OB exam 1

Question 1

Prenatal education provided at a local clinic should include emphasizing to the pregnant client to keep all routine prenatal visits. What is the rationale for this point?

Answer 1

Most pregnancy-related complications are preventable.

Question 2

A pregnant client with premature ruptured membranes is trying to decide whether home care might be the best option. Which advantage should the nurse mention to the client that is most pertinent to their condition?

Answer 2

decreased exposure to infection

Question 3

The experienced nurse has seen many changes in health care throughout the last few decades. One such change has been to move from acute care settings out into the community with an emphasis on which areas? Select all that apply.

Answer 3

health promotion
illness prevention

Question 4

An 18-year-old female client who is sexually active asks the nurse for information on barrier contraceptives. Which statement is appropriate for the nurse to include in the response?

Answer 4

“Cervical caps are most effective when used along with a spermicidal agent.”

Question 5

A nurse is working as part of a multidisciplinary group tasked with creating programs to address the major health issues affecting women. The group would most likely focus their efforts on which condition?

Answer 5

cardiovascular disease

Question 6

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client?

Answer 6

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth.

Question 7

A couple comes to the clinic and states to the nurse, “I don’t think we are ever going to be able to have children. We have been trying but have had no luck.” What assessments does the nurse anticipate will be performed for this couple? Select all that apply.

Answer 7

semen analysis
ovulation monitoring
tubal patency

Question 8

A client is diagnosed with endometriosis. As part of the teaching plan, the nurse is explaining the condition, including the ways that the diagnosis would be confirmed. The nurse determines that the teaching was successful when the client states that which test would confirm the diagnosis?

Answer 8

pelvic laparoscopy

Question 9

A nurse working in the community is involved with secondary prevention. With which activities would the nurse be most likely involved? Select all that apply.

Answer 9

fecal occult blood testing
blood pressure evaluations
cholesterol monitoring

Question 10

A client has been trying to conceive for 3 months. The client tells the nurse, “I just know something is wrong with me.” Which response by the nurse is best?

Answer 10

“It can take up to 1 year of regular, unprotected intercourse to conceive.”

Question 11

The nurse is providing discharge instructions to a client who gave birth to a healthy newborn via cesarean birth 3 days ago. The nurse is advising the client how to shower with the surgical incision when the client reports that their cultural beliefs include not showering for several weeks after childbirth to avoid illness. Which action by the nurse is appropriate?

Answer 11

Teach the client signs of surgical site infection.

Question 11

The nurse is teaching a group of college students about the four phases of the sexual response. Which phase will the nurse point out as producing an elevation in heart rate, blood pressure, and respirations?

Answer 11

excitement

Question 12

The nurse is providing teaching to an adolescent female on the function of the female reproductive system. Which statement by the client best reflects understanding of the material presented?

Answer 12

“My menstrual cycle lasts about 28 days each month but varies sometimes, which is normal.”

Question 13

A nurse is teaching an 18-year-old client about circumcision care for their second infant. Which statement made by the nurse would be most appropriate to assess the client’s learning ability?

Answer 13

“I notice you’re having problems with reading the information. Will you tell me about this?”

Question 13

A pregnant client is questioning the nurse about the advantages of the various health care options. When providing information about home care and births, which factor should the nurse point out as an advantage?

Answer 13

Families can be better kept intact.

Question 14

The nursing faculty is explaining to students the historical background regarding the reasoning for the introduction of nurseries in the 1900s. Which statement most accurately explains the reason for the nurseries?

Answer 14

Parents could not care for their newborns due to chloroform gas.

Question 15

A sex education class is being conducted at a local community center. The attendees ask the nursing instructor about why they experience sensations of increased warmth during sex and redness of the neck and chest. Which information would the nurse provide to explain this experience? Select all that apply.

Answer 15

A person’s heart rate increases during sex, making them warmer.
The blood pressure will increase, which can cause a feeling of warmth.
Vessels in the pelvis are receiving more blood and can cause a warm sensation.

Question 16

A nursing student doing a maternity rotation is assigned to care for a client receiving abortion care. The nursing student feels uncomfortable being involved with abortion care due to their personal beliefs and informs their instructor. Which action by the nursing instructor is appropriate?

Answer 16

Assign the student to observe a different client for the day.

Question 17

A nurse is conducting an orientation at a health clinic for newly hired nurses comparing normal and abnormal findings from a female physical assessment. The nurse determines the session is successful when they correctly point out which structure’s secretions assist with sexual intercourse?

Answer 17

Bartholin glands

Question 18

As part of an education program for pregnant clients and their partners, the nurse illustrates the various settings available for birth. The nurse determines that the program was successful when the group correctly chooses which statement about home births?

