NCLEX OB EXAM Questions and Answers
1.Which of the following tasks may be delegated to the nursing assistant?
a. checking the cervix of the patient who is less likely to deliver soon
b. administering oxygen to the mother who has decreasing oxygen satura- tions
c. providing ice chips for a mother who complains of a dry mouth
d. Tearing off a strip of paper from the fetal heart rate monitor and putting it in
the chart
ANS C- When working in L&D the UAP can help with ADLs. They
cannot be delegated tasks that require formulating a care plan, taking
off orders, or administering medications
2.Which of the following situations would most likely warrant contact with a
physician for further orders for care or treatment?
A. A patient has a 3rd degree perineal laceration after delivery
B. A patient has lost 100 mL of blood with delivery
C. A patient has a boggy uterus that does not firm with massage
D. A patient is having rectal pain
ANS C. When caring for postpartum patients, the nurse must be familiar
with what conditions are common occurrences following de- livery and
what situations warrant a call to the physician for further help.
Postpartum complications often include infection, blood clots, and
hemorrhage. Excess bleeding may occur when the uterus is boggy and
it does not firm up with massage.
,3.Following removal of the epidural, the patient develops a severe headache
when she sits up in bed. The physician has instructed the patient that she will
need a blood patch. Which best describes this procedure?
A. Removing blood from a vein in the patient and injecting it into the epidural
space in the back
B. Placement of a large bandage over the site of the epidural insertion.
C. Replacement of the epidural catheter into the same space for long-term
control
D. Placement of a nerve block in the spinal column at the location of the affected
epidural space
ANS A- When CSF leaks out of the epidural space a severe headache in
the patient can occur. A blood patch can be performed by a physician to
close the site. The small amount of blood is withdrawn from the
mother's arm and the blood clots in the space.
4.Which of the patients described should the nurse see first?
A. 20 yr old patient who just had her first baby and doesn't know how to
breastfeed
B. 27 yr old diabetic patient who delivered her second child yesterday and
needs her morning dose of insulin
C. 24 yr old patient who has had a large amount of lochia and has developed a
hematoma on her perineum
D. 30 yr old patient who needs to take a shower and eat breakfast before the
physician comes to dismiss her
ANS C. A patient with a hematoma is at risk of hemorrhage and the
,nurse should assess her first
5.On the first following delivery, the physician ordered a hemoglobin level for the
patient; the result was 9.9 g/dL. The physician did not list any other orders in the
patient's chart since that time. Which response of the nurse is most appropriate>
A. call the physician and ask if he wants a blood transfusion for the patient
B. ask the physician about the hemoglobin level when he comes in for rounds
C. Contact the laboratory and ask them to repeat the test
D. continue to monitor the patient and document the result
ANS B. A postpartum patient is at risk of hemorrhage following delivery;
often the physician will order a hemoglobin level 1-2 days after delivery
to check the mother's risk status. A level of
9.9 g/dL is lower than normal for a female patient, but is not necessarily
low enough to warrant a blood transfusion.
6.The patient's medical record states that she tested positive for group B
Streptococcus infection. which of the following precautions should be given in this
situation?
A. the patient should receive antibiotics at this time
b. the patient should be given antibiotics during labor
c. the fetus should receive antibiotics as a prenatal infusion
d. there is no treatment necessary
ANS B- B. Streptococcus can be transferred to the baby during delivery
to cause an infection. the test for the bacteria is performed at
approximately 35 weeks gestation, but antibiotics are typically not
, given until the mother is in labor to reduce the chance that she will pass
the infection to her child
7.When reviewing information about infant care, the nurse should explain that the
postpartum client should call the physician if her infant developed which of the
following conditions?
A. The infant is only sleeping 4 hours at night
B. the baby wants to eat every hour
C. The baby's cord has not fallen off within 7 days
D. The baby has a dry mouth
ANS D- If a baby has dry mouth or dry mucous mem- branes, he or
she could be dehydrated and not getting enough to eat.
8.Which of the following patients would be at high risk of developing pre-
eclampsia? Select all that apply.
