OB Exam 1 (2023\/ 2024 Update) Complete
Set Exam Prep Questions and Verified
Answers| Grade A| 100% Correct
Q: A woman in the active phase of the first stage of labor is using a shallow pattern of
breathing, which is about twice the normal adult breathing rate. She starts to complain about
feeling lightheaded and dizzy and states that her fingers are tingling. The nurse should:
A. Notify the woman’s physician.
B. Tell the woman to slow the pace of her breathing.
C. Administer oxygen via a mask or nasal cannula.
D. Help her breathe into a paper bag. Correct
Answer:
d
Q: A woman is experiencing back labor and complains of intense pain in her lower back. An
effective relief measure is to use:
A. Counterpressure against the sacrum.
B. Pant-blow (breaths and puffs) breathing techniques.
C. Effleurage.
D. Biofeedback.
Answer:
a
Q: Nurses should be aware of the difference that experience can make in labor pain, such as:
A. Sensory pain for nulliparous women often is greater than for multiparous women during early
labor.
B. Affective pain for nulliparous women usually is less than for multiparous women throughout
the first stage of labor.
C. Women with a history of substance abuse experience more pain during labor.
D. Multiparous women have more fatigue from labor and therefore experience more pain.
Answer:<\/p>\n\n\n\n
a
Q: In the current practice of childbirth preparation, emphasis is placed on:
A. The Dick-Read (natural) childbirth method.
B. The Lamaze (psychoprophylactic) method.
C. The Bradley (husband-coached) method.
D. Encouraging expectant parents to attend childbirth preparation in any or no specific method.
Answer:
d
Q: With regard to breathing techniques during labor, maternity nurses should be aware that:
A. Breathing techniques in the first stage of labor are designed to increase the size of the
abdominal cavity to reduce friction.
B. By the time labor has begun, it is too late for instruction in breathing and relaxation.
C. Controlled breathing techniques are most difficult near the end of the second stage of labor.
D. The patterned-paced breathing technique can help prevent hyperventilation.
Answer:
a
Q: With regard to what might be called the tactile approaches to comfort management, nurses
should be aware that:
A. Either hot or cold applications may provide relief, but they should never be used together in
the same treatment.
B. Acupuncture can be performed by a skilled nurse with just a little training.
C. Hand and foot massage may be especially relaxing in advanced labor, when a woman’s
tolerance for touch is limited.
D. Therapeutic touch (TT) uses handheld electronic stimulators that produce sympathetic
vibrations.
Answer:
c<\/p>\n\n\n\n
Q: 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 bloodbrain 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.
Answer:
b
Q: 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.
Answer:
b
Q: 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
Answer:
b
Q: Fetal bradycardia is most common during:
A. Maternal hyperthyroidism.
B. Fetal anemia.
C. Viral infection.<\/p>\n\n\n\n
D. Tocolytic treatment using ritodrine.
Answer:
c
Q: 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
Answer:
a
Q: 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.
Answer:
d
Q: 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.
Answer:<\/p>\n\n\n\n
OB Exam 2 (2023\/ 2024 Update) Complete
Set Exam Prep Questions and Verified
Answers| Grade A| 100% Correct
Q: The nurse should be aware of what important information regarding systemic analgesics
administered during labor?
a. Systemic analgesics cross the maternal blood-brain barrier as easily as they do the fetal bloodbrain barrier.
b. Effects on the fetus and newborn can include decreased alertness and delayed sucking.
c. Intramuscular (IM) administration is preferred over IV administration.
d. IV patient-controlled analgesia (PCA) results in increased use of an analgesic.
Answer:
B
The effects of analgesics depend on the specific drug administered, the dosage, and the timing.
Systemic analgesics cross the fetal blood-brain barrier more readily than the maternal bloodbrain barrier. IV administration is preferred over IM administration because the drug acts faster
and more predictably. PCA results in a decrease in the use of an analgesic.
Q: Developing a realistic birth plan with the pregnant woman regarding her care is important
for the nurse. How would the nurse explain the major advantage of nonpharmacologic pain
management?
a. Greater and more complete pain relief is possible.
b. No side effects or risks to the fetus are involved.
c. The woman will remain fully alert at all times.
d. Labor will likely be more rapid.
Answer:
B
Because nonpharmacologic pain management does not include analgesics, adjunct drugs, or
anesthesia, it is harmless to the mother and the fetus. However, pain relief is lessened with
nonpharmacologic pain management during childbirth. Although the woman’s alertness is not
altered by medication, the increase in pain may decrease alertness. Pain management may or may
not alter the length of labor. At times when pain is decreased, the mother relaxes and labor
progresses at a quicker pace.<\/p>\n\n\n\n
Q: What is the correct terminology for the nerve block that provides anesthesia to the lower
vagina and perineum?
a. Epidural
b. Pudendal
c. Local
d. Spinal block
Answer:
B
A pudendal block anesthetizes the lower vagina and perineum to provide anesthesia for an
episiotomy and the use of low forceps, if needed. An epidural provides anesthesia for the uterus,
perineum, and legs. A local provides anesthesia for the perineum at the site of the episiotomy. A
spinal block provides anesthesia for the uterus, perineum, and down the legs.
