OB Test 1 Questions Flashcards
The nurse expects to see which maternal cardiovascular finding during labor?
a. decreased BP
b. Dereased Pulse
c. Decreased WBC
d. Increased Cardiac Output
d. Increased Cardiac Output
Regarding how the fetus moves through the birth canal, nurses should be aware that:
a. the transverse lie is preferred for vaginal birth
b. the fetal attitude describes the angle at which the fetus exits the uterus
c. of the 2 primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother.
D. the normal attitude of the fetus is called general flexion
D. the normal attitude of the fetus is called general flexion
When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called the fetal ___.
A. Position
B. Presentation
C. Lie
D. Attitude
D. Attitude
The nurse recognises that a woman is in true labor when she states:
a. my baby dropped and i have to urinate more frequently now
b. my water just broke
c. the contractions in my uterus are getting stronger and more close together now
D. I passes some thick, pink mucus when i urinated this morning
c. the contractions in my uterus are getting stronger and more close together now
What position is least effective when gravity is desired to assist in fetal decent?
a. Lithotomy
b. Sitting
C. Walking
d. Kneeling
a. Lithotomy
To adequately care for laboring women, the nurse should know which stage of labor varies the most in length?
a. third
b. first
c. fourth
d. second
b. first
The factors that affect the process of labor and birth, known commonly as the 5 P’s include all but:
a. Passageway
b. Passenger
C. Powers
D. Pressure
D. Pressure
The slight overlapping of the cranial bones or shaping of the fetal head during labor is called?
a. molding
b. lightening
c. furguson’s reflex
d. Valsava Maneuver
a. molding
When assess a woman in the first stage of labor, the nurse recognizes that the most conclusive sign that uterine contractions are effective is:
a. dilation of the cervix
b. decent of the fetus
c. increase in bloody show
d, rupture of the amniotic membranes
a. dilation of the cervix
Nurse alert to signs of the onset of the second stage of labor can be certain that the stage has begun when:
a. the woman has a sudden episode of vomiting
b. the nurse is unable to feel the cervix during a vaginal examination
c. the bloody show increases
d. the woman involuntarily tries to bear down
b. the nurse is unable to feel the cervix during a vaginal examination
Which collection of risk factors will most likely result in damaging lacerations including episiotomies?
a. a first time mother with red hair whose rapid labor was overseen by an obsterrician
b. a red haired mother of 2 who is going through a breech birth
a. a first time mother with red hair whose rapid labor was overseen by an obsterrician
wasn’t typing all that shit out lol
A 25 year old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9 pound 7 oz boy after agmentation of labor with pitocin. She puts on her call light and asks for her nurse right away stating that she is bleeding a lot. The most likely cause of her hemorrhage is this woman is:
a. retained placental fragments
b. un repaired vaginal lacerations
c. uterine atony
d. puerperal infection
c. uterine atony
Emergency conditions during labor that require immediate nursing interventions can arise with startling speed. Examples of such emergencies include
vaginal bleeding
infection
prolapse of the cord
nonreassuring or abnormal fetal heart rate
inadequate uterine relaxation
Which factors influence cervical dilation?
scaring of the cervix
the force of the presenting fetal part against the cervix
the pressure applied by the amniotic sac
the size of the female
strong uterine contractions
everything but the size of the female
- The diagnosis of pregnancy is based on which positive signs of pregnancy? Choose all that apply,
A. Verification of fetal movement, B. identification of fetal heartbeat, C. Positive human chorionic gonadotropin hCG test, D. palpation of the fetal outline, E. visualization of the fetus
A. Verification of fetal movement,
B. identification of fetal heartbeat,
E. visualization of the fetus
- A 31 year old women believes that she may be pregnant. She took an over-the-counter pregnancy test one week ago after missing her., The test was positive. During her assessment interview, the nurse inquires about the woman’s last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She is under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the of the false positive pregnancy test results?
A. She took the pregnancy test too early.
B. She has been under considerable stress and has a hormone imbalance.
C. She takes anticonvulsants.
D. she has a fibroid tumor.
C. She takes anticonvulsants
- What represents a typical progression through the phases of a woman’s establishing a relationship with the fetus?
A. Except the fetus as distinct from herself, except the biologic fact of pregnancy, has a feeling of caring and responsibility.