A. A patient who is pregnant with her 3rd child
B. A patient who is married
C. A patient who is 40 yrs old
D. A patient who is overweight
E. A patient who is pregnant with twins
ANS C, D, E-Pre-eclampsia is a state that develops during pregnancy in
which a mother has high blood pressure and starts losing protein into
the urine.Certain risks that increase such as a first time pregnancy,
advanced maternal age, overweight or obesity in the mother, and
pregnancy with multiple babies
1.Which of the following tasks may be delegated to the nursing assistant?
a. checking the cervix of the patient who is less likely to deliver soon
b. administering oxygen to the mother who has decreasing oxygen satura- tions
c. providing ice chips for a mother who complains of a dry mouth
d. Tearing off a strip of paper from the fetal heart rate monitor and putting it in
the chart
ANS C- When working in L&D the UAP can help with ADLs. They
cannot be delegated tasks that require formulating a care plan, taking
off orders, or administering medications
2.Which of the following situations would most likely warrant contact with a
physician for further orders for care or treatment?
A. A patient has a 3rd degree perineal laceration after delivery
B. A patient has lost 100 mL of blood with delivery
C. A patient has a boggy uterus that does not firm with massage
D. A patient is having rectal pain
ANS C. When caring for postpartum patients, the nurse must be familiar
with what conditions are common occurrences following de- livery and
what situations warrant a call to the physician for further help.
Postpartum complications often include infection, blood clots, and
hemorrhage. Excess bleeding may occur when the uterus is boggy and
it does not firm up with massage.
,3.Following removal of the epidural, the patient develops a severe headache
when she sits up in bed. The physician has instructed the patient that she will
need a blood patch. Which best describes this procedure?
A. Removing blood from a vein in the patient and injecting it into the epidural
space in the back
B. Placement of a large bandage over the site of the epidural insertion.
C. Replacement of the epidural catheter into the same space for long-term
control
D. Placement of a nerve block in the spinal column at the location of the affected
epidural space
ANS A- When CSF leaks out of the epidural space a severe headache in
the patient can occur. A blood patch can be performed by a physician to
close the site. The small amount of blood is withdrawn from the
mother's arm and the blood clots in the space.
4.Which of the patients described should the nurse see first?
A. 20 yr old patient who just had her first baby and doesn't know how to
breastfeed
B. 27 yr old diabetic patient who delivered her second child yesterday and
needs her morning dose of insulin
C. 24 yr old patient who has had a large amount of lochia and has developed a
hematoma on her perineum
D. 30 yr old patient who needs to take a shower and eat breakfast before the
physician comes to dismiss her
ANS C. A patient with a hematoma is at risk of hemorrhage and the
,nurse should assess her first
5.On the first following delivery, the physician ordered a hemoglobin level for the
patient; the result was 9.9 g/dL. The physician did not list any other orders in the
patient's chart since that time. Which response of the nurse is most appropriate>
A. call the physician and ask if he wants a blood transfusion for the patient
B. ask the physician about the hemoglobin level when he comes in for rounds
C. Contact the laboratory and ask them to repeat the test
D. continue to monitor the patient and document the result
ANS B. A postpartum patient is at risk of hemorrhage following delivery;
often the physician will order a hemoglobin level 1-2 days after delivery
to check the mother's risk status. A level of
9.9 g/dL is lower than normal for a female patient, but is not necessarily
low enough to warrant a blood transfusion.
6.The patient's medical record states that she tested positive for group B
Streptococcus infection. which of the following precautions should be given in this
situation?
A. the patient should receive antibiotics at this time
b. the patient should be given antibiotics during labor
c. the fetus should receive antibiotics as a prenatal infusion
d. there is no treatment necessary
ANS B- B. Streptococcus can be transferred to the baby during delivery
to cause an infection. the test for the bacteria is performed at
approximately 35 weeks gestation, but antibiotics are typically not
, given until the mother is in labor to reduce the chance that she will pass
the infection to her child
7.When reviewing information about infant care, the nurse should explain that the
postpartum client should call the physician if her infant developed which of the
following conditions?
A. The infant is only sleeping 4 hours at night
B. the baby wants to eat every hour
C. The baby's cord has not fallen off within 7 days
D. The baby has a dry mouth
ANS D- If a baby has dry mouth or dry mucous mem- branes, he or
she could be dehydrated and not getting enough to eat.
8.Which of the following patients would be at high risk of developing pre-
eclampsia? Select all that apply.
A. A patient who is pregnant with her 3rd child
B. A patient who is married
C. A patient who is 40 yrs old
D. A patient who is overweight
E. A patient who is pregnant with twins
ANS C, D, E-Pre-eclampsia is a state that develops during pregnancy in
which a mother has high blood pressure and starts losing protein into
the urine.Certain risks that increase such as a first time pregnancy,
advanced maternal age, overweight or obesity in the mother, and
pregnancy with multiple babies