Answer 18

“Clients giving birth at home have control over every part of labor.”

Question 19

The nurse is caring for a client experiencing premenstrual syndrome. Which finding should the nurse report to the health care provider?

Answer 19

feelings of hopelessness and sadness

Question 19

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings?

Answer 19

the possibility of a chlamydia infection

Question 20

A nurse is providing education to a client with infertility concerns. Which statement by the client indicates appropriate understanding of the Spinnbarkeit Test?

Answer 20

“Halfway in my cycle I will need to check my cervical mucus to see if I can stretch it into long strands, indicating I am close to ovulating.

Question 20

The nurse is providing education to a 24-year-old client experiencing irregular menstruation. The client and their male spouse are trying to conceive. Which statement by the client indicates they understand the teaching provided?

Answer 20

“Having my hormones tested is a way to determine what is going on.”

Question 21

The nurse in a primary care clinic and a client have come to see the health care provider because the client is getting married and wants to have a prenuptial gynecologic examination. After the exam, the nurse asks about the client’s plan to have a family. The client responds, “Why do I have to plan for a family?” What would be the nurse’s best response?

Answer 21

The couple can control the time between births when they plan their family.

Question 21

The nurse is caring for several families enrolled in Medicaid in the prenatal setting. Which statement by an expectant parent would alert the nurse to assess the family further?

Answer 21

“We just moved here from another state and I am still getting used to the new town.”

Question 22

A 22-year-old client comes to the clinic for an evaluation. Assessment findings are as follows: age of first intercourse: 15 years; intrauterine contraception inserted 4 weeks ago; multiple sexual partners; cigarette smoking since age 16, approximately 1/2 to 1 pack per day; oral temperature 100.4°F (38°C). The client is diagnosed with pelvic inflammatory disease (PID). Which order(s) does the nurse anticipate from the health care provider? Select all that apply.

Answer 22

ceftriaxone 1 gram IV daily
doxycycline 100 mg PO every 12 hours
initiation of IV fluids
semi-Fowler position when in bed

Question 23

A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?

Answer 23

endometriosis

Question 23

The school nurse is preparing a teaching session for a group of adolescents explaining the menstrual cycle. The nurse determines the session is successful when the young students correctly choose which fact?

Answer 23

The average menstrual flow lasts 4 to 6 days.

Question 24

A nurse is conducting a health class for a group of adolescents about reproduction. When describing the testes, the nurse would explain that these organs are important for manufacturing which hormone?

Answer 24

testosterone

Question 25

The nursing student has learned the importance of documenting care in the client’s chart. The student understands that documentation is equally important in regard to client education because it aids in which actions? Select all that apply.

Answer 25

serves as a communication tool for all team members
testifies to the education that the client has received if legal matters arise
verifies standards set by JCAHO that hold health care providers accountable for education of clients
informs third-party payers of the services that were provided for reimbursement purposes

Question 25

A nurse is meeting with a group of nurses who have transitioned from working in an acute care facility to working in the community. When talking with the nurses about their experiences, which statements would the nurse likely hear? Select all that apply.

Answer 25

“Sometimes, the time we have available to address issues is limited.”
“Often, I have to make decisions on my own and trust myself.”
“It’s important to have great assessment skills when you’re in this setting.”

Question 26

The nursing instructor is teaching a session outlining the necessary skills of a community nurse. The instructor determines the session is successful when the students correctly choose which factor as the foundation of all nursing care?

Answer 26

Nursing process

Question 26

After teaching a health education class on the female reproductive cycle, the nurse determines that the teaching was effective when the group identifies which phase as belonging to the ovarian cycle?

Answer 26

follicular phase

Question 26

A client has just been prescribed clomiphene citrate to stimulate ovulation. Which possible effect should the nurse warn the client about?

Answer 26

overstimulation of the ovary resulting in potential multiple births

Question 27

The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would the nurse include as a major structure to help ensure fertilization of the ovum?

Answer 27

vas deferens

Question 28

A 52-year-old client reports recent onset of hot flashes, fatigue, and vaginal dryness. While assessing the client, which response should the nurse prioritize?

Answer 28

“Tell me what you are currently doing to manage these symptoms?”

Question 28

A couple who has not conceived after 6 years of not using birth control are being seen in the infertility clinic. In assessing the client’s psychosocial response to infertility, which might the nurse expect to find? Select all that apply.

Answer 28

Guilt related to the lack of conception
Anger toward others who have conceived
Fear of the possible outcome of the testing

Question 29

When utilizing a doula during labor, the client would expect which services to be included? Select all that apply.

