RNC-OB Exam Questions with 100% Correct Answers

1. Late in pregnancy, a patient often develops supine hypotension because of a. partial occlusion of the vena cava and aorta. b. decreased peripheral collateral circulation. c. increased blood flow to the placenta. Correct Answer A because of partial occlusion of the vena cava and aorta from the weight of the uterus. This impedes venous return from the lower extremities although increased collateral circulation during pregnancy helps to compensate. Remaining in the supine position for long periods of time could decrease fetal oxygenation as well. The lateral recumbent position relieves the pressure on the vena cava and aorta, allowing the blood pressure to increase and symptoms to decrease. The nurse must educate the new mother that a contraindication to breast feeding is a. fetal macrosomia. b. type II diabetes. c. infection with HIV/AIDS. Correct Answer C Some maternal contraindications to breastfeeding include: -Infection with HIV/AIDS -Use of antiretroviral medications -Active TB not treated -Infection with human T-cell lymphotropic virus -Illicit drug use -Use of chemotherapeutic agents -Radiation therapy (may require only interruption during treatment) -Use of other medications that pass into the breast milk and may harm the child -Presence of herpes on the breast -Presence of varicella lesions on the breast (may resume after lesions crust) The initial postpartal intervention indicated for a soft boggy uterus is to a. apply an ice compress. b. massage the fundus until firm. c. apply a warm compress. Correct Answer B ...with the dominant hand while supporting the inferior uterus with the non-dominant hand to prevent trauma. If the fundus does not contract with massage, then further evaluation is indicated to determine if placental fragments remain. After the fundus becomes contracted, the nurse should push firmly downward on the fundus to expel clots that may have pooled. With the vibroacoustic stimulation test, stimulus with an artificial larynx or other device is applied to the maternal abdomen for a. 1 to 3 seconds. b. 5 to 10 seconds. c. 1 to 2 minutes. Correct Answer A Usually, stimulus is applied for 1-2 seconds and repeated up to 3 times with time extending to 3 seconds in order to stimulate fetal movement. A positive or reactive finding is an increased fetal heart rate of 15 bpm or more for at least 15 seconds; however, a nonreactive result does not always indicate fetal abnormality but indicates the need for further testing. Absence of the Moro reflex on one side only in a neonate may indicate a. fractured scapula. b. cerebral palsy. c. fractured clavicle. Correct Answer C a fractured clavicle or brachial plexus injury. Damage to the central nervous system, such as may occur with cerebral palsy, often results in bilateral absence of the reflex. The Moro reflex is elicited by allowing the infant's head and trunk to fall slightly backward when the infant is raised. A positive Moro reflex includes immediate extension and abduction of the arms(and sometimes the legs) with fingers fanning and forming a C-shape with a return of the limbs to the flexed states In a multiparous woman, what is the lowest Bishop score that predicts labor induction will be successful? a. 5 b. 7 c. 9 Correct Answer A In a multiparous woman, the Bishop score that predicts that labor induction will be successful is 5 or more while it is a 9 or more for a nulliparous woman. The Bishop score is a rating system to determine readiness for induction based on scores of 0-3 in four different measures: dilation (cm), effacement (percentage), station (cm), and cervical consistency (firm, medium, soft), and cervical position (posterior, mid position, anterior). The fifth measure, cervical position, is scored only 0-2. When cervical laceration occur during delivery, they are most common at what position? a. 3 and 9 o'clock b. 12 and 6 o'clock c. 10 and 4 o'clock Correct Answer A Cervical lacerations are most often identified with vaginal retractors when bleeding is persistent after delivery. The lacerations are sutured with absorbable sutures, so no further treatment is usually indicated. Minor lacerations often occur during delivery, but they usually require no treatment. Tears are more common after forceps assisted and vacuum assisted deliveries than normal vaginal births If using fetal pulse oximetry, what is normal oxygen saturation? a. 30% to 65% b. 65% to 90% c. 90% to 100% Correct Answer A because of the fetus's high hemoglobin and hematocrit. A value below 30% may be associated with hypoxia and metabolic acidosis. For fetal pulse oximetry, which may be