Q: The obstetric nurse is preparing the client for an emergency cesarean birth, with no time to
administer spinal anesthesia. The nurse is aware of and prepared for the greatest risk of
administering general anesthesia to the client. What is this risk?
a. Respiratory depression
b. Uterine relaxation
c. Inadequate muscle relaxation
d. Aspiration of stomach contents
Answer:
D
Aspiration of acidic gastric contents with possible airway obstruction is a potentially fatal
complication of general anesthesia. Respirations can be altered during general anesthesia, and the
anesthesiologist will take precautions to maintain proper oxygenation. Uterine relaxation can
occur with some anesthesia but can be monitored and prevented. Inadequate muscle relaxation
can be improved with medication.
Q: What is the rationale for the use of a blood patch after spinal anesthesia?
a. Hypotension
b. Headache
c. Neonatal respiratory depression
d. Loss of movement
Answer:
B<\/p>\n\n\n\n
The subarachnoid block may cause a postspinal headache resulting from the loss of cerebrospinal
fluid from the puncture in the dura. When blood is injected into the epidural space in the area of
the dural puncture, it forms a seal over the hole to stop the leaking of cerebrospinal fluid.
Hypotension is prevented by increasing fluid volume before the procedure. Neonatal respiratory
depression is not an expected outcome with spinal anesthesia. Loss of movement is an expected
outcome of spinal anesthesia.
Q: Maternal hypotension is a potential side effect of regional anesthesia and analgesia. What
nursing interventions could the nurse use to increase the client’s blood pressure? (Select all that
apply.)
a. Place the woman in a supine position.
b. Place the woman in a lateral position.
c. Increase IV fluids.
d. Administer oxygen.
e. Perform a vaginal examination.
Answer:
B, C, D
Nursing interventions for maternal hypotension arising from analgesia or anesthesia include
turning the woman to a lateral position, increasing IV fluids, administering oxygen via face
mask, elevating the woman’s legs, notifying the physician, administering an IV vasopressor, and
monitoring the maternal and fetal status at least every 5 minutes until the woman is stable.
Placing the client in a supine position causes venous compression, thereby limiting blood flow to
and oxygenation of the placenta and fetus. A sterile vaginal examination has no bearing on
maternal blood pressure.
Q: Which alternative approaches to relaxation have proven successful when working with the
client in labor? (Select all that apply.)
a. Aromatherapy
b. Massage
c. Hypnosis
d. Cesarean birth
e. Biofeedback
Answer:
A, B, C, E
Approaches to relaxation can include neuromuscular relaxation, aromatherapy, music, massage,
imagery, hypnosis, or touch relaxation. Cesarean birth is a method of delivery, not a method of
relaxation.<\/p>\n\n\n\n
Q: A woman has requested an epidural block for her pain. She is 5 cm dilated and 100%
effaced. The baby is in a vertex position and is engaged. The nurse increases the woman’s IV
fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be
informed regarding the disadvantages of an epidural block. Which concerns should the nurse
share with this client? (Select all that apply.)
a. Ability to move freely is limited.
b. Orthostatic hypotension and dizziness may occur.
c. Gastric emptying is not delayed.
d. Higher body temperature may occur.
e. Blood loss is not excessive.
Answer:
A, B, D
The woman’s ability to move freely and to maintain control of her labor is limited, related to the
use of numerous medical interventions (IV lines and electronic fetal monitoring [EFM]).
Significant disadvantages of an epidural block include the occurrence of orthostatic hypotension,
dizziness, sedation, and leg weakness. Women who receive an epidural block have a higher body
temperature (38\u00b0 C or higher), especially when labor lasts longer than 12 hours, and may result
in an unnecessary neonatal workup for sepsis. An advantage of an epidural block is that blood
loss is not excessive. Other advantages include the following: the woman remains alert and able
to participate, good relaxation is achieved, airway reflexes remain intact, and only partial motor
paralysis develops.
Q: The class of drugs known as opioid analgesics (butorphanol, nalbuphine) is not suitable for
administration to women with known opioid dependence. The antagonistic activity could
precipitate withdrawal symptoms (abstinence syndrome) in both mothers and newborns. Which
signs would indicate opioid or narcotic withdrawal in the mother? (Select all that apply.)
a. Yawning, runny nose
b. Increase in appetite
c. Chills or hot flashes
d. Constipation
e. Irritability, restlessness
Answer:
A, C, E
The woman experiencing maternal opioid withdrawal syndrome will exhibit yawning, runny
nose, sneezing, anorexia, chills or hot flashes, vomiting, diarrhea, abdominal pain, irritability,
restlessness, muscle spasms, weakness, and drowsiness. Assessing both the mother and the
newborn and planning the care accordingly are important steps for the nurse to take.<\/p>\n","protected":false},"excerpt":{"rendered":"
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