MATERNITY NCLEX QUESTIONS WITH CORRECT SOLUTIONS 2023

Which of the following maternal factors may decrease fetal oxygenation? Select all that apply A. Asthma B. Gestational diabetes C. Hypertension D. Epidural - A. Asthma C. Hypertension D. 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 2. 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) A. Decreased cardiac output B. Increased clotting factors C. Decreased lung volume D. Skin color changes that should return to normal after pregnancy E. 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. A. My pain duration changes when I move around B. My contractions are occurring every 6 minutes and last 1 minute long C. I have pain located back to front D. My cervix is changing E. 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? A. November 13, 2021 B. November 9, 2020 C. October 13, 2020 D. 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? A. Probable B. Presumptive C. Positive D. Negative - A. Probable