Exam 1 OB NCLEX Questions

question

A nursing student is preparing a prenatal class on the process of fetal circulation. The nursing instructor asks the student specifically to describe the process through the umbilical cord. Which of the following statements from the student is correct? 1. “The one artery carries freshly oxygenated blood and nutrient-rick blood back from the placenta to the fetus.” 2. “The two arteries carry freshly oxygenated blood back from the placenta to the fetus.” 3. “The two arteries in the umbilical cord carry deoxygenated blood and waste products away from the fetus to the placenta.” 4. “The two veins in the umbilical cord carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta.”
answer

3. “The two arteries in the umbilical cord carry deoxygenated blood and waste products away from the fetus to the placenta.” Rational: Blood pumped by the embryo’s heart leaves the embryo through two umbilical arteries. When oxygenated, the blood is returned by one umbilical vein.
question

A pregnant client tells the clinic nurse that she wants to k now the sex of her baby as soon as it can be determined. The nurse understands that the client should be able to find out at 12 weeks’ gestation because by the end of the twelfth week: 1. The sex of the fetus can be determined by the appearance of the external genitalia. 2. The sex of the fetus can be determined because the external genitalia begin to differentiate. 3. The sex of the fetus can be determined because the testes are descended into the scrotal sac. 4. The sex of the fetus can be determined because the internal differences in males and females becomes apparent.
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1. The sex of the fetus can be determined by the appearance of the external genitalia. Rational: By the end of the 12th week, the external genitalia of the fetus have developed to such a degree that the sex of the fetus can be determined visually.
question

A nurse is performing an assessment on a client who is at 38 weeks gestation and notes that the FHR is 174/bpm. On the basis of this finding, the appropriate nursing action is to: 1. Notify the physician 2. Document the findings. 3. Check the mother’s heart rate 4. Tell the client that the FHR is normal.
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1. Notify the physican Rational: The FHR depends on gestational age and ranges from 160-170/bpm in the 1st trimester, but slows with fetal growth to 120-160/bpm near or at term. Because the FHR is increased from the reference range, the nurse should notify the physican.
question

A nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the Fallopian tube for 3 days, the nurse responds that the reason for this is that it: 1. Promotoes the fertilized ovum’s changes of survival. 2. Promotes the fertilized ovum’s exposure to estrogen & progesterone. 3. Promotes the fertilized ovum’s normal implantation in the top portion of the uterus. 4. Promotes the fertilized ovum’s exposure to LH and FSH
answer

3. Promotes the fertilized ovum’s normal implantation in the top portion of the uterus.
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A nursing instructor is reviewing the menstrual cycle with a nursing student who will be conducing a prenatal teaching session. The instructor asks the student to describe the FSH and LF. The student accurately responds by stating that: 1. FSH & LH are secreted by the adrenal glands. 2. FSH & LH are released from the anterior pituitary gland 3. FSH & LH are secreted by the corpus luteum of the ovary 4. FSH & LH stimulate the formation of the milk during pregnancy.
answer

2. FSH & LH are released from the anterior pituitary gland
question

A nurse explains some of the purposes of the placenta to a client during a prenatal visit. The nurse determins that the client understands some of these purposes when the client states that the placenta: 1. Cushions and protects the baby 2. Maintains the temperature of the baby 3. Is the way the baby gets food and oxygen 4. Prevents all antibodies and viruses from passing to the baby.
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3. Is the way the baby gets food and oxygen.
question

A nursing instructor asks a nursing student to list the functions of the amniotic fluid. The student responds correctly by stating that which of the following are functions of the amniotic fluid? SELECT ALL THAT APPLY. 1. Allows for fetal movement 2. Is a measure of kidney function 3. Surrounds, cushions, and protects the fetus 4. Maintains the body temperature of the fetus 5. Prevents large particles such as bacteria from passing to the fetus 6. Provides an exchange of nutrients and waste products between the mother and fetus
answer

1. Allows for fetal movement 2. Is a measure of kidney function 3. Surrounds, cushions, and protects the fetus 4. Maintains the body temperature of the fetus
question

A nurse is performing an assessment of a pregnant client who is at 28 wks gestation. The nurse measures the fundal height in centimeters and expects he finding to be which of the following? 1. 22 cm 2. 30 cm 3. 36 cm 4. 40 cm
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2. 30 cm Rational: During the 2nd/3rd trimesters (18 wks-30wks), fundal height in cm approximately equals the fetus’ age in weeks +/- 2cm. At 16 wks, the fundus can be located halfway between the symphysis pubis and the umbilicus. At 20-22 wks, the fundus is at the umbilicus. At 36 wks, the fundus is at the xiphoid process.
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A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year-old child who was delivered at 38 wks and tells the nurse that she does not have a history of any type of abortion or fetal demise. The nurse would document the GTPAL for this client as: 1. G3, T2, P0, A0, L1 2. G2, T1, P0, A0, L1 3. G1, T1, P1, A0, L1 4. G2, T0, P0, A0, L1
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2. G2, T1, P0, A0, L1
question

