OB exam 1 practice questions
To avoid supine hypotensive syndrome while measuring fundal height, where would a nurse position a pillow under a client? A. Head B. Hip C. Feet D. Knees
B.
The nurse is obtaining a 24-hour diet history from a pregnant client. which food consumed by the client would indicate the need for further teaching by the nurse? A. Pasteurized milk B. Alfalfa sprouts C. Cheddar cheese D. A cup of coffee
B. Raw sprouts of any kind should be avoided during pregnancy. Pasteurized milk is safe to drink. Unpasteurized dairy products should be avoided due to bacterial contamination.
A nurse is assessing a client who is at 35 weeks gestation and has mild gestational hypertension. Which of the following findings should the nurse identify as priority? A. 480 mL of urine output in 24 hours B. BP 144/92 C. +2 edema of the feet D. +1 protein in the urine
A
A nurse is caring for a client who believes she may be pregnant. Which of the following findings should the nurse identify as a positive sign of pregnancy? A. Palpable fetal movement B. Chadwick's sign C. Positive pregnancy test D. Amenorrhea
A
A nurse in a prenatal clinic is providing education to a client who is at 8 weeks of gestation. The clients states, "I don't like milk" Which of the following foods should the nurse recommend as a good source of calcium? A. Dark green leafy vegetables B. Deep red or orange vegetables C. White breads and rice D. Meat, poultry, and fish
A
A couple was recently diagnosed with a genetic disorder in pregnancy. The couple decided to continue with their pregnancy. They asked the nurse where else they could get more information. Which response by the nurse is most appropriate? A. "The health team is here if you want to talk about how you feel." B. "Avoid using websites as they do not provide accurate information about the disorder." C. "There is no need to worry because I have given you all the information you need to know." D. "There is no support group for parents who have children with the same genetic disorder."
A
During a physical examination, the nurse observed that a client in her late pregnancy has hemorrhoids and varicosities in her legs. Which statement by the nurse explains the cause for these two conditions in a pregnant client? A. "Increased venous pressure and decreased blood flow to the extremities, due to compression of the iliac veins and inferior vena cava." B. "Increased action of adrenocorticosteroids leads to cutaneous elastic tissues becoming fragile." C. "The stretching of the abdominal muscle, due to the enlarging uterus." D. "Increased plasma fibrin by 40% and the fibrinogen by 50%."
A
During which day of a typical 28-day menstrual cycle does the follicular phase occur? A. Cycle days 1 to 13 B. Cycle days 15 to 28 C. Cycle day 14 D. Cycle day 1 to 5
A
In genetic testing, which role would the nurse question performing? A. Diagnosing a fetus with a genetic disorder B. Identifying at-risk clients and families C. Providing emotional support for the client and family D. Providing a referral to support groups and genetic counseling services
A
The multiple marker screenings identify: A. Neural tube defects B. Cerebral palsy C. Hemolytic diseases D. Cleft palate
A
The nurse is teaching a woman about her diagnosis of preeclampsia. Which statement made by the patient indicates the need for further teaching? A. "I only have mild preeclampsia, so it will not be harmful to me or my baby." B. "I am at risk of developing heart disease." C. "I need to report severe headaches or changes in my vision." D. "I might need to be induced early."
A
When assessing the newborn, the nurse notes two vessels in the umbilical cord. What should the nurse do next? A. Call the pediatrician. B. Start an IV on the infant. C. Check the infant's pulse oximetry. D. Listen to the infant's heart sounds.
A
A client in her second trimester presented at the clinic with a history of vaginal bleeding. She has no history of trauma. Which condition in the client's history would assist the nurse to determine the cause for the bleeding? Select all that apply. A. Friable cervix B. Placenta previa C. Urinary frequency D. Hyperemesis gravidarum E. Absence of fetal movement
A, B
The nurse obtains a fundal height measurement of 32 cm on a client experiencing a healthy, low-risk pregnancy. How does the nurse interpret this measurement? A. The client is approximately 32-week gestation. B. The weight of the fetus is approximately 3200 grams. C. The amniotic fluid volume is 3.2 cm. D. The distance from the fundus to the xiphoid process is 32 cm.
A.
The nurse is reviewing antenatal screening and diagnostic testing with a group of nursing students. The nurse explains that this test inserts a needle into the maternal abdominal area through the uterine cavity to obtain amniotic fluid. One of the student's best response is: A. Amniocentesis B. Percutaneous biopsy C. Percutaneous umbilical cord sampling D. Chorionic villus sampling (CVS)
A. Amniocentesis is done by inserting a needle intra-abdominally into the uterine cavity using ultrasound to guide the needle placement. The fluid is used to test for chromosomal defects, genetic disorders, including neural tube defects, fetal lung maturity, and hemolytic disease in the fetus or intrauterine infection.
