OB Power Point Presentation 002

8/3/2019 OB Power Point Presentation 002

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51. The nurse is monitoring the patient who isexperiencing an ectopic pregnancy. She notesthat vaginal bleeding is scanty while the patientis showing signs of hypovolemic shock. Sheevaluates that:

a. Shock signs are misleading in this case

b. Infection could cause signs of shock

c. Level of pain is causing signs of shock

d. Bleeding into the pelvic cavity is occurring

d. Bleeding into the pelvic cavity is occurring



52. In order to assess bleeding into the

peritoneal cavity, the nurse looks forCullen’s sign. This is:

a. cyanosis around the lips and tip of nose

b. scant, dark reddish-brown vaginal bleedingc. frequent gush of bright red blood from vagina

d. bluish tinge surrounding the umbilical area

d. bluish tinge surrounding the umbilical area



53. The nurse caring for a patient in pre-term labor

may exhibit which of the following side effectswhen administered intravenous terbutalinesulfate (Brethine)?

a. uterine hypertonia

b. epistaxis

c. tachycardia

d. dysuria

c. tachycardia



54. A breast-feeding mother on her thirdpostpartum day states that she is planning the

lactational amenorrhea method (LAM) forcontraception.

The most appropriate nursing response would beto inform the mother that:

a. this method can be used for one yearb. this method is effective if she is fully

breastfeeding and menses has not returned

c. she can supplement with formula for the night

feedingsd. she should check her basal temperature to

determine effectiveness of the method

d. she should check her basal temperature to determineeffectiveness of the method



55. Which of the following actions would be thehighest priority in the treatment of

disseminated intravascular coagulation (DIC)?a. maintaining central blood volume

b. correcting the coagulation deficit

c. correcting the triggering caused. maintaining strict intake and output

b. correcting the coagulation deficit



56. In primigravida, the nurse would suspectcephalopelvic disproportion when

a. an unopened cervix fails to dilate after 20hours of contractions

b. the cervix remains unchanged for 3 hourswith regular contractions and prior cervicaldilatation

c. the fetus descends in active labor at a rate of1.0cm per hour

d. the woman complains of an urge to push at7cm dilatation

b. the cervix remains unchanged for 3 hours withregular contractions and prior cervical dilatation



57. A primigravida complains to the nurse aboutdyspnea, nausea, and bladder fullness. The

nurse should be aware that these symptomsduring pregnancy are usually the result of anincrease in which of the following hormones?

a. Estrogen

b. Progesterone

c. follicle stimulating hormone

d. melanocyte stimulating hormone

b. Progesterone



58. The nurse should be aware that for a fetal non-stresstest (NST) to be considered reactive, which of the

following criteria should be met?a. Fetal heart rate baseline is above 110, with no

decelerations during fetal movement

b. Fetal heart rate baseline is above 110, withaccelerations noted during fetal activity

c. Fetal heart rate baseline is between 110-160, withtwo accelerations of 15 beats for 15 seconds inresponse to fetal activity for 10 mins

d. Fetal heart baseline is between 110 and 160, with

less than two accelerations during a 20-minuteperiod

c. Fetal heart rate baseline is between 110-160,with two accelerations of 15 beats for 15 seconds

in response to fetal activity for 10 mins



59. A patient planning to become pregnant asksthe prenatal nurse for dietary advice. To

facilitate normal spinal cord formation in adeveloping fetus, the nurse should instruct thepatient to include foods in her diet that contain

a. Fiber c. folic acid

b. Calcium d. protein

c. folic acid



60. A patient has begun prenatal care in the firsttrimester of pregnancy. The nurse should

instruct the patient to return for the next visit inhow many weeks?

a. One c. Four

b. Two d. Eight

c. Four



61. The nurse should carry out which of thefollowing interventions first when caring for a

patient experiencing variable decelerationsduring labor?

a. Encourage the patient to breath deeply

b. Administer oxygen, 21/min via face mask

c. Reposition patient onto her left side

d. Cleanse the perineum in preparation for

delivery

c. Reposition patient onto her left side.