B. Views the child as a part of her self, has feelings of well-being, excepts the biologic factor pregnancy.
C. Fantasize about the child’s gender and personality, views the child as part of her self, becomes introspective.
D. I am pregnant, I am going to have a baby, I am going to be a mother.
D. I am pregnant, I am going to have a baby, I am going to be a mother.
- For what reason is breast-feeding contraindicated?
A. Human immunodeficiency virus HIV positive
B. History of breast cancer three years ago.
C. Hepatitis B.
D. Everted nipples.
A. Human immunodeficiency virus HIV positive
- Many pregnant women have questions regarding work in travel during pregnancy. The nurse should instruct clients that,
A. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
B. Women should avoid seatbelt and shoulder restraints in the car because they press on the fetus.
C. metal detectors at airport security checkpoints can harm the fetus if the woman passes through them a number of times.
D. Women should sit for long periods and crossed her legs at the knees from time to time for exercise.
A. While working or traveling in a car or on a plane, women should arrange to walk around at least every hour or so.
- Which time based description of a stage of development and pregnancy is accurate?
A. Postdate, pregnancy that extends beyond 38 weeks.
B. Preterm, pregnancy from 20 to 28 weeks.
C. Viability, 22 to 37 weeks since the last menstrual period Assuming a fetal weight greater than 500 g
D. Term, pregnancy from the beginning of week 38 of just Teish into the end of week 42.
D. Term, pregnancy from the beginning of week 38 of just Teish into the end of week 42.
- A musculoskeletal system adapts to changes that occur during pregnancy. A woman can expect to experience what change?
A. She will have increased abdominal muscle tone.
B. She will notice decreased mobility and her pelvic joints.
C. Her center of gravity will shift backwards.
D. She will have increased lordosis.
D. She will have increased lordosis.
- In her work with pregnant women of various cultures, a nurse practitioner has observed various practices that seem strange or unusual. She has learned that cultural rituals and practices during pregnancy seem to have one purpose in common. Which statement best describes that purpose?
A. To promote family unity.
B. to protect the mother and fetus during pregnancy.
C. To ward off the evil eye.
D. To appease the gods of fertility.
B. to protect the mother and fetus during pregnancy
- A nurse caring for a newly pregnant woman advises her that ideally prenatal care should begin,
A. after the first missed menstrual period
B. after the third missed menstrual period
C. Before the first missed menstrual period
D. After the second missed menstrual period.
A. after the first missed menstrual period
- A woman’s obstetric history indicates that she is pregnant for a fourth time, and all of her children from previous pregnancies are living. One child was born at 39 weeks of just station, twins were burnt born at 34 weeks of gestation, and another child was born at 35 weeks of just station. What is her gravidity and parity using the GT PAL system?
A. 4-1-2-0-4
B. 3-0-3-0-3
C. 4-2-1-0-3
D. 3-1-1-1-3
A. 4-1-2-0-4
- A woman arrived at the clinic for a pregnancy test. Her last menstrual period was February 14, 2013. Her expected date of birth was,
A. November 7, 2013
B. November 21, 2013
C. December 17, 2013
D. September 17, 2013
B. November 21, 2013
- A pregnant couple has formulated a birth plan and is reviewing it with the nurse at an expected parents class. Which aspect of their birth plan would be considered unrealistic and require further discussion with the nurse?
A. We plan to use the technique taught in the Lamaze class to reduce pain experienced during labor.
B. My husband and I have agreed that my sister will be my coach because he becomes anxious with regard to medical procedures and blood. He will be nearby and check on me every so often to make sure that everything is okay.
C. we want the labor and birth to take place in a birthing broom. My husband will come in the minute the baby is born.
D. We do not want the fetal monitor used during labor because it will interfere with movement and doing Effeurage.
D. We do not want the fetal monitor used during labor because it will interfere with movement and doing Effeurage.
- Prenatal testing for the human immunodeficiency virus HIV is recommended for which women?
A. All women who is monogamous with their partner.
B. All women, regardless of the risk factors
C. A woman who has had more than one sexual partner.
D. A woman who has had a sexually transmitted infection.
B. All women, regardless of the risk factors
- A nurse should be aware that a partners main role and pregnancy is,
A. To protect the pregnant woman from old wives tells
B. To provide financial support.
C. To make sure that the pregnant woman keeps prenatal appointments.
D. To support and nurture the pregnant woman.
D. To support and nurture the pregnant woman.
- During the initial visit with the client who is beginning prenatal care, nurses should be aware that,
A. The first interview is relaxed, get acquainted affair in which nurses gather some general impressions.
B. If nurses observed handicapping conditions, they should be sensitive and not inquire about them because the client will do that on her own time.
