OB exam with hw questions
A patient who wishes to conceive asks when fertilization should occur. Which response should the nurse make?
"Fertilization that occurs approximately 1 day before or after ovulation is optimal for conception." The ovum and sperm are both only fertile for approximately 24 hours. However, sperm can remain viable in the female reproductive tract for 48-72 hours. Therefore, the best time for fertilization to occur would be 1 day before or after ovulation (a 48-hour window). Fertilization can occur the day after ovulation, but it can also occur the day before. Fertilization three days before ovulation would not result in conception. A period of 48-72 hours after ovulation is too late for conception.
The nurse is teaching about ovum fertilization. Which statement should indicate teaching was effective?
"Human chorionic gonadotropin is secreted by the fertilized egg."
The nurse is assessing a 44-year-old patient at 37 weeks' gestation. Which statement should indicate a possible issue regarding the patient's psychologic adaptation to pregnancy?
"I haven't even started thinking about names for the baby yet. We still have time."
The nurse is assessing a pregnant patient's psychologic status. Which statement should indicate the patient is in the second trimester?
"I'm frustrated because my husband seems disinterested in the pregnancy."
A pregnant patient's hemagglutination inhibition (HAI) test result is 1:12. Which patient statement should indicate that teaching about this test result was effective?
"I'm immune to rubella, which is normal during pregnancy."
The nurse teaches a client who is 6 weeks pregnant about fetal development. Which client statement should indicate that teaching was effective? A: "My baby is able to move and kick." B. "The sex of my baby can be determined by this stage." C. "My baby is beginning to produce blood cells." D. "My baby's cranial nerves will not develop until 8 weeks."
"My baby is beginning to produce blood cells."
A patient in the second trimester of pregnancy discusses sex and intimacy issues with the nurse.
"My husband says he loves my body because it is growing a baby."
An African American couple who is expecting their first child asks if the child is at risk for sickle cell disease. Which response should the nurse make?
"Sickle cell disease is an autosomal recessive disorder that requires two abnormal genes for an individual to be affected."
A patient at 15 weeks' gestation reports not having sexual intercourse due to the spouse finding the pregnancy physically unattractive. Which response should the nurse make?
"Some men do find pregnancy unattractive, but feelings of intimacy should increase in the third trimester."
A pregnant patient is diagnosed with a urinary tract infection (UTI). Which information should be provided when teaching about this infection?
"The UTI increases the risk for preterm labor."
A pregnant couple asks how genetics influence the baby's hair color. Which response should the nurse make?
"The observable expression of a gene's trait is referred to as the phenotype."
The nurse documents a patient's obstetric history as gravida 2, para 1, ab 1. Which should the nurse include when providing this information during hand-off communication?
"The patient has had two pregnancies. One ended in delivery after 20 weeks' gestation and one ended in delivery before 20 weeks' gestation."
The nurse explains the process of fertilization to a couple wishing to conceive. Which statement by the couple should indicate that the teaching was effective? A. "The sex of our baby is determined at the moment of fertilization." B. "Fertilization has occurred when the sperm enters the ovum." C. "Multiple sperm may fertilize the egg during conception." D. "The process of fertilization takes place in the uterus."
"The sex of our baby is determined at the moment of fertilization."
A patient who is 4 weeks pregnant asks about the embryo's cardiovascular system. Which response should the nurse make?
"The tubular heart has begun beating at a regular rhythm." At week 4, the tubular heart begins beating at a regular rhythm and pushing its own primitive blood cells through the main blood vessels. At week 6, chambers are present in the heart and groups of blood cells can be identified. At week 8, development of the heart is essentially complete. At week 18, fetal heart tone is audible with fetoscope.
The nurse is explaining the anatomy of the female reproductive system. Which statement should the nurse make?
"The uterus is divided into the corpus and cervix."
A pregnant patient has an autosomal dominant genetic disorder and wonders how this will affect the fetus. Which response should the nurse make?
