OB practice questions

30. Which of the following statements is correct regarding TORCH infections? Select one: a. TORCH infections are viral illnesses that can cross the placental barrier and have teratogenic effects on the fetus. b. TORCH infections do not have risks to the mother c. Group B streptococcus is considered a TORCH infection d. TORCH infections are caused by bacteria and may be treated with IV antibiotics.

a

8. Which nursing action should take priority when caring for a client with suspected ectopic pregnancy? Select one: a. Monitor vital signs. b. Obtain surgical consent c. Administer oxygen d. Provide emotional support

a

21. A nurse is assessing a 38 week gestation gravid client in the clinic. It has been 2 weeks since the client's last prenatal visit. The nurse should highlight which of the following findings for the client's primary healthcare practitioner? Select all that apply. Select one or more: a. Dysuria b. Weight change from 146 lb. to 158 lb. c. Decreased fundal height d. Fetal heart change from 156 bpm to 148 bpm e. Orthopnea

a & b

23. The home care nurse is caring for a postpartum client and suspects the development of postpartum psychosis. Which client findings support the nurse's judgement? Select all that apply. Select one or more: a. Has a history of bipolar disorder b. Reports voices telling her the baby is evil and must die c. Unable to remember details of delivery or when she last fed the baby d. Is tearful without any identifiable reason e. Is calm and seated and answers all the questions

a b & c

3. The home care nurse is caring for a postpartum client and suspects the development of postpartum psychosis. Which client findings support the nurse's judgement? Select all that apply a Has a history of bipolar disorder b Reports voices telling her the baby is evil and must die c Unable to remember details of delivery or when she last fed the baby d Is tearful without any identifiable reason e Is calm and seated and answers all the questions

a b c

5. Which of the following factors could delay uterine involution in a post partum client? SATA a Distention of bladder b Grand multipara c Prolonged labor d The use of epidural analgesia e Uterine Infection

a b c e

26. A nurse is discussing risk factors for urinary tract infections with a newly licensed nurse. Which of the following conditions should the nurse include in her teaching? Select one or more: a. Frequent pelvic examinations b. History of UTIs c. Vaginal birth d. Epidural anesthesia e. Urinary bladder catheterizations

a b d e

6. A nurse is caring for a postpartum mother who delivered her third infant 2 days ago. Which of the following are suggestive of postpartum depression Select one or more: a. Flat affect b. Euphoria c. Insomnia d. Hallucinations e. Fatigue

a c & e

9. Which of the following are expected findings of a 32 week gestational age newborn (preterm) who weighs 1200 grams? Select one or more: a Lanugo b Long nails c Weak grasp reflex d Translucent skin e Chubby cheeks

a c d

9. High risk factors for developing post-partal thrombophlebitis include (Select all that apply). Select one or more: a. Cesarean delivery b. Normal pre-pregnant weight c. Obesity d. Grand multiparity e. History of smoking

a c d & e

10. You are teaching potential mothers about complications of uncontrolled diabetes in a growing fetus. It will be accurate for you to say Select one: a. Hyperglycemia in early pregnancy can cause small for gestational baby b. Hyperglycemia in early pregnancy can lead to congenital anomalies in the baby c. Hyperglycemia in early pregnancy can cause large for gestational baby d. Hyperglycemia in early pregnancy can lead to maternal hypertension

b

14. In anticipation of potential complication during the 2nd trimester of pregnancy, the nurse teaches an 18-week gestation client to call the office if she experiences which of the following? Select one: a. Puffy feet b. Headache and decreased urine output c. Backache d. Hemorrhoids and vaginal discharge

b

15. A nurse is preparing to administer a prophylactic eye ointment to the newborn. What medication should she get ready to administer? a Nystatin b Erythromycin c Cefotaxime d Silver nitrate

b

17. A type I diabetic pregnant woman is seen for preconception counseling. The nurse should emphasize that during the 1st trimester the woman may experience which of the following? Select one: a. Signs and symptoms of hydramnios b. Need for less insulin than she normally injects c. A need to be hospitalized for fetal testing d. An increased risk for hyperglycemic episodes

