OB EXAM MOD 1 QUESTIONS AND ANSWERS A+GRADED STUDY GUIDE

OB EXAM MOD 1 QUESTIONS AND ANSWERS A+GRADED STUDY GUIDE A 22 yr old client has come to the clinic because her menstrual period is 10 days late. She tells the nurse "I'm sure I'm pregnant because my period is late and my breasts are tender" Which of the following responses by the nurse would be most accurate? A. "those are positive signs of pregnancy" B. "those are presumptive signs of pregnancy" C. "those are probable signs of pregnancy" D. "those are negative signs of pregnancy" - CORRECT ANSWER-B. Breast tenderness and missed menses are presumptive signs. Other presumptive signs include: N/V, fatigue, urinary frequency and quickening A client delivered a term infant 7 hours ago. Which of the following postpartum assessment findings indicate normal postpartum progression? A. Firm fundus at 1-2 fingerbreadths above the umbilicus with moderate lochia rubra B. Firm fundus at the umbilicus and midline with moderate rubra C. Firm fundus at 1-2 fingerbreadths below umbilicus, deviated to the right side with moderate lochia rubra D. Soft fundus at 1-2 fingerbreadths below umbilicus with severe lochia rubra - CORRECT ANSWER-A. Within 12 hours, fundus can rise to approx. 1 cm above the umbilicus. The fundus descends 1-2 cm every 24 hours. Located about halfway between umbilicus and symphysis pubis, not longer palpable after 2 weeks, returned to pre-pregnant state by 6 weeks pp A client delivered at 39 weeks 6 hours ago. Upon assessment, the nurse palpated a soft, boggy fundus deviated to the left side. Which action of the nurse would be most appropriate? A. Massage the fundus until firm B. Call HCP immediately C. Assist woman to the restroom D. Increase Pitocin per HCP order - CORRECT ANSWER-C. A distended bladder can impede uterine contractions which can lead to uterine atony which may lead to pp hemorrhage if we don't intervene **KEY WORDS: deviated to the left side** A client is in active labor at term with cervical findings of 7/80/-1. The FHR baseline is 130bpm. Four early decelerations were noted within the last hour. Which of the following nursing actions would be most appropriate? A. Position client on her back so the monitor gives more accurate results B. perform vaginal exam C. turn client on her left side D. document and continue to monitor both FHR and laboring women - CORRECT ANSWER-D. early decelerations indicate head compression. It is benign and no interventions are needed. just document and continue monitoring **KNOW VEAL CHOP** The nurse gives a 35 yr old primigravida client a RhoGAM injection for her 28th week of pregnancy. Which of the following client situations requires the nurse to take this action. A. Rh + mother and Rh - father B. Rh - mother and Rh + father C. Rh + mother and Rh + father D. Rh - mother and Rh - father - CORRECT ANSWER-B. RhoGAM is only needed if the mother is Rh- and there is possibility of the baby being Rh+. If the father is not Rh+ then there is no chance to have a Rh+ baby A client has just started the third state of labor. Which of the following nursing actions have priority at this time? A. Encourage the client to push B. Administer Pitocin C. Place baby skin to skin on mom D. Assess maternal vital signs Q1hr - CORRECT ANSWER-C. skin to skin contact is contributes to mother and baby bonding **KEY WORDS: just started** pitocin is administered after the placenta is delivered at the end of stage 3, maternal vital signs are assessed Q15min after delivery for first 2 hours. Then hourly assessments are done A client's first day of her LMP was July 18, 2015. Which of the following should the nurse tell the client is her EDB? A. April 18, 2016 B. May 23, 2016 C. April 25, 2016 D. March 25, 2016 - CORRECT ANSWER-C. A primigravida woman delivered her baby boy 12 hours ago. She acquired a 3rd degree midline episiotomy during labor. She expresses moderate discomfort and a pain level of 2 out of 10. Which of the following nursing intervention would be most appropriate? A. Instruct