N444 - OB/L&D NCLEX Questions

A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of a GOODELL'S SIGN. The nurse determines this sign indicates: 1 .A softening of the cervix 2 .A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus. 3. The presence of hCG in the urine 4. The presence of fetal movement

1 .A softening of the cervix R: In a normal, unscarred cervix, softening of the cervical tip may be observed about the beginning of the sixth week. This probable sign of pregnancy is brought about by increased vascularity, slight hypertrophy, and hyperplasia (increase in number of cells).

A pregnant client calls the clinic and tells a nurse that she is experiencing leg cramps and is awakened by the cramps at night. To provide relief from the leg cramps, the nurse tells the client to: 1. Dorsiflex the foot while extending the knee when the cramps occur 2. Dorsiflex the foot while flexing the knee when the cramps occur 3. Plantar flex the foot while flexing the knee when the cramps occur 4. Plantar flex the foot while extending the knee when the cramps occur.

1. Dorsiflex the foot while extending the knee when the cramps occur

. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Select all probable signs of pregnancy. 1. Uterine enlargement 2. Fetal heart rate detected by nonelectric device 3. Outline of the fetus via radiography or ultrasound 4. Chadwick's sign 5. Braxton Hicks contractions 6. Ballottement

1. Uterine enlargement 4. Chadwick's sign 5. Braxton Hicks contractions 6. Ballottement R: The probable signs of pregnancy include uterine enlargement, Hegar's sign (softening and thinning of the uterine segment that occurs at week 6), Goodell's sign (softening of the cervix that occurs at the beginning of the 2nd month), Chadwick's sign (bluish coloration of the mucous membranes of the cervix, vagina, and vulva that occurs at week 6), ballottement (rebounding of the fetus against the examiners fingers of palpation), Braxton Hicks contractions and a positive pregnancy test measuring for hCG. Positive signs of pregnancy include fetal heart rate detected by electronic device (Doppler) at 10-12 weeks and by nonelectronic device (fetoscope) at 20 weeks gestation, active fetal movements palpable by the examiner, and an outline of the fetus via radiography or ultrasound.

A nurse is performing an assessment of a primapira who is being evaluated in a clinic during her second trimester of pregnancy. Which of the following indicates an abnormal physical finding necessitating further testing? 1. Consistent increase in fundal height 2. Fetal heart rate of 180 BPM 3. Braxton hicks contractions 4. Quickening

2. Fetal heart rate of 180 BPM R: The normal range of the fetal heart rate depends on gestational age. The heart rate is usually 160-170 BPM in the first trimester and slows with fetal growth, near and at term, the fetal heart rate ranges from 120-160 BPM. The other options are expected.

A 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 that was delivered at 37 weeks and tells the nurse that she doesn't have any history of abortion or fetal demise. The nurse would document the GTPAL for this client as: 1. G = 3, T = 2, P = 0, A = 0, L =1 2. G = 2, T = 0, P = 1, A = 0, L =1 3. G = 1, T = 1. P = 1, A = 0, L = 1 4. G = 2, T = 0, P = 0, A = 0, L = 1

2. G = 2, T = 0, P = 1, A = 0, L =1 G = gravida (# of times pregnant) T = term (38 weeks) P = preterm A = abortion L = living children

A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of: 1. Two umbilical veins and one umbilical artery 2. Two umbilical arteries and one umbilical vein 3. Arteries carrying oxygenated blood to the fetus 4. Veins carrying deoxygenated blood to the fetus

2.Two umbilical arteries and one umbilical vein R: Arteries carry deoxygenated blood AWAY from fetus; vein carries oxygenated blood TO fetus. OPPOSITE of what our body does

A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client to describe the process of quickening. Which of the following statements if made by the student indicates an understanding of this term? 1. "It is the irregular, painless contractions that occur throughout pregnancy." 2. "It is the soft blowing sound that can be heard when the uterus is auscultated." 3. "It is the fetal movement that is felt by the mother." 4. "It is the thinning of the lower uterine segment."

3. "It is the fetal movement that is felt by the mother." R: The first recognition of fetal movements, or "feeling life," by the multiparous woman may occur as early as 14 to 16 weeks. The nulliparous woman may not notice these sensations until the eighteenth week or later. Described as a flutter and is difficult to distinguish from peristalsis. Fetal movements gradually increase in intensity and frequency as pregnancy progresses. The week in which quickening occurs

During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the fetal heart rate is normal if which of the following is noted? 1. 80 BPM 2. 100 BPM 3. 150 BPM 4. 180 BPM

3. 150 BPM R: The fetal heart rate depends in gestational age and ranges from 160-170 BPM in the first trimester but slows with fetal growth to 120-160 BPM near or at term. At or near term, if the fetal heart rate is less than 120 or more than 160 BPM with the uterus at rest, the fetus may be in distress.

A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19th, 2005. Using Nagele's rule, the nurse determines the estimated date of confinement as: 1. July 26, 2006 2. June 12, 2007 3. June 26, 2006 4. July 12, 2007

3. June 26, 2006 R: Accurate use of Nagele's rule requires that the woman have a regular 28-day menstrual cycle. Nägele's rule is as follows: after determining the first day of the last (normal) menstrual period (LMP), add 7 days to the LMP and count forward 9 months

A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? 1. Auscultating for fetal heart sounds 2. Palpating the abdomen for fetal movement 3. Assessing the cervix for thinning 4. Initiating a gentle upward tap on the cervix

4. Initiating a gentle upward tap on the cervix R: Passive movement of the unengaged fetus and can be identified generally between the sixteenth and eighteenth week. To palpate the fetus, the examiner places a finger within the vagina and taps gently upward on the cervix, causing the fetus to rise. The fetus then sinks, and a gentle tap is felt on the finger

A nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. The nurse tells the client to: 1.Avoid wearing a bra 2.Wash the nipples and areola area daily with soap, and massage the breasts with lotion. 3.Wear tight-fitting blouses or dresses to provide support 4.Wash the breasts with warm water and keep them dry

4. Wash the breasts with warm water and keep them dry R: The pregnant woman should be instructed to wash the breasts with warm water and keep them dry. The woman should be instructed to avoid using soap on the nipples and areola area to prevent the drying of tissues. Wearing a supportive bra with wide adjustable straps can decrease breast tenderness. Tight-fitting blouses or dresses will cause discomfort