OB exam 1 practice questions

A client who gave birth vaginally 16 hours ago states she does not need to void at this time. The nurse reviews the documentation and finds that the client has not voided for 7 hours. Which response by the nurse is indicated? "I'll check on you in a few hours." "If you don't attempt to void, I'll need to catheterize you." "I'll contact your primary care provider." "It's not uncommon after birth for you to have a full bladder even though you can't sense the fullness."

"It's not uncommon after birth for you to have a full bladder even though you can't sense the fullness."

A client calls the nurse in a panic after a home pregnancy test indicates she is pregnant. She reports that that she consumed a lot of alcohol on the night that she thinks the pregnancy occurred. The next day she had taken several acetaminophen. For the past 3 weeks, she has had her usual nightly glass of wine with dinner but no other alcohol. What is an appropriate response for the nurse to make when the client questions if she has caused irreversible damage to the fetus? "Why did you have unprotected sex if you had been drinking? Exposure to alcohol can cause facial deformities, low birth weight, and underdeveloped brains." "The fetus is not exposed to the mother's blood until after it implants about 6 days after fertilization, so the first night is not an issue. But it is best to avoid alcohol while you are pregnant." "The wedding night is not an issue because the fetus is not exposed to the mother's blood at first, but I hope this last week of drinking has not caused any problems." "Alcohol is very damaging to the growing fetus, so you had better be sure to stop drinking. Do you need any support for that?"

"The fetus is not exposed to the mother's blood until after it implants about 6 days after fertilization, so the first night is not an issue. But it is best to avoid alcohol while you are pregnant."

The nurse is caring for a client who underwent a cesarean birth one day ago. After listening to the nurse's discussion about the plan of care, the client indicates that she is in a great deal of pain and does not wish to ambuate until the next day. What response by the nurse is most appropriate? "If you do not get up to walk you will not recover." "As long as you walk more tomorrow to make up for the delay in walking today you should be fine." "Walking is the best way to prevent complications such as blood clots." "Maybe you will feel better after you take pain medication."

"Walking is the best way to prevent complications such as blood clots."

A nurse is performing a vaginal examination of a woman in the early stages of labor. The woman has been at 2 cm dilated for the past 2 hours, but effacement has progressed steadily. Which statement by the nurse would best encourage the client regarding her progress? "You are still 2 cm dilated, but the cervix is thinning out nicely." "There has been no further dilatation; effacement is progressing." "You haven't dilated any further, but hang in there; it will happen eventually." Don't mention anything to the client yet; wait for further dilatation to occur.

"You are still 2 cm dilated, but the cervix is thinning out nicely."

A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station? +4 +2 0 -2

-2

A nurse is assessing the vital signs of a woman who delivered a healthy newborn vaginally 2 hours ago. Which temperature reading would lead the nurse to notify the health care provider? 97.5°F (36.9°C) 100.1°F (37.8°C) 100.8°F (38.2°C) 99.2°F (37.3°C)

100.8°F (38.2°C)

Which finding would the nurse describe as "light" or "small" lochia? 4-inch stain or a 10 to 25 ml loss pad is saturated within 1 hour after changing it 1- to 2-inch lochia stain on the perineal pad or a 10 ml loss 4- to 6-inch stain with an estimated loss of 25 to 50 ml

4-inch stain or a 10 to 25 ml loss

On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily? 1,000 additional calories per day 750 additional calories per day 500 additional calories per day 250 additional calories per day

500 additional calories per day

A client asks the nurse about cervical mucus changes that occur during the menstrual cycle. Which statement should the nurse expect to include in the client's teaching plan? Cervical mucus disappears immediately after ovulation, resuming with menses. About midway through the menstrual cycle, cervical mucus is clear and sticky. During ovulation, the cervix remains dry with scant mucus secretion. As ovulation approaches, cervical mucus is abundant and stretchable.

As ovulation approaches, cervical mucus is abundant and stretchable.

The nurse is preparing to administer the vitamin K injection to a newborn. Which action would be correct for this client? A. Using a 21-gauge needle B. Injecting 1cc of medication C. Injecting the medication into the vastus lateralis D. Injecting at a 45-degree angle

C

A mother is postpartum 2 hours after a cesarean birth with epidural anesthesia. The nurse notes the urine output in the Foley bedside drainage bag is 50 mL. What should the nurse do first? Increase IV fluids. Check the catheter tubing for kinks or obstruction. Remove the catheter and get the mother up to bathroom. Call the obstetric provider.

Check the catheter tubing for kinks or obstruction.