A pregnant client is seen in a health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions, and the nurse determines that she is experiencing Braxton Hicks contractions. Based on this finding, which nursing action is appropriate? 1. Contact the physician 2. Instruct the client to maintain bedrest for the remainder of the pregnancy. 3. Inform the client that these contractions are common and may occur throughout the pregnancy. 4. Call the maternity unit and inform them that the client will be admitted in a prelabor condition.
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3. Inform the client that these contractions are common and may occur throughout the pregnancy.
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A nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus. The nurse tells the client that: 1. Total abstinence from sexual intercourse is necessary during the entire pregnancy. 2. Sitz baths need to be taken every 4 hours while awake if vaginal lesions are present. 3. Daily administration of acyclovir (Zovirax) is necessary during the entire pregnancy. 4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.
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4. A cesarean section will be necessary if vaginal lesions are present at the time of labor.
question

A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of Goodell’s sign. The nurse determines that this sign indicates: 1. A softening of the cervix. 2. The presence of fetal movement 3. The presence of HCG in the urine 4. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus.
answer

1. A softening of the cervix.
question

A client arrives at the clinic for the first prenatal assessment. The client tells a nurse that the first day of her LMP was October 19, 2012. Using Nagele’s rule, the nurse determines the EDD is: 1. July 12, 2012 2. July 26, 2013 3. August 12, 2013 4. August 26, 2013
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2. July 26, 2013
question

A nurse-midwife is assessing a pregnant client for the presence of ballottement. To make this determination, the nurse mid-wife does which of the follwoing? 1. Auscultates for fetal heart sounds 2. Assesses the cervix for compressibility 3. Palpates the abdomen for fetal movement 4. Initiates a gentle upward tap on the cervix.
answer

4. Initiates a gentle upward tap on the cervix.
question

A nurse is performing an assessment of a primigravida who is being evaluated in a clinic during her 2nd trimester of pregnancy. Which of the following indicates an ABNORMAL physical finding that necessitates further testing? 1. Quickening 2. Braxton Hicks Contractions 3. FHR of 180/bpm 4. Consistent increase in fundal height
answer

3. FHR of 180/bpm
question

A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for PROBABLE signs of pregnancy. Which of the following are probably signs of pregnancy? SELECT ALL THAT APPLY. 1. Ballottement 2. Chadwick’s Sign 3. Uterine enlargement 4. Braxton Hicks contractions 5. FHR detected by a non-electronic devise 6. Outline of fetus via radiography or ultrasonography
answer

1. Ballottement 2. Chadwick’s Sign 3. Uterine enlargement 4. Braxton Hicks contractions
question

A nurse is providing instructions to a pregnant client who is scheduled for an amniocentesis. The nurse tells the client that: 1. Strict bed rest is required after the procedure. 2. An informed consent needs to be signed before the procedure 3. Hospitalization is necessary for 24 hours after the procedure 4. A fever is expected after the procedure because of the trauma to the abdomen.
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2. An informed consent needs to be signed before the procedure
question

A pregnant client in the 1st trimester calls a nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client? 1. “Come to the clinic immediately.” 2. “Report the ED at the maternity center immediately.” 3. “The vaginal drainage may be bothersome, but is a normal occurrence.” 4. “Use tampons if the discharge is bothersome, but to be sure to change the tampons ever 2 hours.”
answer

3. “The vaginal drainage may be bothersome, but is a normal occurrence.” Rational: Leukorrhea begins during the 1st trimester. Many clients notice a thin, colorless or yellow vaginal discharge throughout pregnancy. Some clients become distressed about this condition, but it does not require that the client report to the clinic or ED.
question

A nurse has performed a nonstress test on a pregnant client and is reviewing the fetal monitor strip. The nurse interprets the test as reactive and understand that this indicates: 1. Normal findings 2. Abnormal findings 3. The need for further evaluation 4. That the findings on the monitor were difficult to interpreet
answer

1. Normal findings Rational: A reactive NST is a normal result. To be considered reactive, the baseline FHR must be within normal range, 120-160/bpm, with good long-term variability. In addition, 2+ FHR accelerations of t least 15/bpm must occur, each with a duration of at least 15 sec, in a 20-minute interval.
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A NST is performed on a client who is pregnant, and the results of the test indicate NONREACTIVE finding. The physician prescribes a CST, and the results are documented as NEGATIVE. A nurse interprets the finding of the CST as indicating: 1. A normal test result 2. An abnormal test result 3. A high risk for fetal demise 4. The need for a cesarean delivery
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1. A normal test result Rational: A NEGATIVE test result indicates that no late decelerations occurred in the FHR, although the fetus was stressed by three contractions of at least 40 sec duration in a 10 minute period.
question

