OB exam 1 Practice questions OB Exam 1 Questions OB EXAM1 review Questions and Answers tog, Exams of Nursing

Download OB exam 1 Practice questions OB Exam 1 Questions OB EXAM1 review Questions and Answers tog and more Exams Nursing in PDF only on Docsity! OB exam 1 Practice questions OB Exam 1 Questions OB EXAM1 review Questions and Answers together with Rationale ( Latest Updated 2024/2025 A 22 yr old client has come to the clinic because her menstrual period is 10 days late. She tells the nurse "I'm sure I'm pregnant because my period is late and my breasts are tender" Which of the following responses by the nurse would be most accurate? A. "those are positive signs of pregnancy" B. "those are presumptive signs of pregnancy" C. "those are probable signs of pregnancy" D. "those are negative signs of pregnancy" - Correct Answer B. Breast tenderness and missed menses are presumptive signs. Other presumptive signs include: N/V, fatigue, urinary frequency and quickening A client delivered a term infant 7 hours ago. Which of the following postpartum assessment findings indicate normal postpartum progression? A. Firm fundus at 1-2 fingerbreadths above the umbilicus with moderate lochia rubra B. Firm fundus at the umbilicus and midline with moderate rubra C. Firm fundus at 1-2 fingerbreadths below umbilicus, deviated to the right side with moderate lochia rubra D. Soft fundus at 1-2 fingerbreadths below umbilicus with severe lochia rubra - Correct AnswerA. Within 12 hours, fundus can rise to approx. 1 cm above the umbilicus. The fundus descends 1-2 cm every 24 hours. Located about halfway between umbilicus and symphysis pubis, not longer palpable after 2 weeks, returned to pre-pregnant state by 6 weeks pp A client delivered at 39 weeks 6 hours ago. Upon assessment, the nurse palpated a soft, boggy fundus deviated to the left side. Which action of the nurse would be most appropriate? A. Massage the fundus until firm B. Call HCP immediately C. Assist woman to the restroom D. Increase Pitocin per HCP order - Correct AnswerC. A distended bladder can impede uterine contractions which can lead to uterine atony which may lead to pp hemorrhage if we don't intervene **KEY WORDS: deviated to the left side** A client is in active labor at term with cervical findings of 7/80/-1. The FHR baseline is 130bpm. Four early decelerations were noted within the last hour. Which of the following nursing actions would be most appropriate? A. Position client on her back so the monitor gives more accurate results B. perform vaginal exam C. turn client on her left side D. document and continue to monitor both FHR and laboring women - Correct AnswerD. early decelerations indicate head compression. It is benign and no interventions are needed. just document and continue monitoring **KNOW VEAL CHOP** The nurse gives a 35 yr old primigravida client a RhoGAM injection for her 28th week of pregnancy. Which of the following client situations requires the nurse to take this action. A. Rh + mother and Rh - father B. Rh - mother and Rh + father C. Rh + mother and Rh + father D. Rh - mother and Rh - father - Correct AnswerB. RhoGAM is only needed if the mother is Rh- and there is possibility of the baby being Rh+. If the father is not Rh+ then there is no chance to have a Rh+ baby A client has just started the third state of labor. Which of the following nursing actions have priority at this time? A. Encourage the client to push B. Administer Pitocin C. Place baby skin to skin on mom D. Assess maternal vital signs Q1hr - Correct AnswerC. skin to skin contact is contributes to mother and baby bonding **KEY WORDS: just started** pitocin is administered after the placenta is delivered at the end of stage 3, maternal vital signs are assessed Q15min after delivery for first 2 hours. Then hourly assessments are done A client's first day of her LMP was July 18, 2015. Which of the following should the nurse tell the client is her EDB? A. April 18, 2016 B. May 23, 2016 C. April 25, 2016 D. March 25, 2016 - Correct AnswerC. A primigravida woman delivered her baby boy 12 hours ago. She acquired a 3rd degree midline episiotomy during labor. She expresses moderate discomfort and a pain level of 2 out of 10. Which of the following nursing intervention would be most appropriate? A. Instruct patient to apply ice packs to the perinium B. Encourage a sitz bath G? P? - Correct AnswerG1 P1 How should the nurse interpret the fundal ht measurement of a woman at 35 wks gestation a. 33 cm b. 28 cm c. 39 cm - Correct Answera. normal finding b. may indicate intra-uterine growth restriction (IUGR) c. multifetus or macrofetus According to the CDC, women should start taking folic acid supplements... A. when they become pregnant B. when they plan to become pregnant C. When they reach childbearing age D. Only if their diet does not provide adequate amounts - Correct AnswerC. A nurse is caring for a client who is pregnant and states that her LMP was April 1, 2013. Which of the following is the client's estimated date of delivery? A. Jan 8, 2014 B. Jan 15, 2014 C. Feb 8, 2014 D. Feb 15, 2014 - Correct AnswerA. April 1 + 7 is April 8. Count forward 9 months. A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy. The client's health record includes this: G3 T1 P0 A1 L1. How should the nurse interpret this information? Select all that apply A. Client has delivered one newborn at term B. client has experienced no preterm labor C. client has been through active labor D. Client has had two prior pregnancies E. Client has one living child - Correct AnswerA, D, E P0 indicates the client has had no preterm DELIVERIES A1 indicates the client has had one miscarriage/abortion A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following is an appropriate response by the nurse? A. "This is due to an increase in blood volume" B. "This is due to pressure from the uterus on the diaphragm" C. "This is due to weight of the uterus on the vena cava" D. "This is due to increased cardiac output" - Correct AnswerC. laying supine causes the uterus to compress the vena cava and abdominal arteries causing maternal hypotension A nurse in the clinic receives a phone call from a client who believes she is pregnant and would like to be tested in the clinic to confirm. 