OB Exam 4 Questions Answered Correctly Latest Update 2025 Already Passed
Twelve hours after delivery, the fundus of a patient who has just delivered her fifth child after 14 hours
of labor is two fingers above the umbilicus and her uterus feels soft and spongy. What should the nurse
do first?
A) Put on the call button to summon help
B) Gently massage the fundus until it tones up
C) Administer oxytocics to prevent uterine atony
D) Teach the patient to perform periodic self-fundal massage - Answers Ans: B
Feedback:
After delivery, the fundus should be firm and at the umbilicus or lower. The first action is to massage the
uterus until firm. The scenario described does not indicate any need to summon help. The
administration of oxytocics to prevent uterine atony can only be done by order of the health care
provider. Teaching the woman to perform self-fundal massage is not appropriate at this time. It would
be appropriate after the atony of the uterus is corrected.
Which lochia pattern should the nurse report immediately to the RN or primary practitioner?
A) Moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5
B) Moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5
C) Lochia progresses from rubra to serosa to alba within 10 days
D) Moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on day 5 - Answers
Ans: A
Feedback:
Lochia by day 4 should be decreasing in amount, and the color should be changing to pink tinged. Red
rubra on day 4 may indicate bleeding, and the health care provider should be notified. A moderate flow
of lochia rubra on day 3 postpartum, changing to serosa on day 5, is a normal finding; as is lochia
progressing from rubra to serosa to alba within 10 days of delivery; and so is moderate lochia rubra on
day 3, mixed serosa and rubra on day 4, and light serosa on day 5.
A patient has just delivered her second child and will breast-feed. The patient does not want to become
pregnant again until her second child is at least 2 years old. When should the nurse counsel the patient
to begin birth control?
,A) As soon as she stops breast-feeding
B) Within 18 months
C) Within six weeks
D) As soon as she resumes sexual activity - Answers Ans: D
Feedback:
The patient can ovulate even though she is not having a normal menstrual cycle and needs to take
precautions. Beginning to use birth control within six weeks, or within 18 months, or as soon as breast-
feeding ends is not affording her protection from getting pregnant. The patient should use mechanical
means of birth control as soon as she resumes sexual activity.
Before delivery a pregnant patient's hemoglobin was 14 g/dL and hematocrit of 42%. Which postpartum
measurements should the nurse report?
A) Hemoglobin 13 g/dL and hematocrit 40% in a woman who has given birth vaginally
B) Hemoglobin 12 g/dL and hematocrit 38% in a woman who has given birth vaginally
C) Hemoglobin 11 g/dL and hematocrit 34% in a woman who has given birth by cesarean
D) Hemoglobin 9 g/dL and hematocrit 32% in a woman who has given birth by cesarean - Answers Ans:
D
Feedback:
There was a significant change from the prepartum H&H to the postpartum H&H. These values need to
be reported and the patient needs a complete assessment for any bleeding. The other choices are
considered to be within normal limits for a postpartum H&H, given the prepartum values.
A patient has just delivered a baby. Her prelabor vital signs were T - 98.8 B/P-P-R 120/70, 80, 20. Which
combination of findings during the early postpartum period should be reported immediately?
A) Shaking chills with a fever of 100.3ºF
B) B/P-P-R 90/50, 120, 24
C) Bradycardia and excessive, soaking diaphoresis
D) Blood loss of 250 mL and WBC 25,000 cells/mL - Answers Ans: B
,Feedback:
The decrease in BP with an increase in HR and RR indicate a potential significant complication, and are
out of the range of normal, from delivery and need to be reported immediately. Shaking chills with a
temperature of 100.3ºF can occur due to stress on the body and is considered a normal finding.
Bradycardia, diaphoresis, blood loss of 250 mL and WBC count of 25,000 cells/mL are considered to be
within normal limits after delivering a baby.
For several hours after delivery, a patient who experienced a much more difficult labor this time than
any time previously wants to talk about why the birthing process was so hard for her this time. She is
focusing on this aspect to the point that she seems relatively indifferent to her newborn. How should
the nurse handle this situation?
A) Redirect her attention to the baby by reminding her of the details of newborn care
B) Ask her to describe how she plans to integrate the newcomer into her existing family, including any
actions she has taken to prepare the siblings
C) Encourage her to discuss her experience of the birth and answer any questions or concerns she may
have
D) Point out positive features of her baby and encourage her to hold and cuddle the baby - Answers Ans:
C
Feedback:
The patient needs to explore her birth experience and clarify her questions. The nurse should allow her
to ask questions, be supportive and encourage her to express her feelings. Redirecting her attention to
the baby, asking her to describe how she plans to integrate the new baby into the family, or pointing out
positive features of the new baby do not meet the needs of the patient at this time.
