MATERNITY NCLEX QUESTIONS

MATERNITY NCLEX QUESTIONS

ScienceMedicineObstetrics Bruna_Pereira2 Save Maternity Nclex questions 68 terms crystalrose_rivera Preview Maternity Nursing NCLEX 100 terms Nick_McAllister Preview Peds Exam 1 NCLEX style questions 37 terms alanna_buonanno Preview Matern 86 terms jen Which of the following maternal factors may decrease fetal oxygenation? Select all that apply

• Asthma
• Gestational diabetes
• Hypertension
• Epidural
• Asthma
• Hypertension
• Epidural

A 25 year old female is 25 weeks pregnant. she has had one previous pregnancy at 35 weeks and the baby is now 2 years old. she has no history of abortion

G=2, T=0, P=1, A= 0, L=1

So I think the answer would be

G=2, T=0, P=1, A= 0, L=1

More complete description of pregnancy outcomesGTPALG-gravidaT-term>37 weeksP-preterm <37 weeksA-abortions (SAB or TAB)L- living children

• A woman is 37 weeks pregnant and experiencing contractions lasting an average of 35 seconds with varying frequency, her last ones being 12

minutes apart, 8 minutes apart and then 25 minutes. She is 2 cm dilated, her physician would explain that she is in the ....1st Stage, latent phase of labor

Rationale:

1st stage: (latent) frequency 5-30 minutes, duration 30-40seconds, dilation 0-3cm

• active) frequency 3-5 minutes, duration 40-70 seconds, dilation 4-7cm

(transition) frequency 2-3 minutes, duration, 45-90 seconds, 10 cm dilated

Second stage: full dilation, progresses to contractions every 1-2 minutes

Third stage: delivery of the neonate

fourth stage: delivery of the placenta

Which of the following are maternal changes during pregnancy? (select all that apply)

• Decreased cardiac output
• Increased clotting factors
• Decreased lung volume
• Skin color changes that should return to normal after pregnancy
• Supine hypertensive syndrome

Answers: B, C, D

A is incorrect because cardiac output increases with the 30% increased blood volume to compensate for blood loss during birth and to provide fetus with nutrient. E is incorrect because pregnant women develop supine hypotension syndrome (vena caval syndrome), from baby putting pressure on the inferior vena cava.A pregnant woman who is in her late 3rd trimester called her primary care provider complaining of contractions. Which of the following indicates that the patient is experiencing true labor? Select all that apply.

• My pain duration changes when I move around
• My contractions are occurring every 6 minutes and last 1 minute long
• I have pain located back to front
• My cervix is changing
• My contractions are coming 10, 7, and then 15 minutes apart

Answer B,C,D Rational: True labor is regular, location is back to front, and the duration remains constant. Cervical change is a true indicator of labor.A pregnant women presents to her doctors office with nausea, vomiting, and sharp abdominal pain. The doctor suspects an ectopic pregnancy.What would her HCG levels look like?HCG level slowly declining over 48 hours HCG level rising but not doubling appropriately in 48 hours HCG level drastically drops within 24 hours No HCG hormone detected Answer B Rational: HCG levels would still rise because the fertilized ovum is still secreting HCG even though it is in the wrong place. The HCG level would decline over 48 hours if their was a spontaneous abortion/loss.

Janine is a 34-year-old female who is 36 weeks pregnant with fraternal twins, has two living children that are also fraternal twins and now 4 years old, that she delivered at 36 weeks via c-section. She had a therapeutic abortion at 23 years old and spontaneously aborted during her second pregnancy at 27 years old. What is her GTPAL?

A.) G=2, T=1, P=1, A=2, L=2

B.) G=4, T=1, P=0, A=2, L=2

C.) G=4, T=0, P=1, A=2, L=2

D.) G=4, T=0, P=1, A=1, L=2

E.) G=2, T=1, P=0, A=1, L=2

Correct Answer: C

Rationale: Gravida simply refers to the number of pregnancies, regardless of whether or not they are term or aborted, section delivery etc.; it is also important to note that multifetal gestations should only be counted once as they are still just a single pregnancy. To count, she has her current pregnancy, the pregnancy with her first twin children, and the two abortions (one spontaneous one therapeutic), for a total of 4 pregnancies. The greatest number of term pregnancies she could have is one, but because they were born prior to the 37 week cut off they would be considered preterm; so, she has had zero term pregnancies and one preterm. As mentioned earlier, she has had two abortions and has two living children in her 4-year old twins.Your patient's last menstrual cycle was February 6, 2020. Using Naegele's Rule, what is her expected date of delivery?

• November 13, 2021
• November 9, 2020
• October 13, 2020
• November 13, 2020

Correct answer: D

Rationale: Using Naegele's rule, subtract three months and add seven days and adjust the year appropriately to get the expected date of delivery.A 26 year old woman presents to her OB because she missed her last menstrual period. She reports fatigue, nausea, and urinary frequency. The provider interprets these findings as which indication of pregnancy?

• Probable
• Presumptive
• Positive
• Negative
• Probable

A patient comes into the GYN clinic in her second trimester. She is 37 years old. She has had two vaginal births in the past, both at 40 weeks gestation. She miscarried one fetus at 24 weeks. She currently has two living children. What is her GTPAL?

A. G=2, T=3, P=1, A=1, L=3

B. G=4, T=2, P=0, A=1, L=2

C. G=3, T=2, P=1, A=0, L=2

D. G=4, T=3, P=0, A=1, L=1

B. G=4, T=2, P=0, A=1, L=2

A multiparous woman has just delivered her baby. The nurse comes in to assess the patient for signs of postpartum hemorrhage after she had rang the call bell stating that she is bleeding through several pads very quickly. The most important nursing intervention when observing for

postpartum bleeding is:

Call the Provider immediately Administer lovenox Palpate the uterus and massage if it is boggy Assess vital signs and signs of hypovolemic shock

ANSWER: C

Rationale: A: Although it is important to call the provider, it is not the initial and most important intervention the nurse should make. B: Oxytocin is the most effective treatment for postpartum hemorrhage, but even so, it is not the priority action that the nurse should make. C: This is the correct answer. The initial intervention of excessive postpartum bleeding is to massage the firm uterus. D: This is appropriate, but massaging the fundus is most important.A primiparous, 33-year-old female is admitted to the hospital after laboring at home for several hours. She is assessed and determined to be in Stage 1, Phase 2 of labor (7/95/-1). The patient declines an epidural despite reporting pain at 10/10 and appearing extremely uncomfortable.Examples of physical factors that influence pain perception include: (select all)

• Intensity of labor
• Anxiety and fear
• Childbirth preparation
• Interventions of caregivers
• Fatigue and hunger

Correct Answers: A, D, E

Rationale: The intensity of labor (A) is a major source of physical pain and can be determined by the power of contractions, cervical dilation, pushing and pulling of pelvic structures, and distension of the perineum and vagina during delivery. Interventions of caregivers (D) includes the presence and attentiveness provided by the healthcare team, as well as the individual's partner and/or family. Providing adequate support to the patient (providing a temple massage, encouraging fluid intake, supplying cold compresses, etc.) can decrease her perceived feeling of physical pain. Similarly, a patient that arrives already feeling fatigued and hungry (E) may experience an increased perception of physical pain during childbirth.

• Adverse effects of Oxytocin (Pitocin) include ____.
• Hypertension
• Hypotension
• Bradycardia
• Diarrhea

Answer: B

• After birth, the number of wet diapers is counted to measure the baby's hydration status. How many wet diapers a day ensures adequate

hydration?

A. 2-3

B. 4-5

C. 6-8

• 9

Answer: C