b

21. A client is scheduled for an ultrasound at her first prenatal visit. She asks the nurse why she is having the test done. Which of the following is the appropriate answer? Select one: a. "The test will predict the gender of your baby" b. "The test will help determine how many weeks you have been pregnant" c. "The test will determine if your baby is in a good position for delivery" d. "The test will determine if your baby has intrauterine growth restriction"

b

21. A mother is experiencing nipple pain and discomfort while breast feeding. What should be the first priority in the plan of care? a Allow the mother to pump until the nipples heal and bottle feed the breast milk to the baby b Remove the baby from the breast and reposition c Provide a nipple shield to wear while breastfeeding d Provide formula to the baby until the nipples are healed

b

22. A newborn's initial assessment shows the following. What is the appropriate action? Head circumference- 34 cm, chest circumference-32 cm, heart rate 150/minute, and respiratory rate 45/minute a Refer the newborn for psychomotor retardation b Record the finding as normal and take no further action c Provide oxygen therapy for respiratory distress d Refer to the physician stating the heart rate is too high

b

23. A married, 26 year old client, 9 weeks' gestation, states, "If I'm going to have all of these discomforts, I'm not really sure I'm happy about being pregnant!" The nurse interprets the client's statement as an indication of which of the following? Select one: a. Fear of pregnancy b. Ambivalence toward the pregnancy c. Anger at learning of the pregnancy d. Rejection of the pregnancy

b

23. Assessment findings of the C/S incision wound of a client two days after delivery indicates the following- red, edematous, and tender to touch. This best initial nursing action would be a Clean the incision site with Betadine (providone iodine) and change the dressing b Notify the physician c Document your findings d Check the vital signs

b

24. A non-stress test is considered reactive when which of the following occur? Select one: a. There is increased fetal movement b. There are two or more accelerations of 15 beats per minute lasting 15 seconds or more over a 20 minute period c. There is one acceleration of 15 beats per minute lasting 20 seconds over a 20 minute period d. There is decreased fetal movement

b

26. A woman, G4 P1203, is 25 weeks' pregnant. She denies experiencing quickening. The nurse concludes which of the following? Select one: a. She should see a nutritionist as soon as possible b. She may be having difficulty accepting this pregnancy c. She may deliver the baby prematurely d. Her pregnancy is progressing normally

b

27. A woman, who states that she "thinks" she is in labor, has entered the labor suite. Which of the following assessments will provide the nurse with the most valuable information regarding the client's labor status? Select one: a. Client's behaviors b. Cervical change c. Fundal contractility d. Leopold's maneuvers

b

29. The nurse is reviewing breastfeeding positions with the mother of a newborn. Which of the following positions should the nurse discuss? Select one: a. Over-the-shoulder b. Cradle c. Chin-supported d. Supine

b

3. A client has severe pre-eclampsia. The fetus of the client should be assessed for Select one: a. Cardiac failure b. Intrauterine growth restriction c. Hypoprothrombinemia d. Severe anemia

b

5. During ambulation to the bathroom, a postpartum client experiences a gush of dark red blood that soon stops. On assessment, the nurse finds the uterus to be firm, midline, and at the level of umbilicus. The findings are? Select one: a. Abnormally excessive lochia rubra flow b. A normal postural discharge of lochia c. Evidence of a possible vaginal hematoma d. Indication of cervical or perineal laceration

b

27. The nurse is assessing the fetal monitor tracing and suspects variable decelerations. Which of the following actions should the nurse take at this time? Select one or more: a. Provide caring labor support b. Administer oxygen via face mask c. Turn the woman on her side d. Apply the oxygen saturation electrode to the mother

b & c

3. A client at 33 weeks gestation has been diagnosed with mild preeclampsia and is on bed rest at home. The nurse instructs her to contact her primary care provider immediately if she experiences the following (select all that apply). Select one or more: a. Backache b. Vision changes c. Constipation d. Epigastric pain e. Heartburn

b & d

6. A pregnant client with a history of placenta previa is admitted to the L & D suit at 39 weeks of gestation. Which of the orders will you question the physician as inappropriate? Select all that apply. Select one or more: a. Monitor for vaginal bleeding b. Start Pitocin drip c. Check the vital signs d. Check the dilation and effacement by vaginal exam e. Monitor the fetal heart rate.

