. 5. It provides an exchange of nutrients and waste products between the mother and developing fetus.

3. It is the way the baby gets food and oxygen. 5. It provides an exchange of nutrients and waste products between the mother and developing fetus. Rationale: The placenta provides an exchange of oxygen, nutrients, and waste products between the mother and the fetus. The amniotic fluid surrounds, cushions, and protects the fetus and maintains the body temperature of the fetus. Nutrients, medications, antibodies, and viruses can pass through the placenta.

The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority nursing action ? 1. Document the finding. 2. Check the mother's heart rate. 3. Notify the health care provider (HCP). 4. Tell the client that the fetal HR is normal

3. Notify the health care provider (HCP).

The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in centimeters and notes that the fundal height is 30 cm. How should the nurse interpret this finding? 1. The client is measuring large for gestational age. 2. The client is measuring small for gestational age. 3. The client is measuring normal for gestational age. 4. More evidence is needed to determine size for gestational age.

3. The client is measuring normal for gestational age. Rationale: During the second and third trimesters (weeks 18 to 30), fundal height in centimeters approximately equals the fetus's age in weeksÆ2 cm. Therefore, if the client is at 28 weeks gestation, a fundal height of 30 cm would indicate that the client is measuring normal for gestational age. At 16 weeks, the fundus can be located halfway between the symphysis pubis and the umbilicus. At 20 to 22 weeks, the fundus is at the umbilicus. At 36 weeks, the fundus is at the xiphoid process.

A multigravida who is at 34 weeks gestation wants to know at what level her uterine fundus should be. The best answer is to advise the mother that her fundus is: Question 15 options: 1) Midway between the umbilicus and the lower ribs 2) At the level of the umbilicus 3) From 33-35 cm 4) From 32 to 34 cm

3. from 33-35 cm

Treatment of mild preeclampsia includes all of the following except: Question 9 options: 1) Bed rest except for bathroom privileges 2) Close monitoring of weight and blood pressure 3) Close follow-up of urinary protein, serum creatinine, and platelet count 4) A prescription of methyldopa (Aldomet) to control blood pressure

4) A prescription of methyldopa (Aldomet) to control blood pressure

Which of the following is recommended for the outpatient treatment of mild preeclampsia? Question 19 options: 1) Severe sodium restriction 2) Restrict fluid intake to less than 1 liter per 24 hours 3) Aldomet (methyldopa) 250 mg PO (orally) BID 4) Bed rest on the left side with bathroom privileges

4) Bed rest on the left side with bathroom privileges

An Rh-negative pregnant woman with negative rubella titers should be vaccinated at what time period in pregnancy? Question 22 options: 1) She can be vaccinated at any time in her pregnancy 2) During the second trimester 3) During the third trimester 4) During the postpartum period

4) During the postpartum period

A 42 y/o client has an amniocentesis during the 16th week of gestation because of concern about Down syndrome. Examination of the amniotic fluid will also provide information on: Question 2 options: 1) Fetal diabetes 2) Cardiac anomalies 3) Fetal lung maturity 4) Presence of neural tube defects

4) Presence of neural tube defects

A patient is taking a progesterone only contraception. What is a possible healthcare concern for her? a. She will not get pregnant as long as she is on the contraception b. She has an increased risk for an ectopic pregnancy c. She has a decreased risk for osteoporosis later in life d. Progesterone should not be used without estrogen due to uterine cancer risk

b. She has an increased risk for an ectopic pregnancy

How long is a sperm able to survive in optimal conditions? a. 8 hours b. 24 hours c. 72 hours d. 6 days

c. 72 hours

Which of the following should you expect to find on a wet-mount slide of a patient diagnosed with bacterial vaginosis? a. A large amount of leukocytes and epithelial cells b. Tzanck cells c. A large amount of bacteria coating the squamous cells and very few leukocytes d. Epithelial cells and a small amount of blood

c. A large amount of bacteria coating the squamous cells and very few leukocytes

True or False All translocations of genetic material are expressed the same in all individuals

False

True or False: For teratogens or environmental factors, the extent of damage depends on the developmental timing, duration, and dosage exposure

