OB Final Exam

Question 1

The nurse is evaluating a patient who states that she has noticed a decrease in fetal movement. Which test result would reassure the nurse about the status of the fetus?

Answer 1

Reactive NST.

Question 2

What sign (not bleeding) is most often consistent with diagnosis of ruptured ectopic pregnancy?

Answer 2

Referred shoulder pain.

Question 3

When caring for a pregnant patient, you notice she is having heavy vaginal bleeding but denies pain. What is the next nursing action and why?

Answer 3

Prepare for probable C-Section. (Assume placenta previa)

Question 4

While observing the fetal heart monitor, the nurse notices smooth decreases below the baseline FHR immediately after contractions. The nurse recognizes that this fetal heart pattern is caused by:

Answer 4

A. Umbilical cord compression

Question 5

A nurse sees smooth decreases that start when contractions start when contractions start and return to baseline by the end of the contraction. What is this FHR pattern and what is the nurse’s priority action?

Answer 5

• The FHR is early deceleration.
• The nurse should perform assessment to investigate labor progress.

Question 6

A woman at full term is being admitted with ruptured membranes. Which lab is the priority for the nurse to obtain?

Answer 6

Group B strep screening.

Question 7

When caring for a patient with ruptured membranes, they begin to run a fever and are tachycardic. What does the nurse suspect and what assessment should be done?

Answer 7

• The nurse should suspect chorioamnionitis
• The nurse should assess for uterine tenderness between contractions.

Question 8

What are common manifestations of chorioamnionitis?

Answer 8

Fever, tachycardia, increased uterine tenderness, and foul smelling odor.

Question 9

What is the #1 most concerning/common complication of epidural?

Answer 9

Hypotension

Question 10

How does the nurse prevent hypotension in a patient receiving epidural?

Answer 10

IV fluid bolus before procedure.

Question 11

What is the most appropriate nursing action for a patient with persistent early decelerations of FHR?

Answer 11

Assess labor progress

Question 12

A nurse sees smooth decreases that start at the peak of contraction, and persist even after contraction stops. What FHR pattern is this and what are likely causes of this?

Answer 12

• These are late decelerations
• These are likely caused by uterine hyperstimulation, maternal hypotension. (Utero-placental insufficiency)

Question 13

A pregnant patient is due to deliver in 6 weeks and is worried about her weight gain during pregnancy. Before pregnancy, she weighed 125 pounds, her current weight is 150 pounds. How do you respond to the patient?

Answer 13

Inform her that her weight gain is right on track for how far along she is.

Question 14

Which factors may indicate need for nutritional counseling?

Answer 14

• Adolescence
• Special medical diets
• Multiparity
• personal or cultural preference
• Closely spaced pregnancies

Question 15

A nurse is counseling a client at 40 weeks gestation with her First baby about signs that come before Labor starts. Which statement shows a good understanding of this discussion by the client?

A) “A bloody show is abnormal, and it means something might be wrong with my pregnancy”

B)“If my feet are swelling it could be a sign I will go into labor in the next day”

C)If I have a surgery for nesting I should Pace myself, because I might be close to going into labor
D) “When I feel the baby drop I should go right to the hospital, to be monitored”

Answer 15

C

Question 16

The nurse is evaluating a client who is scheduled for a cesarean section birth. Which situations are considered medical indications for cesarean birth? Select all that apply:

A. Dystocia
B. Past 40 weeks gestation
C. Umbilical Cord Prolapse
D. Abnormal Presentation
E. Maternal Discomfort

Answer 16

A,C,D

Question 17

A nurse is caring for a client in the active phase of the first stage of Labor Who currently has opioid use disorder. As the nurse is assisting the client in choosing pain management options, which option is safest?
A. Butorphanol IV
B. Ibuprofen orally
C. Epidural Anesthesia
D. Pudendal Anesthesia

Answer 17

C

Question 18

A nurse is assisting a client immediately after an uncomplicated vaginal birth when the client sits upright, states she cannot breathe then collapses backward unresponsiveness in respiratory arrest. Which complications should the nurse expect?
A. Cord Prolapse
B. Dystocia
C. Uterine Rupture
D. Amniotic Fluid Embolism

Answer 18

D

Question 19

The nurse is preparing a client for induction of labor. Which assessment finding is a contraindication to oxytocin infusion?
A. BP 140/90, lying on left side
B. Contractions with a duration of 90 seconds, frequency every 2 minutes
C. Green amniotic fluid leaking from the vagina
D. Fetal Heart Rate of 120 beats per minute, with moderate variability

Answer 19

B

Question 20

A nurse caring for a client in labor notes vaginal exam findings at 7 cm dilated, 100% effaced -4 station, LOA. Which intervention is appropriate?
A. place the client in upright or squatting positions
B. check maternal VS 12hr
C. Position client in the knee-chest position
D. Prepare the client for immediate birth

Answer 20

A

Question 21

Where’s this monitoring a client in labor who has a Cesarean section with her previous pregnancy. Which finding is the nurse most concerned about?
A. Gush of clear fluid from vaginal
B. Small amount of blood-tinged mucus from vagina
C. Change of fetal station from +2 to -4
D. Report of crampy pain during uterine contractions

Answer 21

C

Question 22

The nurse is discussing contraceptive methods with a client in the Family Planning clinic. Which method provides significant protection for sexually transmitted infections (STIs)? SATA

A. Female condom
B. Intrauterine Device (IUD)
C. Combination Oral Contraceptives (COC)
D. Progestin only contraceptive pills
E. Male condom

Answer 22

A E

Question 23

A labor nurse is preparing for possible use of McRoberts maneuver for a birth. Which situation explains why the nurse anticipates using this maneuver?
A. Breech position
B. Low back Pain
C. Forceps delivery
D. Vaginal bleeding

Answer 23

C

Question 24

A nurse is monitoring an IV infusion of magnesium sulfate to a client who is experiencing preterm labor. which is the priority nursing assessment for this client?
A. Temperature
B. Respiratory rate
C. Bowel sounds
D. Fetal heart rate (FHR)

Answer 24

B

Question 25

A nurse notes a fetal heart rate pattern with a smooth decrease from the baseline heart rate which begins after the peak of the contraction, and ends after the contraction ends. Which are likely causes of this heart rate pattern?
A. Uterine hyperstimulation
B. Fetal head compression
C. Umbilical cord compression
D. Maternal hypertension
E. Utero-placental insufficiency

Answer 25

A,D,E

Question 26

A nurse is admitting a client in the active phase of first stage of Labor. Which assessment finding should the nurse notify the provider immediately?
A. Leaking of clear amniotic fluid vaginally
B. Early decelerations of the fetal heart rate
C. Uterine contractions every 2 minutes lasting 90 seconds
D. Mucus vaginal discharge with blood streaks

Answer 26

C

Question 27

A post menopausal woman with significant hx of diabetes and HTN reports to the clinic with complaints of abnormal vaginal bleeding. What diagnosis does the nurse suspect?

Answer 27

Endometrial cancer