b & d

3. A 12-week pregnant client presents to the ED with abdominal cramps and scant dark red bleeding. Which of the following signs/symptoms should the nurse assess for this client? SATA a Referred shoulder pain b Headache c Hypertension d Fetal Heart Dysarrythmiaas e Tachycardia

b c d e

1. A 36 week pregnant client is presented to the L & D unit with a history of sudden severe abdominal pain and moderate dark colored bleeding. Contractions are strong, every 2 minutes apart lasting about 60 seconds. She has a history of cocaine use during pregnancy. You suspect the client is presenting with? Select one: a. Rupture of uterus b. Ectopic pregnancy c. Abruptio Placenta. d. Placenta previa

c

11. A 32-week gestation client was last seen in the prenatal clinic at 28 weeks'gestation. Which of the following changes should the nurse bring to the attention of the provider? Select one: a. Pulse rate change from 88 bpm to 92 bpm b. Blood pressure change from 120/80 to 118/78 c. Weight change from 128 lbs to 138 lbs d. Respiratory rate change from 16 rpm to 20 rpm

c

12. A 24-week-gravid client is stating that " I have had a terrible headache for the past 2 days". What is the most appropriate action for the nurse to perform first? Select one: a. Ask her whether she has any acute stressors b. Inquire whether she has any allergies c. Take the woman's blood pressure d. Assess the woman's fundal height

c

13. A 26-week gestation woman is diagnosed with severe preeclampsia with HELLP syndrome. The nurse will assess for which of the following signs/symptoms? Select one: a. High serum protein b. Bloody stools c. Epigastric pain d. Low serum creatinine

c

17. A nurse is teaching a group of new parents about proper techniques of bottle feeding. Which of the following instructions should the nurse provide? Select one: a. Burp the newborn after every 10 minutes b. Hold the newborn close to a supine position c. Keep the nipple full of formula during feeding to avoid baby ingesting air d. Refrigerate any unused formula

c

18. A client enters the labor and delivery unit stating, "After I ruptured membranes at home a long cord came out of my vagina." Which of the following actions should the nurse perform first? Select one: a. Inform the client that she will have a cesarean b. Place the client in bed in the knee chest position c. Assess the fetal heart rate d. Call the primary healthcare practitioner

c

19. A client has completed a home pregnancy test with positive results. Which client statement indicate that she understands the meaning of the test results? Select one: a. "I understand that this means I am pregnant" b. "I understand that I have ovulated in the past 24 hours" c. "I understand that this means I might be pregnant" d. "I understand that this means I am not pregnant"

c

19. A post partum mother who exclusively bottle feeding her baby is complaining that her breasts are firm, red and warm to touch. What advice would you give to the mother to relieve her symptoms? Select one: a. Apply lanolin to her breasts and nipples every 3 hours b. Express milk from her breasts every 3 hours c. intermittently apply ice packs to her breasts and axilla d. Ask the primary care provider to order a milk suppressant

c

20. A new mother with mastitis is concerned about breastfeeding her baby with her active infection. How will you respond to this mother's concern? a Immunoglobulins in the breast milk will protect the infant from getting the infection b Infant is protected from getting the infection as the gastric acid kills the organisms c The organisms that cause mastitis is not passed in the breast milk d Mastitis is not an infection

c

22. A client who is 41 weeks gestation just had a biophysical profile with a score of 2. What is the highest priority nursing intervention at this time? Select one: a. Recognize this as equivocal and have the mother come back tomorrow for a repeat b. Tell the mother it indicates fetal well-being c. Contact the physician immediately as there is a probable need for delivery d. Schedule the mother for a repeat in 3 days

c

22. Which of the following is the initial earliest warning sign of hypovolemic shock? Select one: a. Extreme thirst b. Hypertension c. Tachycardia d. Hypotension

c

24. What signs of thrombophlebitis should a nurse include in her discharge teaching of a postpartal client? a Enlarging varicose veins in the lower limbs b Muscle soreness after exercise c Localized calf tenderness, heat, and swelling d New areas of ecchymosis

c

30. Which of the following would be the highest priority of the nurse caring for a laboring patient? Select one: a. Assessing pain and providing pain relief measures b. Checking the intake and output every hour c. Assessing the fetal heart rate frequently d. Assuring her partner is with her in the room

c

7. On the third postpartum day you find your client crying in her room. She verbalizes that she is overwhelmed and not sure whether she can care for her new baby. What is the most appropriate response? a "Are you worried about the care/lack of care you received here? Lets talk about it." b "There is nothing to cry about. You will be fine." c "Many new mothers have similar feelings of confusion and inadequacy. Would you like to talk about it?" d "This is nothing new with new mothers. You will feel better in a couple of days."

