OB Exam 1 Questions and Answers Latest Update 2025 Graded A+
A nurse assessing the laboratory results of a pregnant client in her second trimester notes that she has a
hemoglobin level of 11 gm/dL. What will the nurse interpret this finding to most likely indicate? -
Answers hemodilution of pregnancy
During pregnancy, the red blood cell count increases along with an increase in plasma volume. However,
there is a greater increase in the plasma volume as a result of hormonal factors and sodium and water
retention. Thus, the plasma increase exceeds the increase in RBCs, resulting in hemodilution of
pregnancy, which is also called physiologic anemia of pregnancy. Changes in maternal iron levels would
be more indicative of an iron-deficiency anemia. Although anemia may be present with a multiple
gestation, an ultrasound would be a more reliable method of identifying it. Weight gain does not
correlate with hemoglobin levels.
In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information
would the nurse most likely include? - Answers Over-the-counter antacids can be used to treat acid
reflux with the health care provider's knowledge.
Elevated progesterone levels cause smooth muscle relaxation, which can result in relaxation of the
cardiac sphincter and reflux of the stomach contents into the lower esophagus. OTC antacids will usually
relieve the symptoms but should be discussed with the health care provider first. The hormonal changes
are necessary for the pregnancy to continue, and the woman will return to her usual nonpregnant
hormonal levels after the baby is born. Taking hormonal replacement therapy is not recommended.
Using herbs should be done only with the knowledge of the health care practitioner due to the side
effects and contraindications of some herbs during pregnancy. Some herbs will cause a spontaneous
abortion.
A pregnant client in her third trimester, lying supine on the examination table, suddently grows very
short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the
nurse prioritize? - Answers Blood is trapped in the vena cava in a supine position.
Supine hypotension syndrome, or an interference with blood return to the heart, occurs when the
weight of the fetus rests on the vena cava. Cerebral arteries should not be affected. Mean arterial
pressure is high enough to maintain perfusion of the uterus in any orientation. The sympathetic nervous
system will not be affected by the supine position.
A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling
proud and excited about her pregnancy while at the same time feeling fearful and anxious of its
,implications. Which action should the nurse do next? - Answers Inform the client this is a normal
response to pregnancy that many women experience.
The maternal emotional response experienced by the client is ambivalence. Ambivalence, or having
conflicting feelings at the same time, is universal and is considered normal when preparing for a lifestyle
change and new role. Pregnant women commonly experience ambivalence during the first trimester.
A mother comes in with her 17-year-old daughter to find out why she has not had a menstrual cycle for
a few months. Examination confirms the daughter is pregnant with a fundal height of approximately 24
cm. The nurse interprets this finding as indicating that the daughter is approximately how many weeks
pregnant? - Answers 24
By 20 weeks' gestation, the fundus of the uterus is at the level of the umbilicus and measures 20 cm. A
monthly measurement of the height of the top of the uterus in centimeters, which corresponds to the
number of gestational weeks, is commonly used to date the pregnancy.
Which information provided by a client would be considered a presumptive sign of pregnancy? -
Answers Breast tenderness
Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur
early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is
not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or
could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable
sign.
A 24-week pregnant client calls the clinic crying after a prenatal visit, where she had a pelvic exam. She
states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the
nurse would explain this finding? - Answers the cervix is very vascular during pregnancy, so spotting
after a pelvic exam is not unusual.
Slight bleeding after a pelvic exam in a pregnant woman is common due to the vascularity of her cervix
during pregnancy. Suggesting a bleeding disorder is frightening and not substantiated by the data.
Bleeding is not a normal finding during pregnancy and losing the mucous plug occurs at the end of
pregnancy, just prior to labor.