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 hours prior to the test" C. "You should be NPO for at least 8 hours prior to the test" D. "You should collect urine from the first morning void" - Correct AnswerD. first void provides most accurate results production of hCG can be detected as early as 7-10 days after conception not advised to stop taking meds, they should be reviewed to determine if they may affect results serum or blood tests are not affected by food or fluid intake Structural organ deformities are most likely to occur if an embryo is exposed to a potent teratogen during weeks ________ after conception A. 1-2 B. 3-8 C. 9-12 D. 13-20 - Correct AnswerB. 3-8 The purpose of preconception care is to improve pregnancy outcomes. T/F - Correct AnswerTrue Folic acid should only be take if a women intends to become pregnant. T/F - Correct AnswerFalse The MMR (Measles, Mumps, and Rubella) vaccine should be given to pregnant women. T/F - Correct AnswerFalse. It is a live virus that can cause damage to the fetus Genetic Counselors using the principle of "non-directiveness" strongly recommend which decisions and courses of action individuals and families should take. T/F - Correct AnswerFalse A women's serum pregnancy test is postive. The nurse explains this indicates a: A. presumptive sign of pregnancy B. probable sign of pregnancy C. positive sign of pregnancy D. potential sign of pregnancy - Correct AnswerB. A positive pregnancy test is a probable sign of pregnancy The nurse explains activities routinely included in prenatal care. Which would not be included as an expectation for prenatal care? A. Motivating a women to practice self care B. Encouraging invasive testing for fetal genetic defects C. Identifying existing risk factors and deviations from normal D. Providing information about expected changes of pregnancy - Correct AnswerB. The women should form her own opinions about her choice to have genetic testing done A women's response to pregnancy is characterized by uncertainty, ambivalence, self- focus, and emotional liability. Which trimester of pregnancy is this expected? - Correct AnswerFirst trimester The pregnant uterus is expected to rise to the level of the umbilicus at which week of gestation? A. 12-14 B. 16-18 C. 22-24 D. 28-30 - Correct AnswerC. 22-24 weeks Due to the effect of progesterone, a pregnant women is likely to experience discomforts such as: (select all that apply) A. heartburn B. constipation C. frequent uterine contractions D. gingivitis E. ankle edema - Correct AnswerA, B Antigens are proteins used by the immune system to identify and destroy foreign objects. T/F - Correct AnswerFalse. Those are antibodies. Antigens are the foreign object Which is true of Rh incompatibility between mother and fetus? A. It only occurs when the mother is Rh positive B. It only occurs when the fetus is Rh negative C. It is directly related to the mother's ABO blood type D. It occurs when maternal antibodies destroy fetal red blood cells - Correct AnswerD. Rh negative mom and Rh positive baby RhoGAM: A. Must be given within 24 hours of birth B. Blocks maternal antibodies from crossing placenta C. Prevents the mother from building antibodies against Rh+ blood D. It is only given prenatally if the mother has an amniocentesis - Correct AnswerC. A nurse is teaching a group of clients who are pregnant about behaviors to avoid during pregnancy, Which of the following statements by a client indicates a need for further instruction? A. "I can have a glass of wine with dinner" B. "Smoking is a cause of low birth weight in babies" C. "Signs of infection should be reported to my doctor" D. "I should not take OTC meds w/o checking with my obstetrician - Correct AnswerA. consuming alcohol in pregnancy increases the risk of birth defects A nurse is caring for a client and reviewing the findings of the client's biophysical profile (BPP). Which of the following variables are included in the test? (select all the apply) A. fetal weight B. fetal breathing movement C. Fetal tone D. Reactive FHR E. Amniotic Fluid Volume - Correct AnswerB, C, D, E A nurse is caring for a client who is pregnant and undergoing a non-stress test. The client asks why the nurse is using an acoustic vibration device. Which of the following is an appropriate response by the nurse? A. "It is used to stimulate contractions" B. "It will decrease the incidence of uterine contractions" C. "it lulls the fetus to sleep" D. "It awakens a sleeping fetus" - Correct AnswerD. acoustic vibration is activated over the fetal head to awaken a sleeping fetus A nurse is caring for a client who is pregnant and is to undergo a contraction stress test (CST). Which of the following findings are indications for this procedure? (select all that apply) A. Decreased fetal movement B. Intra-uterine growth restriction C. Post-maturity D. Advanced maternal age E. Amniotic fluid emboli - Correct AnswerA, B, C, D A nurse in the L&D unit receives