c

8. A client receiving Magnesium Sulfate IV presents with a respiratory rate of 12 and diminished deep tendon reflexes. The nurse should anticipate administering which of the following medications? Select one: a. Potassium gluconate b. Lanoxin c. Calcium gluconate d. Narcan

c

The nurse is assessing a client who states "I think I am in labor." Which of the following findings would positively confirm this belief? a Her membranes ruptured b The fetal head is engaged c Her cervix is 2 cm to 4 cm d She is contracting q 5 minutes x 60 seconds

c

2. Postpartum depression is one of the mood disorders found in many women. Which of the following clients would you consider to be at risk for postpartum depression? A client who a Is unmarried primipara with family support b Has history of post-partum blues with the previous pregnancy c Is Primipara living alone and was consistently ambivalent about her pregnancy d Has history of depression with no supportive relationship

c & d

16. A pregnant woman is admitted to the ER after an automobile accident. She has no obvious external injuries. The nurse monitors the woman for which of the following complications? Select all that apply. Select one or more: a. Placenta Previa b. Transverse fetal lie c. Placental abruption d. Severe preeclampsia e. Preterm labor

c & e

2. A woman has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs/symptoms is a characteristic of this diagnosis? a Marked hyperthermia b Dark brown rectal bleeding c Tachycardia d Severe nausea and vomiting e Sharp unilateral pain

c & e

4. A nurse who is assessing a pregnant type 1 diabetic patient should monitor her for which of the following? Select all that apply. Select one or more: a. Maternal hypertension b. multiple gestation c. Urinary tract infection d. Hypolipidemia e. Metabolic acidosis

c & e

25. A nurse caring for an infant diagnosed with hyperbilirubinemia and is receiving phototherapy. Which of the following priority findings are a concern for you? Select all that apply. a Conjunctivitis b Bronze skin discoloration c Sunken fontanelle d Lethargic and not feeding well e Maculopapular rash

c d

17. You are providing breast feeding instructions to a postpartum client. To prevent breast engorgement you should instruct the client to.. Select all that apply a Wear a tight, supportive bra b Alternate breast feeding with bottle feeding to rest the breast c Apply warm compresses if breasts feel full d Encourage her to breast feed her infant frequently e Teach breast feeding techniques soon after delivery and continue support

c d e

1. The nurse is developing a plan of care for the postpartum client during the "taking hold" phase. Which of the following should the nurse include in the plan? Select one: a. Ask the client about her delivery experience b. Offer the client a sandwich c. Give the client a bed bath d. Show the client a video on child care techniques

d

11. A client enters the labor and delivery unit stating, "After I ruptured membranes at home a long cord came out of my vagina." Which of the following actions should the nurse perform first? Select one: a. Place the client in bed in the knee chest position b. Inform the client that she will have a cesarean c. Call the primary healthcare practitioner d. Assess the fetal heart rate

d

11. One of the priority concerns of caring for a newborn immediately after birth is? a Initiate breastfeeding b Give vitamin K injections c Initiate Physical Assessment d Prevent heat loss by covering the newborn's head with a cap

d

15. A client in active labor is complaining of severe back pain during contractions. Which of the following is most likely the fetal position to cause the pain? Select one: a. Right occiput anterior b. Left occiput anterior c. Shoulder position d. Right occiput posterior

d

15. Which of the following clients is at highest risk for developing a hypertensive illness of pregnancy? Select one: a. G3 P1102, age 38 with history of scoliosis b. G2 P0101, age 34 with history rheumatic fever c. G3 P1011, age 20 with history of celiac disease d. G1 P0000, age 41 with history of diabetes mellitus