patient to apply ice packs to the perinium B. Encourage a sitz bath C. Call provider D. Give ordered acetaminophen (Tylenol) for prophylaxis - CORRECT ANSWER-A. During first 24 hours, ice packs decrease edema formation and increase comfort, after first 24 hours after birth prn to provide anesthetic effect A woman admitted in your OB unit, currently on her 2nd pregnancy for this delivery states she wants to try vaginal birth rather than rather than C/S which she had for her first pregnancy. What is the priority action the nurse should perform? A. Call the provider and let her/him know about the pt's wishes B. Assess her abdominal C/S incision C. Look at pt's chart for notes regarding her first delivery D. Perform a vaginal exam - CORRECT ANSWER-C. You have to look at the UTERINE incision, not the abdominal one, the only way to do that is to look at the chart **ABDOMINAL INCISION AND UTERINE INCISION MIGHT NOT MATCH** classic vertical incision labor is contraindicated - risk for uterine rupture! transverse incision vaginal delivery is possible What statement from the postpartum pt about DVT precautions requires further teaching? A. "I need the change positions frequently in bed and avoid prolonged flexed knee positions B. "I will let my husband massage my legs for pain relief" C. "I can keep breastfeeding while I'm on heparin" D "I will evaluate my legs and apply moist heat to decrease discomfort" - CORRECT ANSWER-B. rubbing the affected area could cause clots to be dislodged Heparin and warfarin are administered as ordered and they do not excrete in significant amounts into the breastmilk An L&D nurse is teaching a nursing student about importance of adequate placental perfusion. Which statement should the nurse include in her teaching? Select all that apply A. Lateral recumbent position is ideal for placental perfusion B. Low maternal MAP can decrease uterine blood flow C. Contractions that last more than 2 minutes need immediate action - CORRECT ANSWER-All of the above. Factors that decrease uterine blood flow can starve the baby of oxygen. A women is currently at 36 weeks rushes to the OB clinic and reports that her "water broke". What is the priority nursing action at this time? A. Ask the patient for time, amount, color, and odor of fluid B. Assess FHR C. Administer oxygen at 4L/min via nasal cannula D. Call HCP - CORRECT ANSWER-B. Assess FHR d/t risk of prolapsed cord! TACO is important but not priority A women is currently pregnant at 32 weeks gestation. Her first pregnancy resulted in a spontaneous abortion at 16 weeks. Her second was induced post term and the child is 3 years old. The third delivered at 36 weeks due to placental abruption and the infant died at six months. GTPAL? Parity? - CORRECT ANSWER-4-1-1-1-1 Parity: 2 A women is currently 32 weeks gestation. Her first two pregnancies were electively terminated at 10-12 weeks. Her third pregnancy was twins delivered at 35 weeks. GTPAL? Parity - CORRECT ANSWER-4-0-2-2-2 Parity: 1 A women's EDB is 9-1-15. What is the gestational age if she delivers on: A. 8-25-15 B. 8-18-15 C. 9-8-15 D. 9-3-15 - CORRECT ANSWER-A. 39 weeks B. 38 weeks C. 41 weeks D. 40 weeks A woman at 35 weeks gestation arrives in the ED after an auto accident. She is placed supine on the stretcher. Several minutes later, she reports dizziness and nausea. Her BP is 82/46. What should the nurse do? - CORRECT ANSWER-The nurse should sit the patient up. She is experiencing supine hypotension due to the uterus compressing the vena cava and the abdominal arteries. The nurse obtains a woman's CBC results at 32 weeks gestation: Hgb 11.5 g/dl Hct 35% How should the nurse interpret the report? - CORRECT ANSWER-These are normal pregnancy findings. Hgb will usually be between 11-16g/dl (may be 10 in 2nd trimester) and Hct will be between 33-47% 5-0-0-4-? G? P? - CORRECT ANSWER-Living = 0 G5 P0 1-0-8-0-8 G? P? - CORRECT ANSWER-G1 P1 How should the nurse interpret the fundal ht measurement of a woman at 35 wks gestation a. 33 cm b. 28 cm