"There is a 50% chance your child could inherit your disorder." In autosomal dominant disorders, an affected parent has a 50% chance of having an affected child. Autosomal recessive disorders require both parents to be carriers. Although a parent may have a mild form of the disease, the child may have a more severe form. Autosomal dominant disorders can be passed down via females or males.
A pregnant patient reports having thick, white, cottage cheese-like vaginal discharge. Which statement should the nurse make?
"This is a common occurrence in pregnancy."
A pregnant patient is angry because her spouse does not seem to care about the pregnancy. Which statement should the nurse make?
"This is a normal feeling to experience in the second trimester."
A pregnant patient asks why maternal serum screening was scheduled. Which response should the nurse make?
"This test detects the risk for trisomy 21, trisomy 18, and open spina bifida."
The nurse is assessing a couple in the third trimester of pregnancy.
"We've just enrolled in a childbirth education class."
A pregnant patient at 8 weeks' gestation asks what the baby looks like. Which response should the nurse make?
"Your baby's digits are now forming."
A patient's pregnancy failed because the fertilized ovum did not implant in the uterus. Which explanation should the nurse provide?
"Your body was not creating enough progesterone." Progesterone is often called the "hormone of pregnancy" because it inhibits uterine contractions and relaxes smooth muscle, allowing a pregnancy to be maintained. A lack of estrogen, follicle-stimulating hormone, or luteinizing hormone would not affect the ability of the uterus to prepare for implantation of the fertilized ovum.
A couple whose fetus has Klinefelter syndrome asks questions about the disorder. Which statement should the nurse make?
"Your child is at risk for autism spectrum disorder."
A newly pregnant patient asks how the body keeps the fertilized egg safe and in place. Which response should the nurse make?
"Your egg secretes human chorionic gonadotropin, which helps ensure the egg stays implanted in the uterus."
A pregnant couple with one older child asks how a second child might change the family dynamic.
"Your older child may start showing signs of sibling rivalry, but you can take action to minimize the problem if you catch it early."
A patient at 16 weeks' gestation reports feeling large and comments that the placenta must be providing the growing baby a lot of nutrients. Which response should the nurse make?
"Actually, the exchange between the placenta and the fetus is minimal during the first 5 months." Exchange of substances across the placenta is minimal during the first 3 to 5 months of development because the villous membrane is initially too thick, which limits its permeability. As the villous membrane thins, the placental permeability increases until about the last month of pregnancy, when permeability begins to decrease as the placenta ages.
The nurse is assessing prenatal clients in the clinic. Which client should the nurse identify as exhibiting abnormal findings? A: 28 weeks' gestation, fundus three finger breadths above umbilicus B. 18 weeks' gestation, marked edema C. 12 weeks' gestation, with fetal heart tones heard by Doppler fetoscope D. 15 weeks' gestation, client reports no fetal movement
18 weeks' gestation, marked edema
The nurse is preparing teaching materials on the timing of conception. Which period of time should the nurse specify sperm remain fertile in the female reproductive tract?
24 hours
The nurse tells a pregnant patient that the baby's digits are currently forming. At which week of gestation should the nurse understand this growth occurs?
8 weeks' gestation
The nurse is teaching about maternal-placental-fetal circulation. At which time should the nurse clarify that circulation occurs?
About 17 days after conception
The nurse measures the vital signs of a 25-year-old primigravida at 20 weeks' gestation. Which finding should the nurse immediately report to the healthcare provider? (Select all that apply.) A.Temperature 37.4C (99.3F) B. Rhonchi in both lung bases C. Blood pressure 130/85 mmHg D. Pulse 85 beats/min E. Respiration 14 breaths/min
B. Rhonchi in both lung bases C. Blood pressure 130/85 mmHg
The healthcare provider performs a maneuver to detect the fetal outline of a pregnant patient.
Ballottement
The nurse is caring for a pregnant patient with hypothyroidism. Which should the nurse consider when planning this patient's care?