Answer 29

the doula will act as a nonmedical companion.
The doula will provide emotional, physical, and educational support.

Question 29

The nurse is caring for a 14-year-old client with multiple health problems. Which activity would best reflect evidence-based practice by the nurse?

Answer 29

Following blood pressure monitoring recommendations

Question 30

The nurse is providing education on menstruation to an adolescent client who has just experienced menarche. The nurse will inform the client to contact the health care provider for which situation?

Answer 30

if saturating a menstrual pad in 1 hour

Question 31

The nurse in a sexual health clinic is reviewing the history of a 40-year-old client who is an IV drug addict, has had multiple sexual partners, and has been diagnosed with a sexually transmitted infection. Which therapy does the nurse expect to include in this client’s care?

Answer 31

hepatitis A and hepatitis B recombinant vaccine

Question 32

A young client who has herpes comes to the clinic regularly for treatment and counseling. This is an example of which level of prevention?

Answer 32

tertiary

Question 33

An oncology nurse is preparing a plan of care for a young parent newly diagnosed with lung cancer. What action would be the nurse’s priority?

Answer 33

Teach the family how to navigate the health care system.

Question 34

The nurse is teaching a client diagnosed with genital herpes. The nurse will provide additional teaching if the client makes which statement?

Answer 34

“I should apply warm compresses to my lesions to relieve pain and itching.”

Question 35

A pregnant client in the first trimester has come to the clinic for a checkup. The client mentions to the nurse that they would like to try some complementary and alternative medicine (CAM) therapies to control nausea. When teaching the client about these methods, which information would be important for the nurse to emphasize? Select all that apply.

Answer 35

“Remember that just because it says the remedy is natural, it does not always mean it is safe.”
“It would be important for you to talk with your health care provider about what might be best for you.”
“Check the package to make sure that all the ingredients and their amounts are listed.”

Question 36

A nurse is teaching a group of young adults about the sexual cycle. The nurse determines that the teaching was successful when the group identifies the five phases as they occur. Place the phases below in the correct order from first to last. All options must be used.

Answer 36

desire
excitement
plateau
orgasm
resolution

Question 37

A nurse is providing information regarding ovulation to a couple who want to have a child. Which fact should the nurse tell the clients?

Answer 37

At ovulation, a mature follicle ruptures, releasing an ovum.

Question 37

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

Answer 37

syphilis

Question 38

What are methods for delivering hormonal contraception? Select all that apply.

Answer 38

orally
transdermally
vaginally
implantation
injection

Question 38

A family is seeking sources for payment of health care costs. When talking with the family, the nurse determines that the family makes too much money to qualify for the federal program. Which source would the nurse likely recommend?

Answer 38

State Child Health Insurance Program

Question 39

A nurse educator is preparing for a class discussion on the high maternal mortality rate in the 17th and 18th centuries. Which information would the nurse likely include in the discussion? Select all that apply.

Answer 39

Clients giving birth often died from dehydration.
Exhaustion during labor occurred, resulting in death.

Question 40

The nurse is caring for a client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question?

Answer 40

acyclovir 400 mg orally BID

Question 40

A 15-year-old pregnant client living with their divorced parent is brought into the emergency department by their partner requiring a dilatation and curettage (D&C) after a miscarriage. Who will the nurse approach to sign the consent for the D&C?

Answer 40

the parent who has custody

Question 40

A clinic nurse is interviewing a young female client during a subfertility work up. When the client asks the nurse what causes infertility, the nurse informs the client that the problem can rest with the male, the female, or both. What does the nurse tell the female client are common problem areas related to the female? Select all that apply.

Answer 40

ovulation
tubal transport
impaired implantation

Question 40

The obstetrical nurse notes that a Muslim client has not been eating any of the meals supplied to them. Which actions performed by the nurse best demonstrate cultural competence?

Answer 40

The nurse becomes familiar with the Muslim client’s meal practices.

Question 41

A group of nurses are working to provide quality care for their clients within the current health care environment of cost containment. Which strategy(ies) would be appropriate for the nurses to use? Select all that apply.

Answer 41

educating clients about seeking help for problems early on
urging clients to participate in screening programs
creating easy access programs for clients to receive immunizations

Question 41

A nurse is conducting an in-service education program about the female reproductive cycle for a group of nurses working at a health clinic. When describing the phases of the endometrial cycle, the nurse would explain that the proliferative phase of the endometrial cycle corresponds to which phase in the ovarian cycle?