A pregnant client tells a nurse that she has been craving “unusual foods.” The nurse gathers additional assessment data from the client and discovers that the client has been ingesting daily amounts of white clay dirt from her backyard. Lab studies are performed on the client. The nurse reviews the results and determines that which of the following indicates a physiological consequence of the client’s practice? 1. Hematocrit 38% 2. Glucose 86 mg/dL 3. Hemoglobin 9.1 g/dL 4. WBC count 12,400/mm3
answer

3. Hemoglobin 9.1 g/dL Rational: Pica cravings often lead to iron deficiency anemia, resulting in a decreased hemoglobin level.
question

A clinic nurse is providing instructions to pregnant client regarding measures that assist in alleviating heartburn. Which statement by the client indicates an understanding of the instructions? 1. “I should avoid between-meal snacks.” 2. “I should lie down for an hour after meals.” 3. “I should use spices for cooking rather than using salt.” 4. I should avoid eating foods that produce gas, such as beans and some vegetables, and fatty foods such as deep-fried chicken.”
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4. I should avoid eating foods that produce gas, such as beans and some vegetables, and fatty foods such as deep-fried chicken.”
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A home care nurse visits a pregnant client who ad a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the physician? 1. Urinary output as increased 2. Dependent edema has resolved 3. BP reading is at the prenatal baseline 4. The client complains of a headache and blurred vision.
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4. The client complains of a headache and blurred vision.
question

A nurse implements a teaching plan for a pregnant client who is newly diagnosed with GDM. Which statement made by the client indicates a need for further teaching? 1. “I should stay on the diabetic diet.” 2. “I should perform glucose monitoring at home.” 3. “I should avoid exercise because of the negative effects on insulin production.” 4. “I should be aware of any infections and report signs of infection immediately to may HCP.”
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3. “I should avoid exercise because of the negative effects on insulin production.”
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A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampisa. A nurse monitors for complications associated with the diagnosis and assesses the client for. 1. Enlargement of the breast 2. Complaints of feeling hot when the room is cool 3. Periods of fetal movement followed by quiet periods 4. Evidence of bleeding, such as in the gums, petechiae, and purpura
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4. Evidence of bleeding, such as in the gums, petechiae, and purpura Rational: Severe preeclampsia can trigger DIC because of the widespread damage to vascular integrity.
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A nurse in a maternity unit is reviewing the records of the clients on the unit. Which client would the nurse identify as being at the greatest risk for developing DIC? 1. A primigravida with mild preeclampisa 2. A primigravida who delivered a 10lb infant 3 hours ago 3. A G2 who has just been diagnosed with dead futus syndrome 4. A G4 who delivered 8 hours ago and has lost 500mL of blood
answer

3. A G2 who has just been diagnosed with dead fetus syndrome
question

A client is in the 1st trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instructions? 1. I will watch for the evidence of the passage of tissue. 2. I will maintain strict bedrest throughout the remainder of the pregnancy 3. I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad. 4. I will avoid sexual intercourse until the bleeding as stopped, and for 2 wks following the last evidence of bleeding.
answer

1. I will watch for the evidence of the passage of tissue.
question

A home care nurse is monitoring a pregnant client with gestational HTN who is at risk for preeclampsia. At each home care visit, the nurse assess the client for which classic signs of preeclampsia? SELECT ALL THAT APPLY. 1. Proteinuria 2. HTN 3. Low grade fever 4. Generalized edema 5. Increased pulse rate 6. Increased respirator rate
answer

1. Proteinuria 2. HTN 4. Generalized edema
question

A nurse is assessing a pregant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present? 1. Soft abdomen 2. Uterine tenderness 3. Absence of abdominal pain 4. Painless, bright red vaginal bleeding
answer

2. Uterine tenderness
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A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse review the physican’s prescriptiosn and would question which prescription? 1. Prepare the client for an ultrasound 2. Obtain equipment for a manual pelvic examination 3. Prepare to draw a hemoglobin and hematocrit blood sample 4. Obtain equipment for external electronic FHR monitoring.
answer

2. Obtain equipment for a manual pelvic examination
question

An ultrasound is performed on a client at term gestation who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that abruptio placentae is present. Based on these findings, the nurse would prepare the client for: 1. Delivery of the fetus 2. Strict monitoring of I/O 3. Complete bedrest for the remainder of the pregnancy 4. The need for weekly monitoring of coagulation studies until the time of delivery
answer

1. Delivery of the fetus
question

A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which risk associated with placenta previa? 1. Infection 2. Hemorrhage 3. Chronic HTN 4. DIC
answer

2. Hemorrhage
question

A nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment findings would the nurse expect to note? SELECT ALL THAT APPLY. 1. Uterine rigidity 2. Uterine tenderness 3. Severe abdominal pain 4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age.
answer

4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age.

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