a phone call from a client who reports that her contractions that started about 2 hrs ago, did not go away when she had two glasses of water and rested, and became stronger since she started walking. Her contractions occur every 10 min and last about 30 seconds. She hasn't had any fluid leak from her vagina. However she has some blood when she wiped after voiding. Based on this report, the nurse should recognize the client is experiencing.... A. Braxton Hicks contractions B. rupture of membranes C. fetal descent D. true contractions - Correct AnswerD. True contractions do not go away with hydration or walking. They are regular in frequency, duration, and intensity and become stronger with walking A nurse in the L&D unit is caring for a client in labor and applies and an external fetal and tocotransducer. The FHR is around 140/min, contractions are every 8 min and last 30-40 seconds. A vaginal exam reveals that the cervix is 2cm dilated, 50% effaced, and the fetus is at -2 station. What stage and phase of labor is she in? A. The first stage, latent phase B. The first stage, active phase C. The first stage, transition phase D. The second stage of labor - Correct AnswerA. In the latent phase the cervix dilates 0-3 cm and contractions last between 30-45 seconds A client experiences a large gush of fluid from her vagina while walking in the hallway of the birthing unit. The nurse's first action after establishing that fluid is amniotic fluid should be to... A. assess the amniotic fluid for meconium B. monitor the FHR C. dry the client and make her comfortable D. monitor the client's uterine contractions - Correct AnswerB. The greatest risk at this moment is the risk of fetal cord prolapse, which can be indicated by fetal distress after ROM. The nurse should assess TACO but it is not priority A nurse in L&D is completing an admission hx for a client who is at 39 weeks of gestation. The client reports that she has been leaking fluid from her vagina for 2 days. The nurse knows that this client is at risk for... A. cord prolapse B. infection C. PP hemorrhage D. hydraminos - Correct AnswerB. Rupture of membrane > 24 hours before delivery increases the risk that infectious organisms will enter the vagina and then eventually the uterus A nurse is caring for a client who is in active labor and becomes nauseous and vomits. The client is very irritable and feels the urge to have a bowel movement. She states "I've had enough. I can't do this anymore. I want to go home right now" The nurse knows that these signs indicate the client is in the... A. second stage of labor B. fourth stage of labor C. transition phase of labor D. latent phase of labor - Correct AnswerC. A client is in active labor. She is dilated to 5 cm and membranes are intact. The nurse notes an FHR of 115-125/min with occasional increases to 150-155/min that lasts for 25 secs and have beat-to-beat variability of 20/min. There is no slowing of the FHR from baseline. The nurse should recognize that this client is exhibiting signs of which of the following (select all that apply) A. moderate variability B. FHR accelerations C. FHR decelerations D. Normal baseline FHR E. Fetal tachycardia - Correct AnswerA, B, D variability is 20/min --> moderate increases to 150-155/min for 25 secs --> accelerations FHR of 115-125/min --> normal baseline A nurse is caring for a client who is have an induction of labor. Based on the use of external electronic fetal monitoring, the nurse notes that FHR variability is decreased and resembles a straight line. The client has not received pain medication. Which of the following should occur first before the nurse can apply an internal scalp electrode? A. dilation B. rupture of membranes C. effacement D. Engagement - Correct AnswerB. Before any internal devices can be applied, the membranes must rupture. All must happen before internal monitoring but this is the priority. A nurse is reviewing the electronic monitor tracing of a client who is in active labor. The nurse knows that a fetus receives more oxygen when which of the following appears on the tracing? A. peak of the uterine contraction B. moderate variability C. FHR acceleration D. Relaxation between uterine contractions - Correct AnswerD. During relaxation between uterine contractions the arteries are not compressed (as they are during contractions) and the fetus is most oxygenated A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. Which of the following is the first action the nurse should take? A. Assist the client into the left-lateral position B. Apply a fetal scalp electrode C. Insert an IV catheter D. Perform a vaginal exam - Correct AnswerA. Late decelerations is indicative of placental insufficiency so primary action would be to rotate mother laterally A. Frequency of every 2 min B. Duration of 90-120 secs C. Intensity of 60-90 mmHg D. Resting tone of 15 mmHg - Correct AnswerB. D/C if uterine hyperstimulation occurs. Contractions longer than 90 secs deprive the fetus of oxygen for too long A nurse educator in the L&D unit is reviewing the use of chemical agents to promote cervical ripening with a group of newly hired nurses. Which of the following statements by a nurse indicates understand of the teaching? A. "They are administered in an oral form" B. "The act by absorbing fluid from the tissues" C. "They promote dilation of the os" D. "They include an amniotomy" - Correct AnswerA. Chemical agents are meds administered PO A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse recognizes the adverse effects of the contraction pattern is... A. prolonged labor B. reduced fetal oxygen