C.Because of legal complications, nurses should not ask about illegal drug use, that is left to physicians.
D. The nurses should be alert to appearance a potential parenting problems, such as depression or lack of family support.
D. The nurses should be alert to appearance a potential parenting problems, such as depression or lack of family support
- 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.”
c. “They occur between the third and fifth weeks of development.”
The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.
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.”
b. “A baby in utero does respond to the mother’s voice.”
Fetuses respond to sound by 24 weeks. The fetus can be soothed by the sound of the mother’s voice.
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.
a. It serves as a source of oral fluid and as a repository for waste from the fetus.
Amniotic fluid also cushions the fetus and helps maintain a constant body temperature.
Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that:
A. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing
B. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins
C. Identical twins are more common in Caucasian families
D. Fraternal twins are same gender, usually male
A. Twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing
If the parents-to-be are older and have taken fertility drugs, they would be very interested in this information.
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping:
A. In a side-lying position
B. On her back with a pillow under her knees
C. With the head of the bed elevated
D. On her abdomen
A. In a side-lying position
Optimal circulation is achieved when the woman is lying at rest on her side. Decreased uterine circulation may lead to intrauterine growth restriction. Previously it was believed that the left lateral position promoted maternal cardiac output, thereby enhancing blood flow to the fetus. However, it is now known that either side-lying position enhances uteroplacental blood flow.
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates:
A. The fetus is at risk for Down syndrome
B. The woman is at high risk for developing preterm labor
C. Lung maturity
D. Meconium is present in the amniotic fluid
C. Lung maturity
The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation.
Which time span delineates the appropriate length for a normal pregnancy?
A. 9 lunar months, 8.5 calendar months, 39 weeks, 272 days
B. 10 lunar months, 9 calendar months, 40 weeks, 280 days
C. 9 calendar months, 10 lunar months, 42 weeks, 294 days
D. 9 calendar months, 38 weeks, 266 days
B. 10 lunar months, 9 calendar months, 40 weeks, 280 days
Pregnancy lasts approximately 10 lunar months, 9 calendar months, 40 weeks, 280 days. Length of pregnancy is computed from the first day of the last menstrual period (LMP) until the day of birth.
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system?
A. 2-0-0-1-1
B. 2-1-0-1-0
C. 3-1-0-1-0
D. 3-0-1-1-0
C. 3-1-0-1-0
Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)?
A. Radioimmunoassay
B. Radioreceptor assay
C. Latex agglutination test
D. Enzyme-linked immunosorbent assay (ELISA)
D. Enzyme-linked immunosorbent assay (ELISA)
OTC pregnancy tests use ELISA for its one-step, accurate results.
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is:
A. A positive pregnancy test
B. Fetal movement palpated by the nurse-midwife
C. Braxton Hicks contractions
D. Quickening
B. Fetal movement palpated by the nurse-midwife
Positive signs of pregnancy are those that are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement.
During a client’s physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as:
A. Hegar sign
B. McDonald sign
C. Chadwick sign
D. Goodell sign
A. Hegar sign
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign.
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester?
A. Less audible heart sounds (S1, S2)
B. Increased pulse rate
C. Increased blood pressure
D. Decreased red blood cell (RBC) production
B. Increased pulse rate
Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term.
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:
A. Primipara
B. Primigravida
C. Multipara
D. Nulligravida
A. Primipara
A primipara is a woman who has completed one pregnancy with a viable fetus.
Which presumptive sign (felt by woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause?
A. Amenorrhea-stress, endocrine problems
B. Quickening-gas, peristalsis
C. Goodell sign-cervical polyps
D. Chadwick sign-pelvic congestion
C. Goodell sign-cervical polyps
Goodell sign might be the result of pelvic congestion, not polyps.
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
D. Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy
This compression also leads to varicose veins in the legs and vulva.
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
C. 33% HCT; 11 g/dl HGB
This represents the lowest acceptable value during the first and the third trimesters.
G:
Total number of times the woman has been pregnant
T:
Number of pregnancies carried to term
P:
Number of pregnancies that resulted in a preterm birth
A:
Abortions or miscarriages before the period of viability
L:
Number of children born who are currently living
Chadwick sign
The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation.
Goodell sign
Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy.
