OB 1 Flashcards
A pregnant woman told the nurse she doesn’t know whether she’s ready to have another baby, even though this was a planned pregnancy. Which response should the nurse offer?
a. “You may want to discuss these concerns with a social worker.”
b. “You’re feeling ambivalent, which is normal during the first trimester.”
c. “You need to share these feelings with your partner.”
d. “You may want to consider having an abortion.”
b. “You’re feeling ambivalent, which is normal during the first trimester.”
A 9-week primigravida client asks you, “Is it possible for me to listen to my baby’s fetal heart beat?” Which of the following responses by the nurse would be appropriate?
a. “We can listen to your baby’s heart beat with a Doppler but we still have to wait for additional 4 weeks.”
b. “Fetoscope is best used during the 16th week of your pregnancy to listen to the baby’s heart beat.”
c. “The heart beats 8 weeks before delivery so I don’t think you can listen to it now.”
d. “Your obstetrician would probably use the Doppler to check for fetal heart tones, she may let you listen to it.”
d. “Your obstetrician would probably use the Doppler to check for fetal heart tones, she may let you listen to it.”
A primigravida client, 24 y/o, 18 weeks AOG verbalized her concern, “Why is my baby not yet moving, my neighbor who is also pregnant for the second time says she felt her baby move yesterday. We have the same AOG, I’m afraid there is something wrong with my baby!” what would be your best response:
a. “Quickening is usually felt by first-time mothers a week before delivery.”
b. “Don’t worry everything is alright.”
c. “Normally for a primigravida client like you will feel the first movement on the 20th week”
d. “You’re overreacting ma’am, that might harm the baby.”
c. “Normally for a primigravida client like you will feel the first movement on the 20th week”
- During their rotation in the OB ward, a student nurse was asked by her clinical instructor about the changes in a woman’s body during pregnancy. The student nurse is aware that a common adaptation during pregnancy would be:
a. Hypoventilation
b. Increased pH of the vagina
c. Decreased gastrointestinal motility
d. Decreased glomerular filtration rate
c. Decreased gastrointestinal motility
All but one are principles in identifying parity:
a. Stillbirth is counted
b. Count the number of fetus delivered before 20 weeks
c. Count the number of pregnancy that reached 20 weeks AOG and subsequently delivered dead or alive
d. Multiple pregnancy is considered as one parity
b. Count the number of fetus delivered before 20 weeks
Suppose the primigravida woman had her last menstrual period for 4 days and the menstrual flow ended May 5, 2021. What would be her expected date of confinement?
a. February 5, 2022
b. February 9, 2022
c. January 29, 2022
d. January 5, 2022
b. February 9, 2022
During the physical assessment on a pregnant woman on her late 20’s, the nurse notes the uterus is firm under the abdominal wall just in line with the umbilicus. Approximately what week of gestation is the client in:
a. 20th week
b. 22nd week
c. 36th week
d. 12th week
a.20th week
A woman 19 weeks pregnant, has been admitted to the emergency department following. Contractions are noted which lasted 35 seconds, and cervix dilated at 7cm. She has passed tissue fragments and no fetal heart was heard upon auscultation. Obstetrical history tells that he had a previous cesarean section 3 years ago due to placenta previa @ 38th week AOG giving birth to a small-for-gestational age infant. Her first pregnancy successfully ended via normal spontaneous vaginal delivery @ 37 weeks giving birth to twins. What is her obstetrical score?
a. G-3, T-2, P-1, A-0, L-2
b. G-3, T-2, P-0, A-1, L-2
c. G-2, T-2, P-1, A-0, L-2
d. G-3, T-3, P-0, A-1, L-3
d.G-3, T-3, P-0, A-1, L-3
Emergency nursing interventions for a 16-week pregnancy woman who is suspected to have a miscarriage would include all but one of the following :
a. Withhold oral fluids
b. Save perineal pads and any tissue passed
c. Ensure adequate hydration by letting mother drink plenty of fluids to prevent dehydration
d. Monitor uterine contractions and fetal heart rate
c. Ensure adequate hydration by letting mother drink plenty of fluids to prevent dehydration
Early detection of an ectopic pregnancy is paramount in preventing a life-threatening rupture. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy?
a. Unilateral lower abdominal tenderness and a positive pregnancy test
b. Hyperemesis and weight loss
c. Amenorrhea and a negative pregnancy test
d. Copious discharge of clear mucous and prolonged epigastric pain
a. Unilateral lower abdominal tenderness and a positive pregnancy test
The characteristic manifestation of gestation trophoblastic disease is:
a. Uterus tends to expand faster than a normal pregnancy
b. Lower abdominal quadrant pain
c. Emesis Gravidarum
d. An HCG level of 400,000 IU
a. Uterus tends to expand faster than a normal pregnancy
Which of the following discharge instructions must be given to a woman who has just undergone suction and curettage for gestational trophoblstic disease?
a. “Visit your physician after one year for a follow-up examination to find out if there is still a possibility that get pregnant.”
b. “Women who has had molar pregnancy must avoid sexual intercourse for a year or two.”
c. “HCG levels usually return to normal 48 hours after evacuation.”
d. “Use a reliable contraceptive method for 12 months.”
d. “Use a reliable contraceptive method for 12 months.”