True

1. During a breast exam of a 30-year-old nulliparous female, the provider palpates several rubbery mobile areas of breast tissue. They are slightly tender to palpation. Both breasts have symmetrical findings. There are no skin changes or nipple discharge. The patient is expecting her menstrual period in 5 days. Which will be recommended? a. Tell her to return 1 week after her period so her breasts can be rechecked b. Advise the patient to return in 6 months to have her breasts rechecked c. Refer her to a gynecologist for further evaluation d. Schedule the patient for a mammogram

a. Tell her to return 1 week after her period so her breasts can be rechecked

A 30-year-old female who is sexually active complains of a large amount of milk-like vaginal discharge for several weeks. A microscopy slide reveals a large amount of squamous epithelial cells that have blurred margins (Clue cells). Very few white blood cells are seen. The pH is at 6.0. What is most likely? a. Candida infection b. A normal finding c. Bacterial vaginosis d. Trichomonas infection

a. Bacterial vaginosis

All of the following are infections that affect mostly the labia and vagina except: a. Bacterial vaginosis b. Candidiasis c. Trichomoniasis d. E-coli e. Chlamydia trachomatis

a. Chlamydia trachomatis

Patients who are diagnosed with gonorrhea should also be treated for which of the following infections? a. Chancroid b. Chlamydia trachomatis c. Herpes genitalis d. PID (pelvic inflammatory disease)

a. Chlamydia trachomatis

A 14-year-old female who is sexually active is brought in by her mother for an immunization update. According to the mother, her daughter had 1 dose of hepatitis B vaccine. Which of the following vaccines would you administer at this visit? a. Td and hepatitis B b. DTaP (diptheria, tetanus, acellular pertussis) and hepatitis B c. MMR (measles, mumps, rubella) and Td d. Hepatitis B only

a. DTaP (diptheria, tetanus, acellular pertussis) and hepatitis B

All of the following measures have been found to help lower the risk of osteoporosis except: a. Drinking organic juice b. Eating low-fat dairy foods c. Performing weight-bearing exercises d. Vitamin D supplementation

a. Drinking organic juice

You are reviewing the information for the Basal Body Temperature. What statement made by the patient would signify that further information is needed? a. I will take my temperature during the fertile window period b. I will not eat or drink anything prior to taking my temperature c. I will make sure I take my temperature every morning before rising d. My temperature will be elevated if I ovulated

a. I will take my temperature during the fertile window period

Human papillomavirus (HPV) infection of the larynx has been associated with: a. Esophageal stricture b. Cervical cancer c. Metaplasia of esophageal squamous cells d. Laryngeal neoplasm

a. Laryngeal neoplasm

The corpus luteum is responsible for the production of which hormone? a. Progesterone b. Estrogen c. Testosterone d. Human Chorionic Gonadotropin (HCG

a. Progesterone

The nurse is providing education to a group of women regarding the use of contraception. What is the ultimate goal? a. Use permanent contraception for all women over the age of 35 years b. Prevent the spread of sexually transmittable infections c. Assure all women are placed on contraception d. Promote healthy pregnancy outcomes

a. Promote healthy pregnancy outcomes

A 48-year-old woman is told by a physician that she is starting perimenopause. All of the following are possible findings except: a. Irregular menstrual periods b. Cyclic mood swings c. Hot flashes d. Severe vaginal atrophic changes

a. Severe vaginal atrophic changes

Human placental lactogen (HPL) regulates glucose availability for the fetus and promotes fetal growth by what means? a. It causes the pancreas to excrete less insulin b. It alters maternal protein, carbohydrates and fat metabolism. c. It causes an increase in insulin transportation across the placenta. d. It increases oxygen absorption at the level of the decidua

b. It alters maternal protein, carbohydrates and fat metabolism.

Diaphragms are very effective at contraception. The client needs to be aware that these must be refitted if: a. There is an abnormal PAP smear. b. Loss or gain of 10 pounds. c. Only after giving birth for the 3 rd time. d. Never need to be refitted.

b. Loss or gain of 10 pounds.

Which statement is true regarding an Intrauterine Device (IUD). a. It is effective 100 % if in place. b. There is an associated risk for pelvic inflammatory infection for users. c. Women who want to become pregnant have to use another form of birth control for 3 months after IUD is removed. d. A new IUD needs to be placed after 3 years of use

b. There is an associated risk for pelvic inflammatory infection for users.

A sexually active woman is complaining of amenorrhea and vaginal spotting. On exam, her left adenexa is tender and cervical motion tenderness is positive. Which test should the nurse anticipate being ordered? a. Complete blood count (CBC) with white cell differentials b. Urine pregnancy test c. Flat plate of the abdomen d. Pelvic ultrasound

b. Urine pregnancy test

What is the difference between a Non-Stress Test (NST) and a Contraction Stress Test (CST)? a. A CST requires 2 accelerations that are 15X15 after 32 wks, or 10X10 prior to 32 wks) over 20 minutes. b. A CST is reported as negative if it does not have any decelerations. c. An NST is the same as a CST except for the positioning of the patient. d. The contraindications for both tests are the same

b. A CST is reported as negative if it does not have any decelerations.