A client, 12 weeks' gestational age, is scheduled for a diagnostic test to detect ectopic pregnancy and evaluate uterine structures. The nurse anticipates that the client will need: A. A full bladder for the test B. Pain medications prior to the test C. To empty her bladder before the procedure D. To elevate her legs for the test
A. An abdominal ultrasound is scheduled in the first trimester to detect missed abortion, ectopic pregnancy, evaluate uterine structures, confirm intrauterine pregnancy, and estimate gestational age. This procedure will require a full bladder for better visualization.
The nurse is planning care for a group of clients. Which client would need to receive Rho (D) Immune Globulin (RhoGAM)? A. A client whose blood type is O-negative B. A client whose white blood cell count was below normal C. A client with an autoimmune disorder D. A client whose blood type is O-positive
A. RhoGAM is given to women who have Rh-negative blood to prevent isoimmunization.
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 Näegel's rule, which expected date of delivery should the nurse document in the client's chart? A. July 12, 2019 B. July 26, 2019 C. August 12, 2019 D. August 26, 2019
B
A couple was scheduled for an artificial insemination procedure. Which fertility condition does the nurse expect to find documented in the couple's medical record as a reason for needing this procedure? A. Unexplained infertility B. Diminished sperm motility C. Bilaterally blocked fallopian tubes D. Unsuccessful vasectomy reversal
B
A client from a shelter for battered woman stated, "It is my fault, as I should have not stayed in the situation for so long." Which statement by the nurse is the best response? A. "Did you alert your neighbors to call the police?" B. "Tell your partner that you will be taking out a restraining order." C. "The abuse was not your fault. No one deserves to be mistreated." D. "Whether or not you give me consent, I will be reporting this to the police."
C
the nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. What instruction should the nurse provide? A. Strict bed rest is required after the procedure B. Hospitalization is necessary for 24 hours after the procedure C. An informed consent needs to be signed before the procedure D. A fever is expected after the procedure because of the trauma to the abdomen.
C
Before giving methylergonovine for post-partum hemorrhage, the nurse should check which priority item? A. Uterine Tone B. Amount of Lochia C. Blood Pressure D. Deep tendon reflexes
C Methylergonovine affects the smooth muscle of a woman's uterus, improving the muscle tone as well as the strength and timing of uterine contractions. Methylergonovine is used just after a baby is born, to help deliver the placenta (also called the "afterbirth").
A client is asking for a Clomiphene (Clomid) prescription for infertility because she heard "it works." Which would the nurse evaluate before suggesting medication for infertility? A. Has she and her partner had hormone testing? B. Does she have a history of uterine fibroids? C. Has she had surgery to clear her fallopian tubes? D. How long has the couple been trying to conceive?
D
A nurse is reviewing a new prescription for iron supplements with a client who is at 8 weeks of gestation and has iron deficiency anemia. Which of the following beverages should the nurse instruct the client to take the iron supplements with ? A. Ice water B. Low-fat or whole milk C. tea or coffee D. orange juice
D. Vitamin C aids in the absorption of iron
Aquamephyton is given IM at time of delivery in gluteus maximus of infant? True or False?
False
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? SATA A. Ballottement B. Chadwick's sign C. Uterine enlargment D. Positive pregnancy test E. Fetal heart rate detected by a nonelectronic device. F. outline of fetus via radiography or ultrasonography
A, B, C, D
The client asked the nurse what a complication of the amniocentesis procedure could be. which would be the nurse's best response? Select all that apply. A. Maternal or fetal hemorrhage B. Leakage of amniotic fluid C. Preterm labor D. Maternal or fetal infection E. Nausea/ vomiting
A, B, C, D
What should be reported immediately if noted after a patient receives a Pitocin infusion? A. Fatigue B. Uterine hyperstimulation C. Drowsiness D. Early Decerlerations of FHR
B
A woman experiencing preterm labor has an order to receive betamethasone. Which statement is correct regarding antenatal corticosteroids? Select all that apply. A. They reduce the risk of GBS sepsis in the newborn. B. They are most beneficial from 24 to 34 weeks' gestation. C. They accelerate fetal lung maturity. D. They reduce the risk of necrotizing enterocolitis in the neonate. E. They decrease the contractility of the uterus.
