OB Module 5 Questions

A nurse is caring for an infant born with an elevated bilirubin level. When planning the infant's care, what interventions will assist in reducing the bilirubin level? Select all that apply. 1. Offer early feedings. 2. Increase the infant's hydration. 3. Administer vitamin supplements. 4. Initiate phototherapy. 5. Stop breastfeeding until jaundice resolves.

1, 2, 4

When providing care for a newborn to a mother who was a smoker during her pregnancy, the nurse will anticipate the size of the infant to be what? 1. Larger than average 2. Average 3. Smaller than average

3

A woman is going to have in vitro fertilization. When preparing her for this, the nurse would make which statement? 1. "Most procedures are effective the first time tried." 2. "You will need to select a surrogate mother." 3. "This is dangerous if there is ovarian cancer in your family." 4. "It can be done with frozen donor sperm."

4

A young newly married woman comes to the clinic and asks about ways to prevent pregnancy. When the nurse begins to talk about oral contraceptives, the client says that her religion does not allow oral contraceptives. What can the nurse recommend for this client? 1. Condoms 2. intrauterine device (IUD) 3. Transdermal patch 4. Rhythm method

4

The nurse is caring for a client who reports that they missed taking their oral contraceptive pill (OCP) yesterday. Which instruction would the nurse provide? 1. "You should stop taking the pills for this cycle and start a new pack next month." 2. "You should discard the missed pill and continue with your regular schedule." 3. "You should discontinue the birth control and use condoms for the rest of this month." 4. "You should take the missed tablet as soon as possible."

4

Which condition of delivery would predispose a neonate to respiratory distress syndrome (RDS)? 1. Postdate pregnancy 2. First born of twins 3. Vaginal delivery 4. Premature birth

4

A term neonate is admitted to the neonatal intensive care unit. At birth, thick green amniotic fluid was noted. Which action is the priority? 1. Use vigorous orogastric suctioning. 2. Apply continuous positive airway pressure. 3. Apply oxygen after vigorous suctioning. 4. Vigorously suction the nares. 5. Continue assessment and evaluation for respiratory distress.

5

A nurse is reviewing the medical record of a client requesting oral contraceptive pills (OCPs). Which information, if found on the client's medical record, would alert the nurse to a possible contraindication for OCPs? Select all that apply. 1. History of a deep vein thrombosis 2. Prescription for sertraline 50 mg daily 3. Currently 31 years of age 4. History of migraine headaches with an aura 5. Diagnosed with hypertension

1, 4, 5

A nurse is counseling women on birth control choices. Which woman is the best candidate for an IUD? 1. a woman who has a history of PID 2. a woman who is in her early twenties and wants children later in life 3. a woman who has multiple sex partners 4. a woman who has one partner and three children

4

A nurse observes in a preterm newborn a respiratory rate of 60, nasal flaring, and retractions. What do these clinical manifestations indicate to the nurse? 1. Respiratory distress syndrome 2. Polycythemia 3. Rh incompatibility 4. Neonatal jaundice

1

Which description best explains the hysterosalpingogram procedure? 1. radiograph of the uterus and fallopian tubes following introduction of a radiopaque medium through the cervix 2. passage of an endoscope through a small abdominal incision to inspect the reproductive organs 3. insertion of an endoscope through the posterior fornix to visualize the reproductive organs 4. instillation of carbon dioxide through the cervix into the uterus and fallopian tubes

1

Why is fertility testing initiated with sperm analysis of the male partner? 1. Sperm analysis is one of the easiest tests to complete. 2. The man is found to be fertile in over 75% of couples with subfertility problems. 3. Asking the male partner to undergo diagnostic procedures is the best way to assess his interest in treatment of subfertility. 4. Male fertility testing is time-consuming and, therefore, should be initiated early.

1

The nurse is providing care to a neonate whose mother has heroin use disorder. The nurse suspects that the neonate is experiencing neonatal abstinence syndrome based on which finding? 1. Sneezing 2. Hypotonicity 3. Vigorous Sucking 4. Easy consolability

1 Newborns of mothers with heroin or other opioid use disorder display irritability, hypertonicity, a high-pitched cry, vomiting, diarrhea, respiratory distress, disturbed sleeping, sneezing, diaphoresis, fever, poor sucking, tremors, and seizures.