A benefit to Ultrasound (US) monitoring of a fetus is what? a. There is an associated risk of neurotube defect in fetus' that undergo multiple US exams. b. A pregnancy can be monitored serially. c. The limited pain involved is worth the benefit of the results. d. It cannot be used to establish growth patterns in the fetus

b. A pregnancy can be monitored serially.

Preconception counseling would include all of the following except: a. Daily vitamins with 0.4-0.8 mg folic acid b. Exercise regimen that does not increase the heart rate twice a week c. Decrease or increase weight to ideal levels prior to conception d. Stop smoking

b. Exercise regimen that does not increase the heart rate twice a week

A 44-year-old female who is undergoing treatment for infertility complains of not having a menstrual period for a few months. The night before, she stared spotting and is now having cramp- type pains in her pelvic area. Her blood pressure (BP) is 160/80 the pulse rate is 110, and she is afebrile. Her labs reveal a mild anemia with mild leukocytosis. On pelvic exam, the uterine fundus is found above the symphysis pubis. The cervical os is dilated at 3 cm. Which is the most likely? a. Incomplete abortion b. Threatened abortion c. Inevitable abortion d. Acute pelvic inflammatory diseas

c. Inevitable abortion

Normal physiological changes that accompany ovulation include: a. Decrease in temperature by 1 degree F. approx 24-48 hours past ovulation b. Painful menstruation c. Mittelschmerz d. Spinnbarkheit a week after ovulation due to affects of progesterone

c. Mittelschmerz

A nurse in the office is counseling a couple regarding their fertility awareness. The woman brings in a chart that shows no temperature elevations since her last menstrual cycle. What does the nurse tell the couple? a. "There is a chance you may be pregnant now!" b. "This shows that you ovulated, but did not conceive." c. "This shows that you did not ovulate this month." d. "An error was made in your recording of your temperature. Let's go over the instructions again."

c. "This shows that you did not ovulate this month."

A nurse in the office is counseling a couple regarding their fertility awareness. The woman brings in a chart that shows no temperature elevations since her last menstrual cycle. What does the nurse tell the couple? a. "There is a chance you may be pregnant now!" b. "This shows that you ovulated, but did not conceive." c. "This shows that you did not ovulate this month." d. "An error was made in your recording of your temperature. Let's goover the instructions again"

c. "This shows that you did not ovulate this month."

Oxygen, nutrients and waste are transported back and forth between fetus and mother by the functions of this organ. a. Spleen b. Heart c. Placenta d. Amniotic fluid

c. Placenta

You are admitting a patient to the office. She is complaining that she cannot get rid of a yeast infection no matter what she does. What is your best response? a. The provider probably put you on the wrong medication b. You probably did not place the cream in your vagina correctly c. We may want to screen you for a diabetic condition d. You will keep a yeast infection because you are obese

c. We may want to screen you for a diabetic condition

Which is NOT a function of the amniotic fluid? a. Amniotic fluid cushions the fetus against mechanical injury. b. Controls the embryo's temperature. c. Allows for symmetrical growth. d. Keeps the fetus from moving to prevent injury

d. Keeps the fetus from moving to prevent injury

Combined Oral Contraception includes which 2 hormones to prevent pregnancy? a. TSH and LH b. FSH and progesterone c. Prostaglandin and estrogen d. Progesterone and estrogen

d. Progesterone and estrogen

The Natural Family Method of birth control includes all of the following except: a. Evaluation of cervical mucus b. Monitoring for temperature increases c. Calendar method d. Semen analysis

d. Semen analysis

Day 1 of a menstrual cycle begins with which event: a. Last day of bleeding no matter how light. b. Ovulation c. The first day of the secretory phase d. The first day of bleeding each month

d. The first day of bleeding each month

A young woman is concerned about the odor coming from her vagina. She states she has douched many times to get rid of the smell. What is your best response? a. Douching should only be done after menses b. Douching should be done prior to coming in to the office c. Douching will not kill bacteria that is in the vagina d. Douching modifies the vaginal flora leading to infections

d. Douching modifies the vaginal flora leading to infections

When does menses occur? a. Immediately prior to pregnancy b. Every month regardless of whether or not pregnancy occurs c. Only at puberty d. Only at menopause e. If no pregnancy takes place

e. If no pregnancy takes place

True or False: It will not matter which contraception you put your patient on. If it is not taken as prescribed, it will not work.

true