The insulin dosage during throughout pregnancy is:
*
a. Increased throughout the duration of pregnancy
b. Decreased during the second trimester an increase during the first and third trimester
c. Increased during the first trimester and decreased on the second and third trimester
d. Decreased during the first trimester of pregnancy and increased on the second and third trimester
d. Decreased during the first trimester of pregnancy and increased on the second and third trimester
A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The nurse who is caring for the client is performing assessments every 30 minutes. Which assessment finding would the nurse document as normal? I. Urinary output of 60ml/hour II. Presence of Patellar reflex III. Respiratory rate of 16bpm IV. Urinary output of 10 ml/hour V. Respiratory rate of 9bpmVI.Patellar reflex is negative
a. I, III, and VI
b. II, III, and IV
c. I, III, and V
d. I, II, and III
d. I, II, and III
A 34 y/o client is 34 weeks pregnant and is experiencing bleeding caused by placenta previa. The fetal heart sounds are normal and the client isn’t in labor. Which of the following interventions should the nurse perform?
a. Allow the client to ambulate with assistance
b. Perform an internal examination to check for cervical dilatation
c. Do perineal pad count
d. Notify the physician of FHT of 130 bpm
c. Do perineal pad count
A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The midwife is reviewing the physician’s order and would expect to note which of the following prescribed treatments for this condition?
a. Increase hydration
b. Oxytocin (Pitocin) infusion
c. Medication that will provide sedation
d. Administration of a tocolytic medication
b. Oxytocin (Pitocin) infusion
The nurse is developing a plan of care for a client in her 34th week of gestation who’s experiencing premature labor. What non-pharmacologic intervention should the plan include to halt premature labor?
a. Encouraging ambulation
b. Serving a nutritious diet
c. Promoting adequate hydration
d. Performing nipple stimulation
c. Promoting adequate hydration
A client at 28 weeks’ gestation is complaining of contractions. Following admission and hydration, physician writes an order for the nurse to give 12 mg of betamethasone I.M. The nurse should explain that this medication is given to:
a. Slow contraction
b. Enhance fetal growth
c. Prevent infection
d. Promote fetal lung maturity
d. Promote fetal lung maturity
The nurse would best position a pregnant woman with prolapsed umbillical cord to:
a. Supine position with hips elevated on a pillow
b. Exaggerated Sim’s Lateral Position
c. Right Side lying position
d. Prone position turned to the side
b. Exaggerated Sim’s Lateral Position
During a contraction stress test, a decrease in the fetal heart rate occurs with the onset of contractions. The best nursing action would be to:
a. Reposition the client
b. Continue monitoring the client
c. Stop oxytocin administration
d. Notify the physician
b. Continue monitoring the client
A nurse is monitoring a client labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction?
a. Late decelerations
b. Early decelerations
c. Short-term variability
d. Variable decelerations
d. Variable decelerations
A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to:
a. Place the mother in the supine position and administer magnesium sulfate
b. Document the findings and continue to monitor the fetal patterns
c. Stop oxytocin administration, reposition the woman, administer oxygen via face mask and notify the physician
d. Increase the rate of Pitocin IV infusion
c. Stop oxytocin administration, reposition the woman, administer oxygen via face mask and notify the physician
- Glycosylated hemoglobin level is obtained to determine compliance to treatment plan for GDM.A level of 6% indicates:
a. The client is a candidate for above the knee amputation to prevent further complications
b. There is a risk for spontaneous abortion
c. Client’s education in blood sugar control is adequate
d. Client needs further instruction regarding the treatment plan for GDM.
c. Client’s education in blood sugar control is adequate
24.A nurse is assessing the fundus in a postpartum woman and notes that the uterus is soft and spongy and not firmly contracted. The midwife prepares to implement which of the following interventions EXCEPT:
A. Massaging the uterus
B. Assisting the woman to urinate
C. Checking for distended bladder
D. Administration of ritodrine hydrochloride
D. Administration of ritodrine hydrochloride
- A primigravid client is admitted to the labor and delivery area. Assessment reveals fetal malpresentation, yellow amniotic fluid, and a fetal heart rate (FHR) of 80 beats/minute. What should the nurse do?
a. Increase the I.V. oxytocin flow rate, as ordered, to hasten labor and delivery.
b. Reassess the client for continued normal findings in 15 minutes.
c. Help the client into the lithotomy position for delivery.
d. Notify the physician and surgical team of an emergency.
d. Notify the physician and surgical team of an emergency.
A senior high school student asks the school nurse, “How will I know
that I am fertile?” The school nurse would be inaccurate if she states
that one of the signs of ovulation is:
a. Your cervical mucus is elastic
b. Your cervical mucus is clear, thin, and watery
c. You will experience a diffused lower abdominal discomfort that radiates to the back
d. There will be a sudden drop in you temperature followed by an increase for .7 - .80C for 3 full days
c. You will experience a diffused lower abdominal discomfort that radiates to the back
A pregnant woman on her 34th week of pregnancy asked you what is
the normal fetal movement, so that she knows what she should be
expecting to feel, and knows what she should report. You should let her
know that the normal fetal movement count is:
a. 10-12 times per hour
b. 8-10 times per hour
c. Twice every hour
d. 10 times per day
a.10-12 times per hour
Gravity is counted by:
a. The number of pregnancies that reach the age of viability
b. The number of pregnancies in which the fetus has been born alive
c. The number of pregnancies regardless of duration of outcome
d. The number of pregnant women visiting a pre-natal clinic every week
c. The number of pregnancies regardless of duration of outcome
A participant inquired. “What is the average normal weight gain during pregnancy?” Which of the following responses would be appropriate?
a. 12 to 22 lbs
b. 15 to 25 lbs
c. 14 to 45 lbs
d. 25 to 35 lbs
d.25 to 35 lbs
A woman on her 2nd trimester of pregnancy complains of pyrosis, all
of the following are helpful nursing interventions except:
a. Drinking milk in between meals
b. Lying down with two pillows
c. Lying down after meals
d. Eat small frequent meals
c. Lying down after meals
