OB Questions with Answer IV

81. Twenty-four hours after uncomplicated labor and delivery, the mother’s CBC revels WBC of 17,000/mm3. The nurse would interpret the woman’s WBC count as being indicative of:

1. A bacterial infection of the reproductive system
2. An acute sexually transmitted viral disease

C.    A normal decrease in WBC

4. A normal response to labor process

82. Which of the following statement best describe puerperium?

1. 4-6 hours period after delivery during which the placenta is completely expelled
2. A phase of the fourth stage of labor
3. A term to indicate progressive changes of the breast 4 to 6 weeks after delivery
4. A 6 week period after delivery, during which the reproductive organs return to non-pregnant state

83. A woman G1P1 delivered a 7-lb male infant. She plans to breast feed the baby. On the first day postpartum day, the nurse notes that the woman’s fundus is above the umbilicus and to the left of the midline. What would the nurse initially suspect?   

A.     A full bladder

B.     Retained placental fragments

C.     Uterine atony

D.     Uterine inertia

84. Ellen complains of tenderness and swelling of the breasts. The nurse explains that she is experiencing primary breast engorgement, which lasts for

A.     1 to 2 days

B.     3 to 4 days

C.     5 to 6 days

D.     7 to 8 days

85. Which of the following would the nurse teach the postpartum woman to include in her daily care to keep the nipples in good condition for breastfeeding to prevent potential for infection?

A.     Wash with soap and water before each feeding

B.     Keep the nipples dry and clean

C.     Cover the nipples with a dry and clean plastic pad

D.     Cleanse with antiseptic solution three times a day

86. Which of the following statement best explain why the postpartum mother voids large amount of urine frequently?

A.     A sign of urinary retention and overflow

B.     A normal body’s response to reduce extracellular fluid acquired during pregnancy

C.     A result of decreased bladder tone due to anesthesia during labor

D.     An indication of a bladder infection

87. The period immediately following birth is divided into significant phases. The phase in which the mother’s needs have to be met before she can meet the baby’s needs is called     

A.    Taking-in phase

2. Transition phase
3. Taking-hold phase
4. Bonding phase

88. A woman is discharged on her third postpartum day. What type of lochia should be noted?

A.    Lochia alba

B.    Lochia serosa

3. Lochia rubra
4. Lochia rugae

89. If the fundus of the uterus is felt at the umbilicus immediately after delivery of the placenta,

      the nurse should take which one of the following nursing actions?

1. Catheterize the patient

B.    Massage the fundus to make it firm

3. Administer Methergine
4. Support the mother, because this represents a normal fundus placement

90. Two days after delivery, the nurse assesses a heavy amount of lochia rubra containing

      four blood clots about the size of one-peso coin. This assessment is:

1. Normal for 2 days post-delivery
2. Normal for 4 days post-delivery
3. Abnormal because it is lochia serosa

D.    A sign of complication or hemorrhage

91. Which one of the following conditions would alert the nurse for a possible postpartum hemorrhage?

A.    Delivery of twins after 16 hours of labor

2. Cesarean birth
3. Premature delivery
4. First delivery of 7 lb baby boy 2 hours after rupture of membranes

92. In explaining the pattern of discharge following delivery, the nurse explains that lochia will

 be heavier:

A.    In the morning

2. At night
3. As lochia cessation nears
4. Toward the end of lactation

93. Which hormone works with estrogen and progesterone to stimulate the breast? development and milk production during pregnancy and following pregnancy?

1. FSH
2. Oxytocin

C.    Prolactin

D.    Placental lactogen

94. The first day after delivery, the husband tells the nurse that his wife has been talking constantly about her recent delivery experience. He asks the nurse if this is normal maternal behavior after delivery. The nurse’s best response is:

1. Divert her attention away from the delivery
2. Do you feel uncomfortable talking about the delivery experience?

C.    This is a normal reaction; it allows her to accept the reality of birth

4. It’s a clear sign that your wife needs psychiatric evaluation

95. A mother plans to bottle-feed her son. She asks the nurse when her menstruation will return. The nurse

      correctly states that non-breastfeeding mothers typically resume menstruating in about:

1. 4 to 6 weeks

B.    6-8 weeks

3. 3-6 months
4. 4-8 month

96. The major reason for a 3-week prescription for resumption of sexual intercourse is to prevent

1. Tearing of the episiotomy

B.    Vaginal and cervical infection

3. Bladder infection
4. Dyspareunia

97. After uncomplicated vaginal delivery the mother complains of severe cramping. The nurse knows that such cramping commonly associated with

1. Infection
2. Retained placental fragments

C.    Uterine involution

4. Bladder distension

98. The nurse prepares to help the mother ambulate for the first time after vaginal delivery. Which statement about early ambulation is true?

A.    It may cause hypotensive episodes

2. It facilitates uterine involution
3. It requires no special nursing intervention
4. It should not be attempted for at least 10 hours after delivery

99.  The nurse should assess for a functional let-down reflex. Which sign indicates that the mother’s let-down

 is functioning properly?