62. At 16 weeks gestation, no fetal heart rate was detectedduring assessment of a pregnant patient. An

ultrasound confirmed a hydatidiform molar pregnancy.Which of the following actions should the nurse tell thepatient to expect during her one-year follow-up?

a. Multiple serum chorionic gonadotrophin levels willbe drawn

b. An intrauterine device will be used to decreasevaginal bleeding

c. Pregnancy will be restricted for another year

d. Oral contraceptives will not be prescribed

because they will increase the risk for cancer

a. Multiple serum chorionic gonadotrophin levelswill be drawn



63. Because a woman who is confirmed to be at30 weeks gestation has sudden painless bright

red vaginal bleeding, a nurse would suspectthe woman is experiencing:

a. Abruption placentae

b. An ectopic pregnancy

c. Placenta previa

d. A molar pregnancy

c. Placenta previa



64. A woman who is at 32 week gestation has hadrupture membranes for 26 hours. A nurse

would assess the woman for which of thefollowing manifestation?

a. Proteinuria

b. Dependent edema

c. Constipation

d. Elevated temp

d. Elevated temp



65. A Rh-negative mother would need to receiveRho(D) immune globulin (RhoGam) within 72hours after delivery if her newborn had whichof the following blood test result

a. RH negative, Coombs positiveb. RH negative, Coombs negative

c. RH positive, Coombs negative

d. RH positive, Coombs positive

c. RH positive, Coombs negative



66. When planning care for a 14 year-old

female who is pregnant, a nurse shouldrecognize that the adolescent is at riskof:

a. Glucose intoleranceb. Fetal chromosomal abnormality

c. Incompetent cervix

d. Iron deficiency anemia

d. Iron deficiency anemia



67. At 36 weeks of pregnancy, a woman isto have a lecithin/sphinomyelin (L/S)ration performed. She should beinstructed that the purpose of this test isto determine

a. The amount of fetal muscle massb. Whether the fetal kidneys are mature enough to

excrete createnine

c. Fetal pulmonary maturity

d. The functioning of the placental unit

c. Fetal pulmonary maturity



68. A pregnant woman’s uterine fundus is

palpated at the level of the umbilicus.The nurse would expect the woman to behow many weeks pregnant?

a. 12 c. 20

b. 16 d. 24

c. 20



69. Following an amniocentesis, the nurse shouldinstruct a client to immediately report which ofthe following signs and symptoms

a. Flu-like symptoms

b. Inability to sleep

c. A decrease in uterine contractions

d. An increase in uterine contractions

d. An increase in uterine contractions



70. To help a woman recognize the best time forconceiving, a nurse would instruct the womanto monitor for which of the followingmanifestations of ovulation?

a. drop in body temperature lasting for

several daysb. increase in amount of cervical mucus that

is clear and stretches

c. abnormal bloating that occurs suddenly

d. breast tenderness accompanied by slightnipple discharge

b. increase in amount of cervical mucus that is clear

and stretches



71. The client report frequent constipation.To help relieve constipation, the nurse

should instruct the client to

a. Use glycerin suppositories

b. Drink a glass of hot water in the

morningc. Avoid highly seasoned foods

d. Administer enema

b. Drink a glass of hot water in the morning



72. The physician schedules the client for diagnosticultrasound to assess fetal growth. After instructing theclient about the ultrasound procedure, the nurse

considers the teaching effective when the client makesthe statement:a. “The procedure requires the use of a needle which

will be inserted into the uterus” b. “I can’t have anything to eat or drink after midnight on

the day of the procedure” c. “I may feel some pain and discomfort after the

procedure” d. “I need to drink 32 to 40 ounces of fluid 1 hour before

the procedure”

d. “I need to drink 32 to 40 ounces of fluid 1 hour before the procedure”



