OB exam 1-with 100% verified solutions-2024-2025.docx, Exams of Nursing

Download OB exam 1-with 100% verified solutions-2024-2025.docx and more Exams Nursing in PDF only on Docsity! OB exam 1-with 100% verified solutions-2024-2025 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." correct answer- c 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." correct answer- b 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 correct answer- a Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that: A. Rates of 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. correct answer- a 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. correct answer- a 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 that: A. The fetus is at risk for Down syndrome. B. The woman is at high risk for developing preterm labor. C. The lungs are mature. D. Meconium is present in the amniotic fluid correct answer- c 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 correct answer- b A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination? A. Fetus is in a breech position B. FHR baseline is within normal range C. Fetus with possible renal problems D. Increased fundal height correct answer- c Which developmental finding is accurate with regard to fetal growth? A. Heart starts beating at 12 weeks. B. Lungs take shape by 8 weeks. C. Brain configuration is complete by 8 weeks. D. Main blood vessels form by 8 weeks correct answer- d In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? (Select all that apply.) A. Tylenol OTC occasionally for a headache; twice last week B.Anticonvulsant for seizure disorder C. Lithium for bipolar disorder D. Coumadin for atrial fibrillation E. Multivitamins once a day correct answer- b,c,d 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 according to 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 correct answer- c during her first trimester and would like to know whether it is safe for her to have a drink with dinner now. The nurse tells her: A. "Because you're in your second trimester, there's no problem with having one drink with dinner." B. "One drink every night is too much. One drink three times a week should be fine." C. "Because you're in your second trimester, you can drink as much as you like." D. "Because no one knows how much or how little alcohol it takes to cause fetal problems, the best course is to abstain throughout your pregnancy." correct answer- d Which behavior indicates that a woman is "seeking safe passage" for herself and her infant? A. She keeps all prenatal appointments. B. She "eats for two." C. She drives her car slowly. D. She wears only low-heeled shoes. correct answer- a What type of cultural concern is the most likely deterrent to many women seeking prenatal care? A. Religion B. Modesty C. Ignorance D. Belief that physicians are evil correct answer- b In understanding and guiding a woman through her acceptance of pregnancy, a maternity nurse should be aware that: A. Nonacceptance of the pregnancy very often equates to rejection of the child. B. Mood swings are most likely the result of worries about finances and a changed lifestyle, as well as profound hormonal changes. C. Ambivalent feelings during pregnancy are usually seen only in emotionally immature or very young mothers. D. Conflicts such as not wanting to be pregnant or childrearing and career-related decisions need not be addressed during pregnancy because they will resolve themselves naturally after birth. correct answer- b With regard to the father's acceptance of the pregnancy and preparation for childbirth, the maternity nurse should know that: A. The father goes through three phases of acceptance of his own. B. The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after birth. C. In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home. D. Typically men remain ambivalent about fatherhood right up to the birth of their child. correct answer- a With regard to medications, herbs, shots, and other substances normally encountered, the maternity nurse should be aware that during pregnancy: A. The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy. B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful. C. Critical iron and folic acid levels must be maintained. D. Lactating women can go back to their prepregnant calorie intake correct answer- b When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that: A. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron. B. Iron absorption is inhibited by a diet rich in vitamin C. C. Iron supplements are permissible for children in small doses. D. Constipation is common with iron supplements. correct answer- d A 22-year-old woman pregnant with a single fetus had a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this finding? A. This weight gain indicates possible gestational hypertension. B. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). C. This weight gain cannot be evaluated until the woman has been observed for several more weeks. D. The woman's weight gain is appropriate for this stage of pregnancy. correct answer- d With regard to protein in the diet of pregnant women, nurses should be aware that: A. Many protein-rich foods are also good sources of calcium, iron, and B vitamins. B. Many women need to increase their protein intake during pregnancy. C. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet. D. High-protein supplements can be used without risk by women on macrobiotic diets correct answer- a Which findings could be considered to be a barrier to a pregnant woman seeking prenatal care? (Select all that apply.) A. Patient would prefer to be cared for by a midwife instead of a physician. B. Economic cost of health care. C. Patient's cultural beliefs do not include prenatal care as being valued. D. Patient speaks several languages. E. Patient had a bad experience the last time she went to a doctor for care. correct answer- b,c,e With regard to primary and secondary powers, the maternity nurse should understand that: A. Primary powers are responsible for effacement and dilation of the cervix. B. Effacement generally is well ahead of dilation in women giving birth for the first time; they are more together in subsequent pregnancies. C. Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation. D. Pushing in the second stage of labor is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs. correct answer- a Which sign does not precede the onset of labor? A.A return of urinary frequency as a result of increased bladder pressure B. Persistent low backache from relaxed pelvic joints C. Stronger and more frequent uterine (Braxton Hicks) contractions D.A decline in energy, as the body stores up for labor correct answer- d In order to accurately assess the health of the mother accurately during labor, the nurse should be aware that: A. The woman's blood pressure increases during contractions and falls back to prelabor normal between contractions. B. Use of the Valsalva maneuver is encouraged during the second stage of labor to relieve fetal hypoxia. C. Having the woman point her toes reduces leg cramps. D. The endogenous endorphins released during labor raise the woman's pain threshold and produce sedation. correct answer- d The nurse knows that the second stage of labor, the descent phase, has begun when: A. The amniotic membranes rupture. B. The cervix cannot be felt during a vaginal examination. C. The woman experiences a strong urge to bear down. D.The presenting part is below the ischial spines correct answer- b Which statement is inaccurate with regard to normal labor? A.A single fetus presents by vertex. B. It is completed within 8 hours. C. A regular progression of contractions, effacement, dilation, and descent occurs. D. No complications are involved. correct answer- b Nurses can help their clients by keeping them informed about the distinctive stages of labor. What description of the phases of the first stage of labor is accurate? A. Latent: mild, regular contractions; no dilation; bloody show; duration of 2 to 4 hours B. Active: moderate, regular contractions; 4 to 7 cm dilation; duration of 3 to 6 hours C. Lull: no contractions; dilation stable; duration of 20 to 60 minutes D. Transition: very strong but irregular contractions; 8 to 10 cm dilation; duration of 1 to 2 hours correct answer- b Which position would the nurse suggest for second-stage labor if the pelvic outlet needs to be increased? With regard to systemic analgesics administered during labor, nurses should be aware that: A. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier. B. Effects on the fetus and newborn can include decreased alertness and delayed sucking. C. IM administration is preferred over IV administration. D. IV patient-controlled analgesia (PCA) results in increased use of an analgesic. correct answer- b With regard to spinal and epidural (block) anesthesia, nurses should know that: A. This type of anesthesia is commonly used for cesarean births but is not suitable for vaginal births. B. A high incidence of postbirth headache is seen with spinal blocks. C. Epidural blocks allow the woman to move freely. D. Spinal and epidural blocks are never used together. correct answer- b After change of shift report, the nurse assumes care of a multiparous client in labor. The woman is complaining of pain that radiates to her abdominal wall, lower back, and buttocks, and down her thighs. Before implementing a plan of care, the nurse should understand that this type of pain is: A. Visceral B. Referred C. Somatic D.Afterpain correct answer- b Fetal bradycardia is most common during: A. Maternal hyperthyroidism. B. Fetal anemia. C. Viral infection. D.Tocolytic treatment using ritodrine. correct answer- c The nurse providing care for the laboring woman understands that accelerations with fetal movement: A. Are reassuring. B. Are caused by umbilical cord compression. C. Warrant close observation. D.Are caused by uteroplacental insufficiency correct answer- a The most common cause of decreased variability in the FHR that lasts 30 minutes or less is: A.Altered cerebral blood flow. B. Fetal hypoxemia. C. Umbilical cord compression. D. Fetal sleep cycles. correct answer- d You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase IV fluid, and perform a vaginal exam. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should you take? A. Call for help. B. Insert a Foley catheter. C. Start oxytocin (Pitocin). D. Notify the primary health care provider immediately. correct answer- d When using intermittent auscultation (IA) to assess uterine activity, nurses should be aware that: A. The examiner's hand should be placed over the fundus before, during, and after contractions. B. The frequency and duration of contractions are measured in seconds for consistency. C. Contraction intensity is given a judgment number of 1 to 7 by the nurse and client together. D. The resting tone between contractions is described as either placid or turbulent. correct answer- a A nurse caring for a woman in labor understands that increased variability of the fetal heart rate might be caused by: A. Narcotics. B. Barbiturates. C. Methamphetamines. D. Tranquilizers correct answer- c Which of the following statements is not used to describe a characteristic of a uterine contraction? A. Frequency (how often contractions occur) B. Intensity (the strength of the contraction at its peak) C. Resting tone (the tension in the uterine