A nurse is preparing a class for a group of young adult women about emergency contraceptives (ECs). What information would the nurse need to stress to the group? Select all that apply. 1. ECs are not to be used in place of regular birth control. 2. ECs provide little protection for future pregnancies. 3. ECs are birth control pills in higher, more frequent doses. 4. ECs provide some protection against STIs. 5. ECs induce an abortion-like reaction.

1, 2, 3

The nurse is caring for clients who are experiencing subfertility. When providing instruction on how to aid conception, which instruction will the nurse include in the teaching session? Select all that apply. 1. The woman should remain on her back with knees drawn up after sex. 2. The woman's basal body temperature identifies the onset of menses. 3. The woman should elevate her hips on a pillow during sex. 4. Use lubricants to increase the interest and pleasure of sex. 5. The couple should have sex 5 to 6 times per week until pregnancy occurs.

1, 3

Newborn is small for gestational age and developed a rapid respiratory rate 10 min after birth. Rales present per auscultation. HCP notified. The nurse in the newborn nursery documents the client's information (above). Which diagnostic testing(s) should the nurse anticipate to determine if the newborn is experiencing meconium aspiration syndrome (MAS)? Select all that apply. 1. Pulse ox 2. Complete blood count 3. Arterial blood gas analysis 4. Echocardiogram 5. Chest x-ray

1, 3, 5

The nurse should carefully monitor which neonate for hyperbilirubinemia? 1. Neonate of an Rh-positive mother 2. Neonate with ABO incompatibility 3. Neonate with Apgar scores 9 and 10 at 1 and 5 minutes 4. Neonate of African descent

2 The mother's blood type, which is different from the neonate's, has an impact on the neonate's bilirubin level due to the antigen antibody reaction.

The nurse is assessing a newborn diagnosed with meconium aspiration. Which of the following would the nurse expect to assess? Select all that apply. 1. Respirations of 45 breaths/min 2. Increased anteroposterior chest diameter 3. Intercostal and substernal retractions 4. Tachycardia 5. Pink skin

2, 3

A male client is being evaluated for subinfertility. What additional data should a nurse obtain? 1. testosterone, Rh factor, blood type, UA 2. HIV status, testosterone, HCG, cholesterol 3. blood type, thyroid function, HCG, CBC 4. testosterone, HIV status, CBC, sonogram

1

A nurse is teaching a couple who has chosen condoms as their means of contraception. The nurse determines that the teaching was successful when the couple makes which statements? Select all that apply. 1. "We will use a new condom each time we have sexual intercourse." 2. "We'll keep the condom in its wrapper until we're ready to use it." 3. "The condom should fit tightly from the tip to the end." 4. "We should remove the condom after intercourse once the penis is no longer erect." 5. "The penis needs to be erect before putting on the condom."

1, 2, 5

A nurse is providing medication education to an adolescent who is being prescribed an oral contraceptive pill (OCP). Which side effect(s) is important for the nurse to discuss with this client? Select all that apply. 1. nausea 2. weight gain 3. depression 4. breakthrough bleeding 5. breast tenderness

2, 4, 5

28 yo, G2P2, here for routine pap test, requesting info on contraceptive options. Hx of migraine headaches wiht occlusion aura approx every 2 months and DVT after last pregnancy (treated w/out further complications). vaccines up to date. has reg menses cycles, w/ no abnormalities. The nurse cares for a client who desires to use a hormone-based contraception and notes assessment data in the chart (above). Which type(s) of contraception will the nurse identify as acceptable for use by this client? Select all that apply. 1. progestin-only pill (mini-pill) 2. transdermal patch 3. oral contraceptive pills (OCPs) 4. vaginal estrogen/progestin (contraceptive) ring 5. depot medroxyprogesterone acetate

1, 5

A 32-year-old male client comes to the clinic for a refill of the antihypertensive medication atenolol. The client tells the nurse that since taking the medication, they have had difficulty maintaining an erection. Which follow-up question is most important? 1. When is your next health care provider appointment? 2. Do you take the medication as prescribed? 3. How long have you taken this medication? 4. What time of day do you take the medication?