During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what
condition? - Answers Supine hypotension syndrome
, The left side-lying position prevents the heavy uterus from resting on and compressing her vena cava, a
condition known as supine hypotensive syndrome. Compression of the vena cava can cause maternal
hypotension and poor gas exchange between the placenta and fetus. Preeclampsia is a condition
characterized by elevated blood pressure and proteinuria. Once diagnosed, the treatment includes
resting in a left-lateral position, but a side-lying position does not prevent preeclampsia. Urinary
frequency in the third trimester is due to the enlarged uterus pressing on the bladder and is not
influenced by position. Remaining in an upright position for 1 to 2 hours after meals helps to decrease
heartburn.
A client in her second trimester of pregnancy reports discomfort during sexual activity. Which
instruction should a nurse provide? - Answers Modify sexual positions to increase comfort.
The nurse should instruct the client to change sexual positions to increase comfort as the pregnancy
progresses. Although the nurse should also encourage her to engage in alternative, noncoital modes of
sexual expression, such as cuddling, caressing, and holding, the client need not restrict herself to such
alternatives. It is not advisable to perform frequent douching, because this is believed to irritate the
vaginal mucosa and predispose the client to infection. Using lubricants or performing stress-relieving
and relaxation exercises will not alleviate discomfort during sexual activity.
A new mother voices concerns about breast-feeding her infant. The nurse would explain to the mother
the two hormones that control lactation and letdown are: - Answers prolactin and oxytocin.
Prolactin and oxytocin are both important hormones in regulation of breast-feeding. Prolactin helps in
producing the breast milk and oxytocin stimulates letdown during breast-feeding. The other hormones
do not play a role in breast-feeding or milk production.
Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most
concerning? The inability to: - Answers detect fetal heart sounds with a Doppler.
Fetal heart sounds are audible with a Doppler at 10 to 12 weeks of gestation but cannot be heard
through a stethoscope until 18 to 20 weeks of gestation. Fetal movements can be felt by a woman as
early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is
also palpable around 20 weeks of gestation.
A nurse who has been caring for a pregnant client understands that the client has pica and has been
regularly consuming soil. For which condition should the nurse monitor the client? - Answers iron-
deficiency anemia
A nurse assessing the laboratory results of a pregnant client in her second trimester notes that she has a
hemoglobin level of 11 gm/dL. What will the nurse interpret this finding to most likely indicate? -
Answers hemodilution of pregnancy
During pregnancy, the red blood cell count increases along with an increase in plasma volume. However,
there is a greater increase in the plasma volume as a result of hormonal factors and sodium and water
retention. Thus, the plasma increase exceeds the increase in RBCs, resulting in hemodilution of
pregnancy, which is also called physiologic anemia of pregnancy. Changes in maternal iron levels would
be more indicative of an iron-deficiency anemia. Although anemia may be present with a multiple
gestation, an ultrasound would be a more reliable method of identifying it. Weight gain does not
correlate with hemoglobin levels.
In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information
would the nurse most likely include? - Answers Over-the-counter antacids can be used to treat acid
reflux with the health care provider's knowledge.
Elevated progesterone levels cause smooth muscle relaxation, which can result in relaxation of the
cardiac sphincter and reflux of the stomach contents into the lower esophagus. OTC antacids will usually
relieve the symptoms but should be discussed with the health care provider first. The hormonal changes
are necessary for the pregnancy to continue, and the woman will return to her usual nonpregnant
hormonal levels after the baby is born. Taking hormonal replacement therapy is not recommended.
Using herbs should be done only with the knowledge of the health care practitioner due to the side
effects and contraindications of some herbs during pregnancy. Some herbs will cause a spontaneous
abortion.
A pregnant client in her third trimester, lying supine on the examination table, suddently grows very
short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the
nurse prioritize? - Answers Blood is trapped in the vena cava in a supine position.
Supine hypotension syndrome, or an interference with blood return to the heart, occurs when the
weight of the fetus rests on the vena cava. Cerebral arteries should not be affected. Mean arterial
pressure is high enough to maintain perfusion of the uterus in any orientation. The sympathetic nervous
system will not be affected by the supine position.