73. Following spontaneous rupture of the

mebranes, if the cord prolapses, the nurseshould plan immediately

a. Relieve pressure of the cord

b. Expedite delivery

c. Turn the client to a supine position

d. Replace the cord into the vagina

a. Relieve pressure of the cord



74. A 31-year-old multigravida at 10 weeks gestation isreceiving prenatal care in high risk clinic. She is

insulin-dependent diabetic. The nurse discusses theimportance of keeping blood glucose levels nearnormal throughout the pregnancy. The nurse explainsto the client that as pregnancy progresses, her insulinneeds will:

a. increaseb. decrease

c. remain constant

d. cannot be predicted

a. increase



75. In planning care for the neonate of a diabeticmother, the nurse plans to treat potential

hypoglycemia by preparing aa. 10% glucose intravenous infusion

b. 25% glucose intravenous infusion

c. A bottle of 24-caloric formulad. A balanced electrolyte infusion

a. 10% glucose intravenous infusion



76. When instructing the client about

drinking alcoholic beverages duringpregnancy, the nurse should includewhich of the following?

a. Limit drinking to beer and wine

b. Abstain from drinking alcoholic beverages

c. Drink no more than 1 ounce of liquor per day

d. None of the above

b. Abstain from drinking alcoholic beverages



77. When the head of the infant has been

delivered, which of the following nursingactions is not appropriate?

a.Tell the mother to stop pushing

b. Ask mother to do rapid shallow breathing

c. Coach mother to continue bearing down

d.Suction the mucus present in the infant’s airway

c. Coach mother to continue bearing down



78. After the birth of the baby, she observes for the signs ofplacental separation. Which of the following signs

indicate that the placenta has separated?1. gradual descent of the uterus further into the pelvis

2. protrusion of several more inches of umbilical cord

3. uterus becoming firm and rounded

4. a sudden gush or blood from the vagina

5. Mrs. A holds her abdomen

a. 1 and 2 c. 2, 3 and 5

b. 2, 3 and 4 d. all of them

b. 2, 3 and 4



79. When the placenta has been delivered, the firstthing that the nurse should do:

a. Inspect the placenta for the completeness of thecotyledon

b. Palpate the uterus to see if it is contracted

c. Administer oxytocin drug as ordered

d. Estimate the blood loss to detect any bleeding

a. Inspect the placenta for the completeness of thecotyledon



80. The placenta was expelled by Schultze’smechanism. Which of the following describe

the mechanism?1. Placenta separates first from its center2. the shiny surface presents at vaginal opening3. Placenta separates first at its edges

4. The raw, red, irregular surface presents at the vaginalopening

a. 1 and 2 c. 2 and 3b. 1 and 4 d. 3 and 4

a. 1 and 2



81. During the fourth stage of labor, if thenurse feels that mother’s fundus is notwell contracted and is shifted to the rightshe should realize that this is due mainlyto:

a. A solid mass c. a full bladderb. a clotted blood d. retained

placental fragment

c. a full bladder



82. What nursing action must she take?

a. Ignore the conditionb. Notify the doctor so it would notworsen

c. Massage fundus and/or express bloodclots

d.Encourage mother to void

d.Encourage mother to void



83. The nurse has encouraged mother to ambulate earlyafter delivery which of the following seem to be the

advantages gained from early ambulation?1. Improve bowel and bladder functions

2. Mrs. C. would be able to regain her strength more readily

3. Minimizes the chance of hemorrhage

4. Eliminates incidence of thrombophlebitis

a. 1 & 2 b. 1, 3 & 4c. 2, 3 & 4 d. 1, 2, 3 & 4

d. 1, 2, 3 & 4



84. The mother is in taking- in phase. Which ofthese behaviors would indicate this phase of

restorative period?

a. Requesting rooming- in immediately afterdelivery

b. Asking to bathe her babyc. Experiencing transient feelings of depression

d. Verbalizing the reaction to her labor and delivery

d. Verbalizing the reaction to her labor and delivery



85. What is the priority need of a tearful mother

with post partum depression?a. Fluids and nutrients to combat dehydration

foster feelings of general well-being.

b. Chance to see and touch her baby

c. Privacy and reassurance that crying is normaland therapeutic

d. Talk with her husband

c. Privacy and reassurance that crying isnormal and therapeutic



86. The mother complains of breast enlargementwhich prevents her baby from latching on her

nipple. An appropriate nursing interventionwhich would be to;a. Teach her, breast massage or manual

expression of milk.

b. Use ice pack to breast immediately prior tofeeding.c. Teach her shoulder circling exercises.d. Advise her to restrict her fluids.

a. Teach her, breast massage or manual expression of milk.