supply C. delayed cervical dilation D. increased maternal stress - Correct AnswerB. incomplete relaxation between contractions reduces the amount of oxygen the fetus gets. A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progression? A. Hands and knees B. Lithotomy C. Trendelenburg D. Supine with a rolled towel under one hip - Correct AnswerA. May help the fetus rotate from posterior to anterior position A nurse is caring for a client who is admitted to the L&D unit. Using Leopold maneuvers, it is noted that the fetus is in a breech presentation. For which of the following possible complications should the nurse observe? A. Precipitous labor B. premature ROM C. Postmaturity syndrome D. Prolapsed umbilical cord - Correct AnswerD. Breech position increases risk of prolapsed cord and often results in prolonged labor, not precipitous labor A nurse is caring for a client in active labor. When last examined 2 hrs ago, the client's cervix was 3 cm dilated, 100% effaced, membranes intact, and the fetus was at a -2 station. The client suddenly states "my water broke". The monitor reveals a FHR of 80- 85/min, and the nurse performs a vaginal exam noticing clear fluid and a pulsing loop of umbilical cord in the client's vagina. Which of the following actions should the nurse perform first? A. Place the client in Trendelenburg position B. Apply pressure to the presenting part with her fingers C. Administer oxygen at 10L/min via face mask D. Call for assistance - Correct AnswerD. This is the PRIMARY action the nurse should take. A nurse is performing a fundal assessment for a client in her second PP day and observes the client's perineal pad for lochia. She notes the pad to be saturated approximately 12 cm with lochia that is bright red in color and contains small clots. The nurse knows that this finding is... A. moderate lochia rubra B. excessive lochia rubra C. light lochia rubra D. scant lochia rubra - Correct AnswerA. expected finding for 2 days PP During ambulation to the bathroom, a PP client experiences a gush of dark red blood that soon stops. On assessment, a nurse finds the client's uterus to be firm and midline and at the level of the umbilicus. The nurse interprets this finding as A. evidence of a possible vaginal hematoma B. an indication of a cervical or perineal laceration C. a normal postural discharge of lochia D. abnormally excessive lochia rubra flow - Correct AnswerC. change in position may result in a gush of lochia that has been pooling in the vagina while laying down. Should soon return to normal flow rate (trickle of bright red blood) A nurse is assessing a PP client for fundal ht, location, and consistency. The fundus is found to be displaced laterally to the right, and there is uterine atony. Which of the following is the cause of uterine atony? A. poor involution B. urinary retention C. hemorrhage D. infection - Correct AnswerB. urinary retention can result in bladder distention which can cause uterine atony and lateral displacement of the uterus A nurse is completing a PP discharge teaching to a client who had no immunity to varicella and was given a varicella vaccine. Which of the following statements by the client indicates understanding of the teaching? A. "I will need to use contraception for 3 months before considering pregnancy" B. "I need a second vaccine at my PP visit" C. "I was given the vaccine because my baby is O+" D. "I will be tested in 3 months to see if I have developed immunity" - Correct AnswerB. Clients w/ no hx of immunity need a second vaccine at 4-8 weeks following delivery pregnancy should be avoided for 1 month; testing 3 months out is for rubella and RhoGAM A nurse is caring for a client who is 1 hr following a vaginal birth and experiencing uncontrollable shaking. The nurse should understand that the shaking is due to which of the following? (select all that apply) A. A change in body fluids B. The metabolic effect of labor C. Diaphoresis D. A decrease in body temp E. A decrease in Prolactin levels - Correct AnswerA, B. an increase in body temp is associated with PP chill but it not a cause. A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A. "We don't really know when such defects occur." B. "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." D. "They usually occur in the first 2 weeks of development." - Correct Answerc A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? A. "Many women imagine what their baby is like." B. "A baby in utero does respond to the mother's voice." C. "You'll need to ask the doctor if the baby can hear yet." D. "Thinking that your baby hears will help you bond with the baby." - Correct Answerb A maternity nurse should be aware of which fact about the amniotic fluid? A. It serves as a source of oral fluid and as a repository for waste from the fetus. B. The volume remains about the same throughout the term of a healthy pregnancy. C. A volume of less than 300 ml is associated with gastrointestinal malformations. D. A volume of more than 2 L is associated with fetal renal abnormalities - Correct Answera Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that: A. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause(s)? A. Amenorrhea—stress, endocrine problems B. Quickening—gas, peristalsis C. Goodell sign—cervical polyps D. Chadwick sign—pelvic congestion - Correct Answerc In order to reassure and educate pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A. A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high. B. Shifting the client's position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit. C. The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant. D. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy. - Correct Answerc Which hematocrit (HCT) and hemoglobin (HGB) results represent the lowest acceptable values for a woman in the third trimester of pregnancy? A. 38% HCT; 14 g/dL HGB B. 35% HCT; 13 g/dL HGB C. 33% HCT; 11 g/dL HGB D. 32% HCT; 10.5 g/dL HGB - Correct Answerc A pregnant patient is experiencing some integumentary changes and is concerned that they may represent abnormal findings. The nurse provides information to the patient that the following findings would be considered "normal abnormal" findings during pregnancy so that she should not be alarmed. (Select all that apply.) A. Facial edema B. Melasma C. Linea nigra D. Superficial thrombophlebitis E. Vascular spiders F. Allodynia - Correct Answerb,c,e A pregnant woman at 10 weeks of gestation jogs three or four times per week. She is concerned about the effect of exercise on the fetus. The nurse should tell her: A. "You don't need to modify your exercising any time during your pregnancy." B. "Stop exercising, because it will harm the fetus." C. "You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month." D. "Jogging is too hard on your joints; switch to walking now." - Correct Answerc A woman who is 32 weeks pregnant is informed by the nurse that a danger sign of pregnancy could be: A. Constipation B. Alteration in the pattern of fetal movement C. Heart palpitations D. Edema in the ankles and feet at the end of the day - Correct Answerb A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know whether it is safe for her to have a drink with dinner now. The nurse tells her: A. "Because you're in your second trimester, there's no problem with having one drink with dinner." B. "One drink every night is too much. One drink three times a week should be fine." C. "Because you're in your second trimester, you can drink as much as you like." D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy." - Correct Answerd Which behavior indicates that a woman is "seeking safe passage" for herself and her infant? A. She keeps all prenatal appointments. B. She "eats for two." C. She drives her car slowly. D. She wears only low-heeled shoes. - Correct Answera What type of cultural concern is the most likely deterrent to many women seeking prenatal care? A. Religion B. Modesty C. Ignorance D. Belief that physicians are evil - Correct Answerb In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that: A. Nonacceptance of the pregnancy very often equates to rejection of the child. B. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. C. Ambivalent feelings during pregnancy are usually seen only in emotionally immature or very young mothers. D. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth. - Correct Answerb With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that: A. The father goes through three phases of acceptance of his own. B. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth. C. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home. D. Typically men remain ambivalent about fatherhood right up to the birth of their child. - Correct Answera With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that during pregnancy: A. Prescription and over-the-counter (OTC) drugs that otherwise are harmless can be made hazardous by metabolic deficiencies of the fetus. B. The greatest danger of drug-caused developmental deficits in the fetus is seen in the final trimester. C. Killed-virus vaccines (e.g., tetanus) should not be given, but live-virus vaccines (e.g., measles) are permissible. D. No convincing evidence exists that secondhand smoke is potentially dangerous to the fetus. - Correct Answera Which statement about multifetal pregnancy is not accurate? A. The expectant mother often experiences anemia because the fetuses have a greater demand for iron. B. Twin pregnancies come to term with the same frequency as single pregnancies. C. The mother should be counseled to increase her nutritional intake and gain more weight. D. Backache and varicose veins are often more pronounced. - Correct Answerb The nurse advises the woman who wants to have a nurse-midwife provide obstetric care that: A. She will have to give birth at home. B. She must see an obstetrician as well as the midwife during pregnancy. C. She will not be able to have epidural analgesia for labor pain. D. She must be having a low-risk pregnancy. - Correct Answerd An expectant couple asks the nurse about intercourse during pregnancy and whether it is safe for the baby. The nurse should tell the couple that: A. Intercourse should be avoided if any spotting from the vagina occurs afterward. B. Intercourse is safe until the third trimester. C. Safer-sex practices should be used once the membranes rupture. D. Intercourse and orgasm are often contraindicated if a history or signs of preterm labor are present. - Correct Answerd A pregnant woman demonstrates understanding of the nurse's instructions regarding relief of leg cramps if she: D. High-protein supplements can be used without risk by women on macrobiotic diets - Correct Answera Which findings could be considered to be a barrier to a pregnant woman seeking prenatal care? (Select all that apply.) A. Patient would prefer to be cared for by a midwife instead of a physician. B. Economic cost of health care. C. Patient's cultural beliefs do not include prenatal care as being valued. D. Patient speaks several languages. E. Patient had a bad experience the last time she went to a doctor for care. - Correct Answerb,c,e With regard to primary and secondary powers, the maternity nurse should understand that: A. Primary powers are responsible for effacement and dilation of the cervix. B. Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies. C. Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation. D. Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs. - Correct Answera Which sign does not precede the onset of labor? A. A return of urinary frequency as a result of increased bladder pressure B. Persistent low backache from relaxed pelvic joints C. Stronger and more frequent uterine (Braxton Hicks) contractions D. A decline in energy, as the body stores up for labor - Correct Answerd In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that: A. The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions. B. Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia. C. Having the woman point her toes reduces leg cramps. D. The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation. - Correct Answerd The nurse knows that the second stage of labor, the descent phase, has begun when: A. The amniotic membranes rupture. B. The cervix cannot be felt during a vaginal examination. C. The woman experiences a strong urge to bear down. D. The presenting part is below the ischial spines - Correct Answerb Which statement is inaccurate with regard to normal labor? A. A single fetus presents by vertex. B. It is completed within 8 hours. C. A regular progression of contractions, effacement, dilation, and descent occurs. D. No complications are involved. - Correct Answerb Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate? A. Latent: mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hours B. Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours C. Lull: no contractions; dilation stable; duration of 20 to 60 minutes D. Transition: very strong but irregular contractions; 8 to 10 cm dilation; duration of 1 to 2 hours - Correct Answerb Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased? A. Semirecumbent B. Sitting C. Squatting D. Side-lying - Correct Answerc Fetal circulation can be affected by many factors during labor. Accurate assessment of the laboring woman and fetus requires knowledge of these expected adaptations. Which factor will not affect fetal circulation during labor? A. Fetal position B. Uterine contractions C. Blood pressure D. Umbilical cord blood flow - Correct Answera Concerning the third stage of labor, nurses should be aware that: A. The placenta eventually detaches itself from a flaccid uterus. B. The duration of the third stage may be as short as 3 to 5 minutes. C. It is important that the dark, roughened maternal surface of the placenta appear before the shiny fetal surface. D. The major risk for women during the third stage is a rapid heart rate. - Correct Answerb Which of the following findings would be a cause for concern for a nurse who is monitoring an obstetric patient who is in early labor? (Select all that apply.) A. Biparietal diameter of less than 9.25 cm B. Vertex presenting part C. Transverse lie D. General flexion attitude E. Android pelvis - Correct Answera,c,e 1. A woman in active labor receives an opioid agonist analgesic. Which medication relieves severe, persistent, or recurrent pain, creates a sense of well-being, overcomes inhibitory factors, and may even relax the cervix but should be used cautiously in women with cardiac disease? A. Meperidine (Demerol) B. Promethazine (Phenergan) C. Butorphanol tartrate (Stadol) D. Nalbuphine (Nubain - Correct Answera A woman in the active phase of the first stage of labor is using a shallow pattern of breathing, which is about twice the normal adult breathing rate. She starts to complain about feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should: A. Notify the woman's physician. B. Tell the woman to slow the pace of her breathing. C. Administer oxygen via a mask or nasal cannula. D. Help her breathe into a paper bag. Correct - Correct Answerd A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief measure is to use: A. Counterpressure against the sacrum. B. Pant-blow (breaths and puffs) breathing techniques. C. Effleurage. D. Biofeedback. - Correct Answera Nurses should be aware of the difference that experience can make in labor pain, such as: A. Sensory pain for nulliparous women often is greater than for multiparous women during early labor. B. Affective pain for nulliparous women usually is less than for multiparous women throughout the first stage of labor. C. Women with a history of substance abuse experience more pain during labor. D. Multiparous women have more fatigue from labor and therefore experience more pain. - Correct Answera In the current practice of childbirth preparation, emphasis is placed on: A. The Dick-Read (natural) childbirth method. B. The Lamaze (psychoprophylactic) method. C. The Bradley (husband-coached) method. D. Encouraging expectant parents to attend childbirth preparation in any or no specific method. - Correct Answerd With regard to breathing techniques during labor, maternity nurses should be aware that: A. Breathing techniques in the first stage of labor are designed to increase the size of the abdominal cavity to reduce friction. A. Frequency (how often contractions occur) B. Intensity (the strength of the contraction at its peak) C. Resting tone (the tension in the uterine muscle) D. Appearance (shape and height) - Correct Answerd The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by: A. Change in position. B. Oxytocin administration. C. Regional anesthesia. D. Intravenous analgesic. - Correct Answera Fetal well-being during labor is assessed by: A. The