A nulliparous client at 37 weeks gestation calls the labor and delivery unit to report she thinks she is in labor. The nurse predicts she is in true labor based on which answer to her assessment questions? Contractions, irregular, lasting 15 to 20 seconds Bloody mucus in the toilet once earlier in the day Contraction, regular and lasting longer and stronger Scant amount of thick, white vaginal discharge, no odor

Contraction, regular and lasting longer and stronger

A postpartum client is having difficulty stopping her urine stream. Which should the nurse do next? Educate the client on how to perform Kegel exercises. Determine if the client is emptying her bladder. Perform an in and out catheter on the client. Ask the client when she last urinated.

Educate the client on how to perform Kegel exercises.

The nurse is assessing a pregnant client at 37 weeks' gestation and notes the fetus is at zero station. When questioned by the client as to what has happened, the nurse should point out which event has occurred? Flexion Engagement Extension Expulsion

Engagement

While assessing the progress of the labor, the nurse explains that the fetal heart rate variability is moderate. Which explanation is best to use with the parents? FHR fluctuates from 6 to 25 beats per minute. FHR fluctuation range is undetectable. FHR fluctuates less than 5 beats per minute. FHR fluctuates over 25 beats per minute.

FHR fluctuates from 6 to 25 beats per minute.

A nurse is caring for a client who is in labor. For which fetal response should the nurse monitor? Fetal presentation Fetal attitude Fetal position Fetal lie

Fetal lie

A nurse is assessing a woman during the first 24 hours after birth. Which assessment finding would the nurse determine as acceptable during this time? Select all that apply. Inverted nipples following breastfeeding Hypotonic bowel sounds Urination of 100 mL every 4 hours Moderate saturation of peripad every 3 hours Fundus one fingerbreadth below the umbilicus

Fundus one fingerbreadth below the umbilicus Moderate saturation of peripad every 3 hours

Which type of anesthesia is anticipated when the delivery of the fetus must be done quickly due to an emergency situation? General Regional Local Short acting

General

Which nursing action is a priority when the fetus is at the +4 station? Have a blue bulb suction and an infant warmer ready Have a tocometer and a patient gown ready Provide lubricating jelly and an internal monitor Prepare for an immediate cesarean section

Have a blue bulb suction and an infant warmer ready

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention? Help the woman change positions. Prepare the woman for an emergency cesarean birth. Obtain assistance to check for a compressed umbilical cord. Document the finding.

Help the woman change positions.

When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after birth of the infant. What should the nurse do? Nothing. Normal time for stage three is 5 to 30 minutes. Notify the primary care provider of the problem. Increase the IV tocolytic to help in expulsion of the placenta. Do a vaginal exam to see if the placenta is stuck in the birth canal.

Nothing. Normal time for stage three is 5-30 minutes

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? Pain is focal in nature. Pain originates from the cervix and lower uterine segment. Diffuse abdominal pain signals a complication with progression of labor. It is reported as the worst pain a woman will ever feel.

Pain originates from the cervix and lower uterine segment.

A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritize at this stage? Administering a sedative such as secobarbital or pentobarbital Practicing effleurage on the abdomen Immersing the client in warm water in a pool or hot tub Administering an opioid such as meperidine or fentanyl

Practicing effleurage on the abdomen

A nurse is coaching a woman during the second stage of labor. Which action should the nurse encourage the client to do at this time? Push with contractions and rest between them. Hold the breath while pushing during contractions. Begin pushing as soon as the cervix has dilated to 8 cm. Pant while pushing.

Push with contractions and rest between them.

The nurse is assessing the blood pressure of a pregnant client on a routine prenatal visit. This nurse is employing which level of prevention for this client? Primary Secondary Tertiary Not considered prevention

Secondary

A mother tells the nurse that she has been reading a book that says that newborns need stimulation to develop properly and asks what she can do to help her infant. Which tip would not be helpful to the mother?

Swaddling the infant

What assessment finding would suggest to the care team that the pregnant client has completed the first stage of labor? The client's cervix is fully dilated. The infant is born. The client has contractions once every two minutes. The client experiences her first full contraction.

The cervix is fully dilated

A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? The contraction pains are 2 minutes apart and 1 minute in duration. The client reports back pain, and the cervix is effacing and dilating. The contraction pains have been present for 5 hours, and the patterns are regular. After walking for an hour, the contractions have not fully subsided.

The client reports back pain, and the cervix is effacing and dilating.