Which maternal reaction is cause for concern and should prompt a consultation with the RN?
A) Hesitation to take newborn when offered and expresses disappointment with the way the baby looks
B) Neglects to engage with or provide care for the baby and shows little interest in it
C) Tearful for several days and has difficulty eating and sleeping
D) Expresses doubt about her ability to care for the baby as well as the nurse can - Answers Ans: B
Feedback:
, A mother not bonding with the infant or showing disinterest is a cause for concern and requires a
referral or notification of the primary health care provider. Some mothers hesitate to take their
newborn, and express disappointment in the way the baby looks, especially if they want a child of one
sex and have a child of the opposite sex. Expressing doubt about the ability to care for the baby is not
unusual, and being tearful for several days with difficulty eating and sleeping is common with
"postpartum blues."
The nurse is providing postpartum care to a woman who has delivered by cesarean section. According to
her records, simethicone, diphenhydramine, and naloxone have been prescribed. Which manifestation
should the nurse report immediately?
A) Intense itching manifested by scratching
B) Abdominal distention and pain
C) Difficulty coughing and turning
D) Slow respiration's, less than 12 a minute - Answers Ans: D
The nurse is discharging a new mother and notes she is not rubella-immune and administers the rubella
vaccine. The patient will breast-feed her infant and plans to get pregnant again as soon as possible.
What is the most important information the nurse should give her about this immunization?
A) Advise her that the vaccine is excreted in breast milk
B) Warn her not to attempt another pregnancy for at least three months
C) Tell her that she may experience rash, sore throat, headache, general malaise, or some combination
of these symptoms within two to four weeks of the injection
D) Advise her that the immunization will prevent hemolytic disease of the infant in her next pregnancy -
Answers Ans: B
Feedback:
After the immunization, she needs to wait for at least three months so the fetus would not be exposed
to the rubella vaccination. The rubella vaccine is a live virus and is considered teratogenic. Inform the
breast-feeding woman that the rubella vaccine crosses over into the breast milk. The newborn benefits
from short-term immunity but may become flushed, fussy, or develop a slight rash. Suggest that the
patient speak to the pediatrician if she has concerns. The nurse should not advise the new mother that
the immunization will prevent hemolytic disease of the infant in her next pregnancy because this is
incorrect information.
Twelve hours after delivery, the fundus of a patient who has just delivered her fifth child after 14 hours
of labor is two fingers above the umbilicus and her uterus feels soft and spongy. What should the nurse
do first?
A) Put on the call button to summon help
B) Gently massage the fundus until it tones up
C) Administer oxytocics to prevent uterine atony
D) Teach the patient to perform periodic self-fundal massage - Answers Ans: B
Feedback:
After delivery, the fundus should be firm and at the umbilicus or lower. The first action is to massage the
uterus until firm. The scenario described does not indicate any need to summon help. The
administration of oxytocics to prevent uterine atony can only be done by order of the health care
provider. Teaching the woman to perform self-fundal massage is not appropriate at this time. It would
be appropriate after the atony of the uterus is corrected.
Which lochia pattern should the nurse report immediately to the RN or primary practitioner?
A) Moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5
B) Moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5
C) Lochia progresses from rubra to serosa to alba within 10 days
D) Moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on day 5 - Answers
Ans: A
Feedback:
Lochia by day 4 should be decreasing in amount, and the color should be changing to pink tinged. Red
rubra on day 4 may indicate bleeding, and the health care provider should be notified. A moderate flow
of lochia rubra on day 3 postpartum, changing to serosa on day 5, is a normal finding; as is lochia
progressing from rubra to serosa to alba within 10 days of delivery; and so is moderate lochia rubra on
day 3, mixed serosa and rubra on day 4, and light serosa on day 5.
A patient has just delivered her second child and will breast-feed. The patient does not want to become
pregnant again until her second child is at least 2 years old. When should the nurse counsel the patient
to begin birth control?
,A) As soon as she stops breast-feeding
B) Within 18 months
C) Within six weeks
D) As soon as she resumes sexual activity - Answers Ans: D
Feedback:
The patient can ovulate even though she is not having a normal menstrual cycle and needs to take
precautions. Beginning to use birth control within six weeks, or within 18 months, or as soon as breast-
feeding ends is not affording her protection from getting pregnant. The patient should use mechanical
means of birth control as soon as she resumes sexual activity.
Before delivery a pregnant patient's hemoglobin was 14 g/dL and hematocrit of 42%. Which postpartum
measurements should the nurse report?