B, C, D
The nurse is seeing a woman at 18 weeks gestation for an assessment due to an increased risk for intrauterine growth restriction. To which drug or chemical should the nurse be concerned the mother has been exposed? Select all that apply. A. Alcohol B. Angiotensin-converting enzyme (ACE) inhibitors C. Carbamazepine (anticonvulsants) D. Cocaine E. Warfarin (coumadin)
B, C, D
A nurse is reviewing the health record of a client who is pregnant. the provider indicated client exhibits probable signs of pregnancy. which of the following findings should the nurse expect? A. Montgomery's glands B. Goodell's sign C. Ballottenment D. Chadwick's sign E. Quickening
B, C, D quickening and montgomery's glands is a presumptive sign of pregnancy
A male partner was diagnosed with infertility and a determination is to be made as to which treatment is best. Which nursing assessment is an indication for a surgical intervention to treat his condition? A. Over production of sperm antibodies B. Infections of the genitourinary tract C. Inguinal hernia D. Poor nutrition
C
A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching? A. "you will lay on your right side during the procedure" B. "you should not eat anything for 24 hrs prior to the procedure" C. "you should empty your bladder prior to the procedure" D. "the test is done to determine gestational age"
C
A pregnant client at 34 weeks gestation called the OB/GYN clinic, stating that she does not feel any fetal activity. How would the nurse respond to the client? A. "Tell me about your intake of meals and fluids." B. "When was the last time you ate?" C. "Come to the hospital so that further assessments can be done." D. "You will need to have a biophysical profile test."
C
A nurse at a prenatal clinic is caring for a client who suspects she may be pregnant and asks the nurse how the provider will confirm her pregnancy. The nurse should inform the client that which of the following laboratory tests will be used to confirm her pregnancy? A. blood test for estrogen B. blood test for circulating progesterone C. a urine test for human chorionic somatomammotropin D. a urine test for human chorionic gonadatropin
D
A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make? A. "it is used to stimulate uterine contraction" B. "it will decrease the incidence of uterine contractions" C. "it lulls the fetus to sleep" D. "it awakens a sleeping fetus"
D
A nurse is teaching a client who is at 12 weeks of gestation and has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching. A. Breastfeed your newborn to provide passive immunity B. Abstain from sexual intercourse throughout the pregnancy C. You will be in isolation after delivery D. You should take zidovudine throughout pregnancy
D
A woman diagnosed with Gestational Diabetes Mellitus (GDM) was referred to have a Group B Streptococcus (GBS) screening done. At which stage of the pregnancy would the nurse recommend the client to have this screening done? A. 10 to 12 weeks of gestation B. 15 to 23 weeks of gestation C. 24 to 28 weeks of gestation D. 35 to 37 weeks of gestation
D
A nurse in a clinic receives a phone call from a client who would like to be tested in the clinic to confirm a pregnancy. Which of the following information should the nurse provide to the client? A. "you should wait until 4 weeks after conception to be tested." B. "you should be off any medications for 24 hrs prior to the test." C. "you should be NPO for at least 8 hrs prior to the test" D. "you should collect urine from the first morning void."
D.
A patient with preeclampsia has orders for magnesium sulfate administration. Which order would the nurse question? A. Loading dose 4 grams 10% magnesium sulfate in 100 mL solution over 20 minutes B. Maintenance dose 1 gram per hour C. Maintenance dose 2 grams per hour D. Loading dose 1 gram 10% magnesium sulfate in 100 mL solution over 20 minutes
D.
The nurse is teaching a group of high-risk antepartum patients about the effects of substance abuse on pregnancy. Which substance does the nurse discuss as having the highest risk for causing placental abruption? A. Marijuana B. Opioids C. Alcohol D. Cocaine
D.
what are signs of magnesium sulfate toxicity? A. proteinuria 3+ B. Serum Magnesium level of 6 mEq/L C. Presence of deep tendon reflex D. Respiration of 10 bpm
D.
The nurse reviews a pregnant client's record and notes that the amniotic fluid index (AFI) is 30 cm. The nurse understands that this measurement can indicate: A. An AFI of 30 cm is average measurement of amniotic fluid in pregnancy and represents good renal perfusion. B. This result is indicative of oligohydramnios (decreased or no amniotic fluid) and can be associated with increased prenatal death, and close maternal and fetal monitoring is needed. C. The result is good measurement and shows increased urine production. D. The result reflects polyhydramnios and may indicate fetal malformation, such as NTDs, obstruction of fetal gastrointestinal tract.