d

2. A 38 week gestation client with preeclampsia is receiving magnesium sulfate and Pitocin IV for induction of labor. What is the expected effect of magnesium sulfate on this client? Select one: a. She will experience seizures b. She will have a lower blood pressure c. She will be sedated d. She will have no seizures

d

2. A fetus, 38 weeks' gestation, is diagnosed as SGA (small for gestational age) on ultrasound. Which of the following findings in the mother's history may be related to the fetal diagnosis? Select one: a. Mother's fundal height is 30 centimeters b. Mother's pregnancy weight gain is 30 pounds c. Mother has gestational diabetes d. Mother has chronic hypertension

d

20. A client is receiving intravenous magnesium sulfate for severe preeclampsia. Which of the following assessment findings would make the nurse suspect that the client is developing hypermagnesemia? Select one: a. Rapid pulse rate b. Tingling of her toes c. Cool skin temperature d. Decreased patellar reflexes

d

7. A prenatal lab finding of your client indicated that her blood group is O and Rh negative. She will require further follow up to identify a potential problem that could affect her unborn baby such as? Select one: a. Placenta previa. b. Congenital anomalies. c. Ectopic pregnancy. d. Erythroblastosis Fetalis.

d

7. As labor progresses the uterine contractions should: a Increase in intensity & frequency b Increase in duration & decrease in frequency c Increase in frequency & duration d Increase in intensity, frequency & duration

d

9. You are providing discharge teaching to a client who underwent evacuation of her hydatidiform molar pregnancy. Which response by the client indicates understanding of the teaching? Select one: a. "It is better for us to try to get pregnant as soon as possible as the chances of recurrence are minimal". b. "I will need chemotherapy treatment after this" c. "I am so sad that I lost this baby". d. "I will need to see the doctor regularly for follow up".

d

25. A pregnant client with history of placenta previa is admitted to the L & D suit at 39 weeks of gestation. Which of the orders will you question the physician as inappropriate? Select all that apply. Select one or more: a. Monitor the fetal heart rate b. Monitor for vaginal bleeding c. Check the vital signs d. Check the dilation and effacement by vaginal exam e. Start Pitocin drip

d & e

28. Second stage of labor. (Select all that apply) Select one or more: a. Be latent phase of the labor process b. Lasts about 8-12 hours c. Indicates delivery of the placenta d. Indicates delivery of the baby e. Lasts about 1-2 hours

d & e

18. Discharge care instructions given to the parents regarding cord care of a newborn should include Select one: a. Cleaning the cord with hydrogen peroxide at each diaper change b. Cover the cord with small gauze at all times c. Cleaning the cord with water at each diaper change d. Keeping the cord dry, with the diaper folded below the cord

d

19. The nurse is assessing the uterine fundus of a client 8 hours after a C/S and finds it firm, round, 2 cm above the umbilicus and displaced to the right. The most appropriate intervention you should do is a Massage the fundus b Check the lochia for excessive bleeding c Notify the physician d Encourage the client to empty the bladder and reassess the fundus

d

8. A laboring client's FHR at 9am was 144. At 10am the FHR is 100 and progressively decreasing. This could indicate (select all that apply) a Cord compression b Utero-Placenta insufficiency c Maternal Fever d Fetal Distress e Twin gestation

A & d

20. A client in active labor is complaining of severe back pain during contractions. Which of the following is most likely the fetal position to cause the pain? Select one: a. Right occiput posterior b. Shoulder position c. Left occiput anterior d. Right occiput anterior

a

28. A mother, G6P6006, is 15 minutes postpartum. Her baby weighed 4,595 grams at birth. For which of the following complications should the nurse monitor this client? Select one: a. Hemorrhage b. Infection c. Thrombosis d. Seizures

a

29. Which of the following is an appropriate rationale for nurses to communicate to clients to encourage them to attend childbirth education classes? Select one: a. Knowledge learned at childbirth classes helps reduce client fears b. Participants in childbirth education classes develop support groups after their deliveries c. Partners who attend childbirth education classes are allowed into delivery rooms d. Mothers who attend childbirth education classes have shorter labors

a

10. A postpartal mother verbalizes that she does not want to breast feed her newborn son. What actions should you take to suppress milk production? Select all that apply a Encourage her to pump the breast to empty the breast b Apply Ice packs to the breast c Apply warm compresses to the breast d Advise her to wear a supportive bra e Administer medications to suppress breast milk production