response of the fetal heart rate (FHR) to uterine contractions (UCs). B. Maternal pain control. C. Accelerations in the FHR. D. An FHR greater than 110 beats/min - Correct Answera A group of fetal monitoring experts (National Institute of Child Health and Human Development, 2008) recommends that fetal heart rate (FHR) tracings demonstrate certain characteristics to be described as reassuring or normal (category I). These characteristics include: A. Bradycardia not accompanied by baseline variability. B. Early decelerations, either present or absent. C. Sinusoidal pattern. D. Tachycardia. - Correct Answerb A nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates her understanding of the instructions when the woman states: A. "True labor contractions will subside when I walk around." B. "True labor contractions will cause discomfort over the top of my uterus." C. "True labor contractions will continue and get stronger even if I relax and take a shower." D. "True labor contractions will remain irregular but become stronger." - Correct Answerc Under which circumstance would a nurse not perform a vaginal examination on a patient in labor? A. An admission to the hospital at the start of labor B. When accelerations of the fetal heart rate (FHR) are noted C. On maternal perception of perineal pressure or the urge to bear down D. When membranes rupture - Correct Answerb When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include: A. Encouraging the woman to try various upright positions, including squatting and standing. B. Telling the woman to start pushing as soon as her cervix is fully dilated. C. Continuing an epidural anesthetic so that pain is reduced and the woman can relax. D. Coaching the woman to use sustained, 10- to 15-second, closed-glottis bearing- down efforts with each contraction. - Correct Answera Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period? A. The healthy newborn should be taken to the nursery for a complete assessment. B. After drying, the infant should be given to the mother wrapped in a receiving blanket. C. Skin-to-skin contact of mother and baby should be encouraged. D. The father or support person should be encouraged to hold the infant while awaiting delivery of the placenta. - Correct Answerc Which description of the phases of the second stage of labor is accurate? A. Latent phase: feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45 minutes B. Active phase: overwhelmingly strong contractions, Ferguson reflux activated, duration is 5 to 15 minutes C. Descent phase: significant increase in contractions, Ferguson reflux activated, average duration varies D. Transitional phase: woman "laboring down," fetal station is 0, duration is 15 minutes - Correct Answerc When performing vaginal examinations on a laboring woman, the nurse should be guided by what principle? A. Cleanse the vulva and perineum before and after the examination as needed. B. Wear a clean glove lubricated with tap water to reduce discomfort. C. Perform the examination every hour during the active phase of the first stage of labor. D. Perform an examination immediately if active bleeding is present. - Correct Answera Which test is performed to determine whether membranes are ruptured? A. Urine analysis B. Fern test C. Leopold maneuvers D. AROM - Correct Answerb When assessing a multiparous woman who has just given birth to an 8-pound boy, the nurse notes that the woman's fundus is firm and has become globular. A gush of dark red blood comes from her vagina. The nurse concludes that: A. The placenta has separated. B. A cervical tear occurred during the birth. C. The woman is beginning to hemorrhage. D. Clots have formed in the upper uterine segment - Correct Answera A woman who is 39 weeks pregnant expresses fear about her impending labor and how she will manage. The nurse's best response is: A. "Don't worry about it. You'll do fine." B. "It's normal to be anxious about labor. Let's discuss what makes you afraid." C. "Labor is scary to think about, but the actual experience isn't." D. "You may have an epidural. You won't feel anything." - Correct Answerb Which of the following would not be included in a labor nurse's plan of care for an expectant mother? A. The onset of progressive, regular contractions B. The bloody, or pink, show C. The spontaneous rupture of membranes D. Formulation of the woman's plan of care for labor - Correct Answerd If a woman complains of back labor pain, the nurse might best suggest that she: A. Lie on her back for a while with her knees bent. B. Do less walking around. C. Take some deep, cleansing breaths. D. Lean over a birth ball with her knees on the floor. - Correct Answerd In a variation of rooming-in called couplet care, the mother and infant share a room and the mother shares the care of the infant with: A. The father of the infant. B. Her mother (the infant's grandmother). C. Her eldest daughter (the infant's sister). D. The nurse. - Correct Answerd The breasts of a woman who is bottle feeding her baby are engorged. The nurse should instruct her to: A. Wear a snug, supportive bra. B. Allow warm water to soothe the breasts during a shower. C. Express milk from breasts occasionally to relieve discomfort. D. Place absorbent pads with plastic liners into her bra to absorb leakage - Correct Answera A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious likely consequence of bladder distention is: A. Urinary tract infection. B. Excessive uterine bleeding. C. A ruptured bladder. D. Bladder wall atony. - Correct Answerb D. 4 hours - Correct Answer1 Which finding would be a source of concern