A) Hemoglobin 13 g/dL and hematocrit 40% in a woman who has given birth vaginally
B) Hemoglobin 12 g/dL and hematocrit 38% in a woman who has given birth vaginally
C) Hemoglobin 11 g/dL and hematocrit 34% in a woman who has given birth by cesarean
D) Hemoglobin 9 g/dL and hematocrit 32% in a woman who has given birth by cesarean - Answers Ans:
D
Feedback:
There was a significant change from the prepartum H&H to the postpartum H&H. These values need to
be reported and the patient needs a complete assessment for any bleeding. The other choices are
considered to be within normal limits for a postpartum H&H, given the prepartum values.
A patient has just delivered a baby. Her prelabor vital signs were T - 98.8 B/P-P-R 120/70, 80, 20. Which
combination of findings during the early postpartum period should be reported immediately?
A) Shaking chills with a fever of 100.3ºF
B) B/P-P-R 90/50, 120, 24
C) Bradycardia and excessive, soaking diaphoresis
D) Blood loss of 250 mL and WBC 25,000 cells/mL - Answers Ans: B
,Feedback:
The decrease in BP with an increase in HR and RR indicate a potential significant complication, and are
out of the range of normal, from delivery and need to be reported immediately. Shaking chills with a
temperature of 100.3ºF can occur due to stress on the body and is considered a normal finding.
Bradycardia, diaphoresis, blood loss of 250 mL and WBC count of 25,000 cells/mL are considered to be
within normal limits after delivering a baby.
For several hours after delivery, a patient who experienced a much more difficult labor this time than
any time previously wants to talk about why the birthing process was so hard for her this time. She is
focusing on this aspect to the point that she seems relatively indifferent to her newborn. How should
the nurse handle this situation?
A) Redirect her attention to the baby by reminding her of the details of newborn care
B) Ask her to describe how she plans to integrate the newcomer into her existing family, including any
actions she has taken to prepare the siblings
C) Encourage her to discuss her experience of the birth and answer any questions or concerns she may
have
D) Point out positive features of her baby and encourage her to hold and cuddle the baby - Answers Ans:
C
Feedback:
The patient needs to explore her birth experience and clarify her questions. The nurse should allow her
to ask questions, be supportive and encourage her to express her feelings. Redirecting her attention to
the baby, asking her to describe how she plans to integrate the new baby into the family, or pointing out
positive features of the new baby do not meet the needs of the patient at this time.
Which maternal reaction is cause for concern and should prompt a consultation with the RN?
A) Hesitation to take newborn when offered and expresses disappointment with the way the baby looks
B) Neglects to engage with or provide care for the baby and shows little interest in it
C) Tearful for several days and has difficulty eating and sleeping
D) Expresses doubt about her ability to care for the baby as well as the nurse can - Answers Ans: B
Feedback:
, A mother not bonding with the infant or showing disinterest is a cause for concern and requires a
referral or notification of the primary health care provider. Some mothers hesitate to take their
newborn, and express disappointment in the way the baby looks, especially if they want a child of one
sex and have a child of the opposite sex. Expressing doubt about the ability to care for the baby is not
unusual, and being tearful for several days with difficulty eating and sleeping is common with
"postpartum blues."
The nurse is providing postpartum care to a woman who has delivered by cesarean section. According to
her records, simethicone, diphenhydramine, and naloxone have been prescribed. Which manifestation
should the nurse report immediately?
A) Intense itching manifested by scratching
B) Abdominal distention and pain
C) Difficulty coughing and turning
D) Slow respiration's, less than 12 a minute - Answers Ans: D
The nurse is discharging a new mother and notes she is not rubella-immune and administers the rubella
vaccine. The patient will breast-feed her infant and plans to get pregnant again as soon as possible.
What is the most important information the nurse should give her about this immunization?
A) Advise her that the vaccine is excreted in breast milk
B) Warn her not to attempt another pregnancy for at least three months
C) Tell her that she may experience rash, sore throat, headache, general malaise, or some combination
of these symptoms within two to four weeks of the injection
D) Advise her that the immunization will prevent hemolytic disease of the infant in her next pregnancy -
Answers Ans: B
Feedback:
After the immunization, she needs to wait for at least three months so the fetus would not be exposed
to the rubella vaccination. The rubella vaccine is a live virus and is considered teratogenic. Inform the
breast-feeding woman that the rubella vaccine crosses over into the breast milk. The newborn benefits
from short-term immunity but may become flushed, fussy, or develop a slight rash. Suggest that the
patient speak to the pediatrician if she has concerns. The nurse should not advise the new mother that
the immunization will prevent hemolytic disease of the infant in her next pregnancy because this is
incorrect information.