b

4. A woman has just had a low forceps delivery. For which of the following should the nurse assess the woman during the immediate postpartum period? Select one: a. Rectal abrasions b. Bloody urine c. Heavy lochia d. Infection

c

5. Which finding should the nurse expect when assessing a client with placenta previa? Select one: a. previous premature delivery b. history of pelvic inflammatory disease c. Painless vaginal bleeding d. Severe headache

c

7. During initial physical assessment of a newborn, the nurse is holding the newborn in a semi-sitting position and allows the newborn's head and trunk to fall backward. This is done to elicit what reflex? Select one: a. Rooting reflex b. Grasp reflex c. Moro reflex d. Tonic neck reflex

c

14. What is the mode of heat loss in a newborn who is not dried completely after birth? a Evaporation b Conduction c Convection d Radiation

a

24. A deceleration of the fetal heart rate from 145 to 80 beats per minute with contractions followed by a rapid return to baseline rate is most likely indicative of Select one: a. Uteroplacental insufficiency b. Severe fetal hypoxia c. Umbilical cord compression d. Fetal head compression

d

6. The nurse is assessing a client 6 hours after a normal vaginal delivery. The priority assessment should be: a Assess for DVT b check the lochia c Assess the fundus d Check vital signs

C

16. A breastfeeding woman was counselled on how to prevent breast engorgement. Which of the following actions by the mother best shows that the teaching was effective? Select one: a. She feeds her baby every 2-3 hours b. She feeds the baby 10 minutes on each side c. She supplements each feeding with formula d. She pumps her breasts after every feeding

a

18. After delivering a large for gestational age infant, the nurse notices bright red blood continuously trickling from the client's vagina. Her fundus is firm and midline. The nurse suspects the most likely cause of bleeding to be a Perineal lacerations b Hematoma c Uterine atony d Retained fragments of conception

a

12. A non-stress test is considered reactive when which of the following occur? Select one: a. There are two or more accelerations of 15 beats per minute lasting 15 seconds or more over a 20 minute period b. There is one acceleration of 15 beats per minute lasting 20 seconds over a 20 minute period c. There is increased fetal movement d. There is decreased fetal movement

a

14. A postpartum client is diagnosed to have deep vein thrombosis. for which of the following additional complications is this client at high risk? Select one: a. Stroke b. Hematoma c. Endometritis d. Hemorrhage

a

16. A new nurse is being taught about the symptoms of neonatal abstinence syndrome. Which of the statements by the new nurse indicate understanding of the teaching? Select all that apply a The newborn will have decreased muscle tone b The newborn will have continuous high-pitched cry c The newborn will sleep for 3-4 hours after feeds d The newborn will have difficulty feeding e The newborn will have jitteriness and tremors

b d e

1. A 25- year old client is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heart beat detected on ultrasound. The nurse would expet the provider to write an order to prepare the client for which of the following: a Amniocentesis b Cervical Cerclage c Dilatation and curettage d Nonstress test

c

10. What condition is suspected when a third trimester client presents with painless bright red vaginal bleeding? Select one: a. Molar pregnancy b. Ectopic pregnancy c. Placental previa d. Placental abruption

c

25. A primigravid client asks the nurse how much alcohol she is able to drink during her pregnancy. Which of the following is an appropriate reply from the nurse? Select one: a. "You should limit your consumption to beer only" b. "You can safely consume one or two drinks of alcohol per week" c. "The effects of small amounts of alcohol on the fetus are minimal" d. "It is best to abstain from alcohol throughout your pregnancy"

d

26. The nurse notes that a newborn baby, who's Apgar scores were 9 and 9, is 8 minutes old. The baby's axillary temperature is 97.0 ºF. Which of the following nursing actions should the nurse perform at this time? a Report the temperature to the unit's neonatologist b Perform a rectal temperature to confirm the abnormal results c Immediately transport the baby to the newborn nursery d Place the naked baby on the mother's naked chest and cover them both

d

13. A client with preeclampsia is receiving magnesium sulfate. The nurse determines the medications has been effective after noting which effect on the client?

no seizures