OB NCLEX Questions and Answers with verified solutions

OB NCLEX Questions and Answers with verified solutions A client is using the basal body temperature (BBT) method of contraception .She calls the clinic and tells the nurse, "My period is due in a few days, and my temperature has not gone up." The nurse's most appropriate response is: A. "This probably means you're pregnant." B. "Don't worry; it's probably nothing." C. "Have you been sick this month?" D. "You probably didn't ovulate during this cycle." - ANS- d-Pregnancy cannot occur without ovulation (which is being measured using the BBT method). A comment such as this discredits the client's concerns. Illness would most likely cause an increase in BBT. The absence of a temperature decrease most likely is the result of lack of ovulation. A client with pica has been ingesting daily amounts of white clay dirt from her backyard. laboratory studies are performed and the nurse determines that which finding indicates a physiological consequence of the client's practice? a. hct 38% b. glucose 86 mg/dL c. hemoglobin 9.1 g/dL d. wbc 12,400 cell/mm - ANS- C-pica often leads to iron deficiency anemia resulting in a decreased hemoglobin lvl. other lab values are normal for the pregnant mother A high risk pregnant patient has had a complicated delivery and is in the recovery room with active bleeding. The physician has ordered hetastarch in sodium chloride (Hespan) IV infusion. Which best describes the indications for this fluid? A. increasing plasma volume during shock or bleeding B. Causing blood coagulation to promote blood clotting C. Improving circulation by causing vasodilation D. Increasing cardiac contractility to improve circulation - ANS- A- Hetastarch in sodium chloride (Hespan) is a type of plasma expanding solution that is used to increase the volume of the intravascular system during times of blood loss. Hespan is typically used for volume replacement to prevent complications of severe hemorrhage, such as hypovolemic shock A married woman has made the decision to use a diaphragm as her primary method of birth control. The clinic nurse should provide which instructions regarding care of, insertion, and removal of the diaphragm? (Select all that apply.) A. Remove the diaphragm by catching the rim from below the dome. B. Avoid using mineral oil body products C. On insertion, direct the diaphragm down toward the space below cervix D. Wash diaphragm monthly with mild soap and water E. A dusting of cornstarch is appropriate after drying the diaphragm - ANS- B C D E-The diaphragm should not be removed by trying to catch the rim from below the dome. Oil-based products can cause the breakdown of the rubber. The diaphragm should be inserted into the vagina, directing it inward and downward as far as it will go to the space behind and below the cervix. The diaphragm should be washed after each use with mild soap and water. Cornstarch may be used. A nurse is providing genetic counseling for an expectant couple who already have a child with trisomy 18. The nurse should: A. tell the couple they need to have an abortion within 2 to 3 weeks. B. explain that the fetus has a 50% chance of having the disorder. C. discuss options with the couple, including amniocentesis to determine whether the fetus is affected D. refer the couple to a psychologist for emotional support. - ANS- c- The couple should be given information about the likelihood of having another baby with this disorder so that they can make an informed decision. A genetic counselor is the best source for determining genetic probability ratios. Genetic testing, including amniocentesis, would need to be performed to determine whether the fetus is affected a nurse notes that the patient is actively bleeding and her blood pressure has dropped from 110/78 mm Hg to 94/58 mmHg. Which factor would most likely increase the risk of hemorrhage after cesarean section? a. having a large baby b. a history of oligohydramnios c. use of staples to close the incision d. a history of deep vein thrombosis - ANS- A- postpartum hemorrhage is a risk that is apparent whether a patient has delivered thru vaginal or cesarean methods when bleeding occurs after a cesarean section, the nurse must manage the condition as if it were a surgical complication, since the patient has undergone surgery. risks of post-op bleeding after cesarean section include having a large baby, which can stretch the size of the uterus and put pressure on the blood vessels, increasing the risk of hemorrhage A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates an understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A. a positive pregnancy test. B. fetal movement palpated by the nurse-midwife C. Braxton Hicks contractions. D. quickening. - ANS- B-positive signs of pregnancy are those attributed to the presence of a fetus such as HEARING THE FETAL HEARTBEAT OR PALPATING FETAL MOVEMENT Probable sign of pregnancy- Braxton Hicks contractions Presumptive signs- Quickening A patient receiving TPN with lipids thru a central line placed in the subclavian vein. Which complication is most closely associated with this type of fluid administration? A. Fractured ribs B. Pneumothorax C. Mental confusion D. Allergic reaction - ANS- Pneumothorax A patient who is 28 weeks' gestation undergoes a nonstress test when she noticed that the baby hasn't moved recently. the results are considered reactive. What does this mean? A. the baby has normal heart rate accelerations b. the baby does not have any noted birth defects c. the baby is most likely neurologically impaired d. the baby is going to be born preterm - ANS- A- NST may be performed on a pregnant patient after approximately 28 weeks' gestation. the NST is noninvasive and involves monitoring the baby's heart rate and movements for a period of about 30 minutes. A reactive test indicates that the baby has changes in heart rate in response to movement, which is normal a patient who is 37 weeks' pregnant has collapsed in the hallway of the hospital. a nurse responds and notes that the patient does not have a heart rate. which intervention must be modified because of this patient's pregnancy in order to respond to this situation? a. the nurse must open the patient's airway using the jaw thrust b. the nurse must displace the uterus slightly before performing chest compressions c. the nurse cannot use an AED on a pregnant patient d. the nurse should provide compressions at a rate of 200/min on the pregnant patient - ANS- B- cardiopulmonary resuscitation and AED can be used on a pregnant patient with some modifications. if the nurse must perform chest compressions, she should still provide the same rate as to a non pregnant patient, but she may need to slightly displace the uterus to perform the compressions A patient with high bp during labor has been given magnesium sulfate IV. In addition to regulation of bp, which of the following results would the nurse expect to see after administration of this medication? A. cool, pale skin B. Constipation C. Muscle weakness D. Neck pain - ANS- C- Administration of magnesium sulfate is a form of treatment used for some women who have pre-eclampsia during pregnancy and labor. Magnesium sulfate is given to prevent preterm delivery but it can also cause some negative effects in the mother, including muscle weakness, blurred vision, headache, nausea, and vomiting