Answer 41

Follicular

Question 41

A nurse is educating a client about a care plan. Which question is appropriate to assess whether the client is learning?

Answer 41

“Many people have trouble remembering information. Is this a problem for you?

Question 42

A client who has chosen the cervical cap as their method of contraception states that they know how to use it. Which statement by the client would indicate to the nurse that the client does understand this method of contraception?

Answer 42

“I do not have any spermicidal allergies, so this method is OK for me.”

Question 43

The nurse is caring for a client who has been trying to conceive for the past 6 months without success. The client has no children and reports a heavy menstrual flow. Which action should the nurse perform first?

Answer 43

Palpate the pelvic area for tenderness.

Question 43

The nurse is caring for a client at 36 weeks’ gestation who has had no prenatal care to date. The client reports a sore throat, headache, and fatigue. The nurse notes a maculopapular rash on the palms and soles of the feet. Which order in the client’s chart should the nurse perform first?

Answer 43

Apply a continuous electronic fetal monitor.

Question 44

The nurse is caring for four clients, all prescribed oral contraceptive pills (OCPs). The nurse will question giving an oral contraceptive pill to which client?

Answer 44

37-year-old client who has migraines with aura several times a week and smokes

Question 45

A nursing instructor is preparing a class discussion on case management in maternal and newborn health care. Which factors would the instructor include as a key component? Select all that apply.

Answer 45

advocacy
coordination
communication
resource management

Question 45

A client who is scheduled for hysteroscopy says to a nurse, “I thought I would be able to have children, but now I know that will never be possible.” Which response would be most appropriate for the nurse to make?

Answer 45

“I will call the health care provider to come visit with you.”

Question 46

Which hormone is secreted from the hypothalamus in a pulsatile manner throughout the reproductive cycle?

Answer 46

gonadotropin-releasing hormone (GnRH)

Question 47

A 45-year-old client and their spouse are present in the clinic. Results of fertility testing indicate that the client has damage to their fallopian tubes. Which would be the most appropriate infertility option for this client?

Answer 47

In vitro fertilization

Question 47

The nurse is conducting a health history on a couple planning to become pregnant over the next few months. Which statement by the male client most concerns the nurse?

Answer 47

“I have a degree as a chemical engineer and work at the local plant.”

Question 48

The nurse who is working with families knows the importance of using good communication, both verbal and nonverbal. Which actions are examples of nonverbal communication? Select all that apply.

Answer 48

nodding
attending to others
active listening

Question 48

The nursing instructor is discussing the infant mortality rate with a group of students. The instructor determines the discussion is successful when the students correctly choose which action as a priority to help decrease infant mortality in the United States?

Answer 48

Improving accessibility to postnatal health care for infants

Question 49

After a discussion on the human papillomavirus (HPV) vaccine with a parent and 15-year-old adolescent at a well-child visit, the nurse recognizes the discussion was successful when the parent makes which statement?

Answer 49

“My adolescent will need three injections over a 6-month period.”

Question 49

The nursing student demonstrates an understanding of fetal mortality rates when compared to the other mortality rates when the student correctly describes the fetal mortality rate by which statement?

Answer 49

“The fetal mortality rate includes the intrauterine death of a fetus who is 20 weeks of gestation or more per 1,000 live births.”

Question 50

A nurse is conducting education classes at the local high school on reproductive life planning. Which would be appropriate for the nurse to implement during the teaching? Select all that apply.

Answer 50

encouragement of abstinence
proper condom application
sexually transmitted infection statistics

Question 50

A nurse is assisting with the pelvic examination of a client. The client has given birth to two living children, ages 5 and 2 years. The nurse would expect the client’s cervical os to appear as which shape on examination?

Answer 50

slit-like

Question 51

A client is 6 weeks’ postpartum and preparing to receive a depot medroxyprogesterone acetate injection. Which statement by the client requires follow up by the nurse?

Answer 51

“I need to be patient as it will take a few weeks before I can get pregnant again.”

Question 52

A 52-year-old client is seeking treatment for menopause. The client is not very active and has a history of cardiac problems. Which therapy option should the nurse recognize as contraindicated for this client?

Answer 52

long-term hormone replacement therapy

Question 52

The nurse is developing a presentation for a group of young adults about premenstrual syndrome. Which treatment options should the nurse point out as most appropriate? Select all that apply.

Answer 52

reduction of caffeine intake
vitamin and mineral supplements
NSAIDs

Question 52

The nurse at a health fair is teaching about the various changes of puberty. Which sequence of events will be best for the nurse to present when illustrating pubertal changes in females?

