Some OB Nclex Questions I Like

some ob nclex questions i like 5.0 (2 reviews) Students also studied Terms in this set (30) Science MedicineObstetrics Save Intrapartum 82 terms meg_m21Preview

1 PRENATAL PERIOD

15 terms Mikejohnson23 Preview Maternity 48 terms kim_noble6Preview EVOLV 174 term laur A nonstress test is performed on a client who is pregnant, and the results of the test indicate nonreactive findings.The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding?

• A normal test result
• An abnormal test result
• A high risk for fetal demise
• The need for a cesarean section
• A normal test result

Contraction stress test results may be interpreted as negative (normal), positive (abnormal), or equivocal. A negative test result indicates that no late decelerations occurred in the fetal heart rate, although the fetus was stressed by

• contractions of at least 40 seconds' duration in a 10-minute period. Options 2, 3,

and 4 are incorrect interpretations.A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level?

• Not palpable above the symphysis at this time
• Slightly above the symphysis pubis
• At the level of the umbilicus
• Slightly above the umbilicus
• Slightly above the symphysis pubis

In normal pregnancies, the uterus grows at a predictable rate. It may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy. As the uterus grows, it may be palpated above the symphysis pubis sometime between the 12th and 14th weeks of pregnancy. The uterus rises gradually to the level of the umbilicus at 22 to 24 weeks of gestation.During a patient's physical examination the nurse notes that the lower uterine segment is soft on palpation. The

nurse would document this finding as:

• Hegar's sign.
• McDonald's sign.
• Chadwick's sign.
• Goodell's sign.
• Hegar's sign.

At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occurs; this is called Hegar's sign. McDonald's sign indicates a fast food restaurant. Chadwick's sign is the blue-violet coloring of the cervix caused by increased vascularity; this occurs around the fourth week of gestation.Softening of the cervical tip is called Goodell's sign, which may be observed around the sixth week of pregnancy.

The nurse caring for the pregnant patient must understand that the hormone essential for maintaining

pregnancy is:

• estrogen.
• human chorionic gonadotropin (hCG).
• oxytocin.
• progesterone.
• progesterone.

Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles. This reduces uterine activity and prevents miscarriage. Estrogen plays a vital role in pregnancy, but it is not the primary hormone for maintaining pregnancy. hCG levels increase at implantation but decline after 60 to 70 days.Oxytocin stimulates uterine contractions.Which finding in the urine analysis of a pregnant woman is considered a variation of normal?

• Proteinuria
• Glycosuria
• Bacteria in the urine
• Ketones in the urine
• Glycosuria

Small amounts of glucose may indicate "physiologic spilling." The presence of protein could indicate kidney disease or preeclampsia. Urinary tract infections are associated with bacteria in the urine. An increase in ketones indicates that the patient is exercising too strenuously or has an inadequate fluid and food intake.The diagnosis of pregnancy is based on which positive signs of pregnancy? Select all that apply.

• Identification of fetal heartbeat
• Palpation of fetal outline
• Visualization of the fetus
• Verification of fetal movement
• Positive hCG test
• Identification of fetal heartbeat
• Visualization of the fetus
• Verification of fetal movement

Identification of fetal heartbeat, visualization of the fetus, and verification of fetal movement are all positive, objective signs of pregnancy. Palpation of fetal outline and a positive hCG test are probable signs of pregnancy. A tumor also can be palpated. Medication and tumors may lead to false-positive results on pregnancy tests.During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criterion? Select all that apply.

• Leukorrhea
• Development of the operculum
• Quickening
• Ballottement
• Lightening
• Quickening
• Ballottement
• Lightening

Leukorrhea is a white or slightly gray vaginal discharge that develops in response to cervical stimulation by estrogen and progesterone. Quickening is the first recognition of fetal movements or "feeling life." Quickening is often described as a flutter and is felt earlier in multiparous women than in primiparas. Lightening occurs when the fetus begins to descend into the pelvis. This occurs 2 weeks before labor in the nullipara and at the start of labor in the multipara. Mucus fills the cervical canal creating a plug otherwise known as the operculum. The operculum acts as a barrier against bacterial invasion during the pregnancy. Passive movement of the unengaged fetus is referred to as ballottement.The multiple marker test is used to assess the fetus for which condition?

• Down syndrome
• Diaphragmatic hernia
• Congenital cardiac abnormality
• Anencephaly
• Down syndrome

The maternal serum level of alpha-fetoprotein is used to screen for Down syndrome, neural tube defects, and other chromosome anomalies. The multiple marker test would not detect diaphragmatic hernia, congenital cardiac abnormality, or anencephaly.Additional testing, such as ultrasonography and amniocentesis, would be required to diagnose these conditions.

During the first trimester, a woman can expect which of the following changes in her sexual desire?