muscle) D.Appearance (shape and height) correct answer- d The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by: A. Change in position. B. Oxytocin administration. C. Regional anesthesia. D. Intravenous analgesic. correct answer- a Fetal well-being during labor is assessed by: A. The response of the fetal heart rate (FHR) to uterine contractions (UCs). B. Maternal pain control. C. Accelerations in the FHR. D.An FHR greater than 110 beats/min correct answer- a A group of fetal monitoring experts (National Institute of Child Health and Human Development, 2008) recommends that fetal heart rate (FHR) tracings demonstrate certain characteristics to be described as reassuring or normal (category I). These characteristics include: A. Bradycardia not accompanied by baseline variability. B. Early decelerations, either present or absent. C. Sinusoidal pattern. D.Tachycardia. correct answer- b A nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates her understanding of the instructions when the woman states: A. "True labor contractions will subside when I walk around." B. "True labor contractions will cause discomfort over the top of my uterus." C. "True labor contractions will continue and get stronger even if I relax and take a shower." D. "True labor contractions will remain irregular but become stronger." correct answer- c Under which circumstance would a nurse not perform a vaginal examination on a patient in labor? A. An admission to the hospital at the start of labor B. When accelerations of the fetal heart rate (FHR) are noted C. On maternal perception of perineal pressure or the urge to bear down D. When membranes rupture correct answer- b When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. These measures include: A. Encouraging the woman to try various upright positions, including squatting and standing. B. Telling the woman to start pushing as soon as her cervix is fully dilated. C. Continuing an epidural anesthetic so that pain is reduced and the woman can relax. D. Coaching the woman to use sustained, 10- to 15-second, closed- glottis bearing- down efforts with each contraction. correct answer- a Evidence-based care practices designed to support normal labor and birth recommend which practice during the immediate newborn period? A. The healthy newborn should be taken to the nursery for a complete assessment. B. After drying, the infant should be given to the mother wrapped in a receiving blanket. C. Skin-to-skin contact of mother and baby should be encouraged. D. The father or support person should be encouraged to hold the infant while awaiting delivery of the placenta. correct answer- c Which description of the phases of the second stage of labor is accurate? A. Latent phase: feels sleepy, fetal station is 2+ to 4+, duration is 30 to 45 D. Lean over a birth ball with her knees on the floor. correct answer- d In a variation of rooming-in called couplet care, the mother and infant share a room and the mother shares the care of the infant with: A. The father of the infant. B. Her mother (the infant's grandmother). C. Her eldest daughter (the infant's sister). D.The nurse. correct answer- d The breasts of a woman who is bottle feeding her baby are engorged. The nurse should instruct her to: A. Wear a snug, supportive bra. B. Allow warm water to soothe the breasts during a shower. C. Express milk from breasts occasionally to relieve discomfort. D. Place absorbent pads with plastic liners into her bra to absorb leakage correct answer- a A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious likely consequence of bladder distention is: A. Urinary tract infection. B. Excessive uterine bleeding. C. A ruptured bladder. D. Bladder wall atony. correct answer- b What statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth? A. "My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter." B. "My first menstrual cycle will be heavier than normal and will return to my prepregnant volume within three or four cycles." C. "I will not have a menstrual cycle for 6 months after childbirth." D. "My first menstrual cycle will be heavier than normal and then will be light for several months after." correct answer- b With regard to afterbirth pains, nurses should be aware that these pains are: A. Caused by mild, continual contractions for the duration of the postpartum period. B. More common in first-time mothers. C. More noticeable in births in which the uterus was overdistended. D.Alleviated somewhat when the mother breastfeeds correct answer- c Postbirth uterine/vaginal discharge, called lochia: A. Is similar to a light menstrual period for the first 6 to 12 hours. B. Is usually greater after cesarean births. C. Will usually decrease with ambulation and breastfeeding. D. Should smell like normal menstrual flow unless an infection is present. correct answer- d Which description of postpartum restoration or healing times is accurate? A. The cervix shortens, becomes firm, and returns to form within a month postpartum. B. Rugae reappear within 3 to 4 weeks. C. Most episiotomies heal within a week. D. Hemorrhoids usually decrease in size within 2 weeks of childbirth. correct answer- b With regard to the condition and reconditioning of the urinary system after childbirth, nurses should be aware that: A. Kidney function returns to normal a few days after birth. B. Diastasis recti abdominis is a common condition that alters the voiding reflex. C. Fluid loss through perspiration and increased urinary output account for a weight loss of more than 2 kg during the puerperium. D. With adequate emptying of the bladder, bladder tone is usually restored 2 to 3 weeks after childbirth. correct answer- c As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman 1 day postpartum. An expected finding is: A. Little if any change. B. Leakage of milk at let-down. C. Swollen, warm and tender on palpation. D.A few blisters and a bruise on each areola. correct answer- a Which of the following findings would raise concern for the nurse who is monitoring a postpartum patient who had a spontaneous vaginal delivery (SVD) of a 10-lb baby boy? A. Lochia rubra with minimal clots expressed on fundal massage B. Fundus midline and firm with nonpalpable bladder C. Fundus midline and firm with spurts of bright red blood upon fundal massage D. Patient report of mild to moderate cramping and request for pain medication correct answer- c Which of the following changes are consistent with metabolic function during the postpartum period? (Select all that apply.) A. Moderate hyperglycemia B. Increased BMR in the immediate postpartum period C. Secretion of insulinase D. Mildly increased T3 and T4 levels for the first several weeks postpartum E. Decrease in estrogen and cortisol levels correct answer- b,c,e Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman: A. Uses soap and warm water to wash the vulva and perineum. C. Constipation D. Hematoma formation correct answer- d Nurses are getting ready for bedside reporting at change of shift. A benefit of this type of change of shift report is that: A. Information is transparent so that the nurses and patients are aware of all pertinent data and delivery of care aspects. B. Patients can ask questions of the nurses during change of shift report so that they can better direct the delivery of their health care. C. Nurses are able to visualize their patient's directly at the time of report leading to better patient satisfaction. D. There is no need for additional information to be exchanged as the patient is right there to answer questions and voice concerns. correct answer- c Which test result would provide evidence of fetal blood in maternal circulation? A. Positive Fern test result B. Positive Coombs test result C. Positive Kleihauer-Betke test result D. Negative Coombs test result correct answer- c The nurse is observing a postpartum patient who has been bleeding excessively during the first hour, saturating multiple pads. Which interventions would the nurse anticipate that the physician would order? (Select all that apply.) A. Document findings in the health care record B. Decrease flow rate for intravenous fluid administration C. Administer oxygen via nonrebreather mask @ 10 L/minute D. Insert a secondary intravenous line access E. Type & screen for 2 units of blood correct answer- c,d The nurse observes several interactions between a postpartum woman and her new son. What behavior, if exhibited by this woman, does the nurse identify as a possible maladaptive behavior regarding parent-infant attachment? A. Talks and coos to her son B. Seldom makes eye contact with her son C. Cuddles her son close to her D.Tells visitors how well her son is feeding correct answer- b The process in which the infant's behaviors and characteristics call forth a corresponding set of maternal behaviors and characteristics is called: A. Mutuality. B. Bonding. C. Claiming. D.Acquaintance. correct answer- a In follow-up appointments or visits with parents and their new baby, it may be useful if the nurse can identify parental behaviors that can either facilitate or inhibit attachment. Which of the following is a facilitating behavior? A. The parents have difficulty naming the infant. B. The parents hover around the infant, directing attention to and pointing at the infant. C. The parents make no effort to interpret the actions or needs of the infant. D. The parents do not move from fingertip touch to palmar contact and holding correct answer- b Which statement is inaccurate with regard to a nurse working with parents who have a sensory impairment? A. One of the major difficulties visually impaired parents experience is the skepticism of health care professionals. B. Visually impaired mothers cannot overcome the infant's need for eye-to- eye contact. C. The best approach for the nurse is to assess the parents' capabilities rather than focusing on their disabilities. D. Technologic advances, including the Internet, can provide deaf parents with a full range of parenting activities and information. correct answer- b Health care providers demonstrate a variety of reactions to lesbian couples, including failure to acknowledge the "other mother's" role in pregnancy, birth, and parenting. Integration of the nonchildbearing partner into care includes offering the same opportunities afforded male partners of heterosexual women. Which opportunity could not be provided to male partners? A. Labor support B. Cutting the cord C. Rooming-in during hospitalization D. Breastfeeding the infant correct answer- d While making a visit to the home of a postpartum woman 1 week after birth, the nurse should recognize that the woman would characteristically: A. Express a strong need to review the events and her behavior during the process of labor and birth. B. Exhibit a reduced attention span, limiting readiness to learn. C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn. D. Have reestablished her role as a spouse or partner. correct answer- c Parents can facilitate the adjustment of their other children to a new baby by: A. Having children at home choose or make a gift to give the new baby on his or her arrival home. B. Emphasizing activities that keep the new baby and other children together. C. Having the mother carry the new baby into the home so she can show the other children the baby. D. Reducing stress on the other children by limiting their involvement and care of the new baby. correct answer- a