Answer 52

breast budding, appearance of pubic hair, menarche

Question 52

A nurse is preparing to teach insulin administration to an adolescent newly diagnosed with diabetes. Which strategy(ies) will the nurse use to assist the adolescent’s learning? Select all that apply.

Answer 52

Go slow and repeat information often.
Use plain nonmedical language to explain procedures.
Teach the prioritized information.

Question 53

The nurse is caring for clients who have STIs. Which client is most at risk for becoming infertile due to the infection?

Answer 53

a client diagnosed with chlamydia

Question 54

A couple is being assessed for infertility. The male partner is required to collect a semen sample for analysis. What instruction should the nurse give the client?

Answer 54

Deliver sample for analysis within 1 to 2 hours after ejaculation.

Question 54

The nurse, while teaching a group of pregnant clients about the production of breast milk, describes colostrum and compares it with mature breast milk. Which characteristic would the nurse identify as associated with colostrum?

Answer 54

high mineral content

Question 55

After teaching a group of young adult females about preventing pelvic inflammatory disease (PID), the nurse determines that the teaching was successful when the group identifies which method as effective?

Answer 55

having infected sexual partners receive treatment

Question 55

The nurse is reviewing the laboratory test results of a client who presented to the emergency room with reports of persistent, heavy bleeding. The client states being on day 6 of their menstrual cycle. Which finding should the nurse prioritize?

Answer 55

hemoglobin level of 10.1 g/dl (101 g/l) (normal: 12 to 16 g/dl; 120 to 160 g/l)

Question 55

An adolescent client has been airlifted to a large urban hospital for emergent care. The nurse will illustrate family-centered care by prioritizing which actions? Select all that apply.

Answer 55

The health care team gives the client and family regular updates.
The nurse assists the family with travel plans in order to stay with the client.
The client and family are able to communicate their potential fears to nurses and health care providers.

Question 56

Semen analysis has been ordered for the partner of a client who has been unable to become pregnant. What instructions should the nurse provide to the partner?

Answer 56

“Bring the sample to the lab immediately after you collect it.”

Question 56

A nurse is teaching a female client who is unable to conceive how to monitor their basal body temperature. Which instruction would the nurse prioritize for this client?

Answer 56

Chart body temperature for at least a month

Question 56

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure?

Answer 56

clitoris

Question 57

A client is 40 years old and a heavy smoker. The client has a single sexual partner but has very irregular menstrual cycles. The client wants a highly reliable contraceptive. Which method would be the best recommendation?

Answer 57

a diaphragm and spermicide

Question 58

Which statement is not an advantage of home care?

Answer 58

It can increase self-confidence because it allows sick people to rest while others take care of them.

Question 58

The labor and birth nurse is precepting a nursing student. The preceptor informs the student that there are indicators for increased infant mortality. The preceptor includes which as predictors of higher infant mortality? Select all that apply.

Answer 58

chromosomal abnormalities
prematurity

Question 59

A client is attempting to become pregnant and is using varied methods to identify ovulation. What assessment finding would most clearly suggest that the client is ovulating?

Answer 59

The client has clear, thin cervical mucus

Question 59

A nurse is working on developing cultural competence. Which actions would reflect that the nurse is attaining cultural skills? Select all that apply.

Answer 59

examination of personal biases toward other cultures
assessment of each client’s unique cultural values and beliefs
acting as an advocate for social justice to eliminate health disparities

Question 59

A client reports monthly, one-sided, lower abdominal pain to the nurse. Which question will the nurse ask next?

Answer 59

“Does the pain occur a week or two before your period?”

Question 60

A nurse is planning care for a client and their spouse recently diagnosed with multiple sclerosis and wanting to prevent pregnancy for now. What is the most appropriate nursing diagnosis for this couple?

Answer 60

Readiness for enhanced knowledge regarding contraception options

Question 60

A nurse manager is working with a group of staff nurses at a local health clinic on enhancing the staff’s cultural humility. The clinic serves a culturally diverse client population. Which aspect would the nurse manager emphasize as a crucial first step?

Answer 60

having each staff member identify their own preconceptions about the cultures being served

Question 61

At a prenatal class, the nurse is told by a client that their parent advises them not raise their hands above their head during pregnancy in order to avoid umbilical cord problems. What is the nurse’s best response?

Answer 61

“This is a belief from your parent’s culture about what to avoid during pregnancy.”

Question 62

A nurse is providing care to a client who has experienced a heart attack. When reviewing the client’s medical record, the nurse would identify which factors as placing the client at risk for this condition? Select all that apply.

Answer 62

history of preeclampsia
repeated fluctuations in weight gain and loss
history of type 2 diabetes