OB EXAM 3 PRACTICE QUESTIONS
WITH VERIFIED SOLUTIONS
Your rpregnant rpatient ris rin rher rfirst rtrimester rand ris rscheduled rfor ran rabdominal
rultrasound. rWhen rexplaining rthe rrationale rfor rearly rpregnancy rultrasound, rthe rbest
rresponse ris: r
a. r"The rtest rwill rhelp rto rdetermine rthe rbaby's rposition."
b. r"The rtest rwill rhelp rto rdetermine rhow rmany rweeks ryou rare rpregnant."
c. r"The rtest rwill rhelp rto rdetermine rif ryour rbaby ris rgrowing rappropriately."
d. r"The rtest rwill rhelp rto rdetermine rif ryou rhave ra rboy ror rgirl." r- rcorrect ranswers r-b.
rFetal rgrowth rand rsize rare rfairly rconsistent rduring rthe rfirst rtrimester rand rare ra
rreliable rindicator rof rthe rweeks rof rgestation.
Your rpregnant rpatient ris rhaving rmaternal ralpha-fetoprotein r(AFP) rscreening. rShe
rdoes rnot runderstand rhow ra rtest ron rher rblood rcan rindicate ra rbirth rdefect rin rthe
rfetus. rThe rbest rreply rby rthe rnurse ris:
a. r"We rhave rdone rthis rtest rfor ra rlong rtime."
,b. r"If rbabies rhave ra rneural rtube rdefect, ralpha-fetoprotein rleaks rout rof rthe rfetus rand
ris rabsorbed rinto ryour rblood, rcausing ryour rlevel rto rrise. rThis rserum rblood rtest
rdetects rthat rrise."
c. r"Neural rtube rdefects rare ra rgenetic ranomaly, rand rwe rexamine rthe ramount rof
ralpha-fetoprotein rin ryour rDNA."
d. r"If rbabies rhave ra rneural rtube rdefect, rthis rresults rin ra rdecrease rin ryour rlevel rof
ralpha-fetoprotein." r- rcorrect ranswers r-b. rWhen ra rneural rtube rdefect ris rpresent,
rAFP ris rabsorbed rin rthe rmaternal rcirculation, rresulting rin ra rrise rin rthe rmaternal
rAFP rlevel.
The rprimary rcomplications rof ramniocentesis rare:
a. rDamage rto rfetal rorgans
b. rPuncture rof rumbilical rcord
c. rMaternal rpain
d. rInfection r- rcorrect ranswers r-d. rAmniocentesis rinvolves rinsertion rof ra rneedle rinto
rthe ramniotic rsac, rand rinfection ris rthe rprimary rcomplication.
Your rpatient ris r34 rweeks rpregnant rand rduring ra rregular rprenatal rvisit rtells ryou rshe
rdoes rnot runderstand rhow rto rdo r"kick rcounts." rThe rbest rresponse rby rthe rnurse
rwould rbe rto rexplain:
a. r"Here ris ran rinformation rsheet ron rhow rto rdo rkick rcounts."
b. r"It ris rnot rimportant rto rdo rkick rcounts rbecause ryou rhave ra rlow-risk rpregnancy."
c. r"Fetal rkick rcounts rare rnot ra rreliable rindicator rof rfetal rwell-being rin rthe rthird
rtrimester."
d. r"Fetal rmovements rare ran rindicator rof rfetal rwell-being. rYou rshould rcount rtwice ra
rday, rand ryou rshould rfeel r10 rfetal rmovements rin r2 rhours." r- rcorrect ranswers r-d.
rThis rresponse rprovides rthe rpatient rwith rinformation ron rhow rto rdo rkick rcounts rand
rthe rrationale rfor rdoing rkick rcounts rand rcriteria rfor rnormal rfetal rmovement.