• An increase, because of enlarging breasts
• A decrease, because of nausea and fatigue
• No change
• An increase, because of increased levels of female

hormones

• A decrease, because of nausea and fatigue

Maternal physiologic changes such as breast enlargement, nausea, fatigue, abdominal changes, perineal enlargement, leukorrhea, pelvic vasocongestion, and orgasmic responses may affect sexuality and sexual expression. Libido may be depressed in the first trimester but often increases during the second and third trimesters. During pregnancy, the breasts may become enlarged and tender; this tends to interfere with coitus, decreasing the desire to engage in sexual activity.With regard to follow-up visits for women receiving

prenatal care, nurses should be aware that:

• the interview portions become more intensive as the

visits become more frequent over the course of the pregnancy.

• monthly visits are scheduled for the first trimester,

every 2 weeks for the second trimester, and weekly for the third trimester.

• during the abdominal examination, the nurse should be

alert for supine hypotension.

• for pregnant women, a systolic blood pressure (BP) of

130 and a diastolic BP of 80 is sufficient to be considered hypertensive.

• during the abdominal examination, the nurse should be alert for supine

hypotension.The woman lies on her back during the abdominal examination, possibly compressing the vena cava and aorta, which can cause a decrease in blood pressure and a feeling of faintness. The interview portion of follow-up examinations is less extensive than in the initial prenatal visits, during which so much new information must be gathered. Monthly visits are routinely scheduled for the first and second trimesters; visits increase to every 2 weeks at week 28 and to once a week at week 36. For pregnant women hypertension is defined as a systolic BP of 140 or greater and a diastolic BP of 90 or greater.A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was September 10, 2019. Her expected date of birth (EDB) would be?June 17, 2020 Using Nägele's rule, June 17, 2020, is the correct EDB. The EDB is calculated by subtracting 3 months from the first day of the LMP and adding 7 days + 1 year to

the day of the LMP. Therefore, with an LMP of September 10, 2019:September 10,

2019 − 3 months = June 10, 2019 + 7 days = June 17, 2019 + 1 year = June 17, 2020 Which meal would provide the most absorbable iron?

• Toasted cheese sandwich, celery sticks, tomato slices,

and a grape drink

• Oatmeal, whole wheat toast, jelly, and low-fat milk
• Black bean soup, wheat crackers, orange sections, and

prunes

• Red beans and rice, cornbread, mixed greens, and

decaffeinated tea

• Black bean soup, wheat crackers, orange sections, and prunes

Food sources that are rich in iron include liver, meats, whole grain or enriched breads and cereals, deep green leafy vegetables, legumes, and dried fruits. In addition, the vitamin C in orange sections aids absorption. Dairy products and tea are not sources of iron.To prevent gastrointestinal upset, patients should be

instructed to take iron supplements:

• on a full stomach.
• at bedtime.
• after eating a meal.
• with milk.
• at bedtime.

Patients should be instructed to take iron supplements at bedtime. Iron supplements are best absorbed if they are taken when the stomach is empty.Bran, tea, coffee, milk, and eggs may reduce absorption. Iron can be taken at bedtime if abdominal discomfort occurs when it is taken between meals.

A woman arrives at the clinic seeking confirmation that

she is pregnant. The following information is obtained:

She is 24 years old with a body mass index (BMI) of 17.5.She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer.Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category?

• Blood pressure, age, and BMI
• Drug/alcohol use, age, and family history
• Family history, blood pressure, and BMI
• Family history, BMI, and drug/alcohol abuse
• Family history, BMI, and drug/alcohol abuse

i'm not putting the rationale b/c you should know why!A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero.Which diagnostic tool would yield more detailed information about the fetus?

• Ultrasound for fetal anomalies
• Biophysical profile (BPP)
• Maternal serum alpha-fetoprotein (MSAFP) screening
• Percutaneous umbilical blood sampling (PUBS)
• Biophysical profile (BPP)

Real-time ultrasound permits detailed assessment of the physical and physiologic characteristics of the developing fetus and cataloging of normal and abnormal biophysical responses to stimuli. BPP is a noninvasive, dynamic assessment of a fetus that is based on acute and chronic markers of fetal disease. An ultrasound for fetal anomalies would most likely have been performed earlier in the pregnancy. It is too late in the pregnancy to perform MSAFP screening. Also, MSAFP screening does not provide information related to fetal well-being.Indications for PUBS include prenatal diagnosis or inherited blood disorders, karyotyping of malformed fetuses, detection of fetal infection, determination of the acid-base status of a fetus with IUGR, and assessment and treatment of isoimmunization and thrombocytopenia in the fetus.A patient asks her nurse, "My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?" The best response by

the nurse is:

A."Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."

• "Your placenta isn't working properly, and your baby is

in danger."

• "This means that we will need to perform an

amniocentesis to detect if you have any placental damage."

• "Don't worry about it. Everything is fine."

A."Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby."

b/c it's the longest answer :P ~ check chapter 10 for more info if you please