OB Questions with Answer I

1. True labor can be differentiated from prodromal or false labor in that in true labor there is a

A.    Strengthening of uterine contractions with walking

2. Failure of presenting part to descend
3. Lack of cervical dilation
4. Cessation of uterine contractions with walking

2. Which of the following statement best describe the characteristic of true contraction?

1. True contractions begin in the lower abdomen
2. True contractions are difficult to determine because they come and go

C.    True contractions have a regularity and become more intense over time

4. True contractions decrease with activity

3. The nurse is assessing between false and true labor. What does she ask the patient to do?

1. Bear down

B.    Walk around

3. Time the contractions
4. Do breathing exercise

4. The birth hazard unassociated with breech delivery is:

1. Intracranial hemorrhage

B.    Cephalhematoma

3. Compression of the cord
4. Separation of placenta prior to delivery of the head

5. Assessment findings indicate that patient is 3 cm dilated, and contractions every 6 minutes lasting 40 seconds. The nurse should monitor the FHT

1. Every 15 minutes
2. Every   30 minutes

C.    Every 60 minutes

4. Every 90 minutes

6. When a patient is admitted to the unit in active labor. What is the initial action the nurse should take?

1. Assess for ruptured membranes

B.    Take V/S and check FHT

3. Perform the Leopold’s maneuvers
4. Catheterize for urine specimen

7. Which of the following statement best describe a normal female pelvis

A.    Sacrum well hollowed, coccyx movable, spines not prominent, wide pubic arch

2. Flat sacrum, movable coccyx, prominent spines, wide pubic arch
3. Sacrum deeply hollowed, immovable coccyx, narrow pubic arch, spines not prominent
4. Flat sacrum, movable coccyx, prominent spines, wide pubic arch

8. The most effective method of determining if the pelvis is adequate to allow the passage of the fetus vaginally is:

1. Pelvimetry

B.    X-ray examination

3. Assessment of characteristics of contractions
4. Duration of labor

9. What does it mean during labor when the nurse assesses the fetal presenting part at “plus one”?

1. One inch above ischial spines
2. One inch below ischial spines

C.    One cm above ischial spines

4. One cm below ischial spine

10.The nurse should be aware that which of the following variations in FHT may be considered normal

1. Decrease in rate during the second stage of labor

B.    Decrease in rate during the midportion of contraction

3. Increase in rate following the rupture of membranes
4. Increase in rate when engagement begins

11. The nursing assessment of a woman in labor reveals contractions lasting 60 seconds and 4 minutes apart; cervix is 6 cm and dilated. The woman is in what phase of the first stage of labor?

1. Latent phase

B.    Active phase

3. Transition phase
4. Early phase I

12. Nursing assessment reveals active labor, breech presentation, ruptured membranes and passage of meconium stained amniotic fluid. The nurse valuates this as:

1. A fetus in distress

B.    A normal assessment

3. A sign of labor is progressing
4. Indicative of CS

13. The bag of water is ruptured artificially when the fetal head is engaged in order to

1. Enable the bag of water to rupture spontaneously if possible, thus avoiding difficult and painful instrumentation
2. Prevent prolapse of the umbilical cord during the forceful expulsion of amniotic fluid from the sac
3. Ensure that small amount of amniotic fluid would be left in the upper portion of the amniotic sac
4. Have the amniotic sac in a dependent position that could be reached without difficulty