D. An AFI above 24 cm is polyhydramnios. This result shows too much amniotic fluid present and overproduction of urine.
A gravid patient with preeclampsia is due for an assessment. Which correctly describes how to assess deep tendon reflexes (DTRs)? A. Asking the patient to dorsiflex the foot against the nurse's hand and then releasing it suddenly B. Striking the tendon of a partially stretched muscle briskly with a reflex hammer C. Shining a light in the patient's eye, and noting the constriction of the pupil D. Stimulating the sole of the foot with a blunt instrument
B
A male client is seen at the provider's office for infertility. Which issue would the nurse not question as a cause of male infertility? A. Attending daily cycling classes at the local gym B. Having an overweight body mass index C. Smoking two to three cigarettes a day D. Taking a calcium channel blocker for hypertension
B
A nurse is assessing a client who is at 37 weeks gestation and has a suspected pelvic fracture due to blunt abdominal trauma. Which of the following findings should the nurse expect? A. Bradycardia B. Uterine contractions C. Seizures D. Bradypnea
B
The nurse is caring for a woman with preterm premature rupture of membranes, not in active labor. Which of the following nursing actions would be included in the plan of care for this patient? Select all that apply. A. Digital vaginal exams every four hours B. Assess for signs of infection C. Assess fetal heart rate with internal fetal scalp electrode D. Report maternal fever to provider E. Placement of a Foley catheter
B, D,
A student nurse in developing a plan of care documented, "Altered pattern of elimination" for a pregnant client who complained of not having regular bowel movements. Which nursing action by the student nurse is appropriate for the client to resume regular bowel patterns? Select all that apply. A. Advise the client to avoid high-fat and spicy food. B. Assist the client to establish regular time for bowel movement. C. Suggest the client eat small, frequent meals instead of large meals. D. Encourage the client to eat high-fiber foods and fresh vegetables. E. Discuss with the client prior strategies used successfully to relieve constipation.
B, D, E
The nurse educator is teaching a class of pregnant teenagers about the importance of receiving regular prenatal care. which are the maingoals of prenatal care that the nurse would include in the teaching? Select all that apply. A. To complete a one-time assessment of health risk status of the pregnancy B. To provide referrals to resources C. To maintain maternal fetal health D. To build rapport with the physician and nursing staff E. To determine the gestational age of the fetus
B,C,E
A gravid patient in her third trimester has iron-deficiency anemia. Which instruction by the nurse is correct regarding iron supplementation? A. Iron should be taken with food to increase absorption. B. Iron should be taken on an empty stomach to increase absorption. C. If stools turn black, discontinue the use of iron supplementation. D. The correct dose of ferrous sulfate is 20 mg once daily.
B.
A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. the nurse should evaluate which of the following tests to assess fetal lung maturity? A. Alpha-fetoprotein (AFP) B. Lethicin/sphingomyelin (L/S) ratio C. Kleihauer-Betke test D. Indirect Coombs test
B.
The nurse is assessing a patient who at 32 weeks gestation is being evaluated for intrahepatic cholestasis of pregnancy. Which laboratory findings would be most indicative of this diagnosis? A. Decreased bilirubin level B. Elevated bile acids C. Decreased platelets D. Proteinuria
B.
The nurse is caring for a client who completed the chorionic villus sampling test 2 hours ago. Which finding would be concerning for the nurse? A. The client complains of nausea. B. The client reports abdominal cramping. C. The client's temperature is 98.3 degrees Fahrenheit. D. The client's blood pressure is 102/64.
B.
During an amniocentesis, the nurse instructs the client to call the nurse if she experiences: A. Fetal movements B. Hunger C. Abdominal cramping D. Fetal kicks
C One of the risks following an amniocentesis procedure is preterm labor which is associated with abdominal cramping. Other risks are bleeding, or leakage of amniotic fluid, maternal infection, trauma to the placenta, Rh sensitization from fetal blood into the maternal circulation.
A patient receiving magnesium sulfate for preeclampsia is found to be unresponsive with a respiratory rate of 8 breaths/minute. Which nursing action is the highest priority? A. Notify the provider. B. Prepare to administer calcium gluconate. C. Discontinue the magnesium sulfate infusion. D. Administer oxygen via face mask.
C.
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? A. contact the health care provider B. Instruct the client to maintain best rest for the remainder of the pregnancy. C. Inform the client that these contractions are common and may occur throughout the pregnancy. D. Call the maternity unit and inform them that client will be admitted in a preterm labor condition.
C.