A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling
proud and excited about her pregnancy while at the same time feeling fearful and anxious of its
,implications. Which action should the nurse do next? - Answers Inform the client this is a normal
response to pregnancy that many women experience.
The maternal emotional response experienced by the client is ambivalence. Ambivalence, or having
conflicting feelings at the same time, is universal and is considered normal when preparing for a lifestyle
change and new role. Pregnant women commonly experience ambivalence during the first trimester.
A mother comes in with her 17-year-old daughter to find out why she has not had a menstrual cycle for
a few months. Examination confirms the daughter is pregnant with a fundal height of approximately 24
cm. The nurse interprets this finding as indicating that the daughter is approximately how many weeks
pregnant? - Answers 24
By 20 weeks' gestation, the fundus of the uterus is at the level of the umbilicus and measures 20 cm. A
monthly measurement of the height of the top of the uterus in centimeters, which corresponds to the
number of gestational weeks, is commonly used to date the pregnancy.
Which information provided by a client would be considered a presumptive sign of pregnancy? -
Answers Breast tenderness
Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur
early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is
not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or
could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable
sign.
A 24-week pregnant client calls the clinic crying after a prenatal visit, where she had a pelvic exam. She
states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the
nurse would explain this finding? - Answers the cervix is very vascular during pregnancy, so spotting
after a pelvic exam is not unusual.
Slight bleeding after a pelvic exam in a pregnant woman is common due to the vascularity of her cervix
during pregnancy. Suggesting a bleeding disorder is frightening and not substantiated by the data.
Bleeding is not a normal finding during pregnancy and losing the mucous plug occurs at the end of
pregnancy, just prior to labor.
During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what
condition? - Answers Supine hypotension syndrome
, The left side-lying position prevents the heavy uterus from resting on and compressing her vena cava, a
condition known as supine hypotensive syndrome. Compression of the vena cava can cause maternal
hypotension and poor gas exchange between the placenta and fetus. Preeclampsia is a condition
characterized by elevated blood pressure and proteinuria. Once diagnosed, the treatment includes
resting in a left-lateral position, but a side-lying position does not prevent preeclampsia. Urinary
frequency in the third trimester is due to the enlarged uterus pressing on the bladder and is not
influenced by position. Remaining in an upright position for 1 to 2 hours after meals helps to decrease
heartburn.
A client in her second trimester of pregnancy reports discomfort during sexual activity. Which
instruction should a nurse provide? - Answers Modify sexual positions to increase comfort.
The nurse should instruct the client to change sexual positions to increase comfort as the pregnancy
progresses. Although the nurse should also encourage her to engage in alternative, noncoital modes of
sexual expression, such as cuddling, caressing, and holding, the client need not restrict herself to such
alternatives. It is not advisable to perform frequent douching, because this is believed to irritate the
vaginal mucosa and predispose the client to infection. Using lubricants or performing stress-relieving
and relaxation exercises will not alleviate discomfort during sexual activity.
A new mother voices concerns about breast-feeding her infant. The nurse would explain to the mother
the two hormones that control lactation and letdown are: - Answers prolactin and oxytocin.
Prolactin and oxytocin are both important hormones in regulation of breast-feeding. Prolactin helps in
producing the breast milk and oxytocin stimulates letdown during breast-feeding. The other hormones
do not play a role in breast-feeding or milk production.
Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most
concerning? The inability to: - Answers detect fetal heart sounds with a Doppler.
Fetal heart sounds are audible with a Doppler at 10 to 12 weeks of gestation but cannot be heard
through a stethoscope until 18 to 20 weeks of gestation. Fetal movements can be felt by a woman as
early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is
also palpable around 20 weeks of gestation.
A nurse who has been caring for a pregnant client understands that the client has pica and has been
regularly consuming soil. For which condition should the nurse monitor the client? - Answers iron-
deficiency anemia