The emergency nurse is providing care for a pregnant woman admitted with a broken femur, blackened eye, and multiple contusions. She admits her partner is abusive. Which activity would be considered at the tertiary level of prevention? The nurse discusses with the client how to avoid her partner's triggers. The nurse asks the client to enroll in a self defense class. The nurse contacts the crisis social worker for assistance. The nurse refers the client for an orthopedic assessment.

The nurse contacts the crisis social worker for assistance.

A first-time mother informs the nurse that she is unable to breastfeed her newborn through the day as she is usually away at work. She adds that she wants to express her breast milk and store it for her newborn to have later. What instruction would be correct to offer the mother to ensure the safety of the stored expressed breast milk?

Use the sealed and chilled milk within 24 hours.

A client with hypertension tells her nurse that she would like to use an herbal substance (CAM) to lower her blood pressure instead of taking the antihypertensive medication. The nurse should: tell the client that if she uses the herbal substance, she will need to check her blood pressure daily. advise the client to speak with her primary care provider about combining herbal substances with her medication. show the client how to take her blood pressure so she can monitor it closely. tell the client that she should never use herbal substances because they are dangerous.

advise the client to speak with her primary care provider about combining herbal substances with her medication.

A nurse finds the uterus of a postpartum woman to be boggy and somewhat relaxed. This a sign of which condition? infection atony normal involution hemorrhage

atony

The nurse determines that the fetal heart rate averages approximately 140 beats per minute over a 10-minute period. The nurse identifies this as: fetal bradycardia. baseline variability. short-term variability. baseline FHR.

baseline FHR

A nurse is caring for a client who is in labor. For which fetal response should the nurse monitor? decrease in arterial carbon dioxide pressure increase in fetal breathing movements increase in fetal oxygen pressure decrease in circulation and perfusion to the fetus

decrease in circulation and perfusion to the fetus

A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which sign marks the termination of the first stage of labor in the client? diffuse abdominal cramping rupturing of fetal membranes start of regular contractions dilation of cervix diameter to 10 cm

dilation of cervix diameter to 10 cm

Elevation of a client's temperature is a crucial first sign of infection. However, when is elevated temperature not a warning sign of impending infection? after any period of decreased intake when the elevated temperature exceeds 100.4° F (38° C) during the first 24 hours after birth owing to dehydration from exertion when the white blood cell count is less than 10,000/mm³

during the first 24 hours after birth owing to dehydration from exertion

Which nursing intervention is appropriate for prevention of a urinary tract infection (UTI) in the postpartum woman? screening for bacteriuria in the urine increasing oral fluid intake encouraging the woman to empty her bladder completely every 2 to 4 hours increasing intravenous fluids

encouraging the woman to empty her bladder completely every 2 to 4 hours

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? fetal baseline rate increasing at least 5 mm Hg with contractions a shallow deceleration occurring with the beginning of contractions variable decelerations, too unpredictable to count fetal heart rate declining late with contractions and remaining depressed

fetal heart rate declining late with contractions and remaining depressed

The nurse is determining how often contractions occur measuring from the beginning of the one contraction to the beginning of the next contraction. The nurse documents this finding as: duration. intensity. frequency. peak.

frequency

The nurse measures a newborn's temperature immediately after birth and finds it to be 99°F (37.2°C). An hour later, it has dropped several degrees. The nurse understands that this heat loss can be explained in part by which factor in the newborn? lack of subcutaneous fat continual kicking continual crying constriction of blood vessels

lack of subcutaneous fat

Two days ago, a woman gave birth to her third infant; she is now preparing for discharge home. After the birth of her second child, she developed an endometrial infection. Nursing goals for this discharge include all of the following except: discuss methods that the woman will use to prevent infection. the client will show no signs of infection. list signs of infection that she will report to her health care provider. maintain previous household routines to prevent infection.

maintain previous household routines to prevent infection.

The nurse is observing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus? below the symphysis pubis one fingerbreadth above the umbilicus one fingerbreadth below the umbilicus at the level of the umbilicus

one fingerbreadth below the umbilicus

A client is trying to have a baby and wants to know the best time to have intercourse to increase the chances of pregnancy. Which time for intercourse is ideal to help her chances of conceiving? a week after ovulation any time after ovulation one or two days before ovulation any time during the week before ovulation

one or two days before ovulation

When palpating for fundal height on a postpartal woman, which technique is preferable? placing one hand at the base of the uterus, one on the fundus palpating the fundus with only fingertip pressure resting both hands on the fundus placing one hand on the fundus, one on the perineum

placing one hand at the base of the uterus, one on the fundus

A client gave birth 2 days ago and is preparing for discharge. The nurse assesses respirations to be 26 rpm and labored, and the client was short of breath ambulating from the bathroom this morning. Lung sounds are clear. The nurse alerts the primary care provider and the nurse-midwife to her concern that the client may be experiencing: thrombophlebitis. pulmonary embolism. upper respiratory infection. mitral valve collapse.

pulmonary embolism

The nurse is preparing to apply a thermistor probe to a newborn to monitor the newborn's temperature. At which location would the nurse apply the probe? lower back right upper abdominal quadrant upper left arm right great toe

right upper abdominal quadrant

The mother of a formula-fed newborn asks how she will know if her newborn is receiving enough formula during feedings. Which response by the nurse is correct?