The nurse is caring for an 18 weeks gestation client who recently had an amniocentesis procedure. The client informed the nurse that she feels her underwear is wet. Which would be the nurse's first action? A. Call the physician B. Measure the client's vital signs C. Assess the perineal area D. Administer IV fluids
C.
A woman visits the clinic and stated that she has missed four menstrual periods and remains unsure whether or not she is pregnant. the nurse informs her that a ballottement test will be done to diagnose whether or not she is pregnant. How can a ballottement test assist the nurse in confirming a pregnancy? A. By using a transvaginal ultrasound the nurse will be able to visualize the gestational sac. B. By detecting the presence of the human chorionic gonadotropin in the urine sample in a laboratory. C. By detecting the presence of the human chorionic gonadotropin in the blood sample in a laboratory. D. By tapping on the cervix the fetus will rise in the amniotic fluid and then rebound to its original position.
D
The nurse is conducting a presentation on the prevention of food-borne illnesses with the clients of the prenatal clinic. Which advice would the nurse emphasize? A. Warm cooked food should be taken out of the refrigerator for more than two hours before consuming. B. Drink plenty herbal teas such as peppermint and chamomile. C. Refrigerate smoked seafood before consuming. D. Wash hands before and after handling food.
D
The nurse is caring for a pregnant client and knows that this test is done for chromosomal analysis between 10-12 weeks' gestation to detect fetal anomalies caused by genetic disorders. It does not test for neural tube defects (NTDs). The nurse identified the following test as: A. Amniocentesis B. Triple marker screening C. Percutaneous umbilical cord sampling D. Chorionic villus sampling (CVS)
D This CVS procedure is for chromosomal, metabolic and DNA testing. It does not test for neural tube defects. A small sample of placental tissue is obtained via a catheter transvaginally or abdominally using a needle.
A gravid patient at 8 weeks gestation presents to the emergency department reporting unilateral sharp lower abdominal pain, shoulder pain, and light vaginal bleeding. The nurse knows these signs and symptoms are associated with which pregnancy complication? A. Ectopic pregnancy B. Hydatidiform mole C. Spontaneous abortion D. Therapeutic abortion
A
A mother who had a stillbirth 2 months ago stated that she has been trying to get pregnant. The nurse determines that she may be at risk for iron-deficiency anemia. Which advice would the nurse give to this woman? A. "Take iron supplements." B. "Continue taking megadoses of vitamins and minerals." C. "Increase your intake of calcium and magnesium." D. "Take Folic acid 0.6mg once per day."
A
A multiparous client asks the nurse what she can do to help with leaking urine when she coughs or sneezes. Which intervention would the nurse recommend? A. Perform Kegel exercises B. See a urology specialist for surgery C. Empty her bladder every hour D. Obtain a specimen for urinalysis
A
A nonstress test is performed on a client who is pregnant and the results of the test indicate non-reactive findings. The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? A. A normal test result B. An abnormal test result C. A high risk for fetal demise D. The need for a cesarean section
A
The nurse knows that the assessment of fetal status is a key component of perinatal care. In a class discussion with nursing students, which would the nurse identify as appropriate methods used for ongoing assessment of the fetal-well-being during pregnancy? Select all that apply. A. Non-stress test (NST) B. Daily fetal movement count (kick count) C. Biophysical profile D. Amniotic fluid index E. Vibroacoustic stimulation
A, B, C, D, E To assess fetal well-being during pregnancy depending on the fetal accelerations and fetal heart patterns observed on the EFM. Daily kick counts of 10 fetal movements within 2 hours is considered normal and reassuring. This can be done for most pregnancies after 28 weeks gestation. This is an ultrasound assessment of fetal status along with NST to assess five variables (FHR reactivity, fetal movement, tone, breathing, and amniotic fluid volume). Measures the amniotic fluid index to determine normal measurement 8 to 24 cm to indicate placental function and perfusion. This test is effective in eliciting a change in fetal behavior, fetal startle movements, and increased FHR variability.