Your rpatient ris ra r37-year-old rpregnant rwoman rwho ris r5 rweeks rpregnant rand ris
rconsidering rgenetic rtesting. rDuring ryour rdiscussion, rthe rwoman rasks rthe rnurse
rwhat rthe radvantages rof rchorionic rvillus rsampling r(CVS) rare rover ramniocentesis.
rThe rbest rresponse ris:
a. r"You rwill rneed ranesthesia rfor ramniocentesis, rbut rnot rfor rCVS."
b. r"CVS ris ra rfaster rprocedure."
c. r"CVS rprovides rmore rdetailed rinformation rthan ramniocentesis."
d. r"CVS rcan rbe rdone rearlier rin ryour rpregnancy, rand rthe rresults rare ravailable rmore
rquickly." r- rcorrect ranswers r-d. rCVS rcan rbe rdone rearlier rin rgestation
The rclinic rnurse rmeets rwith rRebecca, ra r30-year-old rwoman rwho ris rexperiencing
rher rfirst rpregnancy. rRebecca's rquadruple rmarker rscreen rresult ris rpositive rat r17
rweeks' rgestation. rThe rnurse rexplains rthat rRebecca rneeds ra rreferral rto:
a. rA rgenetics rcounselor/specialist
b. rAn robstetrician
c. rA rgynecologist
, d. rA rsocial rworker r- rcorrect ranswers r-a. rAll rwomen rshould rbe roffered rscreening
rwith rmaternal rserum rmarkers. rThe rTriple rMarker rscreen rand rthe rQuadruple rMarker
rscreen rtest rfor rthe rpresence rof ralpha-fetoprotein r(AFP), restradiol, rhuman rchorionic
rgonadotropin r(hCG), rand rother rmarkers. rThese rtests rscreen rfor rpotential rneural
rtube rdefects, rDown rsyndrome, rand rTrisomy r18. rIf rthe rscreen ris rpositive, rthe
rwoman rshould rbe rreferred rto ra rgenetics rspecialist rfor rcounseling, rand rfurther
rtesting, rsuch ras rchorionic rvillus rsampling r(CVS) ror ramniocentesis, rshould rbe
rperformed.
A r37-year-old rwoman rwho ris r17 rweeks rpregnant rhas rhad ran ramniocentesis. rBefore
rdischarge, rthe rnurse rteaches rthe rwoman rto rcall rher rdoctor rif rshe rexperiences
rwhich rof rthe rfollowing rside reffects?
a. rPain rat rthe rpuncture rsite
b. rMacular rrash ron rthe rabdomen
c. rDecrease rin rurinary routput
d. rCramping rof rthe ruterus r- rcorrect ranswers r-d. rThe rwoman rshould rreport rany
ruterine rcramping. rAlthough rrare, ramniocentesis rcould rstimulate rpreterm rlabor.
A rlaboratory rreport rindicates rthe rL/S rratio r(lecithin/sphingomyelin) rresults rfrom ran
ramniocentesis rof ra rgravid rpatient rwith rpreeclampsia rare r2:1. rThe rnurse rinterprets
rthe rresult ras rwhich rof rthe rfollowing?
a. rThe rbaby's rlung rfields rare rmature.
b. rThe rmother ris rhigh rrisk rfor rhemorrhage.
c. rThe rbaby's rkidneys rare rfunctioning rpoorly.
d. rThe rmother ris rhigh rrisk rfor reclampsia. r- rcorrect ranswers r-a. rAn rL/S rratio rof r2:1
rusually rindicates rthat rthe rfetal rlungs rare rmature.
A rclient ron r2 rgm/hr rof rmagnesium rsulfate rhas rdecreased rdeep rtendon rreflexes.
rIdentify rthe rpriority rnursing rassessment rto rensure rclient rsafety.
a. rAssess ruterine rcontractions rcontinuously.
b. rAssess rfetal rheart rrate rcontinuously.
c. rAssess rurinary routput.
d. rAssess rrespiratory rrate. r- rcorrect ranswers r-d. rRespiratory reffort rand rdeep rtendon
rreflexes r(DTRs) rare rinvoluntary, rand ra rdecrease rin rDTRs rcould rindicate rthe rrisk rof
rmagnesium rsulfate rtoxicity rand rthe rrisk rfor rdecreased rrespiratory reffort.
A rpregnant rclient rwith ra rhistory rof rmultiple rsexual rpartners ris rat rhighest rrisk rfor
rwhich rof rthe rfollowing rcomplications:
a. rPremature rrupture rof rmembranes
b. rGestational rdiabetes
c. rEctopic rpregnancy
d. rPregnancy-induced rhypertension r- rcorrect ranswers r-c. rA rhistory rof rmultiple
rsexual rpartners rplaces rthe rclient rat ra rhigher rrisk rof rhaving rcontracted ra rsexually
rtransmitted rdisease rthat rcould rhave rascended rthe ruterus rto rthe rfallopian rtubes rand
rcaused rfallopian rtube rblockage, rplacing rthe rclient rat rhigh rrisk rfor ran rectopic
rpregnancy.