if noted during the assessment of a woman at 12 hours postpartum? A. Postural hypotension B. Temperature of 38° C C. Bradycardia—pulse rate of 55 beats/min D. Pain in left calf with dorsiflexion of left foot - Correct Answerd The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action is to: A. Place her on a bedpan to empty her bladder B. Massage her fundus C. Call the physician D. Administer methylergonovine (Methergine), 0.2 mg IM, which has been ordered prn - Correct Answerb Two hours after giving birth, a primiparous woman becomes anxious and complains of intense perineal pain with a strong urge to have a bowel movement. Her fundus is firm, at the umbilicus, and midline. Her lochia is moderate rubra with no clots. The nurse suspects: A. Bladder distention B. Uterine atony C. Constipation D. Hematoma formation - Correct Answerd Nurses are getting ready for bedside reporting at change of shift. A benefit of this type of change of shift report is that: A. Information is transparent so that the nurses and patients are aware of all pertinent data and delivery of care aspects. B. Patients can ask questions of the nurses during change of shift report so that they can better direct the delivery of their health care. C. Nurses are able to visualize their patient's directly at the time of report leading to better patient satisfaction. D. There is no need for additional information to be exchanged as the patient is right there to answer questions and voice concerns. - Correct Answerc Which test result would provide evidence of fetal blood in maternal circulation? A. Positive Fern test result B. Positive Coombs test result C. Positive Kleihauer-Betke test result D. Negative Coombs test result - Correct Answerc The nurse is observing a postpartum patient who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.) A. Document findings in the health care record B. Decrease flow rate for intravenous fluid administration C. Administer oxygen via nonrebreather mask @ 10 L/minute D. Insert a secondary intravenous line access E. Type & screen for 2 units of blood - Correct Answerc,d The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? A. Talks and coos to her son B. Seldom makes eye contact with her son C. Cuddles her son close to her D. Tells visitors how well her son is feeding - Correct Answerb The process in which the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics is called: A. Mutuality. B. Bonding. C. Claiming. D. Acquaintance. - Correct Answera In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which of the following is a facilitating behavior? A. The parents have difficulty naming the infant. B. The parents hover around the infant, directing attention to and pointing at the infant. C. The parents make no effort to interpret the actions or needs of the infant. D. The parents do not move from fingertip touch to palmar contact and holding - Correct Answerb Which statement is inaccurate with regard to a nurse working with parents who have a sensory impairment? A. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals. B. Visually impaired mothers cannot overcome the infant's need for eye-to-eye contact. C. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities. D. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information. - Correct Answerb Health care providers demonstrate a variety of reactions to lesbian couples, including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the nonchildbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. Which opportunity could not be provided to male partners? A. Labor support B. Cutting the cord C. Rooming-in during hospitalization D. Breastfeeding the infant - Correct Answerd While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: A. Express a strong need to review the events and her behavior during the process of labor and birth. B. Exhibit a reduced attention span, limiting readiness to learn. C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D. Have reestablished her role as a spouse or partner. - Correct Answerc Parents can facilitate the adjustment of their other children to a new baby by: A. Having children at home choose or make a gift to give the new baby on his or her arrival home. B. Emphasizing activities that keep the new baby and other children together. C. Having the mother carry the new baby into the home so she can show the other children the baby. D. Reducing stress on the other children by limiting their involvement and care of the new baby. - Correct Answera The early postpartum period is a time of emotional and physical vulnerability. Many mothers can easily become psychologically overwhelmed by the reality of their new parental responsibilities. Fatigue compounds these issues. Although the baby blues are a common occurrence in the postpartum period, about a half million women in America experience a more severe syndrome known as postpartum depression (PPD). Which statement regarding PPD is essential for the nurse to be aware of when attempting to formulate a nursing diagnosis? A. PPD symptoms are consistently severe. B. This syndrome affects only new mothers. C. PPD can easily go undetected. D. Only mental health professionals should teach new parents about this condition. - Correct Answerc Which statement accurately reflects the La cuarentena ritual for a Hispanic patient? A. No restrictions are placed on the mother during this ritual period. B. This ritual occurs over a period of 40 days. C. Spicy foods are encouraged as part of the maternal diet. D. The ritual is limited to preparing the woman to become a good mother - Correct Answerb