Blood pressure and urine protein will need to be monitored.
A pregnant client is suspected of having preeclampsia. Which clinical manifestation should confirm the suspicion? (Select all that apply.) A. Vaginal bleeding B. Nausea and vomiting C. Blurred vision D. Seizures E. Edema of hands or face
C. Blurred vision D. Seizures E. Edema of hands or face
The nurse is explaining the journey of sperm through the female reproductive tract to result in conception. Which sperm transformations should the nurse refer to during this explanation?
Capacitation and the acrosomal reaction
The healthcare provider reports that a pregnant client's cervix is bluish-purple in color. Which finding should the nurse document?
Chadwick sign
The nurse assesses a pregnant client's laboratory values. Which finding should the nurse expect? (Select all that apply.)
Increased erythrocyte volume. Decreased hemoglobin level Increased plasma volume
A pregnant woman is diagnosed with hyperemesis gravidarum. Which action should the nurse take?
Instruct to change positions slowly.
The nurse explains different types of chromosomal abnormalities to a couple undergoing genetic testing. Which information should the nurse provide about mosaicism? (Select all that apply).
It often involves the sex chromosomes. This is the correct answer. It happens when chromosomes improperly separate after fertilization. It results in two different cell lines with different chromosomal makeup.
While assessing a pregnant patient, the nurse notices a thick, white vaginal discharge that resembles the appearance of cottage cheese. For which health problem should the nurse plan care?
Moniliasis aka yeast infection
Piskacek's sign
enlargement of the uterus near the uterine tube over the site of implantation
ovarian cycle
follicular phase, ovulation, luteal phase
fetal circulation
oxygenated, nutrient-rich blood from placenta carried to fetus via umbilical vein → half enters Ductus venosus (allows blood to bypass the liver) →carried to inferior vena cava → RA → RV → Ductus arteriosus (conducts some blood from the pulmonary artery to the aorta [bypassing the lungs/fetal pulmonary circulation]) → aorta. Other half enters liver/portal vein → RA → Foramen ovale (allows blood to bypass pulmonary circulation by entering the left atria directly from the right atria since there is no gas exchange in fetal lung) → LA → LV → aorta. Illustrated here.
The nurse is teaching a pregnant patient about the fetal circulatory system. At which week of gestation should the nurse explain that the embryo's heartbeat is present?
week 4
A patient who had trophoblastic disease 16 months ago reports spotting. For which pregnancy test should the nurse prepare the patient?
β-subunit radioimmunoassay (RIA)
A pregnant couple whose fetus is diagnosed with Down syndrome asks about coping with a child who has a disability. Which response should the nurse make?
"I can connect you with a local Down syndrome support group in the community."
The nurse assesses a newly pregnant client. Which client statement should indicate normal psychosocial adjustment in the first trimester?
"I'm not really sure how I feel about this pregnancy."
The nurse counsels a pregnant couple who are carriers for Tay-Sachs disease. Which client statement should indicate an understanding of this disorder?
"Our baby has a 25% chance of developing Tay-Sachs disease."
A middle-aged couple looking to conceive is receiving genetic counseling. Which statement should the nurse make during the counseling? (Select all that apply.)
"Your baby would be at risk for a genetic defect." "You can be tested for genetic defects in the first trimester."
A pregnant patient reports having trouble sleeping due to a tingling sensation in the legs. Which action should the nurse take?
Obtain a prescription for a blood test.
The nurse teaches a pregnant client about fetal gas exchange. Which information should the nurse include? A: Gas exchange occurs in the lungs of the fetus. B. Oxygen and carbon dioxide gas exchange occurs through the placenta. C. Oxygen is exchanged through the placenta, whereas other gases are exchanged in the lungs. D. Oxygen is vital for the fetus and is exchanged through amniotic fluid.
Oxygen and carbon dioxide gas exchange occurs through the placenta.