"A sign of good nutrition is when your newborn seems satisfied and is gaining sufficient weight."

A pregnant woman experiencing morning sickness has asked her nurse about ways to reduce or alleviate it. After receiving education and information from the nurse, which statement would indicate that the client understood the information? "I'll just drink less ginger tea than I used to." "I really don't think there's anything wrong with taking a few vitamins." "I'll discuss with my primary care provider whether it is a good idea for me to use sea-bands." "My mother told me that she took vitamins to reduce the sickness and there wasn't a problem."

"I'll discuss with my primary care provider whether it is a good idea for me to use sea-bands."

A student observes during an initial prenatal visit. The student states, "I heard the primary care provider say that the client has a gynecoid pelvis. What does that mean?" The best response by the nurse is: "It is a typical male pelvis. With this type of pelvis, large neonates must be born by cesarean birth although some small neonates are able to be born vaginally." "It is flat and narrow, making it extremely difficult for the neonate to pass through." "It is rounded in shape and allows ample room for the neonate to fit through the passageway." "It is elongated, the width is roomy, but the length is narrow."

"It is rounded in shape and allows ample room for the neonate to fit through the passageway."

When completing the morning postpartum data collection, the nurse notices the client's perineal pad is completely saturated. Which action should be the nurse's first response? Vigorously massage the fundus. Immediately call the primary care provider. Ask the client when she last changed her perineal pad. Have the charge nurse review the assessment.

Ask the client when she last changed her perineal pad.

A G1 P1001 mother is just home after giving birth to her first child 5 days ago. Her birth was complicated by an emergency cesarean birth resulting from incomplete cervical dilation and hemorrhage. The nurse determines that the mother has not slept longer than 3 hours at one time. The appropriate nursing diagnosis for this client care issue is: At risk for interruption of tissue integrity. At risk for inadequate healing due to decreased nutrition. At risk for safety due to low hemoglobin. At risk for postpartum depression due to inadequate rest.

At risk for postpartum depression due to inadequate rest.

Which statement best expresses the role of the corpus luteum? The corpus luteum promotes the increased production of estrogen before ovulation. The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. During the luteal phase, the corpus luteum secretes glycogen. Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum.

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation.

A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out? The end of the second trimester The end of the first trimester The end of the third trimester The end of the fourth trimester

The end of the third trimester

A pregnant client arrives to the clinic for a prenatal visit appearing uncomfortable. During the assessment, the nurse determines the client is experiencing fairly strong contractions at 12:05 p.m., 12:10 p.m., 12:15 p.m., and 12:20 p.m. What can the nurse conclude from these findings? The client is in active labor. The duration of the contractions is every 5 minutes. The frequency of the contractions is every 5 minutes. The client can be sent home.

The frequency of the contractions is every 5 minutes.

A nurse has moved into a new community and will begin practicing at the local health department. Why is it important for this nurse to become familiar with the community where the nurse will work? It is not necessary for the nurse to become familiar with the community prior to treating the individuals there. The workplace may implement alternate methods of treatment than the ones the nurse is used to employing. The nurse may not like it and choose to move before settling too deeply in the community. The health of a community influences the health of its individuals.

The health of a community influences the health of its individuals.

It is important that nurses include a discussion about teratogens in their prenatal discussions to help prevent deformities or abnormalities. Whcih substances would the nurse include as teratogens? Select all that apply. alcohol certain medications caustic chemicals multivitamin supplement

alcohol, certain medications, caustic chemicals

A client who is 12 hours postbirth is reporting perineal pain. After the assessment reveals no signs of an infection, which measure could the nurse offer the client? a heating pad applied to the perineum a sitz bath an ice pack applied to the perineum narcotic pain medication

an ice pack applied to the perineum

A new mother tells the nurse at the baby's 3 month check-up, "When she cries, it seems like I am the only one who can calm her down." This is an example of which behavior? bonding attachment being spoiled none of the above

attachment