2

Newborns born to a mother with diabetes are at risk for which of the following? 1. Hypoglycemia, polycythemia, respiratory distress, and hyperviscosity of the blood 2. Hypoglycemia, delayed fetal lung maturity, respiratory distress, and shoulder dystocia 3. Hyperglycemia, intrauterine hypoxia, hemolytic disease of the newborn, and hyperviscosity of the blood 4. Hyperglycemia, meconium aspiration syndrome, cerebral ischemia, and polycythemia

2

The nurse is educating a client who recently had the etonogestrel contraceptive implant inserted. Which statement made by the client indicates a correct understanding of the teaching? 1. "The implant will protect me against sexually transmitted infections." 2. "I may experience random bleeding while I have this implant." 3. "I will need to have the implant replaced every year." 4. "I should expect a regular menstrual cycle while using the implant."

2

The nurse is performing the initial assessment of a client who has just arrived in active labor. What will the nurse do to assist the client once they inform the nurse they plan to put the newborn up for adoption? 1. Ensure the client has a clear understanding of the possible consequences. 2. Keep the client informed of their rights and options and support their decision. 3. Find out who the adoptive parents are and notify them of the pending birth. 4. Remove the newborn from the room as soon as they are born.

2

The nurse is reviewing with a new client the diagnosis of polycystic ovary syndrome (PCOS). Which long-term health problems would the nurse review as a risk with this syndrome? 1. Cellulitis 2. Type 2 diabetes 3. Migraine 4. Celiac Disease

2

When developing a teaching plan for a couple who are considering contraception options, the nurse would include which statement? 1. "You should select one that is considered to be 100% effective." 2. "The best contraceptive is one that you will use correctly and consistently." 3. "The best one is the one that is the least expensive and most convenient." 4. "A good contraceptive doesn't require a primary care provider's prescription."

2

Which information is important for a woman to understand before undergoing a scheduled tubal ligation? 1. She should schedule it to be done just before a menstrual flow. 2. She must think of the procedure as irreversible. 3. The procedure will reduce her menstrual flow in amount. 4. She will have lessened dysmenorrhea following the procedure.

2

Which respiratory disorder in a neonate is usually mild and runs a self-limited course? 1. Persistent pulmonary hypertension 2. Transient tachypnea of the newborn 3. Pneumonia 4. Meconium aspiration syndrome

2

What would the nurse suspect in a premature newborn who has difficulty feeding and maintaining a stable temperature and is vomiting bile? 1. Respiratory distress syndrome 2. Necrotizing enterocolitis 3. Intraventricular hemorrhage 4. Meconium aspiration syndrome

2 Necrotizing enterocolitis is a disease that is characterized by inflammation in the bowels. It is generally idiopathic and results in difficulty feeding and maintaining thermoregulation, as well as vomiting of bile.

A nurse is preparing a presentation for a local community group about menopause. When describing the body system changes that occur, the nurse would include which changes? Select all that apply. 1. Decreased waist size 2. Decreased bone density 3. Moist, supple skin 4. Increased abdominal fat 5. Vaginal dryness 6. Hot flashes

2, 4, 5, 6

A nurse is collecting assessment data on a new client. The client states that she does not have menses. What term will the nurse use in her documentation to describe the absence of menstrual flow? 1. Dysmenorrhea 2. Menorrhagia 3. Amenorrhea 4. Metororrhagia

3

A woman and her partner have been unable to conceive. The female client's chart reveals a history of pelvic inflammatory disease (PID), oral contraceptive usage for 5 years, blood pressure 98/72 mm Hg, pulse 78 beats/min, temperature 99°F (37.2°C), and white blood cell (WBC) count 9,500 mm3 (9.5 x 109/l). Which order will the nurse anticipate for this client? 1. serum estrogen and progesterone testing 2. oral antibiotic therapy 3. hysterosalpingography 4. urinalysis

3

A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation? 1. the rhythm (calendar) method 2. an ovulation suppressant 3. a diaphragm and spermicide 4. a spermicidal suppository

3

A woman visits the family planning clinic to request a prescription for birth control pills. Which factor would indicate that an ovulation suppressant would not be the best contraceptive method for her? 1. She is 30 years old. 2. She has a history of allergy to foreign protein. 3. She has a family history of thromboembolism. 4. She has irregular menstrual cycles.

3

When using the contraceptive patch, a client should understand that it: 1. is immediately effective after application. 2. should be covered when swimming in a pool because of chlorine's effect on the adhesive. 3. should be applied to the abdomen, buttocks, or back. 4. should be applied to the breasts, hips, or back.