14. The cervix is considered completely dilated when the diameter of the os is:

1. 6 cm
2. 8 cm

C.    10 cm

4. 12 cm

15. In timing the contraction the nurse should notify the physician if she detects a contraction lasting longer than

1. 30 seconds

B.    60 seconds

3. 90 seconds
4. 120 seconds

16. The mechanics of the second stage of labor differ from the first stage in that during the second stage

1. The lower uterine segment contracts more than the fundus

B.    The abdominal muscles assist in the expulsion of the fetus

3. The joint of the pelvis are stretched and dislocated
4. All muscles involved in fetal propulsion undergo Tetany

17. The fetal head is engaged when

1. The vertex of the skull is level with the symphysis pubis

B.    The biparietal diameter has passed the pelvic inlet

3. The head rotates from the transverse to the AP position
4. The head has descended beyond the external os

18. To determine the fetal position during labor the nurse should assess which of the following

1. First body part of the fetus felt by the nurse upon vaginal examination

B.    Relationship of a fixed point of the fetus to the quadrants of the maternal pelvis

3. Relationship of the furthermost fetal part to the ischial spines of the maternal pelvis
4. Relationship of the long axis to the mother’s body

19. During the early second stage of labor FHT should be taken at least every

1. 2-4 minutes
2. 5 to 10 minutes

C.    10 to 20 minutes

4. 20 to 30 minutes

20. The changes in shape of the infant’s head that occur owing to pressure from the walls of birth canal are called

A.    Molding

2. Cephalhematoma
3. Microcephaly
4. Caput succedaneum

21. If crowning occurs while the nurse is alone with the patient, the nurse should

1. Place a sterile water over the infant’s head and apply manual pressure until a physician arrives
2. Place a mask over the woman’s face and administer a few drops of ether to delay the delivery
3. Call for help, stay with the patient and guide the slow delivery of the head between contractions
4. Instruct the woman to hold her knees together and leave to obtain help from an experienced nurse

22. The most common position for the fetus at birth is

1. Right occiput anterior

B.    Left occiput anterior

3. Right occiput posterior
4. Left occiput posterior

23. The second stage of labor ends with

1. Complete cervical dilation
2. Bulging of the perineum

C.    Delivery of the baby

4. Removal of the placenta

24. The fetal heart rate variability is not affected by

A.    Maternal sleep

2. The second stage of labor
3. Fetal sleep
4. Maternal drug use

25. The nurse is timing the contractions in a patient who is 7 cm dilated. The nurse should time the contractions

1. From the beginning of a contraction to end

B.    From the beginning of a contraction to the beginning of the next

3. From the end of a contraction to the beginning of the next
4. From the end of a contraction to the end of the next contraction

26. A woman in labor comes to the labor and delivery area with ruptured membranes, contractions that occur every 3 minutes and last 50 to 60 seconds. The fetus is in the LOA position. The nurse’s first action should be to:

A.    Check the FHR

2. Call the physician
3. Check the vaginal fluid with nitrazine paper
4. Admit the patient to the labor and delivery area

27. A woman in labor was admitted with ruptured membranes. Assessment indicates that the FHT is audible in left lower quadrant. When asked to describe the amniotic fluid, the woman states that it was brown-tinged. This indicates that

1. The fetus has an infection

B.    At some point, the fetus experienced oxygen deprivation

3. The fetus is in distress and should be delivered immediately
4. The fetus is not experiencing any undue stress

28. An electronic fetal monitor is attached. The fetal monitoring strip shows an FHR deceleration occurring about 30 seconds after each contraction begins; the FHR return to baseline after the contraction is over. This type of deceleration is caused by:

1. Fetal head compression
2. Umbilical cord compression

C.    Uteroplacental insufficiency

4. Cardiac anomalies

29. The fetal monitoring strip shows an FHR deceleration occurring about 30 seconds after each contraction begins; the FHR return to baseline after the contraction is over. With this type of deceleration, the nurse’s first action should be to:

1. Increase the IV flow rate
2. Call the physician

C.    Position the woman in labor on the left side

4. Continue monitoring the FHR

30. A woman is active labor cries out, “I’m feeling a lot of pressure. I want to push.” The nurse notes that her cervix is dilated 7 cm. How should the nurse respond?

1. Tell the woman to begin to push, then call the physician
2. Tell the woman to breath by blowing air through her mouth when she feels the urge to push
3. Instruct the woman to breath when she gets the urge to push
4. Instruct the woman to hold her breath when she gets the urge to push