87. Most common cause of post partumhemorrhage is uterine atony. The firstthing to do;

a. Administer an oxytocin drug

b. Take a firm grasp of the fundus and massage

itc. Empty bladder

d. Check for hypotension

b. Take a firm grasp of the fundus and massage it



88. In response to the nurse’s question about howshe feels, the client replies that she is tired,

sore, and hungry. Begins to relate her birthexperience. Based on the assessment data,the nurse determines that the client is in whichphase of post partal psychological adaptation

process.a. Acting out c. Taking – hold

b. Taking – in d. Letting – go

b. Taking – in



89. The nurse caring for a client detects a firm

fundus, yet on inspection of the perineum,there is constant trickle of blood. The nurseshould assess the client for

a. vaginal tears

b.retained placental tissue

c. uterine inversion

d. uterine infection

a. vaginal tears



90. Which of the following situation a post partalwoman would be most indicative of an

abnormality?a. chilling shortly after deliveryb. pulse rate of 60 the morning after deliveryc. urinary output of 1,200 ml on second day post

partumd. oral temperature of 38 C on the third day post

partum

d. oral temperature of 38 C on thethird day post partum



91. During the second day the post partum, the

nurse examines the client, which of thefollowing is a normal finding

a. lochia serosa, fundus 4-5 cm below umbilicus

b. lochia rubra, fundus 2-3 cm below umbilicus

c. lochia alba, fundus 4-5 cm above the umbilicus

d. lochia serosa, fundus 2-3 cm above theumbilicus

b. lochia rubra, fundus 2-3 cm below umbilicus



92. The most common position for the fetus at birth

is the:a. right occiput anterior

b. left occitput anterior

c. right occiput posteriord. left occiput posterior

b. left occitput anterior



93. What is used to relieve perineal

discomfort on the second postpartumday?

a. application of ice bag

b. application of heat

c. administration of oxytocic

d. administration of hormones

b. application of heat



94. There are several theories for the cause of

labor onset. The theory that states the needfor inhibition of uterine contractility throughoutpregnancy is known as:

a. oxytocin theory

b. prostaglandin theoryc. fetal endocrine control theory

d. progesterone deprivation theory

d. progesterone deprivation theory



95. The nurse performed Leopold’s maneuver in examiningAra. Abdominal palpation revealed a soft rounded

mass in the fundus, irregular lumps or nodules on Ara’s right side and a hard prominence on Ara’s rightside above the symphysis pubis. The most accurateassessment of fetal position would be:

a. left occiput anterior

b. left sacrum anterior

c. right sacrum posterior

d. right occiput posterior

a. left occiput anterior



96. The fetus is most likely to be damaged

by the pregnant woman’s ingestion of drugs during

a. first trimester c. third trimester

b. second trimester d.entire trimester

a. first trimester



97. The nurse would suspect an ectopic pregnancyif the client complained of:

a. lower abdominal cramping for a long periodof time

b. sharp lower right or left abdominal painradiating to the shoulder

c. leucorrhea and dysuria a few days aftermissed periodd. an adherent painful ovarian mass

b. sharp lower right or left abdominal painradiating to the shoulder



98. The pregnant woman complains of morning

sickness. The nurse realizes that apredisposing factor which causes morningsickness during the first trimester or pregnancyis the adaptation to increased level of:

a. estrogen c. leuteinizing hormone

b. progesterone d. pituitary gland

a. estrogen



99. Which of the following statements by a client withhyperemesis indicates effective teaching about post

discharge management plan?a. “I’m glad I won’t ever have to be hospitalized again for

this” b. “I need to eat small, frequent meals to maintain my

weight”

c. “I hope the doctor will give me medicine to stop thisnausea”

d. “Prenatal vitamins are making me sick. I need to quittaking them.”

b. “I need to eat small, frequent meals

to maintain my weight”



100. The hormone that is secreted by the

corpus luteum and prepares theendometrium for implantation is:

a. estrogen c. progesterone

b. luteinizing hormone d. prostaglandin

c. progesterone















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OB Power Point Presentation 002

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