WITH VERIFIED SOLUTIONS
Your rpregnant rpatient ris rin rher rfirst rtrimester rand ris rscheduled rfor ran rabdominal
rultrasound. rWhen rexplaining rthe rrationale rfor rearly rpregnancy rultrasound, rthe rbest
rresponse ris: r
a. r"The rtest rwill rhelp rto rdetermine rthe rbaby's rposition."
b. r"The rtest rwill rhelp rto rdetermine rhow rmany rweeks ryou rare rpregnant."
c. r"The rtest rwill rhelp rto rdetermine rif ryour rbaby ris rgrowing rappropriately."
d. r"The rtest rwill rhelp rto rdetermine rif ryou rhave ra rboy ror rgirl." r- rcorrect ranswers r-b.
rFetal rgrowth rand rsize rare rfairly rconsistent rduring rthe rfirst rtrimester rand rare ra
rreliable rindicator rof rthe rweeks rof rgestation.
Your rpregnant rpatient ris rhaving rmaternal ralpha-fetoprotein r(AFP) rscreening. rShe
rdoes rnot runderstand rhow ra rtest ron rher rblood rcan rindicate ra rbirth rdefect rin rthe
rfetus. rThe rbest rreply rby rthe rnurse ris:
a. r"We rhave rdone rthis rtest rfor ra rlong rtime."
,b. r"If rbabies rhave ra rneural rtube rdefect, ralpha-fetoprotein rleaks rout rof rthe rfetus rand
ris rabsorbed rinto ryour rblood, rcausing ryour rlevel rto rrise. rThis rserum rblood rtest
rdetects rthat rrise."
c. r"Neural rtube rdefects rare ra rgenetic ranomaly, rand rwe rexamine rthe ramount rof
ralpha-fetoprotein rin ryour rDNA."
d. r"If rbabies rhave ra rneural rtube rdefect, rthis rresults rin ra rdecrease rin ryour rlevel rof
ralpha-fetoprotein." r- rcorrect ranswers r-b. rWhen ra rneural rtube rdefect ris rpresent,
rAFP ris rabsorbed rin rthe rmaternal rcirculation, rresulting rin ra rrise rin rthe rmaternal
rAFP rlevel.
The rprimary rcomplications rof ramniocentesis rare:
a. rDamage rto rfetal rorgans
b. rPuncture rof rumbilical rcord
c. rMaternal rpain
d. rInfection r- rcorrect ranswers r-d. rAmniocentesis rinvolves rinsertion rof ra rneedle rinto
rthe ramniotic rsac, rand rinfection ris rthe rprimary rcomplication.
Your rpatient ris r34 rweeks rpregnant rand rduring ra rregular rprenatal rvisit rtells ryou rshe
rdoes rnot runderstand rhow rto rdo r"kick rcounts." rThe rbest rresponse rby rthe rnurse
rwould rbe rto rexplain:
a. r"Here ris ran rinformation rsheet ron rhow rto rdo rkick rcounts."
b. r"It ris rnot rimportant rto rdo rkick rcounts rbecause ryou rhave ra rlow-risk rpregnancy."
c. r"Fetal rkick rcounts rare rnot ra rreliable rindicator rof rfetal rwell-being rin rthe rthird
rtrimester."
d. r"Fetal rmovements rare ran rindicator rof rfetal rwell-being. rYou rshould rcount rtwice ra
rday, rand ryou rshould rfeel r10 rfetal rmovements rin r2 rhours." r- rcorrect ranswers r-d.
rThis rresponse rprovides rthe rpatient rwith rinformation ron rhow rto rdo rkick rcounts rand
rthe rrationale rfor rdoing rkick rcounts rand rcriteria rfor rnormal rfetal rmovement.
Your rpatient ris ra r37-year-old rpregnant rwoman rwho ris r5 rweeks rpregnant rand ris
rconsidering rgenetic rtesting. rDuring ryour rdiscussion, rthe rwoman rasks rthe rnurse
rwhat rthe radvantages rof rchorionic rvillus rsampling r(CVS) rare rover ramniocentesis.
rThe rbest rresponse ris:
a. r"You rwill rneed ranesthesia rfor ramniocentesis, rbut rnot rfor rCVS."
b. r"CVS ris ra rfaster rprocedure."
c. r"CVS rprovides rmore rdetailed rinformation rthan ramniocentesis."
