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OB -GYN ATI OB QUESTIONS AND ANSWERS
Graded A 2024
1.A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected
placenta revia. Which of the following findings support this diagnosis?
A. Painless red vaginal bleeding
RATIONALE: Placenta previa is a condition of pregnancy when the placenta
implants in the lower part of the uterus, partly or completely
obstructing the cervical os (outlet to the vagina). Bright red, painless
vaginal bleeding occurs in the second and third trimester.
B. Increasing abdominal pain with a nonrelaxed uterus
RATIONALE: Abruptio placenta is separation of the placenta from the site of
uterine implantation before delivery of the fetus. When the placenta
separates prematurely, there is internal bleeding, which is painful, and
the uterus is nonrelaxed or becomes rigid as the separation advances.
C. Abdominal pain with scant red vaginal bleeding
RATIONALE: Placenta previa involves minimal to severe bright red vaginal
bleeding in the absence of abdominal pain.
D. Intermittent abdominal pain following passage of bloody mucus
RATIONALE: Intermittent abdominal pain following passage of bloody mucus is a
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description of normal labor. The passage of bloody mucus represents
the loss of the cervical mucous plug, also referred to as the "bloody
show."
2.A nurse is caring for a client who is 1 hr postpartum and observes a large amount of
lochia rubra and several small clots on the client's perineal pad. The fundus is midline
and firm at the umbilicus. Which of the following actions should the nurse take?
A. Document the findings and continue to monitor the client.
RATIONALE: These are expected findings. At 1 hr postpartum, lochia rubra
should be intermittent and associated with uterine contractions. The
volume of lochia resembles that of a heavy menstrual period. Small
clots are common. The nurse should document the findings and
continue to monitor the client.
B. Notify the client’s provider.
RATIONALE: These are expected findings, so there is no need to notify the
provider.
C. Increase the frequency of fundal massage.
RATIONALE: These are expected findings and the fundus is already firm.
Increasing the frequency of fundal massage is not indicated at this
time.
D. Encourage the client to empty her bladder.
RATIONALE: These are expected findings, and the fundus is firm at the midline. If
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the fundus was deviated, this would be an indication of a distended
bladder and the client should be encouraged to void to prevent uterine
atony.
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3.A nurse is caring for a newborn immediately following birth. After assuring a patent
airway, what is the priority nursing action?
A. Administer vitamin K.
RATIONALE: Administration of vitamin K is important, but it can be delayed
until the newborn is held by the mother and is breastfed. There is
another, more important nursing action.
B. Dry the skin.
RATIONALE: The newborn should be thoroughly dried, covered with a warm
blanket, placed on the mother’s abdomen, and a cap applied to the
newborn’s head to prevent cold stress. The newborn responds to the
cooler environment by increasing his respiratory rate, which can lead
to respiratory distress. Based on Maslow’s hierarchy of needs, this is
the most important nursing action after securing the airway.
C. Administer eye prophylaxis.
RATIONALE: Administration of eye prophylaxis should occur within the first hour
after birth. There is another, more important nursing action.
D. Place an identification bracelet.
RATIONALE: Correct identification of the newborn is important, but it can be
delayed, as long as it is completed prior to the mother and newborn
leaving the delivery room. There is another, more important nursing
action.
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OB -GYN ATI OB QUESTIONS AND ANSWERS
Graded A 2024
1.A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected
placenta revia. Which of the following findings support this diagnosis?
A. Painless red vaginal bleeding
RATIONALE: Placenta previa is a condition of pregnancy when the placenta
implants in the lower part of the uterus, partly or completely
obstructing the cervical os (outlet to the vagina). Bright red, painless
vaginal bleeding occurs in the second and third trimester.
B. Increasing abdominal pain with a nonrelaxed uterus
RATIONALE: Abruptio placenta is separation of the placenta from the site of
uterine implantation before delivery of the fetus. When the placenta
separates prematurely, there is internal bleeding, which is painful, and
the uterus is nonrelaxed or becomes rigid as the separation advances.
C. Abdominal pain with scant red vaginal bleeding
RATIONALE: Placenta previa involves minimal to severe bright red vaginal
bleeding in the absence of abdominal pain.
D. Intermittent abdominal pain following passage of bloody mucus
RATIONALE: Intermittent abdominal pain following passage of bloody mucus is a
Page 1
, 2
description of normal labor. The passage of bloody mucus represents
the loss of the cervical mucous plug, also referred to as the "bloody
show."
2.A nurse is caring for a client who is 1 hr postpartum and observes a large amount of
lochia rubra and several small clots on the client's perineal pad. The fundus is midline
and firm at the umbilicus. Which of the following actions should the nurse take?
A. Document the findings and continue to monitor the client.
RATIONALE: These are expected findings. At 1 hr postpartum, lochia rubra
should be intermittent and associated with uterine contractions. The
volume of lochia resembles that of a heavy menstrual period. Small
clots are common. The nurse should document the findings and
continue to monitor the client.
B. Notify the client’s provider.
RATIONALE: These are expected findings, so there is no need to notify the
provider.
C. Increase the frequency of fundal massage.
RATIONALE: These are expected findings and the fundus is already firm.
Increasing the frequency of fundal massage is not indicated at this
time.
D. Encourage the client to empty her bladder.
RATIONALE: These are expected findings, and the fundus is firm at the midline. If
Page 2
, 3
the fundus was deviated, this would be an indication of a distended
bladder and the client should be encouraged to void to prevent uterine
atony.
Page 3
, 4
3.A nurse is caring for a newborn immediately following birth. After assuring a patent
airway, what is the priority nursing action?
A. Administer vitamin K.
RATIONALE: Administration of vitamin K is important, but it can be delayed
until the newborn is held by the mother and is breastfed. There is
another, more important nursing action.
B. Dry the skin.
RATIONALE: The newborn should be thoroughly dried, covered with a warm
blanket, placed on the mother’s abdomen, and a cap applied to the
newborn’s head to prevent cold stress. The newborn responds to the
cooler environment by increasing his respiratory rate, which can lead
to respiratory distress. Based on Maslow’s hierarchy of needs, this is
the most important nursing action after securing the airway.
C. Administer eye prophylaxis.
RATIONALE: Administration of eye prophylaxis should occur within the first hour
after birth. There is another, more important nursing action.
D. Place an identification bracelet.
RATIONALE: Correct identification of the newborn is important, but it can be
delayed, as long as it is completed prior to the mother and newborn
leaving the delivery room. There is another, more important nursing
action.
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