A pregnant couple is identified as being at risk for a single gene disorder. For which diagnostic test should the nurse prepare the couple?
Preimplantation genetic diagnosis (PGD)
The nurse suspects that a patient early in a pregnancy is having difficulty adjusting to the thought of having a child. Which physical milestone should assist the patient with the binding-in process?
Quickening
A client in the first trimester of pregnancy states that the baby does not feel "real." Which action should the nurse take?
Show the client a picture of the ultrasound.
The nurse notes that a pregnant client has Ladin sign. Which physical finding should the nurse understand this sign indicates?
Soft spot in the middle of the uterus
A pregnant couple's toddler has started showing signs of sibling rivalry. Which recommendation should the nurse make?
Take constructive actions several weeks before the anticipated birth.
A newly pregnant client asks about the development of the baby's heart. Which response should the nurse make?
The baby's heart will be fully developed by 8 weeks."
A pregnant couple has enrolled in childbirth education classes. In which way should the nurse categorize this couple?
The couple is in their third trimester of pregnancy.
A patient at 21 weeks' gestation has a fundal height slightly below the umbilicus.
The fetus may not be growing enough.
A pregnant patient's immunizations are not current. Which immunization should the nurse refrain from administering at this time?
Varicella
A pregnant patient reports lying supine in bed at night. For which health problem should the nurse assess the patient?
Vena caval syndrome
The nurse notes that a pregnant patient had the Piskacek sign during the last prenatal examination. For which physical change should the nurse assess during this appointment?
A tumorlike, asymmetric enlargement of the uterus
A patient at 32 weeks' gestation reports feeling irregular contractions that are mostly painless. Which symptom should the nurse suspect the patient is experiencing?
Braxton Hicks
A pregnant patient is experiencing consistent nausea and vomiting. Which alternative therapy should the nurse encourage?
Drinking ginger tea
The nurse performs an assessment of a pregnant patient. Which physiologic change should indicate to the nurse that the pregnancy is normal? Edematous nasal mucosa Firm, pink cervix Varicose veins Supine hypertension
Edematous nasal mucosa
The nurse reviews the ultrasound video of a patient who is at 28 weeks' gestation. Which finding should the nurse expect?
Eyes open and close
The nurse is caring for several pregnant patients. For which patient should the nurse suspect genetic counseling will be indicated?
Family history of cystic fibrosis Cystic fibrosis is an example of a single-gene disorder for which prenatal diagnostic testing would be indicated. Prenatal diagnostic testing is not indicated for advanced paternal age or a history of hypothyroidism. Prenatal diagnostic testing is indicated for advanced maternal age, but this starts at age 35.
After an amniocentesis, a fetus is diagnosed with trisomy 13. Which information should the nurse prepare for the parents?
The need for long-term care should the baby live past expectations Most trisomy 13 babies die within the first three months, although 10% survive past the first year. Children with trisomy 21 (Down syndrome), Turner syndrome, and Klinefelter syndrome do not have as poor a life expectancy as trisomy 13.
The parents of a newborn with cystic fibrosis ask which one of them is responsible for passing down the disorder. Which response should the nurse make?
This disorder is inherited from both parents."
A couple trying to conceive is unsure if genetic disorders run in their families. Which information should the nurse request?
Three-generation pedigree
A newborn has a single palmar crease and low-set ears. For which chromosomal abnormality should the nurse prepare teaching for the parents?
Trisomy 21 A single palmar crease and low-set ears are characteristics of trisomy 21 (Down syndrome
A pregnant patient is experiencing preterm labor. Which health problem should the nurse consider as contributing to the patient's early labor?
Urinary tract infection
The nurse is auscultating the lower part of a pregnant patient's uterus. Which finding should the nurse expect?
Uterine souffle The uterine souffle, which is timed precisely with the mother's pulse and heard just above the mother's symphysis pubis (the fibrocartilaginous joint between the pelvic bones), is caused by the augmented blood flow entering the dilated uterine arteries.