A nurse is discussing the indications for an ultrasound with pregnant women in a prenatal education class. A client, who is in her first trimester, asks the nurse which tests the ultrasound could assess for at this time. Which would be an appropriate nursing response? Select all that apply. A. Estimate gestational age B. Evaluate the uterus structures C. Confirm intrauterine pregnancy D. Detect fetal anomalies E. Confirm fetal cardiac activity
A, B, C, E
A woman visits the clinic and states that she has missed four menstrual periods and is unsure if she is pregnant. The nurse informs her that a ballotment test will be done to diagnose pregnancy. How can a ballotement test assist the nurse in confirming a pregnancy? A. Softening of the cervix and vagina B. Softening of the lower uterine segment C. Brownish pigmentation over the client's forehead D. Bluish-purplish coloration of the vaginal mucosa E. A dark line that runs from the umbilicus to the pubis
A, B, D
The nurse taking a patient's history at her initial prenatal appointment assesses her risk factors for high-risk pregnancy. Which finding increases her risk for pregnancy complications? Select all that apply. A. Prior pregnancy complications B. Current hypertension C. Father with hypertension D. Smoking E. Maternal aunt with breast cancer
A, B, D
The nurse is teaching a group of pregnant women about the risks of venous thromboembolism (VTE). Which statements would the nurse include in the education? Select all that apply. A. All pregnant women are at an increased risk because pregnancy is a state of hypercoagulability. B. Women should report any abrupt unilateral leg pain right away. C. Heparin is not considered safe during pregnancy, so it should be avoided. D. Pregnant women should avoid sitting for long periods of time to avoid venous stasis in the lower extremities. E. A prior history of having a blood clot is not significant and does not put a patient at higher risk during pregnancy.
A, B, D,
The nurse is discharging a woman after hospitalization for preterm labor. The nurse would instruct the patient to call the provider for which signs or symptoms? Select all that apply. A. Broken bag of water B. Low back ache with menstrual cramps C. Heartburn D. Leg cramps at night E. Regular contractions that do not go away with rest
A, B, E
The nurse is caring for a patient with congenital heart disease who is beginning her prenatal care. Which normal cardiac changes during pregnancy can exacerbate cardiac disease during pregnancy? Select all that apply. A. Increase in total blood volume from 30 to 50% B. Decrease in heart rate by 10 to 20 beats per minute C. The weight of the gravid uterus can lie on the inferior vena cava D. Increased peripheral vascular resistance E. Increased cardiac output
A, C, E
The nurse is teaching the new pregnant mother about the placenta and its many roles in fetal development. Which statements show an understanding of the hormones the placenta produces? Select all that apply. A. "Progesterone is the hormone that makes you feel bloated." B. "Testosterone is produced only if you are having a boy." C. "Human chorionic gonadotropin doubles or triples the longer you are pregnant." D. "Human placental lactogen helps in the production of breast milk." E. "Estrogen is the reason for my pregnancy glow."
A, D, E
The nurse will be focusing on 'self-care' during a preconception counseling session with women who are seeking to get pregnant. Which advice should the nurse include in the counseling session? Select all that apply. A. Discontinue the use of herbal supplements before pregnancy. B. Avoid aerobic and regular weight-bearing exercise before pregnancy. C. Continue with the same megadoses of vitamins and minerals as prescribed. D. Ensure that smoke alarms and carbon monoxide detectors are in working order. E. Maintain optimal oral health and treat any periodontal disease before pregnancy.
A, D, E
Which is an appropriate assistance the nurse can provide to the couple who found out during pregnancy that their child has a genetic disorder? Select all that apply. A. Provide credible websites containing information specifically about the genetic disorder. B. Leave them be. They have time to learn about it later on in the pregnancy or when the child is born. C. Encourage them to communicate with one another. D. Find a support group for the couple. E. Ask the couple closed-ended questions.
A,C,D
A newly pregnant client is seen in the clinic for her first prenatal appointment. She states she has a family history of an autosomal recessive disease. Which disease has an autosomal recessive pattern of inheritance? A. Cystic fibrosis B. Hemophilia C. Huntington's disease D. Sickle-cell anemia E. Tay-Sachs disease
A,D,E
At her 14-week prenatal appointment, the client reports experiencing a moderate amount of white vaginal discharge. Which teaching would the nurse provide? A. Wear a panty-liner and change it often. B. Use a vaginal douche to cleanse the vagina of discharge. C. Change the type of bath soap she is using. D. Explain that the loss of the mucus plug is normal.
A.
The nurse is caring for a client who had a percutaneous umbilical blood sampling procedure (PUBS) an hour ago. The client complains of lower back pains and the electronic fetal monitor (EFM) shows some contractions. Which medication would the nurse anticipate the healthcare provider to order? A. Terbutaline B. Labetalol C. Percocet D. Oxytocin
A. Terbutaline is one of the tocolytic medications used for preterm labor. PUBS is usually done after 18 weeks. Preterm labor is when uterine contractions occur in clients less than 37 weeks gestation.