d. r"CVS rcan rbe rdone rearlier rin ryour rpregnancy, rand rthe rresults rare ravailable rmore
rquickly." r- rcorrect ranswers r-d. rCVS rcan rbe rdone rearlier rin rgestation
The rclinic rnurse rmeets rwith rRebecca, ra r30-year-old rwoman rwho ris rexperiencing
rher rfirst rpregnancy. rRebecca's rquadruple rmarker rscreen rresult ris rpositive rat r17
rweeks' rgestation. rThe rnurse rexplains rthat rRebecca rneeds ra rreferral rto:
a. rA rgenetics rcounselor/specialist
b. rAn robstetrician
c. rA rgynecologist
, d. rA rsocial rworker r- rcorrect ranswers r-a. rAll rwomen rshould rbe roffered rscreening
rwith rmaternal rserum rmarkers. rThe rTriple rMarker rscreen rand rthe rQuadruple rMarker
rscreen rtest rfor rthe rpresence rof ralpha-fetoprotein r(AFP), restradiol, rhuman rchorionic
rgonadotropin r(hCG), rand rother rmarkers. rThese rtests rscreen rfor rpotential rneural
rtube rdefects, rDown rsyndrome, rand rTrisomy r18. rIf rthe rscreen ris rpositive, rthe
rwoman rshould rbe rreferred rto ra rgenetics rspecialist rfor rcounseling, rand rfurther
rtesting, rsuch ras rchorionic rvillus rsampling r(CVS) ror ramniocentesis, rshould rbe
rperformed.
A r37-year-old rwoman rwho ris r17 rweeks rpregnant rhas rhad ran ramniocentesis. rBefore
rdischarge, rthe rnurse rteaches rthe rwoman rto rcall rher rdoctor rif rshe rexperiences
rwhich rof rthe rfollowing rside reffects?
a. rPain rat rthe rpuncture rsite
b. rMacular rrash ron rthe rabdomen
c. rDecrease rin rurinary routput
d. rCramping rof rthe ruterus r- rcorrect ranswers r-d. rThe rwoman rshould rreport rany
ruterine rcramping. rAlthough rrare, ramniocentesis rcould rstimulate rpreterm rlabor.
A rlaboratory rreport rindicates rthe rL/S rratio r(lecithin/sphingomyelin) rresults rfrom ran
ramniocentesis rof ra rgravid rpatient rwith rpreeclampsia rare r2:1. rThe rnurse rinterprets
rthe rresult ras rwhich rof rthe rfollowing?
a. rThe rbaby's rlung rfields rare rmature.
b. rThe rmother ris rhigh rrisk rfor rhemorrhage.
c. rThe rbaby's rkidneys rare rfunctioning rpoorly.
d. rThe rmother ris rhigh rrisk rfor reclampsia. r- rcorrect ranswers r-a. rAn rL/S rratio rof r2:1
rusually rindicates rthat rthe rfetal rlungs rare rmature.
A rclient ron r2 rgm/hr rof rmagnesium rsulfate rhas rdecreased rdeep rtendon rreflexes.
rIdentify rthe rpriority rnursing rassessment rto rensure rclient rsafety.
a. rAssess ruterine rcontractions rcontinuously.
b. rAssess rfetal rheart rrate rcontinuously.
c. rAssess rurinary routput.
d. rAssess rrespiratory rrate. r- rcorrect ranswers r-d. rRespiratory reffort rand rdeep rtendon
rreflexes r(DTRs) rare rinvoluntary, rand ra rdecrease rin rDTRs rcould rindicate rthe rrisk rof
rmagnesium rsulfate rtoxicity rand rthe rrisk rfor rdecreased rrespiratory reffort.
A rpregnant rclient rwith ra rhistory rof rmultiple rsexual rpartners ris rat rhighest rrisk rfor
rwhich rof rthe rfollowing rcomplications:
a. rPremature rrupture rof rmembranes
b. rGestational rdiabetes
c. rEctopic rpregnancy
d. rPregnancy-induced rhypertension r- rcorrect ranswers r-c. rA rhistory rof rmultiple
rsexual rpartners rplaces rthe rclient rat ra rhigher rrisk rof rhaving rcontracted ra rsexually
rtransmitted rdisease rthat rcould rhave rascended rthe ruterus rto rthe rfallopian rtubes rand
rcaused rfallopian rtube rblockage, rplacing rthe rclient rat rhigh rrisk rfor ran rectopic
rpregnancy.