A.   The neonate’s vigorous sucking at the breast

B.   Nipple soreness

C.   Leakage of milk from one breast while the neonate nurses at the other breast

D.   A feeling of breast fullness

100.  After 2 breastfeeding sessions, the mother tells the nurse, “when I breastfeed my baby, the cramping gets much worse.” T he nurse’s best response is:

A.   Breastfeeding cause the uterus to contract. I can give you something for pain before you breastfeed

B.   Let me watch while you breastfeed; your technique may be causing this problem

C.   The cramping is normal, but you can not take any medication while you are breastfeeding

D.   The cramping will pass. You just need to continue with the breastfeeding

OB Questions with Answer III

61. After the woman receives epidural block anesthesia, the nurse should immediately:

1. Assess the FHR

B.    Assess the woman’s BP, pulse, and respirations

3. Administer oxygen via face mask
4. Place the woman in semi-Fowler’s position

62. Assessment findings on a woman in labor include cervical dilation of 4 cm, 100% effaced, station 0, contractions every 5 to 6 minutes lasting 50 to 60seconds, membranes intact, FHR 140 to 150 BPM loudest in the upper left quadrant, and hard round mass palpable at the level of the fundus. Assessment findings indicate that the fetus is in

A.    Breech presentation

2. Cephalic presentation
3. Posterior position
4. Transverse lie

63. Assessment findings on a woman in labor include cervical dilation of 4 cm, 100% effaced, station 0, contractions every 5 to 6 minutes lasting 50 to 60seconds, membranes intact, FHR 140 to 150 BPM loudest in the upper left quadrant, and hard round mass palpable at the level of the fundus. While monitoring the FHR membranes rupture spontaneously revealing meconium-stained amniotic fluid. The nurse’s initial action should be to:

1. Prepare the woman for CS delivery because of fetal distress
2. Notify the physician

C.    Determine the FHR

4. Place the woman in left side lying position because amniotic fluid indicates fetal distress

64. Assessment reveals cervical dilation of 5 cm cervical effacement 80%, station +3 frequency of contractions 5 to 8 minutes, duration of contractions 40-50 seconds, membranes ruptured spontaneously 1 hour prior to admission, vertex presentation, LOA position. The woman asks the nurse if it is all right for her to get up and walk around. The nurse’s best response should be

1. “You should stay in bed; walking may interfere with proper uterine contractions”
2. “I can’t make a decision on that, you will have to ask the doctor.”
3. “You will have to stay in bed; otherwise your contractions cannot be timed and no one can listen to the FHR”
4. “It’s quite all right for you to be up and about as long as you feel comfortable and your membranes are intact”

65. A woman in labor progresses to 7 to 8 cm dilated and the vertex is low in the midpelvis. To alleviate discomfort during contractions, the nurse should instruct the woman to

1. Pant during contractions

B.    Abdominal breathe

3. Chest breathe
4. Pant between contractions

66. If labor is progressing satisfactorily, when would it be appropriate to administer medication such as Demerol?

1. 3 cm dilation
2. 4 cm dilation
3. 5 cm dilation

D.    7 cm dilation

67. Demerol 50 mg and Phenergan 50 mg are ordered to be administered IM. This medication would:

1. Induce sleep until the time of delivery

B.    Increase pain threshold, resulting I relaxation

3. Act as amnesic drug
4. Act as a preliminary anesthesia

68. The beginning of the second stage of labor can be recognized by the client’s desire to:

1. Relax during contractions

B.    Push during contractions

3. Pant during contractions
4. Blow during contractions

69. A woman is positioned on the delivery table; both legs should be placed simultaneously in the stirrups to prevent:

1. Excessive pull on the fascia
2. Pressure on the perineum

C.    Trauma to the uterine ligaments

4. Venous stasis in the legs

70. A G3P2 is in labor and is progressing rapidly. When should she be moved into the delivery room?

1. Cervix is dilated 2-4 cm

B.    Cervix is dilated 7-8 cm

3. Cervix is dilated 10 cm
4. At the onset of labor

71. Which of the following is observed first when placenta begins to separate?

1. Lengthening of the cord
2. Sudden gush of blood

C.    Abdomen becomes globular and firm

4. Sudden rise of the fundus

72. The placenta should be delivered within the period of time following delivery?

1. 1-2 minutes

B.    3-10 minutes

3. 15-20 minutes
4. 20-30 minutes

73. Ten minutes after the delivery, the placenta is still intact. What action does the nurse take?

1. Gently pull on the cord to initiate separation
2. Call the physician back to the delivery room
3. Push gently, but firmly on the fundus

D.    Allow the infant to suck the breast

74. About 15 minutes after delivery, the woman begins to complain about chills. The most appropriate action by the nurse would be to:  

A.      Notify the physician of the problem

B.      Cover with a blanket

C.      Administer acetaminophen as ordered

D.     Increase the IV infusion rate

75. The nurse assesses the postpartum mother during the fourth stage of labor for:

1. Level of maternal love

B.    Distention of the bladder

3. Ability to relax
4. Knowledge of the newborn behavior

76. The nurse notes bright red bleeding in a patient who delivered 26 hours ago. What is the probable cause of bleeding?

A.    Uterine atony

2. Normal bleeding
3. Perineal laceration
4. Placental fragments

77. The nurse is aware that the nursing action that would be best promote parent-infant attachment behaviors would be:

1. Encouraging rooming-in, with parental infant care

B.    Keeping the new family together immediately postpartum

3. Restricting visitation on the postpartum unit
4. Supporting the parents’ choice of breastfeeding

78. The nurse is aware that during the taking-in phase of the postpartum period the area of health teaching that the mother will be most responsive to is:

1. Family Planning
2. Infant feeding
3. Infant hygiene

D.    Perineal care

79. A woman’s labor does not progress and a cesarean delivery is performed. Afterwards she tells the nurse

      that she is a “natural childbirth flunkie.” The postpartal phase of adjustment that the statement most closely typifies is:

1. Taking hold
2. Working through

C.    Taking in

4. Letting go

80. A mother chooses to bottle feed her newborn because this will cause the least interference with full resumption of her teaching practice. Before discharge the nurse should teach her that if breast engorgement occurs, she should

1. Take 2 aspirins every 4 hours
2. Apply hot compresses to the breasts

C.    Wear a tightly fitted brassiere

4. Cease drinking milk for 2 weeks