The nurse reviews the biophysical profile (BPP) report of 8/10 and interprets the result as: A. Equivocal B. Reassuring C. Non-reassuring D. Abnormal
B. This is the correct answer. A score of 8 is normal and indicates adequate oxygenation and placenta perfusion.
A 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 instructions? A. " I will record the number of movements of kicks." B. " I need to lie flat on my back to perform the procedure." C. "if I ever count fewer than 10 kicks in a 2-hour period, I should count the kicks again over the next 2 hours." D. " I should place my hands on the largest part of my abdomen and concentrate on the fetal movements to count the kicks."
B
A patient at 30 weeks gestation was just diagnosed with gestational diabetes. She asks the nurse how the diabetes will affect her baby. Which is the best response from the nurse? A. "Your baby might have high blood sugar for several days after birth." B. "Your baby might be larger than expected at birth." C. "If you follow your diet and control your blood sugar, there would not be any problem for the baby." D. "Your baby is at increased risk of congenital anomalies."
B
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? A. "come to the clinic immediately" B. "the vaginal discharge may be bothersome, but it is a normal occurrence." C. "Report to the emergency department at the maternity center immediately." D. "Use tampons if the discharge is bothersome but be sure to change the tampons every 2 hours."
B
Angiotensin-converting enzyme (ACE) inhibitors A. FSH & LH induce the production of milk in the breasts. B. FSH & LH are released by the anterior pituitary gland. C. FSH & LH are secreted by the corpus luteum. D. The FSH and LH are released by the adrenal glands.
B
The nurse is caring for a 24-week gestational age client. The client states that she is worried about the scheduled antenatal tests. Which is the nurse's best response? A. "There is no need to worry since all the tests are non-invasive procedure." B. "Tell me what your concerns are." C. "You are not scheduled for the tests until tomorrow." D. "The risks for the tests are minimal."
B
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? A. G=3, T=2, P=0, A=0 L= 1 B. G=2, T=1, P=0, A=0 L= 1 C. G=1 ,T=1, P=1, A=0 L=1 D. G=2,T=0, P=0, A=0 L=1
B
The nurse is conducting an investigation on the effects of teratogenic agents on the newborn. The nurse found that exposure to some viruses and substances during pregnancy may result in blindness in the newborn. Which of the following teratogenic agents would the nurse have identified as increasing the risk of blindness in newborns? A. Cocaine B. Zika C. Carbamazepine D. Angiotensin-converting enzyme (ACE) inhibitors
B
While counseling a couple diagnosed with infertility, the nurse documented "social isolation" on the chart. Which statement made by the woman would have caused the nurse to come to this conclusion? A. "I feel pressure having to adhere to a prescribed sexual routine as part of our treatment." B. "I do not want to be a part of my family reunion this year. I am not ready to meet my sister's baby." C. "My husband should be blamed. He was promiscuous in his early years." D. "Are you sure that I am really pregnant? I want to repeat the test."
B
A nurse in a prenatal clinic is caring for four clients. which of the following clients' weight gain should the nurse report to the the provider? A. 1.8 kg (4 lb) weight gain and is in the first trimester B. 3.6 kg (8 lb) weight gain and is in the first trimester C. 6.8 kg (15 lb) weight gain and is in the second trimester D. 11.3 (25 lb) weight gain and is in the third trimester
B 3-4 lb weight gain is expected in first trimester 1lb per week in the second trimester 25-35 lb weigh gain third trimester
The nurse is performing a vibroacoustic stimulation, a screening tool that uses auditory stimulation (an artificial larynx) to assess fetal well-being with electronic fetal monitor (EFM). The nurse has placed the artificial larynx in the indicated area on the maternal abdomen two times lasting for one second and has noted no fetal accelerations. The next step would be to: A. Call the physician. B. Repeat the test again for 1 second on the indicated area of the maternal abdomen. C. Provide comfort measures. D. Schedule the client for a week's follow up visit.
B The test can be repeated at 1-minute intervals up to three times
The nurse on the antepartum unit is caring for a client post chorionic villus sampling procedure. Which would the nurse's priority intervention be? A. Provide 2L of fluids during the shift. B. Assess the fetal heart rate (FHR). C. Administer RhoGAM. D. Administer oxygen 2L via nasal cannula.
B This is a priority. The nurse must assess the fetal heart rate to ensure fetal status. It is auscultated twice in 30 minutes.