3

Which intervention is helpful for the neonate experiencing drug withdrawal? 1. Withhold all medication to help the liver metabolize drugs. 2. Place the isolette near the nurses' station for frequent contact with health care workers. 3. Place the isolette in a quiet area of the nursery. 4. Dress the neonate in loose clothing so the infant will not feel restricted.

3

A client is scheduling a date for an intrauterine insemination after 18 months of being unable to conceive with her spouse. The nurse evaluates that the client understands the procedure when the client notes which action(s) as important in preparing for this procedure? Select all that apply. 1. douching just prior to the procedure 2. taking progesterone 3. assessing cervical mucus 4. recording basal body temperature (BBT) 5. using an ovulation predictor kit

3, 4, 5

A nurse is preparing a class for a group of women at a family planning clinic about contraceptives. When describing the health benefits of oral contraceptives, which benefits would the nurse include? Select all that apply. 1. decreased risk for depression 2. reduced risk for migraine headaches 3. improvement in acne 4. protection against pelvic inflammatory disease 5. reduced risk for endometrial cancer

3, 4, 5

A 35-year-old client comes to the clinic reporting pelvic pain and vaginal bleeding after sexual intercourse for the past few months. The client has a history of human papillomavirus (HPV). Laboratory values: hemoglobin 9 g/dl (90 g/l) and hematocrit 30% (0.30). Vital signs: temperature, 97.2°F (36.2°C); heart rate, 105 beats/min; blood pressure, 92/55 mm Hg. The nurse suspects the client is at highest risk for developing 1. spontaneous abortion (miscarriage) 2. ovarian cancer 3. cervical cancer as evidenced by 4. lab values 5. history of HPV 6. vital signs AND 7. Pelvic pain 8. age of the client 9. bleeding after intercourse

3, 5, 8

A 67-year-old client comes into the clinic and reports to the nurse that they have started their periods again after 15 years of menopause. After discussing the situation with the client, the nurse recognizes that their symptoms are suspicious for: 1. Vaginal cancer 2. Cervical cancer 3. Ovarian cancer 4. Endometrial cancer

4

A nurse is talking to an adolescent who informs the nurse about being sexually active and wanting some type of birth control. Which option should the nurse recommend to this client? 1. female condom 2. male condom 3. intrauterine devices 4. oral contraceptive pills (OCPs)

4

A preterm newborn has developed necrotizing enterocolitis (NEC). Which of the following gastrointestinal (GI) characteristics would the nurse explain as predisposing a preterm newborn to NEC? 1. Enhanced gut motility 2. Strong esophageal sphincter tone 3. Faster gastric emptying 4. Diminished gastric enzymes

4

Assessment of a client reveals evidence of a cystocele. The nurse interprets this as: 1. Protrusion of intenstinal wall into the vagina 2. Herniation of the rectum into the vagina 3. Downward displacement of the cervix 4. Bulging of the bladder into the vagina

4

The nurse is meeting with a young couple who have undergone the initial screenings for infertility. The man is questioning the possibility of using intrauterine (artificial) insemination if he is found to be infertile. Which response should the nurse prioritize? 1. "You and your sexual partner should consider embryo transfer first because it is safer." 2. "Intrauterine (artificial) insemination is useful only if your sexual partner has an allergy to your sperm, not if you are infertile." 3. "Intrauterine (artificial) insemination is a possibility but there is the increased chance of twins." 4. "Intrauterine (artificial) insemination is your best option if you are found to be infertile."

4

Which nursing action is most important when caring for a sexually active female client requesting contraceptive education? 1. getting a detailed sexual history from the client 2. testing the client for the presence of sexually transmitted infections 3. teaching the client how to apply both a male and female condom 4. obtaining a urine specimen to determine if the client is currently pregnant

4

The nurse is caring for a 2-day-old newborn whose mother was diagnosed with cytomegalovirus during the first trimester. On which health care provider prescription should the nurse place the priority? 1. Assess pulse rate. 2. Obtain a urine specimen. 3. Monitor growth and development. 4. Perform a hearing screen test.

4 Symptoms of CMV in the fetus and newborn, known as CMV inclusion disease, include hepatomegaly, thrombocytopenia, IUGR, jaundice, microcephaly, hearing loss, chorioretinitis, and intellectual disability. A hearing screen would be priority over monitoring growth and development because that will have to be done over an extended period of time.