NCLEX Practice Quiz 4

Maternity Nursing (OB Maternal & Newborn) NCLEX Practice Quiz #4

1.You performed Leopold’s maneuver and found the following: breech

presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heartbeat (PMI) BEST in which location?●A. Left lower quadrant ●B. Right lower quadrant ●C. Left upper quadrant ●D. Right upper quadrantIn

Correct Answer: B. Right lower quadrant

Right lower quadrant. The landmark to look for when looking for PMI is the location of the fetal back in relation to the right or left side of the mother and the presentation, whether cephalic or breech. The best site is the fetal back nearest the head.

●Option A: The fetal limbs may be palpated at the left lower

quadrant.

●Option C: The fetal head may be facing the direction of the left

upper quadrant.

●Option D: The right upper quadrant has the fetal back, but it is

nearer to the lower extremities of the fetus.

• Leopold’s maneuver step #1, you palpated a soft, broad mass that moves with

the rest of the mass. The correct interpretation of this finding is:

●A. The mass palpated at the fundal part is the head part.●B. The presentation is breech.●C. The mass palpated is the back.●D. The mass palpated is the buttocks.

Correct Answer: D. The mass palpated is the buttocks.

The palpated mass is the fetal buttocks since it is broad and soft and moves with the rest of the mass. The first maneuver also called the fundal grip, assesses the uterine fundus to determine its height and which fetal pole—that is, cephalic or podalic—occupies the fundus.

●Option A: The head feels hard and round with a smooth surface of

uniform consistency, is very mobile and ballotable.

●Option B: The breech gives the sensation of a large, nodular mass,

and its surface is uneven, non-ballotable, and not very mobile. The first maneuver aims to determine the gestational age and the fetal lie.

●Option C: The uterine fundus is pressed with force using one hand,

which accentuates the curvature of the fetal back, allowing for easier palpation with the other hand. The fetal heart can be auscultated at this time, which can also provide information on fetal orientation. The heart is well perceived when the stethoscope or the doppler transducer is placed on the back of the fetus.

• In Leopold’s maneuver step #3 you palpated a hard round movable mass at

the suprapubic area. The correct interpretation is that the mass palpated is:

● A. The buttocks because the presentation is breech.●B. The mass palpated is the head.●C. The mass is the fetal back.●D. The mass palpated is the small fetal part.

Correct Answer: B. The mass palpated is the head.

When the mass palpated is hard round and movable, it is the fetal head. The head feels hard and round with a smooth surface of uniform consistency, is very mobile and ballotable. The third maneuver aids in confirmation of fetal presentation. The first Pawlík grip, sometimes called the first pelvic grip, helps to define which presenting part of the fetus is situated in hypogastrium.

●Option A: The palpated mass is the fetal buttocks since it is broad

and soft and moves with the rest of the mass.

●Option C: The uterine fundus is pressed with force using one hand,

which accentuates the curvature of the fetal back, allowing for easier palpation with the other hand. The fetal heart can be auscultated at this time, which can also provide information on fetal orientation. The heart is well perceived when the stethoscope or the doppler transducer is placed on the back of the fetus.

●Option D: The second maneuver, sometimes called the umbilical

grip, involves palpation of the lateral uterine surfaces. Still facing the maternal xiphoid cartilage, both hands slide down from the uterine fundus towards the lateral uterine walls. The clinician’s hands are placed flat and parallel to each other along the abdominal wall at the level of the umbilicus. It allows establishing if the fetus is in a longitudinal, transverse, or oblique situation, and to determine the position of the back and small parts.

4. The hormone responsible for a positive pregnancy test is:

●A. Estrogen ●B. Progesterone ●C. Human Chorionic Gonadotropin ●D. Follicle Stimulating Hormone

Correct Answer: C. Human Chorionic Gonadotropin

Human chorionic gonadotropin (HCG) is the hormone secreted by the chorionic villi which is the precursor of the placenta. In the early stage of pregnancy, while the placenta is not yet fully developed, the major hormone that sustains the pregnancy is HCG.

●Option A: Estrogen helps control the menstrual cycle and is

important for childbearing. Estrogen also has other functions: it

keeps cholesterol in control and protects bone health for both women and men.

●Option B: Progesterone prepares the endometrium for the potential

of pregnancy after ovulation. It triggers the lining to thicken to

accept a fertilized egg. It also prohibits the muscle contractions in the uterus that would cause the body to reject an egg.

●Option D: In women, FSH helps control the menstrual cycle and

stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary. This is known as ovulation. In men, FSH helps control the production of sperm.

5. The hormone responsible for the maturation of the Graafian follicle is:

●A. Follicle-stimulating hormone ●B. Progesterone ●C. Estrogen ●D. Luteinizing hormone

Correct Answer: A. Follicle-stimulating hormone

The hormone that stimulates the maturation of the Graafian follicle is the Follicle Stimulating Hormone which is released by the anterior pituitary gland.

●Option B: Progesterone prepares the endometrium for the potential

of pregnancy after ovulation. It triggers the lining to thicken to accept a fertilized egg. It also prohibits the muscle contractions in the uterus that would cause the body to reject an egg.

●Option C: Estrogen helps control the menstrual cycle and is

important for childbearing. Estrogen also has other functions: it

keeps cholesterol in control and protects bone health for both women and men.

●Option D: Luteinizing hormone is crucial in regulating the function

of the testes in men and ovaries in women. In men, luteinizing hormone stimulates Leydig cells in the testes to produce testosterone, which acts locally to support sperm production.