When should RhoGAM be administered? A. in an Rh+ mother B. At 28 weeks gestation in an Rh- mother C. within 72 hours postpartum if mom Rh- and baby is Rh+ D. in women with hypersensitivity to human immunoglobulins
B, C
A rubella titer result of 1-day day postpartum client 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? SATA A. Breastfeeding needs to be stopped for 3 months B. Pregnancy needs to be avoided for 1 to 3 months. C. The vaccine is administered by the subcutaneous D. Exposure to immunosuppressed individuals needs to be avoided. E. A hypersensitivity reaction can occur if the client has an allergy to eggs F. The area of the injection needs to be covered with a sterile gauze for 1 week.
B, C, D, E
A nurse is reviewing findings of a client's BPPP. The nurse should expect which of the following variables to be included in this test? A. Fetal weight B. Fetal breathing movement C. Fetal tone D. Fetal position E. Amniotic fluid volume
B, C, E
A nurse is monitoring a 30 weeks gestation client on the antepartum unit. Which assessment findings concern the nurse? A.The EFM strip shows two or more accelerations that increase 10 beats above the FHR baseline for 10 seconds in 20 minutes. B. There are several variable decelerations that last for 30 seconds within a 20 minutes period. C. There are no decelerations noted on the EFM strip. D. The EFM strip shows a baseline fetal heart rate (FHR) of 120 bpm (beats per minute).
B. This is a concern. Variable decelerations can indicate cord compression and require further assessment and/or monitoring.
The nurse reviews the client's file upon return from Radiology. The client is 37 weeks gestational age and completed the amniotic fluid index test (AFI). The nurse is concerned with which AFI result? A. The AFI measurement is 22 cm. B. The AFI measurement is 4 cm. C. The AFI measurement is 12 cm. D. The AFI measurement is 9 cm.
B. This result falls below the average measurement of amniotic fluid in pregnancy of 8 cm - 24 cm and is indicative of oligohydramnios (decreased or no amniotic fluid) and can be associated with increased prenatal death, and close maternal and fetal monitoring is needed.
The nursing student asks the nurse about tests that are commonly performed for a suspected brain abnormality. How would the nurse respond? A. Nonstress test B. Magnetic resonance imaging C. Amniocentesis D. Doppler Velocimetry
B. A test used to visualize detailed images of the maternal and/or fetal structures, and most commonly used for suspected brain anomalies.
The labor and delivery unit has had four patients admitted for preterm labor. The nurse recognizes that which patient is not a candidate for tocolysis? A.G1P0 at 33 weeks' gestation with urinary tract infection B. G3P1 at 30 weeks' gestation with placental abruption C. G4P3 at 34 weeks' gestation with positive group B strep D. G1P0 at 35 weeks' gestation with diabetes and amniocentesis confirming immaturity of fetal lungs
B. Placental abruption is a contraindication since there is risk to prolonging pregnancy.
The nurse is admitting a client whose blood type is A-negative and had a miscarriage at 5-weeks gestation. which is the appropriate nursing intervention? A. Prepare the client for a dilation and curettage (D&C) B. Administer Rho (D) Immune Globulin (RhoGAM) C. Instruct the client to use contraception for the next 6 months D. Perform an ultrasound to confirm all products of conception have been expelled
B. Rho (D) Immune Globulin is administered to Rh-negative women with likely exposure to Rh-positive blood such as with pregnancy loss.
The nurse is caring for a couple who is being evaluated for infertility. Which of the following statements by the nurse indicates understanding of the infertility process? A."You will need to see a genetic counselor as part of the assessment." B."it is usually the woman who is having trouble, so the man doesn't have to be involved." C."The man is the easiest to assess, and the provider will begin there." D."Think about adopting first because there are many babies that need good homes."
C
The nurse is performing an assessment of a pregnant client who is at 28 weeks of gestation. The nurse measures the fundal height in cm and notes that the fundal heigh is 30 cm. How should the nurse interpret this finding? A. The client is measuring large for gestational age. B. The client is measuring small for gestational age. C. The client is measuring normal for gestational age. D. More evidence is needed to determine size for gestational age.
C
The nurse is reviewing a client's chart and comes across genetic testing results. When answering questions from the family, which statement would prompt the nurse to provide further education? A. "The human cell has 46 chromosomes." B. "The human cell has 22 homologous pairs." C. "The human cell has two pairs of sex chromosomes." D. "The human cell has XX or XY chromosomes."
C
The nurse suspects that a pregnant patient has been using illicit drugs. Which statement is most appropriate by the nurse? A. "Using drugs during pregnancy is very dangerous for your baby." B. "I need to notify the authorities about your drug use." C. "Have you used any drugs during your pregnancy?" D. "I am going to collect a urine sample from you to see if you are telling me the truth about drug use."
C
